Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DRILL TWIST 4.0 MM 70 MM PT

Facility

$495.00

Hospital Charge Code	270684002
Hospital Revenue Code	272
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$74.25
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

DRILL TWIST 4.0 MM 70 MM PT

Facility

$495.00

Hospital Charge Code	270684002
Hospital Revenue Code	272
Min. Negotiated Rate	$11.93
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$188.10
Rate for Payer: Aetna Medicare Advantage	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.22
Rate for Payer: Cigna Commercial	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.50
Rate for Payer: Oxford Commercial	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.25
Rate for Payer: UnitedHealthcare Commercial	$99.00
Rate for Payer: UnitedHealthcare Community & State	$11.93
Rate for Payer: Wellpoint Medicaid Managed Care	$13.12

DRILL TWIST 4.3x180 CAL 472068

Facility

$530.00

Hospital Charge Code	270641800
Hospital Revenue Code	272
Min. Negotiated Rate	$12.77
Max. Negotiated Rate	$265.00
Rate for Payer: Aetna Commercial	$201.40
Rate for Payer: Aetna Medicare Advantage	$159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.15
Rate for Payer: Cigna Commercial	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.00
Rate for Payer: Oxford Commercial	$106.00
Rate for Payer: Qualcare PPO/HMO/WC	$79.50
Rate for Payer: UnitedHealthcare Commercial	$106.00
Rate for Payer: UnitedHealthcare Community & State	$12.77
Rate for Payer: Wellpoint Medicaid Managed Care	$14.04

DRILL TWIST 4.3x180 CAL 472068

Facility

$530.00

Hospital Charge Code	270641800
Hospital Revenue Code	272
Min. Negotiated Rate	$79.50
Max. Negotiated Rate	$79.50
Rate for Payer: Qualcare PPO/HMO/WC	$79.50

DRILL TWIST CALIBR 3.2 472370

Facility

$307.60

Hospital Charge Code	270633334
Hospital Revenue Code	272
Min. Negotiated Rate	$46.14
Max. Negotiated Rate	$46.14
Rate for Payer: Qualcare PPO/HMO/WC	$46.14

DRILL TWIST CALIBR 3.2 472370

Facility

$307.60

Hospital Charge Code	270633334
Hospital Revenue Code	272
Min. Negotiated Rate	$7.41
Max. Negotiated Rate	$153.80
Rate for Payer: Aetna Commercial	$116.89
Rate for Payer: Aetna Medicare Advantage	$92.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.44
Rate for Payer: Cigna Commercial	$153.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.28
Rate for Payer: Oxford Commercial	$61.52
Rate for Payer: Qualcare PPO/HMO/WC	$46.14
Rate for Payer: UnitedHealthcare Commercial	$61.52
Rate for Payer: UnitedHealthcare Community & State	$7.41
Rate for Payer: Wellpoint Medicaid Managed Care	$8.15

DRILL TWIST CANNULATED 6.5MM

Facility

$3,455.00

Hospital Charge Code	270661525
Hospital Revenue Code	272
Min. Negotiated Rate	$518.25
Max. Negotiated Rate	$518.25
Rate for Payer: Qualcare PPO/HMO/WC	$518.25

DRILL TWIST CANNULATED 6.5MM

Facility

$3,455.00

Hospital Charge Code	270661525
Hospital Revenue Code	272
Min. Negotiated Rate	$83.27
Max. Negotiated Rate	$1,727.50
Rate for Payer: Aetna Commercial	$1,312.90
Rate for Payer: Aetna Medicare Advantage	$1,036.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$881.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$881.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$881.02
Rate for Payer: Cigna Commercial	$1,727.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,036.50
Rate for Payer: Oxford Commercial	$691.00
Rate for Payer: Qualcare PPO/HMO/WC	$518.25
Rate for Payer: UnitedHealthcare Commercial	$691.00
Rate for Payer: UnitedHealthcare Community & State	$83.27
Rate for Payer: Wellpoint Medicaid Managed Care	$91.56

DRILL VOER AQ 3.5 X 13CM

Facility

$852.50

Hospital Charge Code	270701954
Hospital Revenue Code	272
Min. Negotiated Rate	$20.55
Max. Negotiated Rate	$426.25
Rate for Payer: Aetna Commercial	$323.95
Rate for Payer: Aetna Medicare Advantage	$255.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$217.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$217.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$217.39
Rate for Payer: Cigna Commercial	$426.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.75
Rate for Payer: Oxford Commercial	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.88
Rate for Payer: UnitedHealthcare Commercial	$170.50
Rate for Payer: UnitedHealthcare Community & State	$20.55
Rate for Payer: Wellpoint Medicaid Managed Care	$22.59

DRILL VOER AQ 3.5 X 13CM

Facility

$852.50

Hospital Charge Code	270701954
Hospital Revenue Code	272
Min. Negotiated Rate	$127.88
Max. Negotiated Rate	$127.88
Rate for Payer: Qualcare PPO/HMO/WC	$127.88

DRILL W AO2.0MM

Facility

$1,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270692675
Hospital Revenue Code	278
Min. Negotiated Rate	$28.92
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$456.00
Rate for Payer: Aetna Medicare Advantage	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$306.00
Rate for Payer: Cigna Commercial	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$264.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.00
Rate for Payer: UnitedHealthcare Community & State	$28.92
Rate for Payer: Wellpoint Medicaid Managed Care	$31.80

DRILL W AO2.0MM

Facility

$1,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270692675
Hospital Revenue Code	278
Min. Negotiated Rate	$180.00
Max. Negotiated Rate	$290.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$264.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.00

DRILL WLZ TWIST 1.5 50 019195

Facility

$460.85

Hospital Charge Code	270620858
Hospital Revenue Code	272
Min. Negotiated Rate	$69.13
Max. Negotiated Rate	$69.13
Rate for Payer: Qualcare PPO/HMO/WC	$69.13

DRILL WLZ TWIST 1.5 50 019195

Facility

$460.85

Hospital Charge Code	270620858
Hospital Revenue Code	272
Min. Negotiated Rate	$11.11
Max. Negotiated Rate	$230.43
Rate for Payer: Aetna Commercial	$175.12
Rate for Payer: Aetna Medicare Advantage	$138.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.52
Rate for Payer: Cigna Commercial	$230.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.25
Rate for Payer: Oxford Commercial	$92.17
Rate for Payer: Qualcare PPO/HMO/WC	$69.13
Rate for Payer: UnitedHealthcare Commercial	$92.17
Rate for Payer: UnitedHealthcare Community & State	$11.11
Rate for Payer: Wellpoint Medicaid Managed Care	$12.21

DRILL WLZ TWIST 1.5 70 10MM

Facility

$718.45

Hospital Charge Code	270607816
Hospital Revenue Code	272
Min. Negotiated Rate	$17.31
Max. Negotiated Rate	$359.23
Rate for Payer: Aetna Commercial	$273.01
Rate for Payer: Aetna Medicare Advantage	$215.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.20
Rate for Payer: Cigna Commercial	$359.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.53
Rate for Payer: Oxford Commercial	$143.69
Rate for Payer: Qualcare PPO/HMO/WC	$107.77
Rate for Payer: UnitedHealthcare Commercial	$143.69
Rate for Payer: UnitedHealthcare Community & State	$17.31
Rate for Payer: Wellpoint Medicaid Managed Care	$19.04

DRILL WLZ TWIST 1.5 70 10MM

Facility

$718.45

Hospital Charge Code	270607816
Hospital Revenue Code	272
Min. Negotiated Rate	$107.77
Max. Negotiated Rate	$107.77
Rate for Payer: Qualcare PPO/HMO/WC	$107.77

DRILL ZIM FEM 5.0 2255-31-50

Facility

$805.65

Hospital Charge Code	270620532
Hospital Revenue Code	272
Min. Negotiated Rate	$19.42
Max. Negotiated Rate	$402.82
Rate for Payer: Aetna Commercial	$306.15
Rate for Payer: Aetna Medicare Advantage	$241.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$205.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$205.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$205.44
Rate for Payer: Cigna Commercial	$402.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$241.69
Rate for Payer: Oxford Commercial	$161.13
Rate for Payer: Qualcare PPO/HMO/WC	$120.85
Rate for Payer: UnitedHealthcare Commercial	$161.13
Rate for Payer: UnitedHealthcare Community & State	$19.42
Rate for Payer: Wellpoint Medicaid Managed Care	$21.35

DRILL ZIM FEM 5.0 2255-31-50

Facility

$805.65

Hospital Charge Code	270620532
Hospital Revenue Code	272
Min. Negotiated Rate	$120.85
Max. Negotiated Rate	$120.85
Rate for Payer: Qualcare PPO/HMO/WC	$120.85

DRILL ZIM PILOT 5.0 2253350

Facility

$695.00

Hospital Charge Code	270625707
Hospital Revenue Code	272
Min. Negotiated Rate	$104.25
Max. Negotiated Rate	$104.25
Rate for Payer: Qualcare PPO/HMO/WC	$104.25

DRILL ZIM PILOT 5.0 2253350

Facility

$695.00

Hospital Charge Code	270625707
Hospital Revenue Code	272
Min. Negotiated Rate	$16.75
Max. Negotiated Rate	$347.50
Rate for Payer: Aetna Commercial	$264.10
Rate for Payer: Aetna Medicare Advantage	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.22
Rate for Payer: Cigna Commercial	$347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.50
Rate for Payer: Oxford Commercial	$139.00
Rate for Payer: Qualcare PPO/HMO/WC	$104.25
Rate for Payer: UnitedHealthcare Commercial	$139.00
Rate for Payer: UnitedHealthcare Community & State	$16.75
Rate for Payer: Wellpoint Medicaid Managed Care	$18.42

DRILL ZIM QC 3.2MM 2410-032

Facility

$248.85

Hospital Charge Code	270601277
Hospital Revenue Code	272
Min. Negotiated Rate	$37.33
Max. Negotiated Rate	$37.33
Rate for Payer: Qualcare PPO/HMO/WC	$37.33

DRILL ZIM QC 3.2MM 2410-032

Facility

$248.85

Hospital Charge Code	270601277
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$124.42
Rate for Payer: Aetna Commercial	$94.56
Rate for Payer: Aetna Medicare Advantage	$74.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.46
Rate for Payer: Cigna Commercial	$124.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.66
Rate for Payer: Oxford Commercial	$49.77
Rate for Payer: Qualcare PPO/HMO/WC	$37.33
Rate for Payer: UnitedHealthcare Commercial	$49.77
Rate for Payer: UnitedHealthcare Community & State	$6.00
Rate for Payer: Wellpoint Medicaid Managed Care	$6.59

DRILL ZIM QC 4.5MM 2410-045

Facility

$139.25

Hospital Charge Code	270610453
Hospital Revenue Code	272
Min. Negotiated Rate	$3.36
Max. Negotiated Rate	$69.62
Rate for Payer: Aetna Commercial	$52.91
Rate for Payer: Aetna Medicare Advantage	$41.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.51
Rate for Payer: Cigna Commercial	$69.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.77
Rate for Payer: Oxford Commercial	$27.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.89
Rate for Payer: UnitedHealthcare Commercial	$27.85
Rate for Payer: UnitedHealthcare Community & State	$3.36
Rate for Payer: Wellpoint Medicaid Managed Care	$3.69

DRILL ZIM QC 4.5MM 2410-045

Facility

$139.25

Hospital Charge Code	270610453
Hospital Revenue Code	272
Min. Negotiated Rate	$20.89
Max. Negotiated Rate	$20.89
Rate for Payer: Qualcare PPO/HMO/WC	$20.89

DRILL ZIM TWIST 3.2/127MM

Facility

$175.25

Hospital Charge Code	270607660
Hospital Revenue Code	272
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$87.62
Rate for Payer: Aetna Commercial	$66.59
Rate for Payer: Aetna Medicare Advantage	$52.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.69
Rate for Payer: Cigna Commercial	$87.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.58
Rate for Payer: Oxford Commercial	$35.05
Rate for Payer: Qualcare PPO/HMO/WC	$26.29
Rate for Payer: UnitedHealthcare Commercial	$35.05
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.64

Know your out-of-pocket cost for care.

All Charges