Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MANDELAMINE/1GM/TAB

Facility

$3.00

Hospital Charge Code	60633352
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

MANDELAMINE/1GM/TAB

Facility

$3.00

Hospital Charge Code	60633352
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

MANDIBLE COMP 4 VIEW

Facility

$5,100.00

Service Code	HCPCS 70110
Hospital Charge Code	94061001
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

MANDIBLE COMP 4 VIEW

Facility

$5,100.00

Service Code	HCPCS 70110
Hospital Charge Code	94061001
Hospital Revenue Code	320
Min. Negotiated Rate	$38.72
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,627.00
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

MANGANESE

Facility

$168.75

Service Code	HCPCS 83785
Hospital Charge Code	3030900
Hospital Revenue Code	301
Min. Negotiated Rate	$4.47
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$72.49
Rate for Payer: Aetna Medicare Advantage	$86.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.20
Rate for Payer: Cigna Commercial	$84.38
Rate for Payer: Cigna Medicare Advantage	$26.65
Rate for Payer: Clover Medicare Advantage	$25.32
Rate for Payer: EmblemHealth Commercial	$79.95
Rate for Payer: Humana Medicare Advantage	$27.45
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.31
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$21.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.65
Rate for Payer: Wellcare Medicare Advantage	$26.65
Rate for Payer: Wellpoint Medicaid Managed Care	$4.47

MANGANESE

Facility

$168.75

Service Code	HCPCS 83785
Hospital Charge Code	3030900
Hospital Revenue Code	301
Min. Negotiated Rate	$25.31
Max. Negotiated Rate	$25.31
Rate for Payer: Qualcare PPO/HMO/WC	$25.31

MANGANESE

Facility

$174.15

Service Code	HCPCS 83785
Hospital Charge Code	38477175
Hospital Revenue Code	301
Min. Negotiated Rate	$4.61
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$72.49
Rate for Payer: Aetna Medicare Advantage	$86.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.20
Rate for Payer: Cigna Commercial	$87.08
Rate for Payer: Cigna Medicare Advantage	$26.65
Rate for Payer: Clover Medicare Advantage	$25.32
Rate for Payer: EmblemHealth Commercial	$79.95
Rate for Payer: Humana Medicare Advantage	$27.45
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.24
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.12
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$21.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.65
Rate for Payer: Wellcare Medicare Advantage	$26.65
Rate for Payer: Wellpoint Medicaid Managed Care	$4.61

MANGANESE

Facility

$174.15

Service Code	HCPCS 83785
Hospital Charge Code	38477175
Hospital Revenue Code	301
Min. Negotiated Rate	$26.12
Max. Negotiated Rate	$26.12
Rate for Payer: Qualcare PPO/HMO/WC	$26.12

MANGANESE,24 HOUR URINE

Facility

$168.75

Service Code	HCPCS 83785
Hospital Charge Code	3030902
Hospital Revenue Code	301
Min. Negotiated Rate	$25.31
Max. Negotiated Rate	$25.31
Rate for Payer: Qualcare PPO/HMO/WC	$25.31

MANGANESE,24 HOUR URINE

Facility

$168.75

Service Code	HCPCS 83785
Hospital Charge Code	3030902
Hospital Revenue Code	301
Min. Negotiated Rate	$4.47
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$72.49
Rate for Payer: Aetna Medicare Advantage	$86.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.20
Rate for Payer: Cigna Commercial	$84.38
Rate for Payer: Cigna Medicare Advantage	$26.65
Rate for Payer: Clover Medicare Advantage	$25.32
Rate for Payer: EmblemHealth Commercial	$79.95
Rate for Payer: Humana Medicare Advantage	$27.45
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.31
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$21.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.65
Rate for Payer: Wellcare Medicare Advantage	$26.65
Rate for Payer: Wellpoint Medicaid Managed Care	$4.47

MANGANESE INJ 0.1MG/ML 10ML

Facility

$3.85

Hospital Charge Code	6025001
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Qualcare PPO/HMO/WC	$0.58

MANGANESE INJ 0.1MG/ML 10ML

Facility

$3.85

Hospital Charge Code	6025001
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$1.93
Rate for Payer: Aetna Commercial	$1.46
Rate for Payer: Aetna Medicare Advantage	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.98
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.16
Rate for Payer: Oxford Commercial	$0.77
Rate for Payer: Qualcare PPO/HMO/WC	$0.58
Rate for Payer: UnitedHealthcare Commercial	$0.77
Rate for Payer: UnitedHealthcare Community & State	$0.09
Rate for Payer: Wellpoint Medicaid Managed Care	$0.10

MANGANESE INJ 0.1MG/ML 10ML

Facility

$3.85

Hospital Charge Code	6025035
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Qualcare PPO/HMO/WC	$0.58

MANGANESE INJ 0.1MG/ML 10ML

Facility

$3.85

Hospital Charge Code	6025035
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$1.93
Rate for Payer: Aetna Commercial	$1.46
Rate for Payer: Aetna Medicare Advantage	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.98
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.16
Rate for Payer: Oxford Commercial	$0.77
Rate for Payer: Qualcare PPO/HMO/WC	$0.58
Rate for Payer: UnitedHealthcare Commercial	$0.77
Rate for Payer: UnitedHealthcare Community & State	$0.09
Rate for Payer: Wellpoint Medicaid Managed Care	$0.10

MANGANESE URINE

Facility

$168.75

Service Code	HCPCS 83785
Hospital Charge Code	3001874A
Hospital Revenue Code	301
Min. Negotiated Rate	$4.47
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$72.49
Rate for Payer: Aetna Medicare Advantage	$86.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.20
Rate for Payer: Cigna Commercial	$84.38
Rate for Payer: Cigna Medicare Advantage	$26.65
Rate for Payer: Clover Medicare Advantage	$25.32
Rate for Payer: EmblemHealth Commercial	$79.95
Rate for Payer: Humana Medicare Advantage	$27.45
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.31
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$21.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.65
Rate for Payer: Wellcare Medicare Advantage	$26.65
Rate for Payer: Wellpoint Medicaid Managed Care	$4.47

MANGANESE URINE

Facility

$168.75

Service Code	HCPCS 83785
Hospital Charge Code	3001874A
Hospital Revenue Code	301
Min. Negotiated Rate	$25.31
Max. Negotiated Rate	$25.31
Rate for Payer: Qualcare PPO/HMO/WC	$25.31

MANIFOLD 3 PORT

Facility

$20.25

Hospital Charge Code	270663920
Hospital Revenue Code	272
Min. Negotiated Rate	$0.49
Max. Negotiated Rate	$10.12
Rate for Payer: Aetna Commercial	$7.70
Rate for Payer: Aetna Medicare Advantage	$6.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.16
Rate for Payer: Cigna Commercial	$10.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.08
Rate for Payer: Oxford Commercial	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$3.04
Rate for Payer: UnitedHealthcare Commercial	$4.05
Rate for Payer: UnitedHealthcare Community & State	$0.49
Rate for Payer: Wellpoint Medicaid Managed Care	$0.54

MANIFOLD 3 PORT

Facility

$20.25

Hospital Charge Code	270663920
Hospital Revenue Code	272
Min. Negotiated Rate	$3.04
Max. Negotiated Rate	$3.04
Rate for Payer: Qualcare PPO/HMO/WC	$3.04

MANIFOLD UNIV.SET-UP 39TUBING

Facility

$28.00

Hospital Charge Code	270331479
Hospital Revenue Code	272
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

MANIFOLD UNIV.SET-UP 39TUBING

Facility

$28.00

Hospital Charge Code	270331479
Hospital Revenue Code	272
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$10.64
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.40
Rate for Payer: Oxford Commercial	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$5.60
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

MANIFOLD W/COLLECTION SOCK

Facility

$34.30

Hospital Charge Code	270676801
Hospital Revenue Code	272
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$17.15
Rate for Payer: Aetna Commercial	$13.03
Rate for Payer: Aetna Medicare Advantage	$10.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.75
Rate for Payer: Cigna Commercial	$17.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.29
Rate for Payer: Oxford Commercial	$6.86
Rate for Payer: Qualcare PPO/HMO/WC	$5.14
Rate for Payer: UnitedHealthcare Commercial	$6.86
Rate for Payer: UnitedHealthcare Community & State	$0.83
Rate for Payer: Wellpoint Medicaid Managed Care	$0.91

MANIFOLD W/COLLECTION SOCK

Facility

$34.30

Hospital Charge Code	270676801
Hospital Revenue Code	272
Min. Negotiated Rate	$5.14
Max. Negotiated Rate	$5.14
Rate for Payer: Qualcare PPO/HMO/WC	$5.14

MANIP ELBOW W ANESTH

Facility

$13,711.90

Service Code	HCPCS 24300
Hospital Charge Code	16000682
Hospital Revenue Code	360
Min. Negotiated Rate	$330.46
Max. Negotiated Rate	$6,895.75
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,895.75
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,113.57
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,056.78
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$330.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$363.37

MANIP ELBOW W ANESTH

Facility

$13,711.90

Service Code	HCPCS 24300
Hospital Charge Code	16000682
Hospital Revenue Code	360
Min. Negotiated Rate	$2,056.78
Max. Negotiated Rate	$2,056.78
Rate for Payer: Qualcare PPO/HMO/WC	$2,056.78

MANIP SHLDR JOINT,UNDER ANESTH

Facility

$13,711.90

Service Code	HCPCS 23700
Hospital Charge Code	16000545
Hospital Revenue Code	360
Min. Negotiated Rate	$2,056.78
Max. Negotiated Rate	$2,056.78
Rate for Payer: Qualcare PPO/HMO/WC	$2,056.78

Know your out-of-pocket cost for care.

All Charges