Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MERCURY,BLOOD

Facility

$390.00

Service Code	HCPCS 83825
Hospital Charge Code	39900107
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,BLOOD

Facility

$390.00

Service Code	HCPCS 83825
Hospital Charge Code	39900107
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MERCURY (BLOOD) #697***

Facility

$151.00

Hospital Charge Code	3010659
Hospital Revenue Code	301
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$57.38
Rate for Payer: Aetna Medicare Advantage	$45.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.51
Rate for Payer: Cigna Commercial	$75.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.64
Rate for Payer: Wellpoint Medicaid Managed Care	$4.00

MERCURY (BLOOD) #697***

Facility

$151.00

Hospital Charge Code	3010659
Hospital Revenue Code	301
Min. Negotiated Rate	$22.65
Max. Negotiated Rate	$22.65
Rate for Payer: Qualcare PPO/HMO/WC	$22.65

MERCURY URINE

Facility

$559.00

Service Code	HCPCS 86706
Hospital Charge Code	38479490
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

MERCURY URINE

Facility

$559.00

Service Code	HCPCS 86706
Hospital Charge Code	38479490
Hospital Revenue Code	302
Min. Negotiated Rate	$83.85
Max. Negotiated Rate	$83.85
Rate for Payer: Qualcare PPO/HMO/WC	$83.85

MERCURY, URINE

Facility

$113.65

Service Code	HCPCS 83825
Hospital Charge Code	3001906A
Hospital Revenue Code	301
Min. Negotiated Rate	$17.05
Max. Negotiated Rate	$17.05
Rate for Payer: Qualcare PPO/HMO/WC	$17.05

MERCURY, URINE

Facility

$113.65

Service Code	HCPCS 83825
Hospital Charge Code	3001906A
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

MERIDIAN FILTER SYSTEM FEMORAL

Facility

$5,500.00

Hospital Charge Code	2709002792
Hospital Revenue Code	272
Min. Negotiated Rate	$132.55
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,650.00
Rate for Payer: Oxford Commercial	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Commercial	$1,100.00
Rate for Payer: UnitedHealthcare Community & State	$132.55
Rate for Payer: Wellpoint Medicaid Managed Care	$145.75

MERIDIAN FILTER SYSTEM FEMORAL

Facility

$5,500.00

Hospital Charge Code	2709002792
Hospital Revenue Code	272
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

MERIDIAN VENA CAVA JUG MD800J

Facility

$5,750.00

Hospital Charge Code	270651158
Hospital Revenue Code	272
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$862.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

MERIDIAN VENA CAVA JUG MD800J

Facility

$5,750.00

Hospital Charge Code	270651158
Hospital Revenue Code	272
Min. Negotiated Rate	$138.57
Max. Negotiated Rate	$2,875.00
Rate for Payer: Aetna Commercial	$2,185.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,725.00
Rate for Payer: Oxford Commercial	$1,150.00
Rate for Payer: Qualcare PPO/HMO/WC	$862.50
Rate for Payer: UnitedHealthcare Commercial	$1,150.00
Rate for Payer: UnitedHealthcare Community & State	$138.57
Rate for Payer: Wellpoint Medicaid Managed Care	$152.38

MEROPENEM 1G/50 ML NS DUPLEX

Facility

$298.82

Service Code	HCPCS J2185
Hospital Charge Code	6063943368
Hospital Revenue Code	636
Min. Negotiated Rate	$44.82
Max. Negotiated Rate	$72.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.31
Rate for Payer: Qualcare PPO/HMO/WC	$44.82

MEROPENEM 1G/50 ML NS DUPLEX

Facility

$298.82

Service Code	HCPCS J2185
Hospital Charge Code	6063943368
Hospital Revenue Code	636
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$149.41
Rate for Payer: Aetna Commercial	$113.55
Rate for Payer: Aetna Medicare Advantage	$89.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.20
Rate for Payer: Cigna Commercial	$149.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.31
Rate for Payer: Qualcare PPO/HMO/WC	$44.82
Rate for Payer: UnitedHealthcare Community & State	$7.20
Rate for Payer: Wellpoint Medicaid Managed Care	$7.92

MEROPENEM 1G/NS 100ML

Facility

$139.04

Service Code	HCPCS J2185
Hospital Charge Code	606390082
Hospital Revenue Code	636
Min. Negotiated Rate	$20.86
Max. Negotiated Rate	$33.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.65
Rate for Payer: Qualcare PPO/HMO/WC	$20.86

MEROPENEM 1G/NS 100ML

Facility

$139.04

Service Code	HCPCS J2185
Hospital Charge Code	606390082
Hospital Revenue Code	636
Min. Negotiated Rate	$3.35
Max. Negotiated Rate	$69.52
Rate for Payer: Aetna Commercial	$52.84
Rate for Payer: Aetna Medicare Advantage	$41.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.46
Rate for Payer: Cigna Commercial	$69.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.65
Rate for Payer: Qualcare PPO/HMO/WC	$20.86
Rate for Payer: UnitedHealthcare Community & State	$3.35
Rate for Payer: Wellpoint Medicaid Managed Care	$3.68

MEROPENEM 500MG/50ML 0.9%NACL

Facility

$130.92

Service Code	HCPCS J2185
Hospital Charge Code	606360464
Hospital Revenue Code	636
Min. Negotiated Rate	$19.64
Max. Negotiated Rate	$31.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.68
Rate for Payer: Qualcare PPO/HMO/WC	$19.64

MEROPENEM 500MG/50ML 0.9%NACL

Facility

$130.92

Service Code	HCPCS J2185
Hospital Charge Code	606360464
Hospital Revenue Code	636
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$65.46
Rate for Payer: Aetna Commercial	$49.75
Rate for Payer: Aetna Medicare Advantage	$39.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.38
Rate for Payer: Cigna Commercial	$65.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.68
Rate for Payer: Qualcare PPO/HMO/WC	$19.64
Rate for Payer: UnitedHealthcare Community & State	$3.16
Rate for Payer: Wellpoint Medicaid Managed Care	$3.47

MEROPENEM 500 MG PDS

Facility

$149.41

Service Code	HCPCS J2185
Hospital Charge Code	60630095
Hospital Revenue Code	636
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$74.70
Rate for Payer: Aetna Commercial	$56.78
Rate for Payer: Aetna Medicare Advantage	$44.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.10
Rate for Payer: Cigna Commercial	$74.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.16
Rate for Payer: Qualcare PPO/HMO/WC	$22.41
Rate for Payer: UnitedHealthcare Community & State	$3.60
Rate for Payer: Wellpoint Medicaid Managed Care	$3.96

MEROPENEM 500 MG PDS

Facility

$149.41

Service Code	HCPCS J2185
Hospital Charge Code	60630095
Hospital Revenue Code	636
Min. Negotiated Rate	$22.41
Max. Negotiated Rate	$36.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.16
Rate for Payer: Qualcare PPO/HMO/WC	$22.41

MERREM 1 GRAM INJ

Facility

$301.00

Hospital Charge Code	60635584
Hospital Revenue Code	636
Min. Negotiated Rate	$45.15
Max. Negotiated Rate	$72.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.84
Rate for Payer: Qualcare PPO/HMO/WC	$45.15

MERREM 1 GRAM INJ

Facility

$301.00

Hospital Charge Code	60635584
Hospital Revenue Code	636
Min. Negotiated Rate	$7.25
Max. Negotiated Rate	$150.50
Rate for Payer: Aetna Commercial	$114.38
Rate for Payer: Aetna Medicare Advantage	$90.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.75
Rate for Payer: Cigna Commercial	$150.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.84
Rate for Payer: Qualcare PPO/HMO/WC	$45.15
Rate for Payer: UnitedHealthcare Community & State	$7.25
Rate for Payer: Wellpoint Medicaid Managed Care	$7.98

MERREM 500MG INJ

Facility

$150.00

Hospital Charge Code	60635583
Hospital Revenue Code	636
Min. Negotiated Rate	$3.62
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Community & State	$3.62
Rate for Payer: Wellpoint Medicaid Managed Care	$3.98

MERREM 500MG INJ

Facility

$150.00

Hospital Charge Code	60635583
Hospital Revenue Code	636
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$36.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

MESALAMINE 1000 MG SUPP

Facility

$190.08

Service Code	NDC 58914050142
Hospital Charge Code	60629964
Hospital Revenue Code	250
Min. Negotiated Rate	$28.51
Max. Negotiated Rate	$28.51
Rate for Payer: Qualcare PPO/HMO/WC	$28.51

Know your out-of-pocket cost for care.

All Charges