Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

METHADONE (QUANT URINE)

Facility

$153.65

Service Code	HCPCS 80358
Hospital Charge Code	3007630
Hospital Revenue Code	301
Min. Negotiated Rate	$23.05
Max. Negotiated Rate	$23.05
Rate for Payer: Qualcare PPO/HMO/WC	$23.05

METHADONE (QUANT URINE)

Facility

$153.65

Service Code	HCPCS 80358
Hospital Charge Code	3007630
Hospital Revenue Code	301
Min. Negotiated Rate	$4.07
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$58.39
Rate for Payer: Aetna Medicare Advantage	$46.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.18
Rate for Payer: Cigna Commercial	$76.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.09
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.48
Rate for Payer: Wellpoint Medicaid Managed Care	$4.07

METHADONE,UR COMFIR

Facility

$115.64

Service Code	HCPCS 80358
Hospital Charge Code	38479120
Hospital Revenue Code	301
Min. Negotiated Rate	$17.35
Max. Negotiated Rate	$17.35
Rate for Payer: Qualcare PPO/HMO/WC	$17.35

METHADONE,UR COMFIR

Facility

$115.64

Service Code	HCPCS 80358
Hospital Charge Code	38479120
Hospital Revenue Code	301
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$43.94
Rate for Payer: Aetna Medicare Advantage	$34.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.49
Rate for Payer: Cigna Commercial	$57.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.69
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.48
Rate for Payer: Wellpoint Medicaid Managed Care	$3.06

METHADONE,URINE

Facility

$115.64

Service Code	HCPCS 80358
Hospital Charge Code	38472500
Hospital Revenue Code	301
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$43.94
Rate for Payer: Aetna Medicare Advantage	$34.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.49
Rate for Payer: Cigna Commercial	$57.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.69
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.48
Rate for Payer: Wellpoint Medicaid Managed Care	$3.06

METHADONE,URINE

Facility

$115.64

Service Code	HCPCS 80358
Hospital Charge Code	38472500
Hospital Revenue Code	301
Min. Negotiated Rate	$17.35
Max. Negotiated Rate	$17.35
Rate for Payer: Qualcare PPO/HMO/WC	$17.35

METHAMPHETAMINE

Facility

$190.45

Service Code	HCPCS 80300
Hospital Charge Code	3000345
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

METHAMPHETAMINE

Facility

$190.45

Service Code	HCPCS 80300
Hospital Charge Code	3000345
Hospital Revenue Code	301
Min. Negotiated Rate	$4.59
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$72.37
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.59
Rate for Payer: Wellpoint Medicaid Managed Care	$5.05

METHAQUALONE,QUALITATIVE URINE

Facility

$190.45

Service Code	HCPCS 80300
Hospital Charge Code	3000344
Hospital Revenue Code	301
Min. Negotiated Rate	$4.59
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$72.37
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.59
Rate for Payer: Wellpoint Medicaid Managed Care	$5.05

METHAQUALONE,QUALITATIVE URINE

Facility

$190.45

Service Code	HCPCS 80300
Hospital Charge Code	3000344
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

METHAQUALONE, SERUM QUAALUDE

Facility

$277.00

Service Code	HCPCS 80300
Hospital Charge Code	38472503
Hospital Revenue Code	301
Min. Negotiated Rate	$41.55
Max. Negotiated Rate	$41.55
Rate for Payer: Qualcare PPO/HMO/WC	$41.55

METHAQUALONE, SERUM QUAALUDE

Facility

$277.00

Service Code	HCPCS 80300
Hospital Charge Code	38472503
Hospital Revenue Code	301
Min. Negotiated Rate	$6.68
Max. Negotiated Rate	$138.50
Rate for Payer: Aetna Commercial	$105.26
Rate for Payer: Aetna Medicare Advantage	$83.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.64
Rate for Payer: Cigna Commercial	$138.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.55
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.68
Rate for Payer: Wellpoint Medicaid Managed Care	$7.34

METHATREXATE SODIUM 50 MG

Facility

$66.00

Hospital Charge Code	60633390
Hospital Revenue Code	250
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

METHATREXATE SODIUM 50 MG

Facility

$66.00

Hospital Charge Code	60633390
Hospital Revenue Code	250
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$33.00
Rate for Payer: Aetna Commercial	$25.08
Rate for Payer: Aetna Medicare Advantage	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.83
Rate for Payer: Cigna Commercial	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.80
Rate for Payer: Oxford Commercial	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.90
Rate for Payer: UnitedHealthcare Commercial	$13.20
Rate for Payer: UnitedHealthcare Community & State	$1.59
Rate for Payer: Wellpoint Medicaid Managed Care	$1.75

METHAZOLAMIDE 50 MG TAB

Facility

$51.32

Service Code	NDC 781107101
Hospital Charge Code	60628048
Hospital Revenue Code	250
Min. Negotiated Rate	$1.24
Max. Negotiated Rate	$25.66
Rate for Payer: Aetna Commercial	$19.50
Rate for Payer: Aetna Medicare Advantage	$15.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.09
Rate for Payer: Cigna Commercial	$25.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.40
Rate for Payer: Oxford Commercial	$10.26
Rate for Payer: Qualcare PPO/HMO/WC	$7.70
Rate for Payer: UnitedHealthcare Commercial	$10.26
Rate for Payer: UnitedHealthcare Community & State	$1.24
Rate for Payer: Wellpoint Medicaid Managed Care	$1.36

METHAZOLAMIDE 50 MG TAB

Facility

$51.32

Service Code	NDC 781107101
Hospital Charge Code	60628048
Hospital Revenue Code	250
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$7.70
Rate for Payer: Qualcare PPO/HMO/WC	$7.70

METHEMALBUMIN

Facility

$76.00

Service Code	HCPCS 83857
Hospital Charge Code	38477076
Hospital Revenue Code	301
Min. Negotiated Rate	$2.01
Max. Negotiated Rate	$124.00
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	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.77
Rate for Payer: Cigna Commercial	$38.00
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	$22.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.40
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	$2.01

METHEMALBUMIN

Facility

$76.00

Service Code	HCPCS 83857
Hospital Charge Code	38477076
Hospital Revenue Code	301
Min. Negotiated Rate	$11.40
Max. Negotiated Rate	$11.40
Rate for Payer: Qualcare PPO/HMO/WC	$11.40

METHEMOGLOBIN

Facility

$118.00

Service Code	HCPCS 83050
Hospital Charge Code	38472669
Hospital Revenue Code	301
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$22.30
Rate for Payer: Aetna Medicare Advantage	$26.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.60
Rate for Payer: Cigna Commercial	$59.00
Rate for Payer: Cigna Medicare Advantage	$8.20
Rate for Payer: Clover Medicare Advantage	$7.79
Rate for Payer: EmblemHealth Commercial	$24.60
Rate for Payer: Humana Medicare Advantage	$8.45
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.20
Rate for Payer: Wellcare Medicare Advantage	$8.20
Rate for Payer: Wellpoint Medicaid Managed Care	$3.13

METHEMOGLOBIN

Facility

$118.00

Service Code	HCPCS 83050
Hospital Charge Code	38472669
Hospital Revenue Code	301
Min. Negotiated Rate	$17.70
Max. Negotiated Rate	$17.70
Rate for Payer: Qualcare PPO/HMO/WC	$17.70

METHEMOGLOBIN (BLOOD)

Facility

$80.00

Service Code	HCPCS 83050
Hospital Charge Code	3008216
Hospital Revenue Code	301
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00

METHEMOGLOBIN (BLOOD)

Facility

$80.00

Service Code	HCPCS 83050
Hospital Charge Code	3008216
Hospital Revenue Code	301
Min. Negotiated Rate	$2.12
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$22.30
Rate for Payer: Aetna Medicare Advantage	$26.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.60
Rate for Payer: Cigna Commercial	$40.00
Rate for Payer: Cigna Medicare Advantage	$8.20
Rate for Payer: Clover Medicare Advantage	$7.79
Rate for Payer: EmblemHealth Commercial	$24.60
Rate for Payer: Humana Medicare Advantage	$8.45
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.20
Rate for Payer: Wellcare Medicare Advantage	$8.20
Rate for Payer: Wellpoint Medicaid Managed Care	$2.12

METHENAMINE HIPPURATE 1GM TAB

Facility

$23.72

Service Code	NDC 30698027701
Hospital Charge Code	60632347
Hospital Revenue Code	250
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$11.86
Rate for Payer: Aetna Commercial	$9.01
Rate for Payer: Aetna Medicare Advantage	$7.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.05
Rate for Payer: Cigna Commercial	$11.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.12
Rate for Payer: Oxford Commercial	$4.74
Rate for Payer: Qualcare PPO/HMO/WC	$3.56
Rate for Payer: UnitedHealthcare Commercial	$4.74
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.63

METHENAMINE HIPPURATE 1GM TAB

Facility

$23.72

Service Code	NDC 30698027701
Hospital Charge Code	60632347
Hospital Revenue Code	250
Min. Negotiated Rate	$3.56
Max. Negotiated Rate	$3.56
Rate for Payer: Qualcare PPO/HMO/WC	$3.56

METHENAMINE TAB 1GM

Facility

$10.00

Hospital Charge Code	60627351
Hospital Revenue Code	250
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.50

Know your out-of-pocket cost for care.

All Charges