Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC

Facility

$20,573.56

Service Code	MSDRG 761
Min. Negotiated Rate	$6,264.39
Max. Negotiated Rate	$20,573.56
Rate for Payer: Aetna Commercial	$14,393.71
Rate for Payer: Aetna Medicare Advantage	$20,573.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,189.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,189.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,594.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,189.21
Rate for Payer: Cigna Commercial	$10,659.49
Rate for Payer: Cigna Medicare Advantage	$6,594.09
Rate for Payer: Clover Medicare Advantage	$6,264.39
Rate for Payer: EmblemHealth Commercial	$19,782.27
Rate for Payer: Humana Medicare Advantage	$6,791.91
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,594.09
Rate for Payer: Oxford Commercial	$7,661.12
Rate for Payer: UnitedHealthcare Commercial	$13,434.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,594.09
Rate for Payer: Wellcare Medicare Advantage	$6,594.09

MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE

Facility

$11,076.70

Service Code	APR-DRG 7401
Min. Negotiated Rate	$10,859.51
Max. Negotiated Rate	$11,076.70
Rate for Payer: UnitedHealthcare Community & State	$10,859.51
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,076.70
Rate for Payer: Wellpoint Medicaid Managed Care	$10,859.51

MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE

Facility

$61,905.04

Service Code	APR-DRG 7404
Min. Negotiated Rate	$60,691.22
Max. Negotiated Rate	$61,905.04
Rate for Payer: UnitedHealthcare Community & State	$60,691.22
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$61,905.04
Rate for Payer: Wellpoint Medicaid Managed Care	$60,691.22

MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE

Facility

$17,553.50

Service Code	APR-DRG 7402
Min. Negotiated Rate	$17,209.31
Max. Negotiated Rate	$17,553.50
Rate for Payer: UnitedHealthcare Community & State	$17,209.31
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,553.50
Rate for Payer: Wellpoint Medicaid Managed Care	$17,209.31

MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE

Facility

$30,309.08

Service Code	APR-DRG 7403
Min. Negotiated Rate	$29,714.78
Max. Negotiated Rate	$30,309.08
Rate for Payer: UnitedHealthcare Community & State	$29,714.78
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$30,309.08
Rate for Payer: Wellpoint Medicaid Managed Care	$29,714.78

MENTHOL CAM EUCALYP OINT 45GM

Facility

$21.15

Hospital Charge Code	6003461
Hospital Revenue Code	251
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$10.57
Rate for Payer: Aetna Commercial	$8.04
Rate for Payer: Aetna Medicare Advantage	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.39
Rate for Payer: Cigna Commercial	$10.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.34
Rate for Payer: Oxford Commercial	$4.23
Rate for Payer: Qualcare PPO/HMO/WC	$3.17
Rate for Payer: UnitedHealthcare Commercial	$4.23
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

MENTHOL CAM EUCALYP OINT 45GM

Facility

$21.15

Hospital Charge Code	6003461
Hospital Revenue Code	251
Min. Negotiated Rate	$3.17
Max. Negotiated Rate	$3.17
Rate for Payer: Qualcare PPO/HMO/WC	$3.17

MENTHOL CAM METHYLSA LOT 60ML

Facility

$327.05

Hospital Charge Code	6003479
Hospital Revenue Code	251
Min. Negotiated Rate	$7.88
Max. Negotiated Rate	$163.53
Rate for Payer: Aetna Commercial	$124.28
Rate for Payer: Aetna Medicare Advantage	$98.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.40
Rate for Payer: Cigna Commercial	$163.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.11
Rate for Payer: Oxford Commercial	$65.41
Rate for Payer: Qualcare PPO/HMO/WC	$49.06
Rate for Payer: UnitedHealthcare Commercial	$65.41
Rate for Payer: UnitedHealthcare Community & State	$7.88
Rate for Payer: Wellpoint Medicaid Managed Care	$8.67

MENTHOL CAM METHYLSA LOT 60ML

Facility

$327.05

Hospital Charge Code	6003479
Hospital Revenue Code	251
Min. Negotiated Rate	$49.06
Max. Negotiated Rate	$49.06
Rate for Payer: Qualcare PPO/HMO/WC	$49.06

MENTHOL CREAM

Facility

$28.48

Service Code	NDC 41167000885
Hospital Charge Code	606390512
Hospital Revenue Code	250
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$14.24
Rate for Payer: Aetna Commercial	$10.82
Rate for Payer: Aetna Medicare Advantage	$8.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.26
Rate for Payer: Cigna Commercial	$14.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.54
Rate for Payer: Oxford Commercial	$5.70
Rate for Payer: Qualcare PPO/HMO/WC	$4.27
Rate for Payer: UnitedHealthcare Commercial	$5.70
Rate for Payer: UnitedHealthcare Community & State	$0.69
Rate for Payer: Wellpoint Medicaid Managed Care	$0.75

MENTHOL CREAM

Facility

$28.48

Service Code	NDC 41167000885
Hospital Charge Code	606390512
Hospital Revenue Code	250
Min. Negotiated Rate	$4.27
Max. Negotiated Rate	$4.27
Rate for Payer: Qualcare PPO/HMO/WC	$4.27

MENTHOL GEL

Facility

$20.00

Hospital Charge Code	60628645
Hospital Revenue Code	250
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$10.00
Rate for Payer: Aetna Commercial	$7.60
Rate for Payer: Aetna Medicare Advantage	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.10
Rate for Payer: Cigna Commercial	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.00
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$4.00
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

MENTHOL GEL

Facility

$20.00

Hospital Charge Code	60628645
Hospital Revenue Code	250
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

MENTHOL METHYL OINT

Facility

$12.73

Service Code	NDC 54162055501
Hospital Charge Code	60628451
Hospital Revenue Code	250
Min. Negotiated Rate	$1.91
Max. Negotiated Rate	$1.91
Rate for Payer: Qualcare PPO/HMO/WC	$1.91

MENTHOL METHYL OINT

Facility

$12.73

Service Code	NDC 54162055501
Hospital Charge Code	60628451
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.37
Rate for Payer: Aetna Commercial	$4.84
Rate for Payer: Aetna Medicare Advantage	$3.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.25
Rate for Payer: Cigna Commercial	$6.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.82
Rate for Payer: Oxford Commercial	$2.55
Rate for Payer: Qualcare PPO/HMO/WC	$1.91
Rate for Payer: UnitedHealthcare Commercial	$2.55
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

MENTHOL METHYLSALIE CRM 35GM

Facility

$21.15

Hospital Charge Code	6003487
Hospital Revenue Code	251
Min. Negotiated Rate	$3.17
Max. Negotiated Rate	$3.17
Rate for Payer: Qualcare PPO/HMO/WC	$3.17

MENTHOL METHYLSALIE CRM 35GM

Facility

$21.15

Hospital Charge Code	6003487
Hospital Revenue Code	251
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$10.57
Rate for Payer: Aetna Commercial	$8.04
Rate for Payer: Aetna Medicare Advantage	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.39
Rate for Payer: Cigna Commercial	$10.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.34
Rate for Payer: Oxford Commercial	$4.23
Rate for Payer: Qualcare PPO/HMO/WC	$3.17
Rate for Payer: UnitedHealthcare Commercial	$4.23
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

MENTHOL OINT 2%

Facility

$25.60

Hospital Charge Code	60628466
Hospital Revenue Code	250
Min. Negotiated Rate	$3.84
Max. Negotiated Rate	$3.84
Rate for Payer: Qualcare PPO/HMO/WC	$3.84

MENTHOL OINT 2%

Facility

$25.60

Hospital Charge Code	60628466
Hospital Revenue Code	250
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$12.80
Rate for Payer: Aetna Commercial	$9.73
Rate for Payer: Aetna Medicare Advantage	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.53
Rate for Payer: Cigna Commercial	$12.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.68
Rate for Payer: Oxford Commercial	$5.12
Rate for Payer: Qualcare PPO/HMO/WC	$3.84
Rate for Payer: UnitedHealthcare Commercial	$5.12
Rate for Payer: UnitedHealthcare Community & State	$0.62
Rate for Payer: Wellpoint Medicaid Managed Care	$0.68

MEPERIDINE 100MG/ML

Facility

$5.65

Hospital Charge Code	6012058
Hospital Revenue Code	250
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

MEPERIDINE 100MG/ML

Facility

$5.65

Hospital Charge Code	6012058
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.83
Rate for Payer: Aetna Commercial	$2.15
Rate for Payer: Aetna Medicare Advantage	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.70
Rate for Payer: Oxford Commercial	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$1.13
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

MEPERIDINE 25MG/ML

Facility

$6.77

Service Code	HCPCS J2175
Hospital Charge Code	6012025
Hospital Revenue Code	636
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.02

MEPERIDINE 25MG/ML

Facility

$6.77

Service Code	HCPCS J2175
Hospital Charge Code	6012025
Hospital Revenue Code	636
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$3.38
Rate for Payer: Aetna Commercial	$2.57
Rate for Payer: Aetna Medicare Advantage	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.73
Rate for Payer: Cigna Commercial	$3.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.02
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

MEPERIDINE/300MG FOR PCA

Facility

$63.00

Hospital Charge Code	60634944
Hospital Revenue Code	250
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna Commercial	$23.94
Rate for Payer: Aetna Medicare Advantage	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.07
Rate for Payer: Cigna Commercial	$31.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.90
Rate for Payer: Oxford Commercial	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.45
Rate for Payer: UnitedHealthcare Commercial	$12.60
Rate for Payer: UnitedHealthcare Community & State	$1.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1.67

MEPERIDINE/300MG FOR PCA

Facility

$63.00

Hospital Charge Code	60634944
Hospital Revenue Code	250
Min. Negotiated Rate	$9.45
Max. Negotiated Rate	$9.45
Rate for Payer: Qualcare PPO/HMO/WC	$9.45

Know your out-of-pocket cost for care.

All Charges