Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DRILL CANNULATED 3.5MM

Facility

$1,460.00

Hospital Charge Code	270698763
Hospital Revenue Code	272
Min. Negotiated Rate	$35.19
Max. Negotiated Rate	$730.00
Rate for Payer: Aetna Commercial	$554.80
Rate for Payer: Aetna Medicare Advantage	$438.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$372.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$372.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$372.30
Rate for Payer: Cigna Commercial	$730.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$438.00
Rate for Payer: Oxford Commercial	$292.00
Rate for Payer: Qualcare PPO/HMO/WC	$219.00
Rate for Payer: UnitedHealthcare Commercial	$292.00
Rate for Payer: UnitedHealthcare Community & State	$35.19
Rate for Payer: Wellpoint Medicaid Managed Care	$38.69

DRILL CANNULATED 3.5MM

Facility

$1,460.00

Hospital Charge Code	270698763
Hospital Revenue Code	272
Min. Negotiated Rate	$219.00
Max. Negotiated Rate	$219.00
Rate for Payer: Qualcare PPO/HMO/WC	$219.00

DRILL CANNULATED 4.0MM

Facility

$2,455.00

Hospital Charge Code	270668440
Hospital Revenue Code	278
Min. Negotiated Rate	$59.17
Max. Negotiated Rate	$1,227.50
Rate for Payer: Aetna Commercial	$932.90
Rate for Payer: Aetna Medicare Advantage	$736.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$626.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$626.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$626.02
Rate for Payer: Cigna Commercial	$1,227.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$540.10
Rate for Payer: Qualcare PPO/HMO/WC	$368.25
Rate for Payer: UnitedHealthcare Community & State	$59.17
Rate for Payer: Wellpoint Medicaid Managed Care	$65.06

DRILL CANNULATED 4.0MM

Facility

$875.00

Service Code	HCPCS A4649
Hospital Charge Code	270697346
Hospital Revenue Code	272
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

DRILL CANNULATED 4.0MM

Facility

$2,455.00

Hospital Charge Code	270668440
Hospital Revenue Code	278
Min. Negotiated Rate	$368.25
Max. Negotiated Rate	$594.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$540.10
Rate for Payer: Qualcare PPO/HMO/WC	$368.25

DRILL CANNULATED 4.0MM

Facility

$875.00

Service Code	HCPCS A4649
Hospital Charge Code	270697346
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

DRILL CANNULATED 4.5MM

Facility

$920.00

Hospital Charge Code	270655173
Hospital Revenue Code	272
Min. Negotiated Rate	$22.17
Max. Negotiated Rate	$460.00
Rate for Payer: Aetna Commercial	$349.60
Rate for Payer: Aetna Medicare Advantage	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.60
Rate for Payer: Cigna Commercial	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.00
Rate for Payer: Oxford Commercial	$184.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.00
Rate for Payer: UnitedHealthcare Commercial	$184.00
Rate for Payer: UnitedHealthcare Community & State	$22.17
Rate for Payer: Wellpoint Medicaid Managed Care	$24.38

DRILL CANNULATED 4.5MM

Facility

$920.00

Hospital Charge Code	270655173
Hospital Revenue Code	272
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$138.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.00

DRILL CANNULATED 4MM

Facility

$920.00

Hospital Charge Code	270655174
Hospital Revenue Code	272
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$138.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.00

DRILL CANNULATED 4MM

Facility

$920.00

Hospital Charge Code	270655174
Hospital Revenue Code	272
Min. Negotiated Rate	$22.17
Max. Negotiated Rate	$460.00
Rate for Payer: Aetna Commercial	$349.60
Rate for Payer: Aetna Medicare Advantage	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.60
Rate for Payer: Cigna Commercial	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.00
Rate for Payer: Oxford Commercial	$184.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.00
Rate for Payer: UnitedHealthcare Commercial	$184.00
Rate for Payer: UnitedHealthcare Community & State	$22.17
Rate for Payer: Wellpoint Medicaid Managed Care	$24.38

DRILL CANNULATED 5.0

Facility

$2,116.40

Hospital Charge Code	270690803
Hospital Revenue Code	272
Min. Negotiated Rate	$51.01
Max. Negotiated Rate	$1,058.20
Rate for Payer: Aetna Commercial	$804.23
Rate for Payer: Aetna Medicare Advantage	$634.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$539.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$539.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$539.68
Rate for Payer: Cigna Commercial	$1,058.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$634.92
Rate for Payer: Oxford Commercial	$423.28
Rate for Payer: Qualcare PPO/HMO/WC	$317.46
Rate for Payer: UnitedHealthcare Commercial	$423.28
Rate for Payer: UnitedHealthcare Community & State	$51.01
Rate for Payer: Wellpoint Medicaid Managed Care	$56.08

DRILL CANNULATED 5.0

Facility

$2,116.40

Hospital Charge Code	270690803
Hospital Revenue Code	272
Min. Negotiated Rate	$317.46
Max. Negotiated Rate	$317.46
Rate for Payer: Qualcare PPO/HMO/WC	$317.46

DRILL CANNULATED 5.0MM

Facility

$1,740.00

Hospital Charge Code	270662004
Hospital Revenue Code	272
Min. Negotiated Rate	$41.93
Max. Negotiated Rate	$870.00
Rate for Payer: Aetna Commercial	$661.20
Rate for Payer: Aetna Medicare Advantage	$522.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$443.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$443.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$443.70
Rate for Payer: Cigna Commercial	$870.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$522.00
Rate for Payer: Oxford Commercial	$348.00
Rate for Payer: Qualcare PPO/HMO/WC	$261.00
Rate for Payer: UnitedHealthcare Commercial	$348.00
Rate for Payer: UnitedHealthcare Community & State	$41.93
Rate for Payer: Wellpoint Medicaid Managed Care	$46.11

DRILL CANNULATED 5.0MM

Facility

$1,740.00

Hospital Charge Code	270662004
Hospital Revenue Code	272
Min. Negotiated Rate	$261.00
Max. Negotiated Rate	$261.00
Rate for Payer: Qualcare PPO/HMO/WC	$261.00

DRILL CANNULATED 6.5 MM

Facility

$2,200.00

Service Code	HCPCS A4649
Hospital Charge Code	270698643
Hospital Revenue Code	272
Min. Negotiated Rate	$53.02
Max. Negotiated Rate	$1,100.00
Rate for Payer: Aetna Commercial	$836.00
Rate for Payer: Aetna Medicare Advantage	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$561.00
Rate for Payer: Cigna Commercial	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$660.00
Rate for Payer: Oxford Commercial	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$330.00
Rate for Payer: UnitedHealthcare Commercial	$440.00
Rate for Payer: UnitedHealthcare Community & State	$53.02
Rate for Payer: Wellpoint Medicaid Managed Care	$58.30

DRILL CANNULATED 6.5 MM

Facility

$2,200.00

Service Code	HCPCS A4649
Hospital Charge Code	270698643
Hospital Revenue Code	272
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$330.00

DRILL CANNULATED DIAMETER 7MM

Facility

$1,058.75

Hospital Charge Code	270666235
Hospital Revenue Code	272
Min. Negotiated Rate	$158.81
Max. Negotiated Rate	$158.81
Rate for Payer: Qualcare PPO/HMO/WC	$158.81

DRILL CANNULATED DIAMETER 7MM

Facility

$1,058.75

Hospital Charge Code	270666235
Hospital Revenue Code	272
Min. Negotiated Rate	$25.52
Max. Negotiated Rate	$529.38
Rate for Payer: Aetna Commercial	$402.32
Rate for Payer: Aetna Medicare Advantage	$317.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.98
Rate for Payer: Cigna Commercial	$529.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$317.62
Rate for Payer: Oxford Commercial	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$158.81
Rate for Payer: UnitedHealthcare Commercial	$211.75
Rate for Payer: UnitedHealthcare Community & State	$25.52
Rate for Payer: Wellpoint Medicaid Managed Care	$28.06

DRILL CANNULATED KIT 2.2mm

Facility

$750.00

Hospital Charge Code	270669881
Hospital Revenue Code	272
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

DRILL CANNULATED KIT 2.2mm

Facility

$750.00

Hospital Charge Code	270669881
Hospital Revenue Code	272
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$150.00
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

DRILL CANNULATED MAX VPC 2.4MM

Facility

$1,440.00

Hospital Charge Code	270689418
Hospital Revenue Code	272
Min. Negotiated Rate	$216.00
Max. Negotiated Rate	$216.00
Rate for Payer: Qualcare PPO/HMO/WC	$216.00

DRILL CANNULATED MAX VPC 2.4MM

Facility

$1,440.00

Hospital Charge Code	270689418
Hospital Revenue Code	272
Min. Negotiated Rate	$34.70
Max. Negotiated Rate	$720.00
Rate for Payer: Aetna Commercial	$547.20
Rate for Payer: Aetna Medicare Advantage	$432.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$367.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$367.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$367.20
Rate for Payer: Cigna Commercial	$720.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$432.00
Rate for Payer: Oxford Commercial	$288.00
Rate for Payer: Qualcare PPO/HMO/WC	$216.00
Rate for Payer: UnitedHealthcare Commercial	$288.00
Rate for Payer: UnitedHealthcare Community & State	$34.70
Rate for Payer: Wellpoint Medicaid Managed Care	$38.16

DRILL CANNULATED MICRO ASNIS 2

Facility

$1,170.00

Hospital Charge Code	270681125
Hospital Revenue Code	272
Min. Negotiated Rate	$28.20
Max. Negotiated Rate	$585.00
Rate for Payer: Aetna Commercial	$444.60
Rate for Payer: Aetna Medicare Advantage	$351.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$298.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$298.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$298.35
Rate for Payer: Cigna Commercial	$585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$351.00
Rate for Payer: Oxford Commercial	$234.00
Rate for Payer: Qualcare PPO/HMO/WC	$175.50
Rate for Payer: UnitedHealthcare Commercial	$234.00
Rate for Payer: UnitedHealthcare Community & State	$28.20
Rate for Payer: Wellpoint Medicaid Managed Care	$31.00

DRILL CANNULATED MICRO ASNIS 2

Facility

$1,170.00

Hospital Charge Code	270681125
Hospital Revenue Code	272
Min. Negotiated Rate	$175.50
Max. Negotiated Rate	$175.50
Rate for Payer: Qualcare PPO/HMO/WC	$175.50

DRILL CANULATED 4.4

Facility

$1,455.00

Hospital Charge Code	270683637
Hospital Revenue Code	272
Min. Negotiated Rate	$218.25
Max. Negotiated Rate	$218.25
Rate for Payer: Qualcare PPO/HMO/WC	$218.25

Know your out-of-pocket cost for care.

All Charges