Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

OVERDRILL 3.5

Facility

$1,370.00

Hospital Charge Code	270664509
Hospital Revenue Code	270
Min. Negotiated Rate	$205.50
Max. Negotiated Rate	$205.50
Rate for Payer: Qualcare PPO/HMO/WC	$205.50

OVERDRILL AO DIA 3.5X122MM

Facility

$1,160.70

Hospital Charge Code	270692182
Hospital Revenue Code	272
Min. Negotiated Rate	$174.10
Max. Negotiated Rate	$174.10
Rate for Payer: Qualcare PPO/HMO/WC	$174.10

OVERDRILL AO DIA 3.5X122MM

Facility

$1,160.70

Hospital Charge Code	270692182
Hospital Revenue Code	272
Min. Negotiated Rate	$27.97
Max. Negotiated Rate	$580.35
Rate for Payer: Aetna Commercial	$441.07
Rate for Payer: Aetna Medicare Advantage	$348.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$295.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$295.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$295.98
Rate for Payer: Cigna Commercial	$580.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$348.21
Rate for Payer: Oxford Commercial	$232.14
Rate for Payer: Qualcare PPO/HMO/WC	$174.10
Rate for Payer: UnitedHealthcare Commercial	$232.14
Rate for Payer: UnitedHealthcare Community & State	$27.97
Rate for Payer: Wellpoint Medicaid Managed Care	$30.76

OVERDRILL AO SHAFT END 2.3mm

Facility

$860.00

Hospital Charge Code	270669953
Hospital Revenue Code	272
Min. Negotiated Rate	$129.00
Max. Negotiated Rate	$129.00
Rate for Payer: Qualcare PPO/HMO/WC	$129.00

OVERDRILL AO SHAFT END 2.3mm

Facility

$860.00

Hospital Charge Code	270669953
Hospital Revenue Code	272
Min. Negotiated Rate	$20.73
Max. Negotiated Rate	$430.00
Rate for Payer: Aetna Commercial	$326.80
Rate for Payer: Aetna Medicare Advantage	$258.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.30
Rate for Payer: Cigna Commercial	$430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.00
Rate for Payer: Oxford Commercial	$172.00
Rate for Payer: Qualcare PPO/HMO/WC	$129.00
Rate for Payer: UnitedHealthcare Commercial	$172.00
Rate for Payer: UnitedHealthcare Community & State	$20.73
Rate for Payer: Wellpoint Medicaid Managed Care	$22.79

OVERDRILL FOR 3.5 SCREW AO FIT

Facility

$930.00

Hospital Charge Code	270660365
Hospital Revenue Code	272
Min. Negotiated Rate	$22.41
Max. Negotiated Rate	$465.00
Rate for Payer: Aetna Commercial	$353.40
Rate for Payer: Aetna Medicare Advantage	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.15
Rate for Payer: Cigna Commercial	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.00
Rate for Payer: Oxford Commercial	$186.00
Rate for Payer: Qualcare PPO/HMO/WC	$139.50
Rate for Payer: UnitedHealthcare Commercial	$186.00
Rate for Payer: UnitedHealthcare Community & State	$22.41
Rate for Payer: Wellpoint Medicaid Managed Care	$24.64

OVERDRILL FOR 3.5 SCREW AO FIT

Facility

$930.00

Hospital Charge Code	270660365
Hospital Revenue Code	272
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$139.50
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

OVERDRILL TC 2.0/2.5

Facility

$880.00

Hospital Charge Code	270669820
Hospital Revenue Code	272
Min. Negotiated Rate	$132.00
Max. Negotiated Rate	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$132.00

OVERDRILL TC 2.0/2.5

Facility

$880.00

Hospital Charge Code	270669820
Hospital Revenue Code	272
Min. Negotiated Rate	$21.21
Max. Negotiated Rate	$440.00
Rate for Payer: Aetna Commercial	$334.40
Rate for Payer: Aetna Medicare Advantage	$264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.40
Rate for Payer: Cigna Commercial	$440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$264.00
Rate for Payer: Oxford Commercial	$176.00
Rate for Payer: Qualcare PPO/HMO/WC	$132.00
Rate for Payer: UnitedHealthcare Commercial	$176.00
Rate for Payer: UnitedHealthcare Community & State	$21.21
Rate for Payer: Wellpoint Medicaid Managed Care	$23.32

OVERTIME PER HOUR ATS300

Facility

$304.00

Hospital Charge Code	270605798
Hospital Revenue Code	270
Min. Negotiated Rate	$45.60
Max. Negotiated Rate	$45.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.60

OVERTIME PER HOUR ATS300

Facility

$304.00

Hospital Charge Code	270605798
Hospital Revenue Code	270
Min. Negotiated Rate	$7.33
Max. Negotiated Rate	$152.00
Rate for Payer: Aetna Commercial	$115.52
Rate for Payer: Aetna Medicare Advantage	$91.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.52
Rate for Payer: Cigna Commercial	$152.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.20
Rate for Payer: Oxford Commercial	$60.80
Rate for Payer: Qualcare PPO/HMO/WC	$45.60
Rate for Payer: UnitedHealthcare Commercial	$60.80
Rate for Payer: UnitedHealthcare Community & State	$7.33
Rate for Payer: Wellpoint Medicaid Managed Care	$8.06

OVERTUBE GUARDUS 10.0x11.7mm

Facility

$775.00

Hospital Charge Code	270640965
Hospital Revenue Code	272
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$116.25
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

OVERTUBE GUARDUS 10.0x11.7mm

Facility

$775.00

Hospital Charge Code	270640965
Hospital Revenue Code	272
Min. Negotiated Rate	$18.68
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.50
Rate for Payer: Oxford Commercial	$155.00
Rate for Payer: Qualcare PPO/HMO/WC	$116.25
Rate for Payer: UnitedHealthcare Commercial	$155.00
Rate for Payer: UnitedHealthcare Community & State	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$20.54

OVERTUBE GUARDUS 50CM

Facility

$930.00

Hospital Charge Code	270678796
Hospital Revenue Code	272
Min. Negotiated Rate	$22.41
Max. Negotiated Rate	$465.00
Rate for Payer: Aetna Commercial	$353.40
Rate for Payer: Aetna Medicare Advantage	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.15
Rate for Payer: Cigna Commercial	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.00
Rate for Payer: Oxford Commercial	$186.00
Rate for Payer: Qualcare PPO/HMO/WC	$139.50
Rate for Payer: UnitedHealthcare Commercial	$186.00
Rate for Payer: UnitedHealthcare Community & State	$22.41
Rate for Payer: Wellpoint Medicaid Managed Care	$24.64

OVERTUBE GUARDUS 50CM

Facility

$930.00

Hospital Charge Code	270678796
Hospital Revenue Code	272
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$139.50
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

OVERTUBE GUARDUS 8.6x10mm

Facility

$975.00

Hospital Charge Code	270642702
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

OVERTUBE GUARDUS 8.6x10mm

Facility

$525.00

Hospital Charge Code	270636439
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

OVERTUBE GUARDUS 8.6x10mm

Facility

$525.00

Hospital Charge Code	270636439
Hospital Revenue Code	272
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$78.75
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

OVERTUBE GUARDUS 8.6x10mm

Facility

$975.00

Hospital Charge Code	270642702
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

OVERTUBE GUARDUS 8.6X10MM

Facility

$219.95

Hospital Charge Code	2706427002
Hospital Revenue Code	272
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$109.97
Rate for Payer: Aetna Commercial	$83.58
Rate for Payer: Aetna Medicare Advantage	$65.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.09
Rate for Payer: Cigna Commercial	$109.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.98
Rate for Payer: Oxford Commercial	$43.99
Rate for Payer: Qualcare PPO/HMO/WC	$32.99
Rate for Payer: UnitedHealthcare Commercial	$43.99
Rate for Payer: UnitedHealthcare Community & State	$5.30
Rate for Payer: Wellpoint Medicaid Managed Care	$5.83

OVERTUBE GUARDUS 8.6X10MM

Facility

$219.95

Hospital Charge Code	2706427002
Hospital Revenue Code	272
Min. Negotiated Rate	$32.99
Max. Negotiated Rate	$32.99
Rate for Payer: Qualcare PPO/HMO/WC	$32.99

OV-ESTABLISHED-BRIEF

Facility

$319.65

Service Code	HCPCS 99211
Hospital Charge Code	83653180
Hospital Revenue Code	514
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$159.82
Rate for Payer: Aetna Commercial	$121.47
Rate for Payer: Aetna Medicare Advantage	$95.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.51
Rate for Payer: Cigna Commercial	$159.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.89
Rate for Payer: Qualcare PPO/HMO/WC	$47.95
Rate for Payer: UnitedHealthcare Community & State	$7.70
Rate for Payer: Wellpoint Medicaid Managed Care	$8.47

OV-ESTABLISHED-BRIEF

Facility

$319.65

Service Code	HCPCS 99211
Hospital Charge Code	83653180
Hospital Revenue Code	514
Min. Negotiated Rate	$47.95
Max. Negotiated Rate	$47.95
Rate for Payer: Qualcare PPO/HMO/WC	$47.95

OV-ESTABLISHED-COMPREHENSIVE

Facility

$1,213.80

Service Code	HCPCS 99215
Hospital Charge Code	83653220
Hospital Revenue Code	514
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$606.90
Rate for Payer: Aetna Commercial	$461.24
Rate for Payer: Aetna Medicare Advantage	$364.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$309.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$309.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$309.52
Rate for Payer: Cigna Commercial	$606.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.14
Rate for Payer: Qualcare PPO/HMO/WC	$182.07
Rate for Payer: UnitedHealthcare Community & State	$29.25
Rate for Payer: Wellpoint Medicaid Managed Care	$32.17

OV-ESTABLISHED-COMPREHENSIVE

Facility

$1,213.80

Service Code	HCPCS 99215
Hospital Charge Code	83653220
Hospital Revenue Code	514
Min. Negotiated Rate	$182.07
Max. Negotiated Rate	$182.07
Rate for Payer: Qualcare PPO/HMO/WC	$182.07

Know your out-of-pocket cost for care.

All Charges