Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MAGAZINE DISP 7609D

Facility

$71.25

Hospital Charge Code	270604993
Hospital Revenue Code	270
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$35.62
Rate for Payer: Aetna Commercial	$27.07
Rate for Payer: Aetna Medicare Advantage	$21.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.17
Rate for Payer: Cigna Commercial	$35.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.38
Rate for Payer: Oxford Commercial	$14.25
Rate for Payer: Qualcare PPO/HMO/WC	$10.69
Rate for Payer: UnitedHealthcare Commercial	$14.25
Rate for Payer: UnitedHealthcare Community & State	$1.72
Rate for Payer: Wellpoint Medicaid Managed Care	$1.89

MAGAZINE DISP 7609D

Facility

$71.25

Hospital Charge Code	270604993
Hospital Revenue Code	270
Min. Negotiated Rate	$10.69
Max. Negotiated Rate	$10.69
Rate for Payer: Qualcare PPO/HMO/WC	$10.69

MAGIC MIX ORAL SOLUTION

Facility

$150.00

Hospital Charge Code	60628607
Hospital Revenue Code	250
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

MAGIC MIX ORAL SOLUTION

Facility

$150.00

Hospital Charge Code	60628607
Hospital Revenue Code	250
Min. Negotiated Rate	$3.62
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.00
Rate for Payer: Oxford Commercial	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$30.00
Rate for Payer: UnitedHealthcare Community & State	$3.62
Rate for Payer: Wellpoint Medicaid Managed Care	$3.98

MAGNESIUM

Facility

$199.90

Service Code	HCPCS 83735
Hospital Charge Code	8200319RS
Hospital Revenue Code	301
Min. Negotiated Rate	$29.98
Max. Negotiated Rate	$29.98
Rate for Payer: Qualcare PPO/HMO/WC	$29.98

MAGNESIUM

Facility

$199.90

Service Code	HCPCS 83735
Hospital Charge Code	8200319RS
Hospital Revenue Code	301
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$18.22
Rate for Payer: Aetna Medicare Advantage	$21.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.18
Rate for Payer: Cigna Commercial	$99.95
Rate for Payer: Cigna Medicare Advantage	$6.70
Rate for Payer: Clover Medicare Advantage	$6.37
Rate for Payer: EmblemHealth Commercial	$20.10
Rate for Payer: Humana Medicare Advantage	$6.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.98
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.70
Rate for Payer: Wellcare Medicare Advantage	$6.70
Rate for Payer: Wellpoint Medicaid Managed Care	$5.30

MAGNESIUM

Facility

$390.00

Service Code	HCPCS 83735
Hospital Charge Code	39990241E
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MAGNESIUM

Facility

$390.00

Service Code	HCPCS 83735
Hospital Charge Code	39990241E
Hospital Revenue Code	301
Min. Negotiated Rate	$5.36
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$18.22
Rate for Payer: Aetna Medicare Advantage	$21.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.18
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$6.70
Rate for Payer: Clover Medicare Advantage	$6.37
Rate for Payer: EmblemHealth Commercial	$20.10
Rate for Payer: Humana Medicare Advantage	$6.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.70
Rate for Payer: Wellcare Medicare Advantage	$6.70
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

MAGNESIUM***

Facility

$25.00

Hospital Charge Code	3011871
Hospital Revenue Code	309
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$9.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

MAGNESIUM***

Facility

$25.00

Hospital Charge Code	3011871
Hospital Revenue Code	309
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

MAGNESIUM,24HRU

Facility

$87.00

Service Code	HCPCS 83735
Hospital Charge Code	38479036
Hospital Revenue Code	301
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$18.22
Rate for Payer: Aetna Medicare Advantage	$21.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.18
Rate for Payer: Cigna Commercial	$43.50
Rate for Payer: Cigna Medicare Advantage	$6.70
Rate for Payer: Clover Medicare Advantage	$6.37
Rate for Payer: EmblemHealth Commercial	$20.10
Rate for Payer: Humana Medicare Advantage	$6.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.70
Rate for Payer: Wellcare Medicare Advantage	$6.70
Rate for Payer: Wellpoint Medicaid Managed Care	$2.31

MAGNESIUM,24HRU

Facility

$87.00

Service Code	HCPCS 83735
Hospital Charge Code	38479036
Hospital Revenue Code	301
Min. Negotiated Rate	$13.05
Max. Negotiated Rate	$13.05
Rate for Payer: Qualcare PPO/HMO/WC	$13.05

MAGNESIUM, 24 HR UR W/O C

Facility

$46.05

Service Code	HCPCS 83735
Hospital Charge Code	39900105
Hospital Revenue Code	301
Min. Negotiated Rate	$6.91
Max. Negotiated Rate	$6.91
Rate for Payer: Qualcare PPO/HMO/WC	$6.91

MAGNESIUM, 24 HR UR W/O C

Facility

$46.05

Service Code	HCPCS 83735
Hospital Charge Code	39900105
Hospital Revenue Code	301
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$18.22
Rate for Payer: Aetna Medicare Advantage	$21.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.18
Rate for Payer: Cigna Commercial	$23.02
Rate for Payer: Cigna Medicare Advantage	$6.70
Rate for Payer: Clover Medicare Advantage	$6.37
Rate for Payer: EmblemHealth Commercial	$20.10
Rate for Payer: Humana Medicare Advantage	$6.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.81
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.91
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.70
Rate for Payer: Wellcare Medicare Advantage	$6.70
Rate for Payer: Wellpoint Medicaid Managed Care	$1.22

MAGNESIUM CHLORIDE 64 MG ER

Facility

$4.00

Service Code	NDC 68585000575
Hospital Charge Code	60627911
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

MAGNESIUM CHLORIDE 64 MG ER

Facility

$4.00

Service Code	NDC 68585000575
Hospital Charge Code	60627911
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

MAGNESIUM CHLORIDE ER 64MEQ TA

Facility

$4.00

Hospital Charge Code	6063943130
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

MAGNESIUM CHLORIDE ER 64MEQ TA

Facility

$4.00

Hospital Charge Code	6063943130
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

MAGNESIUM CITRATE LIQ 300ML

Facility

$7.70

Hospital Charge Code	6012801
Hospital Revenue Code	251
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.85
Rate for Payer: Aetna Commercial	$2.93
Rate for Payer: Aetna Medicare Advantage	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.96
Rate for Payer: Cigna Commercial	$3.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.31
Rate for Payer: Oxford Commercial	$1.54
Rate for Payer: Qualcare PPO/HMO/WC	$1.16
Rate for Payer: UnitedHealthcare Commercial	$1.54
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

MAGNESIUM CITRATE LIQ 300ML

Facility

$7.70

Hospital Charge Code	6012801
Hospital Revenue Code	251
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.16

MAGNESIUM CITRATE SOL

Facility

$16.88

Service Code	NDC 24385067510
Hospital Charge Code	60628130
Hospital Revenue Code	250
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

MAGNESIUM CITRATE SOL

Facility

$16.88

Service Code	NDC 24385067510
Hospital Charge Code	60628130
Hospital Revenue Code	250
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$8.44
Rate for Payer: Aetna Commercial	$6.41
Rate for Payer: Aetna Medicare Advantage	$5.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.30
Rate for Payer: Cigna Commercial	$8.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.06
Rate for Payer: Oxford Commercial	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$2.53
Rate for Payer: UnitedHealthcare Commercial	$3.38
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

MAGNESIUM CITRATE SOL/4OZ

Facility

$6.00

Hospital Charge Code	60634423
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

MAGNESIUM CITRATE SOL/4OZ

Facility

$6.00

Hospital Charge Code	60634423
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

MAGNESIUM HYDROX 400MG/5ML

Facility

$2.45

Hospital Charge Code	6009781
Hospital Revenue Code	251
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Qualcare PPO/HMO/WC	$0.37

Know your out-of-pocket cost for care.

All Charges