Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

METANEPHRINES

Facility

$390.00

Service Code	HCPCS 83835
Hospital Charge Code	3036034B
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
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	$195.00
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	$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	$13.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.94
Rate for Payer: Wellcare Medicare Advantage	$16.94
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

METANEPHRINES

Facility

$647.00

Service Code	HCPCS 83835
Hospital Charge Code	38472494
Hospital Revenue Code	301
Min. Negotiated Rate	$97.05
Max. Negotiated Rate	$97.05
Rate for Payer: Qualcare PPO/HMO/WC	$97.05

METANEPHRINES

Facility

$390.00

Service Code	HCPCS 83835
Hospital Charge Code	3036034B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

METANEPHRINES,24HR URINE

Facility

$390.00

Service Code	HCPCS 83835
Hospital Charge Code	39900108
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
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	$195.00
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	$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	$13.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.94
Rate for Payer: Wellcare Medicare Advantage	$16.94
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

METANEPHRINES,24HR URINE

Facility

$390.00

Service Code	HCPCS 83835
Hospital Charge Code	39900108
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

METANEPHRINES (FRACTIONAL)

Facility

$281.65

Service Code	HCPCS 83835
Hospital Charge Code	3007622
Hospital Revenue Code	301
Min. Negotiated Rate	$42.25
Max. Negotiated Rate	$42.25
Rate for Payer: Qualcare PPO/HMO/WC	$42.25

METANEPHRINES (FRACTIONAL)

Facility

$281.65

Service Code	HCPCS 83835
Hospital Charge Code	3007622
Hospital Revenue Code	301
Min. Negotiated Rate	$7.46
Max. Negotiated Rate	$140.82
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	$140.82
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	$84.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.25
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	$7.46

METANEPHRINES,UR

Facility

$647.00

Service Code	HCPCS 83835
Hospital Charge Code	38479106
Hospital Revenue Code	301
Min. Negotiated Rate	$97.05
Max. Negotiated Rate	$97.05
Rate for Payer: Qualcare PPO/HMO/WC	$97.05

METANEPHRINES,UR

Facility

$647.00

Service Code	HCPCS 83835
Hospital Charge Code	38479106
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

METAPROTERANOL/10MG/TAB

Facility

$1.00

Hospital Charge Code	60634837
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.50
Rate for Payer: Aetna Commercial	$0.38
Rate for Payer: Aetna Medicare Advantage	$0.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.26
Rate for Payer: Cigna Commercial	$0.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.30
Rate for Payer: Oxford Commercial	$0.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.15
Rate for Payer: UnitedHealthcare Commercial	$0.20
Rate for Payer: UnitedHealthcare Community & State	$0.02
Rate for Payer: Wellpoint Medicaid Managed Care	$0.03

METAPROTERANOL/10MG/TAB

Facility

$1.00

Hospital Charge Code	60634837
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

METAPROTERENOL INJ 15MG/ML

Facility

$133.80

Hospital Charge Code	6003537
Hospital Revenue Code	250
Min. Negotiated Rate	$3.22
Max. Negotiated Rate	$66.90
Rate for Payer: Aetna Commercial	$50.84
Rate for Payer: Aetna Medicare Advantage	$40.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.12
Rate for Payer: Cigna Commercial	$66.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.14
Rate for Payer: Oxford Commercial	$26.76
Rate for Payer: Qualcare PPO/HMO/WC	$20.07
Rate for Payer: UnitedHealthcare Commercial	$26.76
Rate for Payer: UnitedHealthcare Community & State	$3.22
Rate for Payer: Wellpoint Medicaid Managed Care	$3.55

METAPROTERENOL INJ 15MG/ML

Facility

$133.80

Hospital Charge Code	6003537
Hospital Revenue Code	250
Min. Negotiated Rate	$20.07
Max. Negotiated Rate	$20.07
Rate for Payer: Qualcare PPO/HMO/WC	$20.07

METAPROTERENOL LIQ 10MG/5ML

Facility

$53.80

Hospital Charge Code	6003545
Hospital Revenue Code	250
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$26.90
Rate for Payer: Aetna Commercial	$20.44
Rate for Payer: Aetna Medicare Advantage	$16.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.72
Rate for Payer: Cigna Commercial	$26.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.14
Rate for Payer: Oxford Commercial	$10.76
Rate for Payer: Qualcare PPO/HMO/WC	$8.07
Rate for Payer: UnitedHealthcare Commercial	$10.76
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.43

METAPROTERENOL LIQ 10MG/5ML

Facility

$53.80

Hospital Charge Code	6003545
Hospital Revenue Code	250
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.07

METAPROTERENOL ORL INH 0.65MG

Facility

$170.25

Hospital Charge Code	60627458
Hospital Revenue Code	250
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$85.12
Rate for Payer: Aetna Commercial	$64.69
Rate for Payer: Aetna Medicare Advantage	$51.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.41
Rate for Payer: Cigna Commercial	$85.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.08
Rate for Payer: Oxford Commercial	$34.05
Rate for Payer: Qualcare PPO/HMO/WC	$25.54
Rate for Payer: UnitedHealthcare Commercial	$34.05
Rate for Payer: UnitedHealthcare Community & State	$4.10
Rate for Payer: Wellpoint Medicaid Managed Care	$4.51

METAPROTERENOL ORL INH 0.65MG

Facility

$170.25

Hospital Charge Code	60627458
Hospital Revenue Code	250
Min. Negotiated Rate	$25.54
Max. Negotiated Rate	$25.54
Rate for Payer: Qualcare PPO/HMO/WC	$25.54

METAPROTERENOL SOL 0.4% 2.5ML

Facility

$13.65

Hospital Charge Code	60627456
Hospital Revenue Code	250
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$6.83
Rate for Payer: Aetna Commercial	$5.19
Rate for Payer: Aetna Medicare Advantage	$4.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.48
Rate for Payer: Cigna Commercial	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.09
Rate for Payer: Oxford Commercial	$2.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.05
Rate for Payer: UnitedHealthcare Commercial	$2.73
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

METAPROTERENOL SOL 0.4% 2.5ML

Facility

$13.65

Hospital Charge Code	60627456
Hospital Revenue Code	250
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.05

METAPROTERENOL SOL 0.6% 2.5ML

Facility

$10.90

Hospital Charge Code	60627457
Hospital Revenue Code	250
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

METAPROTERENOL SOL 0.6% 2.5ML

Facility

$10.90

Hospital Charge Code	60627457
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$5.45
Rate for Payer: Aetna Commercial	$4.14
Rate for Payer: Aetna Medicare Advantage	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.78
Rate for Payer: Cigna Commercial	$5.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.27
Rate for Payer: Oxford Commercial	$2.18
Rate for Payer: Qualcare PPO/HMO/WC	$1.64
Rate for Payer: UnitedHealthcare Commercial	$2.18
Rate for Payer: UnitedHealthcare Community & State	$0.26
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

METAPROTERENOL SOL 5% 10ML

Facility

$124.20

Hospital Charge Code	60627460
Hospital Revenue Code	250
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$62.10
Rate for Payer: Aetna Commercial	$47.20
Rate for Payer: Aetna Medicare Advantage	$37.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.67
Rate for Payer: Cigna Commercial	$62.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.26
Rate for Payer: Oxford Commercial	$24.84
Rate for Payer: Qualcare PPO/HMO/WC	$18.63
Rate for Payer: UnitedHealthcare Commercial	$24.84
Rate for Payer: UnitedHealthcare Community & State	$2.99
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

METAPROTERENOL SOL 5% 10ML

Facility

$124.20

Hospital Charge Code	60627460
Hospital Revenue Code	250
Min. Negotiated Rate	$18.63
Max. Negotiated Rate	$18.63
Rate for Payer: Qualcare PPO/HMO/WC	$18.63

METAPROTERENOL SYRP 10MG/5ML

Facility

$3.20

Hospital Charge Code	60627459
Hospital Revenue Code	251
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.48
Rate for Payer: Qualcare PPO/HMO/WC	$0.48

METAPROTERENOL SYRP 10MG/5ML

Facility

$3.20

Hospital Charge Code	60627459
Hospital Revenue Code	251
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$1.60
Rate for Payer: Aetna Commercial	$1.22
Rate for Payer: Aetna Medicare Advantage	$0.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.82
Rate for Payer: Cigna Commercial	$1.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.96
Rate for Payer: Oxford Commercial	$0.64
Rate for Payer: Qualcare PPO/HMO/WC	$0.48
Rate for Payer: UnitedHealthcare Commercial	$0.64
Rate for Payer: UnitedHealthcare Community & State	$0.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

Know your out-of-pocket cost for care.

All Charges