Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DRILL BIT STR CANN 2.7MM

Facility

$975.00

Hospital Charge Code	270672350
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

DRILL BIT STR CANN 2.7MM

Facility

$975.00

Hospital Charge Code	270672350
Hospital Revenue Code	272
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

DRILL BIT TM RAIL HOLE 5MM

Facility

$1,350.00

Hospital Charge Code	270697186
Hospital Revenue Code	272
Min. Negotiated Rate	$202.50
Max. Negotiated Rate	$202.50
Rate for Payer: Qualcare PPO/HMO/WC	$202.50

DRILL BIT TM RAIL HOLE 5MM

Facility

$1,350.00

Hospital Charge Code	270697186
Hospital Revenue Code	272
Min. Negotiated Rate	$32.53
Max. Negotiated Rate	$675.00
Rate for Payer: Aetna Commercial	$513.00
Rate for Payer: Aetna Medicare Advantage	$405.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$344.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$344.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$344.25
Rate for Payer: Cigna Commercial	$675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$405.00
Rate for Payer: Oxford Commercial	$270.00
Rate for Payer: Qualcare PPO/HMO/WC	$202.50
Rate for Payer: UnitedHealthcare Commercial	$270.00
Rate for Payer: UnitedHealthcare Community & State	$32.53
Rate for Payer: Wellpoint Medicaid Managed Care	$35.77

DRILL BIT TORNIER

Facility

$425.00

Hospital Charge Code	270339524
Hospital Revenue Code	278
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

DRILL BIT TORNIER

Facility

$425.00

Hospital Charge Code	270339524
Hospital Revenue Code	278
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

DRILL BIT TWIST CROWE POINT 4.

Facility

$975.00

Hospital Charge Code	270662017
Hospital Revenue Code	272
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

DRILL BIT TWIST CROWE POINT 4.

Facility

$975.00

Hospital Charge Code	270662017
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

DRILL BIT TWIST LAQ 2.6X61MM

Facility

$905.45

Service Code	HCPCS A4649
Hospital Charge Code	270699554
Hospital Revenue Code	272
Min. Negotiated Rate	$21.82
Max. Negotiated Rate	$452.73
Rate for Payer: Aetna Commercial	$344.07
Rate for Payer: Aetna Medicare Advantage	$271.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.89
Rate for Payer: Cigna Commercial	$452.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.63
Rate for Payer: Oxford Commercial	$181.09
Rate for Payer: Qualcare PPO/HMO/WC	$135.82
Rate for Payer: UnitedHealthcare Commercial	$181.09
Rate for Payer: UnitedHealthcare Community & State	$21.82
Rate for Payer: Wellpoint Medicaid Managed Care	$23.99

DRILL BIT TWIST LAQ 2.6X61MM

Facility

$905.45

Service Code	HCPCS A4649
Hospital Charge Code	270699554
Hospital Revenue Code	272
Min. Negotiated Rate	$135.82
Max. Negotiated Rate	$135.82
Rate for Payer: Qualcare PPO/HMO/WC	$135.82

DRILL BIT VALOR LONG 4.3X120MM

Facility

$2,245.00

Hospital Charge Code	270694900
Hospital Revenue Code	272
Min. Negotiated Rate	$54.10
Max. Negotiated Rate	$1,122.50
Rate for Payer: Aetna Commercial	$853.10
Rate for Payer: Aetna Medicare Advantage	$673.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$572.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$572.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$572.48
Rate for Payer: Cigna Commercial	$1,122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$673.50
Rate for Payer: Oxford Commercial	$449.00
Rate for Payer: Qualcare PPO/HMO/WC	$336.75
Rate for Payer: UnitedHealthcare Commercial	$449.00
Rate for Payer: UnitedHealthcare Community & State	$54.10
Rate for Payer: Wellpoint Medicaid Managed Care	$59.49

DRILL BIT VALOR LONG 4.3X120MM

Facility

$2,245.00

Hospital Charge Code	270694900
Hospital Revenue Code	272
Min. Negotiated Rate	$336.75
Max. Negotiated Rate	$336.75
Rate for Payer: Qualcare PPO/HMO/WC	$336.75

DRILL BIT VALOR SHORT 4.3MM

Facility

$2,245.00

Hospital Charge Code	270694901
Hospital Revenue Code	272
Min. Negotiated Rate	$54.10
Max. Negotiated Rate	$1,122.50
Rate for Payer: Aetna Commercial	$853.10
Rate for Payer: Aetna Medicare Advantage	$673.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$572.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$572.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$572.48
Rate for Payer: Cigna Commercial	$1,122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$673.50
Rate for Payer: Oxford Commercial	$449.00
Rate for Payer: Qualcare PPO/HMO/WC	$336.75
Rate for Payer: UnitedHealthcare Commercial	$449.00
Rate for Payer: UnitedHealthcare Community & State	$54.10
Rate for Payer: Wellpoint Medicaid Managed Care	$59.49

DRILL BIT VALOR SHORT 4.3MM

Facility

$2,245.00

Hospital Charge Code	270694901
Hospital Revenue Code	272
Min. Negotiated Rate	$336.75
Max. Negotiated Rate	$336.75
Rate for Payer: Qualcare PPO/HMO/WC	$336.75

DRILL BIT WITH STOP 25MM STOP

Facility

$410.00

Hospital Charge Code	270656510
Hospital Revenue Code	271
Min. Negotiated Rate	$61.50
Max. Negotiated Rate	$61.50
Rate for Payer: Qualcare PPO/HMO/WC	$61.50

DRILL BIT WITH STOP 25MM STOP

Facility

$410.00

Hospital Charge Code	270656510
Hospital Revenue Code	271
Min. Negotiated Rate	$9.88
Max. Negotiated Rate	$205.00
Rate for Payer: Aetna Commercial	$155.80
Rate for Payer: Aetna Medicare Advantage	$123.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.55
Rate for Payer: Cigna Commercial	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.00
Rate for Payer: Oxford Commercial	$82.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.50
Rate for Payer: UnitedHealthcare Commercial	$82.00
Rate for Payer: UnitedHealthcare Community & State	$9.88
Rate for Payer: Wellpoint Medicaid Managed Care	$10.87

DRILL BIT W STOP 2.25X12MM

Facility

$500.00

Hospital Charge Code	270696271
Hospital Revenue Code	272
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

DRILL BIT W STOP 2.25X12MM

Facility

$500.00

Hospital Charge Code	270696271
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

DRILL BMT 3.2 20MM 424509

Facility

$720.00

Hospital Charge Code	270612168
Hospital Revenue Code	272
Min. Negotiated Rate	$17.35
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$273.60
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.00
Rate for Payer: Oxford Commercial	$144.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.00
Rate for Payer: UnitedHealthcare Commercial	$144.00
Rate for Payer: UnitedHealthcare Community & State	$17.35
Rate for Payer: Wellpoint Medicaid Managed Care	$19.08

DRILL BMT 3.2 20MM 424509

Facility

$720.00

Hospital Charge Code	270612168
Hospital Revenue Code	272
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$108.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

DRILL BMT 3.2 20MM 424509

Facility

$240.00

Hospital Charge Code	270312168
Hospital Revenue Code	272
Min. Negotiated Rate	$5.78
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.00
Rate for Payer: Oxford Commercial	$48.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Commercial	$48.00
Rate for Payer: UnitedHealthcare Community & State	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$6.36

DRILL BMT 3.2 20MM 424509

Facility

$240.00

Hospital Charge Code	270312168
Hospital Revenue Code	272
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

DRILL BMT 3.2 30MM 424508

Facility

$616.00

Hospital Charge Code	270612166
Hospital Revenue Code	272
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$92.40
Rate for Payer: Qualcare PPO/HMO/WC	$92.40

DRILL BMT 3.2 30MM 424508

Facility

$616.00

Hospital Charge Code	270612166
Hospital Revenue Code	272
Min. Negotiated Rate	$14.85
Max. Negotiated Rate	$308.00
Rate for Payer: Aetna Commercial	$234.08
Rate for Payer: Aetna Medicare Advantage	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.08
Rate for Payer: Cigna Commercial	$308.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.80
Rate for Payer: Oxford Commercial	$123.20
Rate for Payer: Qualcare PPO/HMO/WC	$92.40
Rate for Payer: UnitedHealthcare Commercial	$123.20
Rate for Payer: UnitedHealthcare Community & State	$14.85
Rate for Payer: Wellpoint Medicaid Managed Care	$16.32

DRILL BMT STEP 6.2 330 471748

Facility

$425.65

Hospital Charge Code	270621704
Hospital Revenue Code	272
Min. Negotiated Rate	$63.85
Max. Negotiated Rate	$63.85
Rate for Payer: Qualcare PPO/HMO/WC	$63.85

Know your out-of-pocket cost for care.

All Charges