Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MESNEX INJ/1GM/10ML

Facility

$373.00

Hospital Charge Code	60634311
Hospital Revenue Code	636
Min. Negotiated Rate	$55.95
Max. Negotiated Rate	$90.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.27
Rate for Payer: Qualcare PPO/HMO/WC	$55.95

MESNEX INJ/1GM/10ML

Facility

$373.00

Hospital Charge Code	60634311
Hospital Revenue Code	636
Min. Negotiated Rate	$8.99
Max. Negotiated Rate	$186.50
Rate for Payer: Aetna Commercial	$141.74
Rate for Payer: Aetna Medicare Advantage	$111.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.11
Rate for Payer: Cigna Commercial	$186.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.27
Rate for Payer: Qualcare PPO/HMO/WC	$55.95
Rate for Payer: UnitedHealthcare Community & State	$8.99
Rate for Payer: Wellpoint Medicaid Managed Care	$9.88

MESNEX INJ/400MG/4ML

Facility

$181.00

Hospital Charge Code	60634312
Hospital Revenue Code	636
Min. Negotiated Rate	$27.15
Max. Negotiated Rate	$43.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.80
Rate for Payer: Qualcare PPO/HMO/WC	$27.15

MESNEX INJ/400MG/4ML

Facility

$181.00

Hospital Charge Code	60634312
Hospital Revenue Code	636
Min. Negotiated Rate	$4.36
Max. Negotiated Rate	$90.50
Rate for Payer: Aetna Commercial	$68.78
Rate for Payer: Aetna Medicare Advantage	$54.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.16
Rate for Payer: Cigna Commercial	$90.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.80
Rate for Payer: Qualcare PPO/HMO/WC	$27.15
Rate for Payer: UnitedHealthcare Community & State	$4.36
Rate for Payer: Wellpoint Medicaid Managed Care	$4.80

MESORIDAZIN BSYL LQ 25MG/ML4OZ

Facility

$320.00

Hospital Charge Code	6003529
Hospital Revenue Code	252
Min. Negotiated Rate	$48.00
Max. Negotiated Rate	$48.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.00

MESORIDAZIN BSYL LQ 25MG/ML4OZ

Facility

$320.00

Hospital Charge Code	6003529
Hospital Revenue Code	252
Min. Negotiated Rate	$7.71
Max. Negotiated Rate	$160.00
Rate for Payer: Aetna Commercial	$121.60
Rate for Payer: Aetna Medicare Advantage	$96.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.60
Rate for Payer: Cigna Commercial	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.00
Rate for Payer: Oxford Commercial	$64.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.00
Rate for Payer: UnitedHealthcare Commercial	$64.00
Rate for Payer: UnitedHealthcare Community & State	$7.71
Rate for Payer: Wellpoint Medicaid Managed Care	$8.48

MESORIDAZINE BESYL INJ 25MG/ML

Facility

$30.10

Hospital Charge Code	6003511
Hospital Revenue Code	250
Min. Negotiated Rate	$4.51
Max. Negotiated Rate	$4.51
Rate for Payer: Qualcare PPO/HMO/WC	$4.51

MESORIDAZINE BESYL INJ 25MG/ML

Facility

$30.10

Hospital Charge Code	6003511
Hospital Revenue Code	250
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$15.05
Rate for Payer: Aetna Commercial	$11.44
Rate for Payer: Aetna Medicare Advantage	$9.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.68
Rate for Payer: Cigna Commercial	$15.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.03
Rate for Payer: Oxford Commercial	$6.02
Rate for Payer: Qualcare PPO/HMO/WC	$4.51
Rate for Payer: UnitedHealthcare Commercial	$6.02
Rate for Payer: UnitedHealthcare Community & State	$0.73
Rate for Payer: Wellpoint Medicaid Managed Care	$0.80

MESORIDAZINE INJ 25MG/1MG

Facility

$28.80

Hospital Charge Code	60627811
Hospital Revenue Code	250
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$14.40
Rate for Payer: Aetna Commercial	$10.94
Rate for Payer: Aetna Medicare Advantage	$8.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.34
Rate for Payer: Cigna Commercial	$14.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.64
Rate for Payer: Oxford Commercial	$5.76
Rate for Payer: Qualcare PPO/HMO/WC	$4.32
Rate for Payer: UnitedHealthcare Commercial	$5.76
Rate for Payer: UnitedHealthcare Community & State	$0.69
Rate for Payer: Wellpoint Medicaid Managed Care	$0.76

MESORIDAZINE INJ 25MG/1MG

Facility

$28.80

Hospital Charge Code	60627811
Hospital Revenue Code	250
Min. Negotiated Rate	$4.32
Max. Negotiated Rate	$4.32
Rate for Payer: Qualcare PPO/HMO/WC	$4.32

MESTINON/180MG/TAB

Facility

$3.00

Hospital Charge Code	60634387
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

MESTINON/180MG/TAB

Facility

$3.00

Hospital Charge Code	60634387
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

MESTINON INJ/10MG/2ML

Facility

$26.00

Hospital Charge Code	60634262
Hospital Revenue Code	250
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$3.90
Rate for Payer: Qualcare PPO/HMO/WC	$3.90

MESTINON INJ/10MG/2ML

Facility

$26.00

Hospital Charge Code	60634262
Hospital Revenue Code	250
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$13.00
Rate for Payer: Aetna Commercial	$9.88
Rate for Payer: Aetna Medicare Advantage	$7.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.63
Rate for Payer: Cigna Commercial	$13.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$5.20
Rate for Payer: Qualcare PPO/HMO/WC	$3.90
Rate for Payer: UnitedHealthcare Commercial	$5.20
Rate for Payer: UnitedHealthcare Community & State	$0.63
Rate for Payer: Wellpoint Medicaid Managed Care	$0.69

MESTINON LIQUID/16OZ

Facility

$129.00

Hospital Charge Code	60634621
Hospital Revenue Code	250
Min. Negotiated Rate	$3.11
Max. Negotiated Rate	$64.50
Rate for Payer: Aetna Commercial	$49.02
Rate for Payer: Aetna Medicare Advantage	$38.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.90
Rate for Payer: Cigna Commercial	$64.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.70
Rate for Payer: Oxford Commercial	$25.80
Rate for Payer: Qualcare PPO/HMO/WC	$19.35
Rate for Payer: UnitedHealthcare Commercial	$25.80
Rate for Payer: UnitedHealthcare Community & State	$3.11
Rate for Payer: Wellpoint Medicaid Managed Care	$3.42

MESTINON LIQUID/16OZ

Facility

$129.00

Hospital Charge Code	60634621
Hospital Revenue Code	250
Min. Negotiated Rate	$19.35
Max. Negotiated Rate	$19.35
Rate for Payer: Qualcare PPO/HMO/WC	$19.35

Metal Biliary Stents

Facility

$10,600.00

Service Code	HCPCS C1876
Hospital Charge Code	270685511
Hospital Revenue Code	278
Min. Negotiated Rate	$255.46
Max. Negotiated Rate	$5,300.00
Rate for Payer: Aetna Commercial	$4,028.00
Rate for Payer: Aetna Medicare Advantage	$3,180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,703.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,703.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,703.00
Rate for Payer: Cigna Commercial	$5,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,565.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,332.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,590.00
Rate for Payer: UnitedHealthcare Community & State	$255.46
Rate for Payer: Wellpoint Medicaid Managed Care	$280.90

Metal Biliary Stents

Facility

$10,600.00

Service Code	HCPCS C1876
Hospital Charge Code	270685510
Hospital Revenue Code	278
Min. Negotiated Rate	$255.46
Max. Negotiated Rate	$5,300.00
Rate for Payer: Aetna Commercial	$4,028.00
Rate for Payer: Aetna Medicare Advantage	$3,180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,703.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,703.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,703.00
Rate for Payer: Cigna Commercial	$5,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,565.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,332.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,590.00
Rate for Payer: UnitedHealthcare Community & State	$255.46
Rate for Payer: Wellpoint Medicaid Managed Care	$280.90

Metal Biliary Stents

Facility

$10,600.00

Service Code	HCPCS C1876
Hospital Charge Code	270685510
Hospital Revenue Code	278
Min. Negotiated Rate	$1,590.00
Max. Negotiated Rate	$2,565.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,565.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,332.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,590.00

Metal Biliary Stents

Facility

$10,600.00

Service Code	HCPCS C1876
Hospital Charge Code	270685511
Hospital Revenue Code	278
Min. Negotiated Rate	$1,590.00
Max. Negotiated Rate	$2,565.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,565.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,332.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,590.00

METAL HUMERAL HEAD A-42

Facility

$5,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270686876
Hospital Revenue Code	278
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) NJ Health	$1,100.00
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	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$132.55
Rate for Payer: Wellpoint Medicaid Managed Care	$145.75

METAL HUMERAL HEAD A-42

Facility

$5,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270686876
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

METANEPHRINE,FRAC,FREE(P)

Facility

$667.59

Service Code	HCPCS 83835
Hospital Charge Code	39900341
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

METANEPHRINE,FRAC,FREE(P)

Facility

$667.59

Service Code	HCPCS 83835
Hospital Charge Code	39900341
Hospital Revenue Code	301
Min. Negotiated Rate	$13.55
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$46.08
Rate for Payer: Aetna Medicare Advantage	$54.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.15
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$16.94
Rate for Payer: Clover Medicare Advantage	$16.09
Rate for Payer: EmblemHealth Commercial	$50.82
Rate for Payer: Humana Medicare Advantage	$17.45
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.94
Rate for Payer: Wellcare Medicare Advantage	$16.94
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

METANEPHRINES

Facility

$647.00

Service Code	HCPCS 83835
Hospital Charge Code	38472494
Hospital Revenue Code	301
Min. Negotiated Rate	$13.55
Max. Negotiated Rate	$323.50
Rate for Payer: Aetna Commercial	$46.08
Rate for Payer: Aetna Medicare Advantage	$54.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.15
Rate for Payer: Cigna Commercial	$323.50
Rate for Payer: Cigna Medicare Advantage	$16.94
Rate for Payer: Clover Medicare Advantage	$16.09
Rate for Payer: EmblemHealth Commercial	$50.82
Rate for Payer: Humana Medicare Advantage	$17.45
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.94
Rate for Payer: Wellcare Medicare Advantage	$16.94
Rate for Payer: Wellpoint Medicaid Managed Care	$17.15

Know your out-of-pocket cost for care.

All Charges