Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MALARIA SMEAR

Facility

$133.65

Service Code	HCPCS 87207
Hospital Charge Code	3000189
Hospital Revenue Code	309
Min. Negotiated Rate	$3.54
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$16.29
Rate for Payer: Aetna Medicare Advantage	$19.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.62
Rate for Payer: Cigna Commercial	$66.83
Rate for Payer: Cigna Medicare Advantage	$5.99
Rate for Payer: Clover Medicare Advantage	$5.69
Rate for Payer: EmblemHealth Commercial	$17.97
Rate for Payer: Humana Medicare Advantage	$6.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.09
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.99
Rate for Payer: Wellcare Medicare Advantage	$5.99
Rate for Payer: Wellpoint Medicaid Managed Care	$3.54

MALARIA SMEAR***

Facility

$39.00

Hospital Charge Code	3010188
Hospital Revenue Code	306
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.82
Rate for Payer: Aetna Medicare Advantage	$11.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.95
Rate for Payer: Cigna Commercial	$19.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$0.94
Rate for Payer: Wellpoint Medicaid Managed Care	$1.03

MALARIA SMEAR***

Facility

$39.00

Hospital Charge Code	3010188
Hospital Revenue Code	306
Min. Negotiated Rate	$5.85
Max. Negotiated Rate	$5.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.85

MALARONE 250-100MG TAB

Facility

$54.14

Service Code	NDC 173067501
Hospital Charge Code	60635430
Hospital Revenue Code	250
Min. Negotiated Rate	$8.12
Max. Negotiated Rate	$8.12
Rate for Payer: Qualcare PPO/HMO/WC	$8.12

MALARONE 250-100MG TAB

Facility

$54.14

Service Code	NDC 173067501
Hospital Charge Code	60635430
Hospital Revenue Code	250
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$27.07
Rate for Payer: Aetna Commercial	$20.57
Rate for Payer: Aetna Medicare Advantage	$16.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.81
Rate for Payer: Cigna Commercial	$27.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.24
Rate for Payer: Oxford Commercial	$10.83
Rate for Payer: Qualcare PPO/HMO/WC	$8.12
Rate for Payer: UnitedHealthcare Commercial	$10.83
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.43

MALECOT NEPHROSTOMY ACCESSC

Facility

$379.00

Hospital Charge Code	270331740
Hospital Revenue Code	278
Min. Negotiated Rate	$9.13
Max. Negotiated Rate	$189.50
Rate for Payer: Aetna Commercial	$144.02
Rate for Payer: Aetna Medicare Advantage	$113.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.64
Rate for Payer: Cigna Commercial	$189.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$83.38
Rate for Payer: Qualcare PPO/HMO/WC	$56.85
Rate for Payer: UnitedHealthcare Community & State	$9.13
Rate for Payer: Wellpoint Medicaid Managed Care	$10.04

MALECOT NEPHROSTOMY ACCESSC

Facility

$379.00

Hospital Charge Code	270331740
Hospital Revenue Code	278
Min. Negotiated Rate	$56.85
Max. Negotiated Rate	$91.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$83.38
Rate for Payer: Qualcare PPO/HMO/WC	$56.85

MALECOT NEPHROSTOMY CATHETER

Facility

$379.00

Hospital Charge Code	270332123
Hospital Revenue Code	278
Min. Negotiated Rate	$9.13
Max. Negotiated Rate	$189.50
Rate for Payer: Aetna Commercial	$144.02
Rate for Payer: Aetna Medicare Advantage	$113.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.64
Rate for Payer: Cigna Commercial	$189.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$83.38
Rate for Payer: Qualcare PPO/HMO/WC	$56.85
Rate for Payer: UnitedHealthcare Community & State	$9.13
Rate for Payer: Wellpoint Medicaid Managed Care	$10.04

MALECOT NEPHROSTOMY CATHETER

Facility

$379.00

Hospital Charge Code	270332123
Hospital Revenue Code	278
Min. Negotiated Rate	$56.85
Max. Negotiated Rate	$91.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$83.38
Rate for Payer: Qualcare PPO/HMO/WC	$56.85

MALECOT URET CATH 4 WING 38FR

Facility

$87.00

Hospital Charge Code	270332236
Hospital Revenue Code	272
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$43.50
Rate for Payer: Aetna Commercial	$33.06
Rate for Payer: Aetna Medicare Advantage	$26.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.18
Rate for Payer: Cigna Commercial	$43.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.10
Rate for Payer: Oxford Commercial	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$13.05
Rate for Payer: UnitedHealthcare Commercial	$17.40
Rate for Payer: UnitedHealthcare Community & State	$2.10
Rate for Payer: Wellpoint Medicaid Managed Care	$2.31

MALECOT URET CATH 4 WING 38FR

Facility

$87.00

Hospital Charge Code	270332236
Hospital Revenue Code	272
Min. Negotiated Rate	$13.05
Max. Negotiated Rate	$13.05
Rate for Payer: Qualcare PPO/HMO/WC	$13.05

MALECOT URETHRAL CATHETER 20F

Facility

$87.00

Hospital Charge Code	270332264
Hospital Revenue Code	272
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$43.50
Rate for Payer: Aetna Commercial	$33.06
Rate for Payer: Aetna Medicare Advantage	$26.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.18
Rate for Payer: Cigna Commercial	$43.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.10
Rate for Payer: Oxford Commercial	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$13.05
Rate for Payer: UnitedHealthcare Commercial	$17.40
Rate for Payer: UnitedHealthcare Community & State	$2.10
Rate for Payer: Wellpoint Medicaid Managed Care	$2.31

MALECOT URETHRAL CATHETER 20F

Facility

$87.00

Hospital Charge Code	270332264
Hospital Revenue Code	272
Min. Negotiated Rate	$13.05
Max. Negotiated Rate	$13.05
Rate for Payer: Qualcare PPO/HMO/WC	$13.05

MALE DRIVER HEXALOBE

Facility

$1,300.00

Hospital Charge Code	270696818
Hospital Revenue Code	272
Min. Negotiated Rate	$31.33
Max. Negotiated Rate	$650.00
Rate for Payer: Aetna Commercial	$494.00
Rate for Payer: Aetna Medicare Advantage	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$331.50
Rate for Payer: Cigna Commercial	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.00
Rate for Payer: Oxford Commercial	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00
Rate for Payer: UnitedHealthcare Commercial	$260.00
Rate for Payer: UnitedHealthcare Community & State	$31.33
Rate for Payer: Wellpoint Medicaid Managed Care	$34.45

MALE DRIVER HEXALOBE

Facility

$1,300.00

Hospital Charge Code	270696818
Hospital Revenue Code	272
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$7,593.88

Service Code	APR-DRG 5012
Min. Negotiated Rate	$7,444.98
Max. Negotiated Rate	$7,593.88
Rate for Payer: UnitedHealthcare Community & State	$7,444.98
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,593.88
Rate for Payer: Wellpoint Medicaid Managed Care	$7,444.98

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$11,204.43

Service Code	APR-DRG 5013
Min. Negotiated Rate	$10,984.74
Max. Negotiated Rate	$11,204.43
Rate for Payer: UnitedHealthcare Community & State	$10,984.74
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,204.43
Rate for Payer: Wellpoint Medicaid Managed Care	$10,984.74

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$22,439.43

Service Code	APR-DRG 5014
Min. Negotiated Rate	$21,999.44
Max. Negotiated Rate	$22,439.43
Rate for Payer: UnitedHealthcare Community & State	$21,999.44
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$22,439.43
Rate for Payer: Wellpoint Medicaid Managed Care	$21,999.44

MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY

Facility

$5,696.68

Service Code	APR-DRG 5011
Min. Negotiated Rate	$5,584.98
Max. Negotiated Rate	$5,696.68
Rate for Payer: UnitedHealthcare Community & State	$5,584.98
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,696.68
Rate for Payer: Wellpoint Medicaid Managed Care	$5,584.98

MALERIA SCREEN

Facility

$390.00

Service Code	HCPCS 87207
Hospital Charge Code	39900508
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MALERIA SCREEN

Facility

$390.00

Service Code	HCPCS 87207
Hospital Charge Code	39900508
Hospital Revenue Code	309
Min. Negotiated Rate	$4.79
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$16.29
Rate for Payer: Aetna Medicare Advantage	$19.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.62
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.99
Rate for Payer: Clover Medicare Advantage	$5.69
Rate for Payer: EmblemHealth Commercial	$17.97
Rate for Payer: Humana Medicare Advantage	$6.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.99
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	$4.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.99
Rate for Payer: Wellcare Medicare Advantage	$5.99
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

MALE TO MALE CANNULA ADAPTOR

Facility

$112.00

Hospital Charge Code	270685045
Hospital Revenue Code	272
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$56.00
Rate for Payer: Aetna Commercial	$42.56
Rate for Payer: Aetna Medicare Advantage	$33.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.56
Rate for Payer: Cigna Commercial	$56.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.60
Rate for Payer: Oxford Commercial	$22.40
Rate for Payer: Qualcare PPO/HMO/WC	$16.80
Rate for Payer: UnitedHealthcare Commercial	$22.40
Rate for Payer: UnitedHealthcare Community & State	$2.70
Rate for Payer: Wellpoint Medicaid Managed Care	$2.97

MALE TO MALE CANNULA ADAPTOR

Facility

$112.00

Hospital Charge Code	270685045
Hospital Revenue Code	272
Min. Negotiated Rate	$16.80
Max. Negotiated Rate	$16.80
Rate for Payer: Qualcare PPO/HMO/WC	$16.80

MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE

Facility

$7,021.90

Service Code	APR-DRG 2521
Min. Negotiated Rate	$6,884.22
Max. Negotiated Rate	$7,021.90
Rate for Payer: UnitedHealthcare Community & State	$6,884.22
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,021.90
Rate for Payer: Wellpoint Medicaid Managed Care	$6,884.22

MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE

Facility

$8,607.60

Service Code	APR-DRG 2522
Min. Negotiated Rate	$8,438.82
Max. Negotiated Rate	$8,607.60
Rate for Payer: UnitedHealthcare Community & State	$8,438.82
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,607.60
Rate for Payer: Wellpoint Medicaid Managed Care	$8,438.82

Know your out-of-pocket cost for care.

All Charges