Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MEPIVACAINE INJ 3% 1.8ML

Facility

$129.30

Hospital Charge Code	6003503
Hospital Revenue Code	250
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$64.65
Rate for Payer: Aetna Commercial	$49.13
Rate for Payer: Aetna Medicare Advantage	$38.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.97
Rate for Payer: Cigna Commercial	$64.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.79
Rate for Payer: Oxford Commercial	$25.86
Rate for Payer: Qualcare PPO/HMO/WC	$19.39
Rate for Payer: UnitedHealthcare Commercial	$25.86
Rate for Payer: UnitedHealthcare Community & State	$3.12
Rate for Payer: Wellpoint Medicaid Managed Care	$3.43

MEPROBAMATE

Facility

$124.84

Service Code	HCPCS 80339
Hospital Charge Code	38477146
Hospital Revenue Code	301
Min. Negotiated Rate	$18.73
Max. Negotiated Rate	$18.73
Rate for Payer: Qualcare PPO/HMO/WC	$18.73

MEPROBAMATE

Facility

$124.84

Service Code	HCPCS 80339
Hospital Charge Code	38477146
Hospital Revenue Code	301
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$47.44
Rate for Payer: Aetna Medicare Advantage	$37.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.83
Rate for Payer: Cigna Commercial	$62.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.45
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.73
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.66
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

MEPROBAMATE/400MG/TAB

Facility

$3.00

Hospital Charge Code	60633377
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

MEPROBAMATE/400MG/TAB

Facility

$3.00

Hospital Charge Code	60633377
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

MEPRON/250MG/TAB

Facility

$8.00

Hospital Charge Code	60634884
Hospital Revenue Code	250
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$3.04
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.40
Rate for Payer: Oxford Commercial	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$1.60
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

MEPRON/250MG/TAB

Facility

$8.00

Hospital Charge Code	60634884
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

MEPRON SUSP 750MG/10ML

Facility

$252.00

Hospital Charge Code	60635049
Hospital Revenue Code	250
Min. Negotiated Rate	$37.80
Max. Negotiated Rate	$37.80
Rate for Payer: Qualcare PPO/HMO/WC	$37.80

MEPRON SUSP 750MG/10ML

Facility

$252.00

Hospital Charge Code	60635049
Hospital Revenue Code	250
Min. Negotiated Rate	$6.07
Max. Negotiated Rate	$126.00
Rate for Payer: Aetna Commercial	$95.76
Rate for Payer: Aetna Medicare Advantage	$75.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.26
Rate for Payer: Cigna Commercial	$126.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.60
Rate for Payer: Oxford Commercial	$50.40
Rate for Payer: Qualcare PPO/HMO/WC	$37.80
Rate for Payer: UnitedHealthcare Commercial	$50.40
Rate for Payer: UnitedHealthcare Community & State	$6.07
Rate for Payer: Wellpoint Medicaid Managed Care	$6.68

MERCAPTOPURINE 50 MG TAB

Facility

$54.81

Service Code	NDC 54458111
Hospital Charge Code	6009807
Hospital Revenue Code	250
Min. Negotiated Rate	$8.22
Max. Negotiated Rate	$8.22
Rate for Payer: Qualcare PPO/HMO/WC	$8.22

MERCAPTOPURINE 50 MG TAB

Facility

$54.81

Service Code	NDC 54458111
Hospital Charge Code	6009807
Hospital Revenue Code	250
Min. Negotiated Rate	$1.32
Max. Negotiated Rate	$27.41
Rate for Payer: Aetna Commercial	$20.83
Rate for Payer: Aetna Medicare Advantage	$16.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.98
Rate for Payer: Cigna Commercial	$27.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.44
Rate for Payer: Oxford Commercial	$10.96
Rate for Payer: Qualcare PPO/HMO/WC	$8.22
Rate for Payer: UnitedHealthcare Commercial	$10.96
Rate for Payer: UnitedHealthcare Community & State	$1.32
Rate for Payer: Wellpoint Medicaid Managed Care	$1.45

MERCURY

Facility

$110.70

Hospital Charge Code	39990166D
Hospital Revenue Code	301
Min. Negotiated Rate	$2.67
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$42.07
Rate for Payer: Aetna Medicare Advantage	$33.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.23
Rate for Payer: Cigna Commercial	$55.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.21
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.61
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.67
Rate for Payer: Wellpoint Medicaid Managed Care	$2.93

MERCURY

Facility

$110.70

Hospital Charge Code	39990166D
Hospital Revenue Code	301
Min. Negotiated Rate	$16.61
Max. Negotiated Rate	$16.61
Rate for Payer: Qualcare PPO/HMO/WC	$16.61

MERCURY

Facility

$327.00

Service Code	HCPCS 83825
Hospital Charge Code	38472488
Hospital Revenue Code	301
Min. Negotiated Rate	$49.05
Max. Negotiated Rate	$49.05
Rate for Payer: Qualcare PPO/HMO/WC	$49.05

MERCURY

Facility

$327.00

Service Code	HCPCS 83825
Hospital Charge Code	38472488
Hospital Revenue Code	301
Min. Negotiated Rate	$8.67
Max. Negotiated Rate	$163.50
Rate for Payer: Aetna Commercial	$44.23
Rate for Payer: Aetna Medicare Advantage	$52.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.69
Rate for Payer: Cigna Commercial	$163.50
Rate for Payer: Cigna Medicare Advantage	$16.26
Rate for Payer: Clover Medicare Advantage	$15.45
Rate for Payer: EmblemHealth Commercial	$48.78
Rate for Payer: Humana Medicare Advantage	$16.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.26
Rate for Payer: Wellcare Medicare Advantage	$16.26
Rate for Payer: Wellpoint Medicaid Managed Care	$8.67

MERCURY

Facility

$390.00

Service Code	HCPCS 83825
Hospital Charge Code	401083018E
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MERCURY

Facility

$390.00

Service Code	HCPCS 83825
Hospital Charge Code	401083018E
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$44.23
Rate for Payer: Aetna Medicare Advantage	$52.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.69
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$16.26
Rate for Payer: Clover Medicare Advantage	$15.45
Rate for Payer: EmblemHealth Commercial	$48.78
Rate for Payer: Humana Medicare Advantage	$16.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.26
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	$13.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.26
Rate for Payer: Wellcare Medicare Advantage	$16.26
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

MERCURY***

Facility

$48.00

Hospital Charge Code	3011905
Hospital Revenue Code	309
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

MERCURY***

Facility

$48.00

Hospital Charge Code	3011905
Hospital Revenue Code	309
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$18.24
Rate for Payer: Aetna Medicare Advantage	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.24
Rate for Payer: Cigna Commercial	$24.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.20
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.27

MERCURY 24HR URINE

Facility

$327.00

Service Code	HCPCS 83825
Hospital Charge Code	38479119
Hospital Revenue Code	301
Min. Negotiated Rate	$49.05
Max. Negotiated Rate	$49.05
Rate for Payer: Qualcare PPO/HMO/WC	$49.05

MERCURY 24HR URINE

Facility

$327.00

Service Code	HCPCS 83825
Hospital Charge Code	38479119
Hospital Revenue Code	301
Min. Negotiated Rate	$8.67
Max. Negotiated Rate	$163.50
Rate for Payer: Aetna Commercial	$44.23
Rate for Payer: Aetna Medicare Advantage	$52.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.69
Rate for Payer: Cigna Commercial	$163.50
Rate for Payer: Cigna Medicare Advantage	$16.26
Rate for Payer: Clover Medicare Advantage	$15.45
Rate for Payer: EmblemHealth Commercial	$48.78
Rate for Payer: Humana Medicare Advantage	$16.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.26
Rate for Payer: Wellcare Medicare Advantage	$16.26
Rate for Payer: Wellpoint Medicaid Managed Care	$8.67

MERCURY, ANY SOURCE

Facility

$113.65

Service Code	HCPCS 83825
Hospital Charge Code	3000650
Hospital Revenue Code	301
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$44.23
Rate for Payer: Aetna Medicare Advantage	$52.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.69
Rate for Payer: Cigna Commercial	$56.83
Rate for Payer: Cigna Medicare Advantage	$16.26
Rate for Payer: Clover Medicare Advantage	$15.45
Rate for Payer: EmblemHealth Commercial	$48.78
Rate for Payer: Humana Medicare Advantage	$16.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.09
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.26
Rate for Payer: Wellcare Medicare Advantage	$16.26
Rate for Payer: Wellpoint Medicaid Managed Care	$3.01

MERCURY, ANY SOURCE

Facility

$113.65

Service Code	HCPCS 83825
Hospital Charge Code	3000650
Hospital Revenue Code	301
Min. Negotiated Rate	$17.05
Max. Negotiated Rate	$17.05
Rate for Payer: Qualcare PPO/HMO/WC	$17.05

MERCURY BLOOD

Facility

$559.00

Service Code	HCPCS 86706
Hospital Charge Code	38479491
Hospital Revenue Code	302
Min. Negotiated Rate	$83.85
Max. Negotiated Rate	$83.85
Rate for Payer: Qualcare PPO/HMO/WC	$83.85

MERCURY BLOOD

Facility

$559.00

Service Code	HCPCS 86706
Hospital Charge Code	38479491
Hospital Revenue Code	302
Min. Negotiated Rate	$8.59
Max. Negotiated Rate	$279.50
Rate for Payer: Aetna Commercial	$29.21
Rate for Payer: Aetna Medicare Advantage	$34.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.77
Rate for Payer: Cigna Commercial	$279.50
Rate for Payer: Cigna Medicare Advantage	$10.74
Rate for Payer: Clover Medicare Advantage	$10.20
Rate for Payer: EmblemHealth Commercial	$32.22
Rate for Payer: Humana Medicare Advantage	$11.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$83.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$8.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.74
Rate for Payer: Wellcare Medicare Advantage	$10.74
Rate for Payer: Wellpoint Medicaid Managed Care	$14.81

Know your out-of-pocket cost for care.

All Charges