Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MAGNESIUM HYDROX 400MG/5ML

Facility

$2.45

Hospital Charge Code	6009781
Hospital Revenue Code	251
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.23
Rate for Payer: Aetna Commercial	$0.93
Rate for Payer: Aetna Medicare Advantage	$0.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.62
Rate for Payer: Cigna Commercial	$1.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.74
Rate for Payer: Oxford Commercial	$0.49
Rate for Payer: Qualcare PPO/HMO/WC	$0.37
Rate for Payer: UnitedHealthcare Commercial	$0.49
Rate for Payer: UnitedHealthcare Community & State	$0.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

MAGNESIUM HYDROXIDE SUSP. UD

Facility

$15.68

Service Code	NDC 121043130
Hospital Charge Code	60629315
Hospital Revenue Code	250
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$7.84
Rate for Payer: Aetna Commercial	$5.96
Rate for Payer: Aetna Medicare Advantage	$4.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.00
Rate for Payer: Cigna Commercial	$7.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.70
Rate for Payer: Oxford Commercial	$3.14
Rate for Payer: Qualcare PPO/HMO/WC	$2.35
Rate for Payer: UnitedHealthcare Commercial	$3.14
Rate for Payer: UnitedHealthcare Community & State	$0.38
Rate for Payer: Wellpoint Medicaid Managed Care	$0.42

MAGNESIUM HYDROXIDE SUSP. UD

Facility

$15.68

Service Code	NDC 121043130
Hospital Charge Code	60629315
Hospital Revenue Code	250
Min. Negotiated Rate	$2.35
Max. Negotiated Rate	$2.35
Rate for Payer: Qualcare PPO/HMO/WC	$2.35

MAGNESIUM HYDROX TAB 325MG

Facility

$1.95

Hospital Charge Code	60628637
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.98
Rate for Payer: Aetna Commercial	$0.74
Rate for Payer: Aetna Medicare Advantage	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.50
Rate for Payer: Cigna Commercial	$0.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.59
Rate for Payer: Oxford Commercial	$0.39
Rate for Payer: Qualcare PPO/HMO/WC	$0.29
Rate for Payer: UnitedHealthcare Commercial	$0.39
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

MAGNESIUM HYDROX TAB 325MG

Facility

$1.95

Hospital Charge Code	60628637
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

MAGNESIUM OXIDE

Facility

$1.00

Hospital Charge Code	60634438
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.50
Rate for Payer: Aetna Commercial	$0.38
Rate for Payer: Aetna Medicare Advantage	$0.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.26
Rate for Payer: Cigna Commercial	$0.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.30
Rate for Payer: Oxford Commercial	$0.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.15
Rate for Payer: UnitedHealthcare Commercial	$0.20
Rate for Payer: UnitedHealthcare Community & State	$0.02
Rate for Payer: Wellpoint Medicaid Managed Care	$0.03

MAGNESIUM OXIDE

Facility

$1.00

Hospital Charge Code	60634438
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

MAGNESIUM OXIDE 400 MG TAB UD

Facility

$4.00

Service Code	NDC 68585000641
Hospital Charge Code	60628913
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

MAGNESIUM OXIDE 400 MG TAB UD

Facility

$4.00

Service Code	NDC 68585000641
Hospital Charge Code	60628913
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 RBC

Facility

$87.00

Service Code	HCPCS 83735
Hospital Charge Code	38472473
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 RBC

Facility

$87.00

Service Code	HCPCS 83735
Hospital Charge Code	38472473
Hospital Revenue Code	301
Min. Negotiated Rate	$13.05
Max. Negotiated Rate	$13.05
Rate for Payer: Qualcare PPO/HMO/WC	$13.05

MAGNESIUM, RBC

Facility

$199.90

Service Code	HCPCS 83735
Hospital Charge Code	3030825
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, RBC

Facility

$199.90

Service Code	HCPCS 83735
Hospital Charge Code	3030825
Hospital Revenue Code	301
Min. Negotiated Rate	$29.98
Max. Negotiated Rate	$29.98
Rate for Payer: Qualcare PPO/HMO/WC	$29.98

MAGNESIUM, SERUM

Facility

$659.50

Service Code	HCPCS 83735
Hospital Charge Code	3001872
Hospital Revenue Code	301
Min. Negotiated Rate	$5.36
Max. Negotiated Rate	$329.75
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	$329.75
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	$197.85
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.92
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	$17.48

MAGNESIUM, SERUM

Facility

$659.50

Service Code	HCPCS 83735
Hospital Charge Code	3001872
Hospital Revenue Code	301
Min. Negotiated Rate	$98.92
Max. Negotiated Rate	$98.92
Rate for Payer: Qualcare PPO/HMO/WC	$98.92

MAGNESIUM SERUM PANEL

Facility

$28.60

Service Code	HCPCS 83735
Hospital Charge Code	3001872P
Hospital Revenue Code	301
Min. Negotiated Rate	$0.76
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	$14.30
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	$8.58
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.29
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	$0.76

MAGNESIUM SERUM PANEL

Facility

$28.60

Service Code	HCPCS 83735
Hospital Charge Code	3001872P
Hospital Revenue Code	301
Min. Negotiated Rate	$4.29
Max. Negotiated Rate	$4.29
Rate for Payer: Qualcare PPO/HMO/WC	$4.29

MAGNESIUM SULF 50% L/S

Facility

$19.00

Hospital Charge Code	60635715
Hospital Revenue Code	636
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.50
Rate for Payer: Aetna Commercial	$7.22
Rate for Payer: Aetna Medicare Advantage	$5.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.84
Rate for Payer: Cigna Commercial	$9.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.85
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

MAGNESIUM SULF 50% L/S

Facility

$19.00

Hospital Charge Code	60635715
Hospital Revenue Code	636
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$4.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.85

MAGNESIUM SULFATE,1.000MG

Facility

$5.00

Hospital Charge Code	60635439
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

MAGNESIUM SULFATE,1.000MG

Facility

$5.00

Hospital Charge Code	60635439
Hospital Revenue Code	636
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$1.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

MAGNESIUMSULFATE 1GM/100ML D5W

Facility

$50.38

Service Code	HCPCS J3475
Hospital Charge Code	60628639
Hospital Revenue Code	636
Min. Negotiated Rate	$7.56
Max. Negotiated Rate	$12.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.19
Rate for Payer: Qualcare PPO/HMO/WC	$7.56

MAGNESIUMSULFATE 1GM/100ML D5W

Facility

$50.38

Service Code	HCPCS J3475
Hospital Charge Code	60628639
Hospital Revenue Code	636
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$25.19
Rate for Payer: Aetna Commercial	$19.14
Rate for Payer: Aetna Medicare Advantage	$15.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.85
Rate for Payer: Cigna Commercial	$25.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.19
Rate for Payer: Qualcare PPO/HMO/WC	$7.56
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.34

MAGNESIUM SULFATE 2G 50ML PREM

Facility

$93.53

Service Code	NDC 409523960
Hospital Charge Code	606351016
Hospital Revenue Code	250
Min. Negotiated Rate	$14.03
Max. Negotiated Rate	$14.03
Rate for Payer: Qualcare PPO/HMO/WC	$14.03

MAGNESIUM SULFATE 2G 50ML PREM

Facility

$93.53

Service Code	NDC 409523960
Hospital Charge Code	606351016
Hospital Revenue Code	250
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$46.77
Rate for Payer: Aetna Commercial	$35.54
Rate for Payer: Aetna Medicare Advantage	$28.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.85
Rate for Payer: Cigna Commercial	$46.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.06
Rate for Payer: Oxford Commercial	$18.71
Rate for Payer: Qualcare PPO/HMO/WC	$14.03
Rate for Payer: UnitedHealthcare Commercial	$18.71
Rate for Payer: UnitedHealthcare Community & State	$2.25
Rate for Payer: Wellpoint Medicaid Managed Care	$2.48

Know your out-of-pocket cost for care.

All Charges