Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MONOCLATE P 955UNITS

Facility

$2,800.00

Hospital Charge Code	60635592
Hospital Revenue Code	636
Min. Negotiated Rate	$67.48
Max. Negotiated Rate	$1,400.00
Rate for Payer: Aetna Commercial	$1,064.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.60
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Community & State	$67.48
Rate for Payer: Wellpoint Medicaid Managed Care	$74.20

MONOCRYL 3-0 SPIRAL SH

Facility

$123.17

Service Code	HCPCS A4649
Hospital Charge Code	270691628
Hospital Revenue Code	272
Min. Negotiated Rate	$2.97
Max. Negotiated Rate	$61.59
Rate for Payer: Aetna Commercial	$46.80
Rate for Payer: Aetna Medicare Advantage	$36.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.41
Rate for Payer: Cigna Commercial	$61.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.95
Rate for Payer: Oxford Commercial	$24.63
Rate for Payer: Qualcare PPO/HMO/WC	$18.48
Rate for Payer: UnitedHealthcare Commercial	$24.63
Rate for Payer: UnitedHealthcare Community & State	$2.97
Rate for Payer: Wellpoint Medicaid Managed Care	$3.26

MONOCRYL 3-0 SPIRAL SH

Facility

$123.17

Service Code	HCPCS A4649
Hospital Charge Code	270691628
Hospital Revenue Code	272
Min. Negotiated Rate	$18.48
Max. Negotiated Rate	$18.48
Rate for Payer: Qualcare PPO/HMO/WC	$18.48

MONOCTANOIN CATH INF 120ML

Facility

$841.00

Hospital Charge Code	6017487
Hospital Revenue Code	250
Min. Negotiated Rate	$126.15
Max. Negotiated Rate	$126.15
Rate for Payer: Qualcare PPO/HMO/WC	$126.15

MONOCTANOIN CATH INF 120ML

Facility

$841.00

Hospital Charge Code	6017487
Hospital Revenue Code	250
Min. Negotiated Rate	$20.27
Max. Negotiated Rate	$420.50
Rate for Payer: Aetna Commercial	$319.58
Rate for Payer: Aetna Medicare Advantage	$252.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$214.46
Rate for Payer: Cigna Commercial	$420.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.30
Rate for Payer: Oxford Commercial	$168.20
Rate for Payer: Qualcare PPO/HMO/WC	$126.15
Rate for Payer: UnitedHealthcare Commercial	$168.20
Rate for Payer: UnitedHealthcare Community & State	$20.27
Rate for Payer: Wellpoint Medicaid Managed Care	$22.29

MONOLITH 1 MCV 1091

Facility

$2,222.45

Hospital Charge Code	270604775
Hospital Revenue Code	272
Min. Negotiated Rate	$333.37
Max. Negotiated Rate	$333.37
Rate for Payer: Qualcare PPO/HMO/WC	$333.37

MONOLITH 1 MCV 1091

Facility

$2,222.45

Hospital Charge Code	270604775
Hospital Revenue Code	272
Min. Negotiated Rate	$53.56
Max. Negotiated Rate	$1,111.22
Rate for Payer: Aetna Commercial	$844.53
Rate for Payer: Aetna Medicare Advantage	$666.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$566.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$566.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$566.72
Rate for Payer: Cigna Commercial	$1,111.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$666.74
Rate for Payer: Oxford Commercial	$444.49
Rate for Payer: Qualcare PPO/HMO/WC	$333.37
Rate for Payer: UnitedHealthcare Commercial	$444.49
Rate for Payer: UnitedHealthcare Community & State	$53.56
Rate for Payer: Wellpoint Medicaid Managed Care	$58.89

MONOPRIL/10MG/TAB/U/D

Facility

$12.00

Hospital Charge Code	60634831
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

MONOPRIL/10MG/TAB/U/D

Facility

$12.00

Hospital Charge Code	60634831
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.60
Rate for Payer: Oxford Commercial	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$2.40
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

MONOPRIL/20MG/TAB/U/D

Facility

$12.00

Hospital Charge Code	60634832
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

MONOPRIL/20MG/TAB/U/D

Facility

$12.00

Hospital Charge Code	60634832
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.60
Rate for Payer: Oxford Commercial	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$2.40
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

MONO SCREEN,LA

Facility

$35.55

Service Code	HCPCS 86308
Hospital Charge Code	39900209
Hospital Revenue Code	302
Min. Negotiated Rate	$5.33
Max. Negotiated Rate	$5.33
Rate for Payer: Qualcare PPO/HMO/WC	$5.33

MONO SCREEN,LA

Facility

$35.55

Service Code	HCPCS 86308
Hospital Charge Code	39900209
Hospital Revenue Code	302
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.09
Rate for Payer: Aetna Medicare Advantage	$16.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
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	$18.70
Rate for Payer: Cigna Commercial	$17.77
Rate for Payer: Cigna Medicare Advantage	$5.18
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.66
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.33
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Medicare Advantage	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.94

MONO TEST (SCREEN)***

Facility

$42.00

Hospital Charge Code	3011913
Hospital Revenue Code	309
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$6.30
Rate for Payer: Qualcare PPO/HMO/WC	$6.30

MONO TEST (SCREEN)***

Facility

$42.00

Hospital Charge Code	3011913
Hospital Revenue Code	309
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$15.96
Rate for Payer: Aetna Medicare Advantage	$12.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.71
Rate for Payer: Cigna Commercial	$21.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.01
Rate for Payer: Wellpoint Medicaid Managed Care	$1.11

MONO TITER

Facility

$77.65

Service Code	HCPCS 86309
Hospital Charge Code	3003464
Hospital Revenue Code	302
Min. Negotiated Rate	$11.65
Max. Negotiated Rate	$11.65
Rate for Payer: Qualcare PPO/HMO/WC	$11.65

MONO TITER

Facility

$77.65

Service Code	HCPCS 86309
Hospital Charge Code	3003464
Hospital Revenue Code	302
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$17.60
Rate for Payer: Aetna Medicare Advantage	$20.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.35
Rate for Payer: Cigna Commercial	$38.83
Rate for Payer: Cigna Medicare Advantage	$6.47
Rate for Payer: Clover Medicare Advantage	$6.15
Rate for Payer: EmblemHealth Commercial	$19.41
Rate for Payer: Humana Medicare Advantage	$6.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.47
Rate for Payer: Wellcare Medicare Advantage	$6.47
Rate for Payer: Wellpoint Medicaid Managed Care	$2.06

MONOTITER (MONOSPOT)

Facility

$63.25

Service Code	HCPCS 86308
Hospital Charge Code	3001914
Hospital Revenue Code	302
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$9.49
Rate for Payer: Qualcare PPO/HMO/WC	$9.49

MONOTITER (MONOSPOT)

Facility

$63.25

Service Code	HCPCS 86308
Hospital Charge Code	3001914
Hospital Revenue Code	302
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.09
Rate for Payer: Aetna Medicare Advantage	$16.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
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	$18.70
Rate for Payer: Cigna Commercial	$31.62
Rate for Payer: Cigna Medicare Advantage	$5.18
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.49
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Medicare Advantage	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1.68

MONOTUBE RED 51500475

Facility

$11,990.00

Hospital Charge Code	270643410
Hospital Revenue Code	272
Min. Negotiated Rate	$1,798.50
Max. Negotiated Rate	$1,798.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,798.50

MONOTUBE RED 51500475

Facility

$11,990.00

Hospital Charge Code	270643410
Hospital Revenue Code	272
Min. Negotiated Rate	$288.96
Max. Negotiated Rate	$5,995.00
Rate for Payer: Aetna Commercial	$4,556.20
Rate for Payer: Aetna Medicare Advantage	$3,597.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,057.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,057.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,057.45
Rate for Payer: Cigna Commercial	$5,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,597.00
Rate for Payer: Oxford Commercial	$2,398.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,798.50
Rate for Payer: UnitedHealthcare Commercial	$2,398.00
Rate for Payer: UnitedHealthcare Community & State	$288.96
Rate for Payer: Wellpoint Medicaid Managed Care	$317.74

MONOTUBETRIAX STERILE WRIS.KIT

Facility

$11,075.00

Hospital Charge Code	270656538
Hospital Revenue Code	272
Min. Negotiated Rate	$1,661.25
Max. Negotiated Rate	$1,661.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,661.25

MONOTUBETRIAX STERILE WRIS.KIT

Facility

$11,075.00

Hospital Charge Code	270656538
Hospital Revenue Code	272
Min. Negotiated Rate	$266.91
Max. Negotiated Rate	$5,537.50
Rate for Payer: Aetna Commercial	$4,208.50
Rate for Payer: Aetna Medicare Advantage	$3,322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,824.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,824.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,824.12
Rate for Payer: Cigna Commercial	$5,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,322.50
Rate for Payer: Oxford Commercial	$2,215.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,661.25
Rate for Payer: UnitedHealthcare Commercial	$2,215.00
Rate for Payer: UnitedHealthcare Community & State	$266.91
Rate for Payer: Wellpoint Medicaid Managed Care	$293.49

MONOTUBE TRIAX-STERILEWRISTKIT

Facility

$11,075.00

Hospital Charge Code	270663134
Hospital Revenue Code	270
Min. Negotiated Rate	$266.91
Max. Negotiated Rate	$5,537.50
Rate for Payer: Aetna Commercial	$4,208.50
Rate for Payer: Aetna Medicare Advantage	$3,322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,824.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,824.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,824.12
Rate for Payer: Cigna Commercial	$5,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,322.50
Rate for Payer: Oxford Commercial	$2,215.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,661.25
Rate for Payer: UnitedHealthcare Commercial	$2,215.00
Rate for Payer: UnitedHealthcare Community & State	$266.91
Rate for Payer: Wellpoint Medicaid Managed Care	$293.49

MONOTUBE TRIAX-STERILEWRISTKIT

Facility

$11,075.00

Hospital Charge Code	270663134
Hospital Revenue Code	270
Min. Negotiated Rate	$1,661.25
Max. Negotiated Rate	$1,661.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,661.25

Know your out-of-pocket cost for care.

All Charges