Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

METHYLMALONIC ACID

Facility

$641.00

Service Code	HCPCS 82542
Hospital Charge Code	38472012
Hospital Revenue Code	301
Min. Negotiated Rate	$96.15
Max. Negotiated Rate	$96.15
Rate for Payer: Qualcare PPO/HMO/WC	$96.15

METHYLMALONIC ACID

Facility

$509.00

Service Code	HCPCS 83921
Hospital Charge Code	38473073
Hospital Revenue Code	301
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$254.50
Rate for Payer: Aetna Commercial	$57.69
Rate for Payer: Aetna Medicare Advantage	$68.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.56
Rate for Payer: Cigna Commercial	$254.50
Rate for Payer: Cigna Medicare Advantage	$21.21
Rate for Payer: Clover Medicare Advantage	$20.15
Rate for Payer: EmblemHealth Commercial	$63.63
Rate for Payer: Humana Medicare Advantage	$21.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$76.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.21
Rate for Payer: Wellcare Medicare Advantage	$21.21
Rate for Payer: Wellpoint Medicaid Managed Care	$13.49

METHYLMALONIC ACID

Facility

$641.00

Service Code	HCPCS 82542
Hospital Charge Code	38472012
Hospital Revenue Code	301
Min. Negotiated Rate	$16.99
Max. Negotiated Rate	$320.50
Rate for Payer: Aetna Commercial	$65.52
Rate for Payer: Aetna Medicare Advantage	$78.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.96
Rate for Payer: Cigna Commercial	$320.50
Rate for Payer: Cigna Medicare Advantage	$24.09
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: Humana Medicare Advantage	$24.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$19.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.09
Rate for Payer: Wellcare Medicare Advantage	$24.09
Rate for Payer: Wellpoint Medicaid Managed Care	$16.99

METHYLMALONIC ACID,SERUM

Facility

$667.59

Service Code	HCPCS 83921
Hospital Charge Code	39990016EX
Hospital Revenue Code	301
Min. Negotiated Rate	$16.97
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$57.69
Rate for Payer: Aetna Medicare Advantage	$68.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.56
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$21.21
Rate for Payer: Clover Medicare Advantage	$20.15
Rate for Payer: EmblemHealth Commercial	$63.63
Rate for Payer: Humana Medicare Advantage	$21.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.21
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	$16.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.21
Rate for Payer: Wellcare Medicare Advantage	$21.21
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

METHYLMALONIC ACID,SERUM

Facility

$667.59

Service Code	HCPCS 83921
Hospital Charge Code	39990016EX
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

METHYLMALONIC ACID,SERUM I

Facility

$113.10

Service Code	HCPCS 83918
Hospital Charge Code	39990016A
Hospital Revenue Code	301
Min. Negotiated Rate	$16.96
Max. Negotiated Rate	$16.96
Rate for Payer: Qualcare PPO/HMO/WC	$16.96

METHYLMALONIC ACID,SERUM I

Facility

$113.10

Service Code	HCPCS 83918
Hospital Charge Code	39990016A
Hospital Revenue Code	301
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$64.19
Rate for Payer: Aetna Medicare Advantage	$76.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.19
Rate for Payer: Cigna Commercial	$56.55
Rate for Payer: Cigna Medicare Advantage	$23.60
Rate for Payer: Clover Medicare Advantage	$22.42
Rate for Payer: EmblemHealth Commercial	$70.80
Rate for Payer: Humana Medicare Advantage	$24.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.93
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.96
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$18.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$23.60
Rate for Payer: Wellcare Medicare Advantage	$23.60
Rate for Payer: Wellpoint Medicaid Managed Care	$3.00

METHYLMALONIC ACID,SERUM II

Facility

$113.10

Service Code	HCPCS 83921
Hospital Charge Code	39990016B
Hospital Revenue Code	301
Min. Negotiated Rate	$16.96
Max. Negotiated Rate	$16.96
Rate for Payer: Qualcare PPO/HMO/WC	$16.96

METHYLMALONIC ACID,SERUM II

Facility

$113.10

Service Code	HCPCS 83921
Hospital Charge Code	39990016B
Hospital Revenue Code	301
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$57.69
Rate for Payer: Aetna Medicare Advantage	$68.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.56
Rate for Payer: Cigna Commercial	$56.55
Rate for Payer: Cigna Medicare Advantage	$21.21
Rate for Payer: Clover Medicare Advantage	$20.15
Rate for Payer: EmblemHealth Commercial	$63.63
Rate for Payer: Humana Medicare Advantage	$21.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.93
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.96
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.21
Rate for Payer: Wellcare Medicare Advantage	$21.21
Rate for Payer: Wellpoint Medicaid Managed Care	$3.00

METHYLMALONIC ACID SERUM QUANT

Facility

$2,227.25

Service Code	HCPCS 83921
Hospital Charge Code	3009206
Hospital Revenue Code	301
Min. Negotiated Rate	$16.97
Max. Negotiated Rate	$1,113.62
Rate for Payer: Aetna Commercial	$57.69
Rate for Payer: Aetna Medicare Advantage	$68.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.56
Rate for Payer: Cigna Commercial	$1,113.62
Rate for Payer: Cigna Medicare Advantage	$21.21
Rate for Payer: Clover Medicare Advantage	$20.15
Rate for Payer: EmblemHealth Commercial	$63.63
Rate for Payer: Humana Medicare Advantage	$21.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$668.17
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$334.09
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.21
Rate for Payer: Wellcare Medicare Advantage	$21.21
Rate for Payer: Wellpoint Medicaid Managed Care	$59.02

METHYLMALONIC ACID SERUM QUANT

Facility

$2,227.25

Service Code	HCPCS 83921
Hospital Charge Code	3009206
Hospital Revenue Code	301
Min. Negotiated Rate	$334.09
Max. Negotiated Rate	$334.09
Rate for Payer: Qualcare PPO/HMO/WC	$334.09

METHYLMALONIC ACID, URINE

Facility

$2,227.25

Service Code	HCPCS 83921
Hospital Charge Code	3030327
Hospital Revenue Code	301
Min. Negotiated Rate	$334.09
Max. Negotiated Rate	$334.09
Rate for Payer: Qualcare PPO/HMO/WC	$334.09

METHYLMALONIC ACID, URINE

Facility

$2,227.25

Service Code	HCPCS 83921
Hospital Charge Code	3030327
Hospital Revenue Code	301
Min. Negotiated Rate	$16.97
Max. Negotiated Rate	$1,113.62
Rate for Payer: Aetna Commercial	$57.69
Rate for Payer: Aetna Medicare Advantage	$68.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.56
Rate for Payer: Cigna Commercial	$1,113.62
Rate for Payer: Cigna Medicare Advantage	$21.21
Rate for Payer: Clover Medicare Advantage	$20.15
Rate for Payer: EmblemHealth Commercial	$63.63
Rate for Payer: Humana Medicare Advantage	$21.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$668.17
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$334.09
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.21
Rate for Payer: Wellcare Medicare Advantage	$21.21
Rate for Payer: Wellpoint Medicaid Managed Care	$59.02

METHYLMALONIC H,CYSTEINE

Facility

$641.00

Service Code	HCPCS 83921
Hospital Charge Code	38479108
Hospital Revenue Code	301
Min. Negotiated Rate	$96.15
Max. Negotiated Rate	$96.15
Rate for Payer: Qualcare PPO/HMO/WC	$96.15

METHYLMALONIC H,CYSTEINE

Facility

$641.00

Service Code	HCPCS 83921
Hospital Charge Code	38479108
Hospital Revenue Code	301
Min. Negotiated Rate	$16.97
Max. Negotiated Rate	$320.50
Rate for Payer: Aetna Commercial	$57.69
Rate for Payer: Aetna Medicare Advantage	$68.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.56
Rate for Payer: Cigna Commercial	$320.50
Rate for Payer: Cigna Medicare Advantage	$21.21
Rate for Payer: Clover Medicare Advantage	$20.15
Rate for Payer: EmblemHealth Commercial	$63.63
Rate for Payer: Humana Medicare Advantage	$21.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.21
Rate for Payer: Wellcare Medicare Advantage	$21.21
Rate for Payer: Wellpoint Medicaid Managed Care	$16.99

METHYLNALTREXONE 8MG/0.4ML SYR

Facility

$579.35

Service Code	HCPCS J2212
Hospital Charge Code	606390466
Hospital Revenue Code	636
Min. Negotiated Rate	$13.96
Max. Negotiated Rate	$289.68
Rate for Payer: Aetna Commercial	$220.15
Rate for Payer: Aetna Medicare Advantage	$173.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.73
Rate for Payer: Cigna Commercial	$289.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.20
Rate for Payer: Qualcare PPO/HMO/WC	$86.90
Rate for Payer: UnitedHealthcare Community & State	$13.96
Rate for Payer: Wellpoint Medicaid Managed Care	$15.35

METHYLNALTREXONE 8MG/0.4ML SYR

Facility

$579.35

Service Code	HCPCS J2212
Hospital Charge Code	606390466
Hospital Revenue Code	636
Min. Negotiated Rate	$86.90
Max. Negotiated Rate	$140.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.20
Rate for Payer: Qualcare PPO/HMO/WC	$86.90

METHYLPHENIDATE 10MG

Facility

$6.97

Service Code	NDC 406114401
Hospital Charge Code	6022073
Hospital Revenue Code	251
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.48
Rate for Payer: Aetna Commercial	$2.65
Rate for Payer: Aetna Medicare Advantage	$2.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.09
Rate for Payer: Oxford Commercial	$1.39
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$1.39
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

METHYLPHENIDATE 10MG

Facility

$6.97

Service Code	NDC 406114401
Hospital Charge Code	6022073
Hospital Revenue Code	251
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

METHYLPHENIDATE 5MG

Facility

$1.95

Hospital Charge Code	6022065
Hospital Revenue Code	251
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.98
Rate for Payer: Aetna Commercial	$0.74
Rate for Payer: Aetna Medicare Advantage	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.50
Rate for Payer: Cigna Commercial	$0.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.59
Rate for Payer: Oxford Commercial	$0.39
Rate for Payer: Qualcare PPO/HMO/WC	$0.29
Rate for Payer: UnitedHealthcare Commercial	$0.39
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

METHYLPHENIDATE 5MG

Facility

$1.95

Hospital Charge Code	6022065
Hospital Revenue Code	251
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

METHYLPHENIDATE ER 10MG TAB

Facility

$55.34

Service Code	NDC 53014057907
Hospital Charge Code	6063943133
Hospital Revenue Code	250
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$8.30
Rate for Payer: Qualcare PPO/HMO/WC	$8.30

METHYLPHENIDATE ER 10MG TAB

Facility

$55.34

Service Code	NDC 53014057907
Hospital Charge Code	6063943133
Hospital Revenue Code	250
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$27.67
Rate for Payer: Aetna Commercial	$21.03
Rate for Payer: Aetna Medicare Advantage	$16.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.11
Rate for Payer: Cigna Commercial	$27.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.60
Rate for Payer: Oxford Commercial	$11.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.30
Rate for Payer: UnitedHealthcare Commercial	$11.07
Rate for Payer: UnitedHealthcare Community & State	$1.33
Rate for Payer: Wellpoint Medicaid Managed Care	$1.47

METHYLPHENIDATE TAB 5MG

Facility

$4.29

Service Code	NDC 68084080511
Hospital Charge Code	60627836
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.15
Rate for Payer: Aetna Commercial	$1.63
Rate for Payer: Aetna Medicare Advantage	$1.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.09
Rate for Payer: Cigna Commercial	$2.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.29
Rate for Payer: Oxford Commercial	$0.86
Rate for Payer: Qualcare PPO/HMO/WC	$0.64
Rate for Payer: UnitedHealthcare Commercial	$0.86
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

METHYLPHENIDATE TAB 5MG

Facility

$4.29

Service Code	NDC 68084080511
Hospital Charge Code	60627836
Hospital Revenue Code	250
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$0.64
Rate for Payer: Qualcare PPO/HMO/WC	$0.64

Know your out-of-pocket cost for care.

All Charges