Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MEDROXYPROGESTERONE ACETA

Facility

$3.00

Hospital Charge Code	60633366
Hospital Revenue Code	636
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	$0.73
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

MEDROXYPROGESTERONE ACETA

Facility

$3.00

Hospital Charge Code	60633367
Hospital Revenue Code	636
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.73
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

MEDROXYPROGESTERONE ACETA

Facility

$3.00

Hospital Charge Code	60633366
Hospital Revenue Code	636
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.73
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

MEDRYSONE OPHT SSP 1% 5ML

Facility

$101.80

Hospital Charge Code	6003438
Hospital Revenue Code	252
Min. Negotiated Rate	$15.27
Max. Negotiated Rate	$15.27
Rate for Payer: Qualcare PPO/HMO/WC	$15.27

MEDRYSONE OPHT SSP 1% 5ML

Facility

$101.80

Hospital Charge Code	6003438
Hospital Revenue Code	252
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$50.90
Rate for Payer: Aetna Commercial	$38.68
Rate for Payer: Aetna Medicare Advantage	$30.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.96
Rate for Payer: Cigna Commercial	$50.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.54
Rate for Payer: Oxford Commercial	$20.36
Rate for Payer: Qualcare PPO/HMO/WC	$15.27
Rate for Payer: UnitedHealthcare Commercial	$20.36
Rate for Payer: UnitedHealthcare Community & State	$2.45
Rate for Payer: Wellpoint Medicaid Managed Care	$2.70

MEDTRONIC ANTENA-NEUR STMLR

Facility

$160.00

Hospital Charge Code	270339436
Hospital Revenue Code	278
Min. Negotiated Rate	$3.86
Max. Negotiated Rate	$80.00
Rate for Payer: Aetna Commercial	$60.80
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$35.20
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Community & State	$3.86
Rate for Payer: Wellpoint Medicaid Managed Care	$4.24

MEDTRONIC ANTENA-NEUR STMLR

Facility

$160.00

Hospital Charge Code	270339436
Hospital Revenue Code	278
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$35.20
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

MEFLOQUINE TAB 250MG

Facility

$90.79

Service Code	NDC 54002511
Hospital Charge Code	60627340
Hospital Revenue Code	250
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$45.40
Rate for Payer: Aetna Commercial	$34.50
Rate for Payer: Aetna Medicare Advantage	$27.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.15
Rate for Payer: Cigna Commercial	$45.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.24
Rate for Payer: Oxford Commercial	$18.16
Rate for Payer: Qualcare PPO/HMO/WC	$13.62
Rate for Payer: UnitedHealthcare Commercial	$18.16
Rate for Payer: UnitedHealthcare Community & State	$2.19
Rate for Payer: Wellpoint Medicaid Managed Care	$2.41

MEFLOQUINE TAB 250MG

Facility

$90.79

Service Code	NDC 54002511
Hospital Charge Code	60627340
Hospital Revenue Code	250
Min. Negotiated Rate	$13.62
Max. Negotiated Rate	$13.62
Rate for Payer: Qualcare PPO/HMO/WC	$13.62

MEFOXIN 1GM

Facility

$75.24

Service Code	HCPCS J0694
Hospital Charge Code	6063943287
Hospital Revenue Code	636
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.62
Rate for Payer: Aetna Commercial	$28.59
Rate for Payer: Aetna Medicare Advantage	$22.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.19
Rate for Payer: Cigna Commercial	$37.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.21
Rate for Payer: Qualcare PPO/HMO/WC	$11.29
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

MEFOXIN 1GM

Facility

$75.24

Service Code	HCPCS J0694
Hospital Charge Code	6063943287
Hospital Revenue Code	636
Min. Negotiated Rate	$11.29
Max. Negotiated Rate	$18.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.21
Rate for Payer: Qualcare PPO/HMO/WC	$11.29

MEFOXITIN VL 1GM

Facility

$142.75

Hospital Charge Code	6006878
Hospital Revenue Code	250
Min. Negotiated Rate	$3.44
Max. Negotiated Rate	$71.38
Rate for Payer: Aetna Commercial	$54.24
Rate for Payer: Aetna Medicare Advantage	$42.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.40
Rate for Payer: Cigna Commercial	$71.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.83
Rate for Payer: Oxford Commercial	$28.55
Rate for Payer: Qualcare PPO/HMO/WC	$21.41
Rate for Payer: UnitedHealthcare Commercial	$28.55
Rate for Payer: UnitedHealthcare Community & State	$3.44
Rate for Payer: Wellpoint Medicaid Managed Care	$3.78

MEFOXITIN VL 1GM

Facility

$142.75

Hospital Charge Code	6006878
Hospital Revenue Code	250
Min. Negotiated Rate	$21.41
Max. Negotiated Rate	$21.41
Rate for Payer: Qualcare PPO/HMO/WC	$21.41

MEGACE/40MG/TAB

Facility

$5.00

Hospital Charge Code	60634228
Hospital Revenue Code	250
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	$1.50
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

MEGACE/40MG/TAB

Facility

$5.00

Hospital Charge Code	60634228
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

MEGACE SUSP/40MG/ML

Facility

$53.00

Hospital Charge Code	60634922
Hospital Revenue Code	250
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$26.50
Rate for Payer: Aetna Commercial	$20.14
Rate for Payer: Aetna Medicare Advantage	$15.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.52
Rate for Payer: Cigna Commercial	$26.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.90
Rate for Payer: Oxford Commercial	$10.60
Rate for Payer: Qualcare PPO/HMO/WC	$7.95
Rate for Payer: UnitedHealthcare Commercial	$10.60
Rate for Payer: UnitedHealthcare Community & State	$1.28
Rate for Payer: Wellpoint Medicaid Managed Care	$1.40

MEGACE SUSP/40MG/ML

Facility

$53.00

Hospital Charge Code	60634922
Hospital Revenue Code	250
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$7.95
Rate for Payer: Qualcare PPO/HMO/WC	$7.95

MEGALOBLASTIC ANEMIA PROFILE**

Facility

$483.00

Service Code	HCPCS 82131
Hospital Charge Code	3031523
Hospital Revenue Code	301
Min. Negotiated Rate	$72.45
Max. Negotiated Rate	$72.45
Rate for Payer: Qualcare PPO/HMO/WC	$72.45

MEGALOBLASTIC ANEMIA PROFILE**

Facility

$483.00

Service Code	HCPCS 82131
Hospital Charge Code	3031523
Hospital Revenue Code	301
Min. Negotiated Rate	$12.80
Max. Negotiated Rate	$241.50
Rate for Payer: Aetna Commercial	$62.51
Rate for Payer: Aetna Medicare Advantage	$74.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.95
Rate for Payer: Cigna Commercial	$241.50
Rate for Payer: Cigna Medicare Advantage	$22.98
Rate for Payer: Clover Medicare Advantage	$21.83
Rate for Payer: EmblemHealth Commercial	$68.94
Rate for Payer: Humana Medicare Advantage	$23.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$18.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.98
Rate for Payer: Wellcare Medicare Advantage	$22.98
Rate for Payer: Wellpoint Medicaid Managed Care	$12.80

MEGESTROL 20MG TAB

Facility

$4.42

Service Code	NDC 51079043420
Hospital Charge Code	606361026
Hospital Revenue Code	250
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$0.66
Rate for Payer: Qualcare PPO/HMO/WC	$0.66

MEGESTROL 20MG TAB

Facility

$4.42

Service Code	NDC 51079043420
Hospital Charge Code	606361026
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.21
Rate for Payer: Aetna Commercial	$1.68
Rate for Payer: Aetna Medicare Advantage	$1.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.13
Rate for Payer: Cigna Commercial	$2.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.33
Rate for Payer: Oxford Commercial	$0.88
Rate for Payer: Qualcare PPO/HMO/WC	$0.66
Rate for Payer: UnitedHealthcare Commercial	$0.88
Rate for Payer: UnitedHealthcare Community & State	$0.11
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

MEGESTROL 400 MG UD CUPS

Facility

$40.20

Service Code	NDC 60432012608
Hospital Charge Code	60630225
Hospital Revenue Code	250
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$6.03
Rate for Payer: Qualcare PPO/HMO/WC	$6.03

MEGESTROL 400 MG UD CUPS

Facility

$40.20

Service Code	NDC 60432012608
Hospital Charge Code	60630225
Hospital Revenue Code	250
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$20.10
Rate for Payer: Aetna Commercial	$15.28
Rate for Payer: Aetna Medicare Advantage	$12.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.25
Rate for Payer: Cigna Commercial	$20.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.06
Rate for Payer: Oxford Commercial	$8.04
Rate for Payer: Qualcare PPO/HMO/WC	$6.03
Rate for Payer: UnitedHealthcare Commercial	$8.04
Rate for Payer: UnitedHealthcare Community & State	$0.97
Rate for Payer: Wellpoint Medicaid Managed Care	$1.07

MEGESTROL ACETATE/40MG

Facility

$3.00

Hospital Charge Code	60633368
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

MEGESTROL ACETATE/40MG

Facility

$3.00

Hospital Charge Code	60633369
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

Know your out-of-pocket cost for care.

All Charges