Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DRILL SUBCHONDRAL 1.5mm

Facility

$190.00

Hospital Charge Code	270621558
Hospital Revenue Code	272
Min. Negotiated Rate	$4.58
Max. Negotiated Rate	$95.00
Rate for Payer: Aetna Commercial	$72.20
Rate for Payer: Aetna Medicare Advantage	$57.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.45
Rate for Payer: Cigna Commercial	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.00
Rate for Payer: Oxford Commercial	$38.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.50
Rate for Payer: UnitedHealthcare Commercial	$38.00
Rate for Payer: UnitedHealthcare Community & State	$4.58
Rate for Payer: Wellpoint Medicaid Managed Care	$5.04

DRILL SURG 4.5MM OD ST 3.0MM

Facility

$741.30

Hospital Charge Code	270697894
Hospital Revenue Code	272
Min. Negotiated Rate	$17.87
Max. Negotiated Rate	$370.65
Rate for Payer: Aetna Commercial	$281.69
Rate for Payer: Aetna Medicare Advantage	$222.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.03
Rate for Payer: Cigna Commercial	$370.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.39
Rate for Payer: Oxford Commercial	$148.26
Rate for Payer: Qualcare PPO/HMO/WC	$111.19
Rate for Payer: UnitedHealthcare Commercial	$148.26
Rate for Payer: UnitedHealthcare Community & State	$17.87
Rate for Payer: Wellpoint Medicaid Managed Care	$19.64

DRILL SURG 4.5MM OD ST 3.0MM

Facility

$741.30

Hospital Charge Code	270697894
Hospital Revenue Code	272
Min. Negotiated Rate	$111.19
Max. Negotiated Rate	$111.19
Rate for Payer: Qualcare PPO/HMO/WC	$111.19

DRILL SYN 14MM 324.14

Facility

$1,503.25

Hospital Charge Code	270609419
Hospital Revenue Code	272
Min. Negotiated Rate	$36.23
Max. Negotiated Rate	$751.62
Rate for Payer: Aetna Commercial	$571.24
Rate for Payer: Aetna Medicare Advantage	$450.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$383.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$383.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$383.33
Rate for Payer: Cigna Commercial	$751.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$450.98
Rate for Payer: Oxford Commercial	$300.65
Rate for Payer: Qualcare PPO/HMO/WC	$225.49
Rate for Payer: UnitedHealthcare Commercial	$300.65
Rate for Payer: UnitedHealthcare Community & State	$36.23
Rate for Payer: Wellpoint Medicaid Managed Care	$39.84

DRILL SYN 14MM 324.14

Facility

$1,503.25

Hospital Charge Code	270609419
Hospital Revenue Code	272
Min. Negotiated Rate	$225.49
Max. Negotiated Rate	$225.49
Rate for Payer: Qualcare PPO/HMO/WC	$225.49

DRILL SYN 8 1.0 316443

Facility

$644.00

Hospital Charge Code	270626840
Hospital Revenue Code	272
Min. Negotiated Rate	$96.60
Max. Negotiated Rate	$96.60
Rate for Payer: Qualcare PPO/HMO/WC	$96.60

DRILL SYN 8 1.0 316443

Facility

$644.00

Hospital Charge Code	270626840
Hospital Revenue Code	272
Min. Negotiated Rate	$15.52
Max. Negotiated Rate	$322.00
Rate for Payer: Aetna Commercial	$244.72
Rate for Payer: Aetna Medicare Advantage	$193.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.22
Rate for Payer: Cigna Commercial	$322.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.20
Rate for Payer: Oxford Commercial	$128.80
Rate for Payer: Qualcare PPO/HMO/WC	$96.60
Rate for Payer: UnitedHealthcare Commercial	$128.80
Rate for Payer: UnitedHealthcare Community & State	$15.52
Rate for Payer: Wellpoint Medicaid Managed Care	$17.07

DRILL TIBIAL 4.8MM

Facility

$1,170.00

Hospital Charge Code	270676977
Hospital Revenue Code	272
Min. Negotiated Rate	$175.50
Max. Negotiated Rate	$175.50
Rate for Payer: Qualcare PPO/HMO/WC	$175.50

DRILL TIBIAL 4.8MM

Facility

$1,170.00

Hospital Charge Code	270676977
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 TIP 2.5 GUIDEWIRE 12mm

Facility

$308.75

Hospital Charge Code	270685404
Hospital Revenue Code	272
Min. Negotiated Rate	$7.44
Max. Negotiated Rate	$154.38
Rate for Payer: Aetna Commercial	$117.33
Rate for Payer: Aetna Medicare Advantage	$92.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.73
Rate for Payer: Cigna Commercial	$154.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.62
Rate for Payer: Oxford Commercial	$61.75
Rate for Payer: Qualcare PPO/HMO/WC	$46.31
Rate for Payer: UnitedHealthcare Commercial	$61.75
Rate for Payer: UnitedHealthcare Community & State	$7.44
Rate for Payer: Wellpoint Medicaid Managed Care	$8.18

DRILL TIP 2.5 GUIDEWIRE 12mm

Facility

$308.75

Hospital Charge Code	270685404
Hospital Revenue Code	272
Min. Negotiated Rate	$46.31
Max. Negotiated Rate	$46.31
Rate for Payer: Qualcare PPO/HMO/WC	$46.31

DRILL TIP SPADE 3.9MM

Facility

$525.00

Hospital Charge Code	270687860
Hospital Revenue Code	272
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.50
Rate for Payer: Oxford Commercial	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Commercial	$105.00
Rate for Payer: UnitedHealthcare Community & State	$12.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.91

DRILL TIP SPADE 3.9MM

Facility

$525.00

Hospital Charge Code	270687860
Hospital Revenue Code	272
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$78.75
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

DRILL TRI FLAT

Facility

$1,030.00

Hospital Charge Code	270670470
Hospital Revenue Code	272
Min. Negotiated Rate	$24.82
Max. Negotiated Rate	$515.00
Rate for Payer: Aetna Commercial	$391.40
Rate for Payer: Aetna Medicare Advantage	$309.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$262.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$262.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$262.65
Rate for Payer: Cigna Commercial	$515.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$309.00
Rate for Payer: Oxford Commercial	$206.00
Rate for Payer: Qualcare PPO/HMO/WC	$154.50
Rate for Payer: UnitedHealthcare Commercial	$206.00
Rate for Payer: UnitedHealthcare Community & State	$24.82
Rate for Payer: Wellpoint Medicaid Managed Care	$27.30

DRILL TRI FLAT

Facility

$1,030.00

Hospital Charge Code	270670470
Hospital Revenue Code	272
Min. Negotiated Rate	$154.50
Max. Negotiated Rate	$154.50
Rate for Payer: Qualcare PPO/HMO/WC	$154.50

DRILL TRIM 2 MM X100 MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270690431
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

DRILL TRIM 2 MM X100 MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270690431
Hospital Revenue Code	278
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

DRILL TWIST 1/4 18 ga 4044-16

Facility

$84.85

Hospital Charge Code	270601289
Hospital Revenue Code	272
Min. Negotiated Rate	$12.73
Max. Negotiated Rate	$12.73
Rate for Payer: Qualcare PPO/HMO/WC	$12.73

DRILL TWIST 1/4 18 ga 4044-16

Facility

$84.85

Hospital Charge Code	270601289
Hospital Revenue Code	272
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$42.42
Rate for Payer: Aetna Commercial	$32.24
Rate for Payer: Aetna Medicare Advantage	$25.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.64
Rate for Payer: Cigna Commercial	$42.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.45
Rate for Payer: Oxford Commercial	$16.97
Rate for Payer: Qualcare PPO/HMO/WC	$12.73
Rate for Payer: UnitedHealthcare Commercial	$16.97
Rate for Payer: UnitedHealthcare Community & State	$2.04
Rate for Payer: Wellpoint Medicaid Managed Care	$2.25

DRILL TWIST 1.5 105 01-9198

Facility

$561.65

Hospital Charge Code	270610975
Hospital Revenue Code	272
Min. Negotiated Rate	$84.25
Max. Negotiated Rate	$84.25
Rate for Payer: Qualcare PPO/HMO/WC	$84.25

DRILL TWIST 1.5 105 01-9198

Facility

$561.65

Hospital Charge Code	270610975
Hospital Revenue Code	272
Min. Negotiated Rate	$13.54
Max. Negotiated Rate	$280.82
Rate for Payer: Aetna Commercial	$213.43
Rate for Payer: Aetna Medicare Advantage	$168.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.22
Rate for Payer: Cigna Commercial	$280.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.50
Rate for Payer: Oxford Commercial	$112.33
Rate for Payer: Qualcare PPO/HMO/WC	$84.25
Rate for Payer: UnitedHealthcare Commercial	$112.33
Rate for Payer: UnitedHealthcare Community & State	$13.54
Rate for Payer: Wellpoint Medicaid Managed Care	$14.88

DRILL TWIST 1/8

Facility

$207.00

Hospital Charge Code	270335218
Hospital Revenue Code	272
Min. Negotiated Rate	$4.99
Max. Negotiated Rate	$103.50
Rate for Payer: Aetna Commercial	$78.66
Rate for Payer: Aetna Medicare Advantage	$62.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.78
Rate for Payer: Cigna Commercial	$103.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.10
Rate for Payer: Oxford Commercial	$41.40
Rate for Payer: Qualcare PPO/HMO/WC	$31.05
Rate for Payer: UnitedHealthcare Commercial	$41.40
Rate for Payer: UnitedHealthcare Community & State	$4.99
Rate for Payer: Wellpoint Medicaid Managed Care	$5.49

DRILL TWIST 1/8

Facility

$207.00

Hospital Charge Code	270335218
Hospital Revenue Code	272
Min. Negotiated Rate	$31.05
Max. Negotiated Rate	$31.05
Rate for Payer: Qualcare PPO/HMO/WC	$31.05

DRILL TWIST 3.6x180 472064

Facility

$605.00

Hospital Charge Code	270632875
Hospital Revenue Code	272
Min. Negotiated Rate	$14.58
Max. Negotiated Rate	$302.50
Rate for Payer: Aetna Commercial	$229.90
Rate for Payer: Aetna Medicare Advantage	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.28
Rate for Payer: Cigna Commercial	$302.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Oxford Commercial	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.75
Rate for Payer: UnitedHealthcare Commercial	$121.00
Rate for Payer: UnitedHealthcare Community & State	$14.58
Rate for Payer: Wellpoint Medicaid Managed Care	$16.03

DRILL TWIST 3.6x180 472064

Facility

$605.00

Hospital Charge Code	270632875
Hospital Revenue Code	272
Min. Negotiated Rate	$90.75
Max. Negotiated Rate	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$90.75

Know your out-of-pocket cost for care.

All Charges