Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MEAT FIBER, STOOL

Facility

$52.00

Service Code	HCPCS 89160
Hospital Charge Code	38475099
Hospital Revenue Code	300
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

MEATOTOMY EXCEPT IN NEWBORN

Facility

$18,162.80

Service Code	HCPCS 53020
Hospital Charge Code	1600000546
Hospital Revenue Code	360
Min. Negotiated Rate	$2,724.42
Max. Negotiated Rate	$2,724.42
Rate for Payer: Qualcare PPO/HMO/WC	$2,724.42

MEATOTOMY EXCEPT IN NEWBORN

Facility

$18,162.80

Service Code	HCPCS 53020
Hospital Charge Code	1600000546
Hospital Revenue Code	360
Min. Negotiated Rate	$437.72
Max. Negotiated Rate	$8,964.44
Rate for Payer: Aetna Commercial	$6,754.93
Rate for Payer: Aetna Medicare Advantage	$8,046.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,483.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,964.44
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: Cigna Medicare Advantage	$2,483.43
Rate for Payer: Clover Medicare Advantage	$2,359.26
Rate for Payer: EmblemHealth Commercial	$7,450.29
Rate for Payer: Humana Medicare Advantage	$2,557.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,483.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,448.84
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,724.42
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$437.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,483.43
Rate for Payer: Wellcare Medicare Advantage	$2,483.43
Rate for Payer: Wellpoint Medicaid Managed Care	$481.31

MEBENDAZOLE TAB 100MG

Facility

$31.40

Hospital Charge Code	6003412
Hospital Revenue Code	252
Min. Negotiated Rate	$4.71
Max. Negotiated Rate	$4.71
Rate for Payer: Qualcare PPO/HMO/WC	$4.71

MEBENDAZOLE TAB 100MG

Facility

$31.40

Hospital Charge Code	6003412
Hospital Revenue Code	252
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$15.70
Rate for Payer: Aetna Commercial	$11.93
Rate for Payer: Aetna Medicare Advantage	$9.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.01
Rate for Payer: Cigna Commercial	$15.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.42
Rate for Payer: Oxford Commercial	$6.28
Rate for Payer: Qualcare PPO/HMO/WC	$4.71
Rate for Payer: UnitedHealthcare Commercial	$6.28
Rate for Payer: UnitedHealthcare Community & State	$0.76
Rate for Payer: Wellpoint Medicaid Managed Care	$0.83

MECHANICAL CHEST WALL OSCILL

Facility

$676.95

Service Code	HCPCS 94669
Hospital Charge Code	317094669
Hospital Revenue Code	410
Min. Negotiated Rate	$101.54
Max. Negotiated Rate	$101.54
Rate for Payer: Qualcare PPO/HMO/WC	$101.54

MECHANICAL CHEST WALL OSCILL

Facility

$676.95

Service Code	HCPCS 94669
Hospital Charge Code	317094669
Hospital Revenue Code	410
Min. Negotiated Rate	$16.31
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$707.61
Rate for Payer: Aetna Medicare Advantage	$842.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$939.06
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: Cigna Medicare Advantage	$260.15
Rate for Payer: Clover Medicare Advantage	$247.14
Rate for Payer: EmblemHealth Commercial	$780.45
Rate for Payer: Humana Medicare Advantage	$267.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$260.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.09
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$101.54
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$16.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$260.15
Rate for Payer: Wellcare Medicare Advantage	$260.15
Rate for Payer: Wellpoint Medicaid Managed Care	$17.94

MECHANICAL VENTILATOR INITIAL

Facility

$1,411.65

Service Code	HCPCS 94002
Hospital Charge Code	9500422
Hospital Revenue Code	410
Min. Negotiated Rate	$211.75
Max. Negotiated Rate	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$211.75

MECHANICAL VENTILATOR INITIAL

Facility

$1,411.65

Service Code	HCPCS 94002
Hospital Charge Code	9500422
Hospital Revenue Code	410
Min. Negotiated Rate	$34.02
Max. Negotiated Rate	$2,649.34
Rate for Payer: Aetna Commercial	$1,996.34
Rate for Payer: Aetna Medicare Advantage	$2,378.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,649.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,649.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$733.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,649.34
Rate for Payer: Cigna Commercial	$1,471.21
Rate for Payer: Cigna Medicare Advantage	$733.95
Rate for Payer: Clover Medicare Advantage	$697.25
Rate for Payer: EmblemHealth Commercial	$2,201.85
Rate for Payer: Humana Medicare Advantage	$755.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$733.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$211.75
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$34.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$733.95
Rate for Payer: Wellcare Medicare Advantage	$733.95
Rate for Payer: Wellpoint Medicaid Managed Care	$37.41

MECHLORETHAMINE 10MG

Facility

$117.00

Hospital Charge Code	6000178
Hospital Revenue Code	250
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$17.55
Rate for Payer: Qualcare PPO/HMO/WC	$17.55

MECHLORETHAMINE 10MG

Facility

$117.00

Hospital Charge Code	6000178
Hospital Revenue Code	250
Min. Negotiated Rate	$2.82
Max. Negotiated Rate	$58.50
Rate for Payer: Aetna Commercial	$44.46
Rate for Payer: Aetna Medicare Advantage	$35.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.84
Rate for Payer: Cigna Commercial	$58.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.10
Rate for Payer: Oxford Commercial	$23.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.55
Rate for Payer: UnitedHealthcare Commercial	$23.40
Rate for Payer: UnitedHealthcare Community & State	$2.82
Rate for Payer: Wellpoint Medicaid Managed Care	$3.10

MECHLORETHAMINE INJ 10ML

Facility

$705.36

Hospital Charge Code	6003420
Hospital Revenue Code	636
Min. Negotiated Rate	$105.80
Max. Negotiated Rate	$170.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.70
Rate for Payer: Qualcare PPO/HMO/WC	$105.80

MECHLORETHAMINE INJ 10ML

Facility

$705.36

Hospital Charge Code	6003420
Hospital Revenue Code	636
Min. Negotiated Rate	$17.00
Max. Negotiated Rate	$352.68
Rate for Payer: Aetna Commercial	$268.04
Rate for Payer: Aetna Medicare Advantage	$211.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.87
Rate for Payer: Cigna Commercial	$352.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.70
Rate for Payer: Qualcare PPO/HMO/WC	$105.80
Rate for Payer: UnitedHealthcare Community & State	$17.00
Rate for Payer: Wellpoint Medicaid Managed Care	$18.69

MECH SML MODUL C/D 0-5 02185

Facility

$2,366.00

Hospital Charge Code	270634999
Hospital Revenue Code	272
Min. Negotiated Rate	$57.02
Max. Negotiated Rate	$1,183.00
Rate for Payer: Aetna Commercial	$899.08
Rate for Payer: Aetna Medicare Advantage	$709.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$603.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$603.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$603.33
Rate for Payer: Cigna Commercial	$1,183.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$709.80
Rate for Payer: Oxford Commercial	$473.20
Rate for Payer: Qualcare PPO/HMO/WC	$354.90
Rate for Payer: UnitedHealthcare Commercial	$473.20
Rate for Payer: UnitedHealthcare Community & State	$57.02
Rate for Payer: Wellpoint Medicaid Managed Care	$62.70

MECH SML MODUL C/D 0-5 02185

Facility

$2,366.00

Hospital Charge Code	270634999
Hospital Revenue Code	272
Min. Negotiated Rate	$354.90
Max. Negotiated Rate	$354.90
Rate for Payer: Qualcare PPO/HMO/WC	$354.90

MECH VENT EA ADDL DAY

Facility

$689.00

Service Code	HCPCS 94003
Hospital Charge Code	9501148
Hospital Revenue Code	410
Min. Negotiated Rate	$16.60
Max. Negotiated Rate	$2,649.34
Rate for Payer: Aetna Commercial	$1,996.34
Rate for Payer: Aetna Medicare Advantage	$2,378.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,649.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,649.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$733.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,649.34
Rate for Payer: Cigna Commercial	$1,471.21
Rate for Payer: Cigna Medicare Advantage	$733.95
Rate for Payer: Clover Medicare Advantage	$697.25
Rate for Payer: EmblemHealth Commercial	$2,201.85
Rate for Payer: Humana Medicare Advantage	$755.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$733.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.70
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$103.35
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$16.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$733.95
Rate for Payer: Wellcare Medicare Advantage	$733.95
Rate for Payer: Wellpoint Medicaid Managed Care	$18.26

MECH VENT EA ADDL DAY

Facility

$689.00

Service Code	HCPCS 94003
Hospital Charge Code	9501148
Hospital Revenue Code	410
Min. Negotiated Rate	$103.35
Max. Negotiated Rate	$103.35
Rate for Payer: Qualcare PPO/HMO/WC	$103.35

MECH VENT - SUBSEQ W/SUPPL****

Facility

$258.00

Service Code	HCPCS 94657
Hospital Charge Code	9501150
Hospital Revenue Code	469
Min. Negotiated Rate	$38.70
Max. Negotiated Rate	$38.70
Rate for Payer: Qualcare PPO/HMO/WC	$38.70

MECH VENT - SUBSEQ W/SUPPL****

Facility

$258.00

Service Code	HCPCS 94657
Hospital Charge Code	9501150
Hospital Revenue Code	469
Min. Negotiated Rate	$6.22
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$98.04
Rate for Payer: Aetna Medicare Advantage	$77.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.79
Rate for Payer: Cigna Commercial	$129.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.40
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.70
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$6.22
Rate for Payer: Wellpoint Medicaid Managed Care	$6.84

MECLIZINE 12.5MG

Facility

$4.76

Service Code	NDC 49210066
Hospital Charge Code	6022677
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.38
Rate for Payer: Aetna Commercial	$1.81
Rate for Payer: Aetna Medicare Advantage	$1.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.21
Rate for Payer: Cigna Commercial	$2.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.43
Rate for Payer: Oxford Commercial	$0.95
Rate for Payer: Qualcare PPO/HMO/WC	$0.71
Rate for Payer: UnitedHealthcare Commercial	$0.95
Rate for Payer: UnitedHealthcare Community & State	$0.11
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

MECLIZINE 12.5MG

Facility

$4.76

Service Code	NDC 49210066
Hospital Charge Code	6022677
Hospital Revenue Code	250
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$0.71
Rate for Payer: Qualcare PPO/HMO/WC	$0.71

MECLIZINE/25MG/TAB

Facility

$3.00

Hospital Charge Code	60633361
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

MECLIZINE/25MG/TAB

Facility

$4.00

Hospital Charge Code	60633360
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

MECLIZINE/25MG/TAB

Facility

$3.00

Hospital Charge Code	60633362
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

MECLIZINE/25MG/TAB

Facility

$3.00

Hospital Charge Code	60633362
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

Know your out-of-pocket cost for care.

All Charges