Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MONOTUBE TRIAX WRIST KIT

Facility

$8,771.40

Hospital Charge Code	270660594
Hospital Revenue Code	272
Min. Negotiated Rate	$1,315.71
Max. Negotiated Rate	$1,315.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,315.71

MONOTUBE TRIAX WRIST KIT

Facility

$8,771.40

Hospital Charge Code	270660594
Hospital Revenue Code	272
Min. Negotiated Rate	$211.39
Max. Negotiated Rate	$4,385.70
Rate for Payer: Aetna Commercial	$3,333.13
Rate for Payer: Aetna Medicare Advantage	$2,631.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,236.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,236.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,236.71
Rate for Payer: Cigna Commercial	$4,385.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,631.42
Rate for Payer: Oxford Commercial	$1,754.28
Rate for Payer: Qualcare PPO/HMO/WC	$1,315.71
Rate for Payer: UnitedHealthcare Commercial	$1,754.28
Rate for Payer: UnitedHealthcare Community & State	$211.39
Rate for Payer: Wellpoint Medicaid Managed Care	$232.44

MONSELS 8ML SOLUTION

Facility

$2.50

Hospital Charge Code	60629843
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.25
Rate for Payer: Aetna Commercial	$0.95
Rate for Payer: Aetna Medicare Advantage	$0.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.64
Rate for Payer: Cigna Commercial	$1.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.75
Rate for Payer: Oxford Commercial	$0.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.38
Rate for Payer: UnitedHealthcare Commercial	$0.50
Rate for Payer: UnitedHealthcare Community & State	$0.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.07

MONSELS 8ML SOLUTION

Facility

$2.50

Hospital Charge Code	60629843
Hospital Revenue Code	250
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$0.38
Rate for Payer: Qualcare PPO/HMO/WC	$0.38

MONTELUKAST 10 MG TAB

Facility

$37.92

Service Code	NDC 54025913
Hospital Charge Code	60629041
Hospital Revenue Code	250
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$18.96
Rate for Payer: Aetna Commercial	$14.41
Rate for Payer: Aetna Medicare Advantage	$11.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.67
Rate for Payer: Cigna Commercial	$18.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.38
Rate for Payer: Oxford Commercial	$7.58
Rate for Payer: Qualcare PPO/HMO/WC	$5.69
Rate for Payer: UnitedHealthcare Commercial	$7.58
Rate for Payer: UnitedHealthcare Community & State	$0.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1.00

MONTELUKAST 10 MG TAB

Facility

$37.92

Service Code	NDC 54025913
Hospital Charge Code	60629041
Hospital Revenue Code	250
Min. Negotiated Rate	$5.69
Max. Negotiated Rate	$5.69
Rate for Payer: Qualcare PPO/HMO/WC	$5.69

MONTELUSKAST 4MG (SINGULAR)

Facility

$37.92

Service Code	NDC 93742456
Hospital Charge Code	6000385
Hospital Revenue Code	250
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$18.96
Rate for Payer: Aetna Commercial	$14.41
Rate for Payer: Aetna Medicare Advantage	$11.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.67
Rate for Payer: Cigna Commercial	$18.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.38
Rate for Payer: Oxford Commercial	$7.58
Rate for Payer: Qualcare PPO/HMO/WC	$5.69
Rate for Payer: UnitedHealthcare Commercial	$7.58
Rate for Payer: UnitedHealthcare Community & State	$0.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1.00

MONTELUSKAST 4MG (SINGULAR)

Facility

$37.92

Service Code	NDC 93742456
Hospital Charge Code	6000385
Hospital Revenue Code	250
Min. Negotiated Rate	$5.69
Max. Negotiated Rate	$5.69
Rate for Payer: Qualcare PPO/HMO/WC	$5.69

MONTIOR HANDSET COMMUNICATOR

Facility

$5,975.00

Service Code	HCPCS C1787
Hospital Charge Code	270691736
Hospital Revenue Code	270
Min. Negotiated Rate	$896.25
Max. Negotiated Rate	$896.25
Rate for Payer: Qualcare PPO/HMO/WC	$896.25

MONTIOR HANDSET COMMUNICATOR

Facility

$5,975.00

Service Code	HCPCS C1787
Hospital Charge Code	270691736
Hospital Revenue Code	270
Min. Negotiated Rate	$144.00
Max. Negotiated Rate	$2,987.50
Rate for Payer: Aetna Commercial	$2,270.50
Rate for Payer: Aetna Medicare Advantage	$1,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,523.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,523.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,523.62
Rate for Payer: Cigna Commercial	$2,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,792.50
Rate for Payer: Oxford Commercial	$1,195.00
Rate for Payer: Qualcare PPO/HMO/WC	$896.25
Rate for Payer: UnitedHealthcare Commercial	$1,195.00
Rate for Payer: UnitedHealthcare Community & State	$144.00
Rate for Payer: Wellpoint Medicaid Managed Care	$158.34

MOPATH PROCEDURE LVL 7

Facility

$1,414.40

Service Code	HCPCS 81406
Hospital Charge Code	401181406A
Hospital Revenue Code	306
Min. Negotiated Rate	$212.16
Max. Negotiated Rate	$212.16
Rate for Payer: Qualcare PPO/HMO/WC	$212.16

MOPATH PROCEDURE LVL 7

Facility

$1,414.40

Service Code	HCPCS 81406
Hospital Charge Code	401181406A
Hospital Revenue Code	306
Min. Negotiated Rate	$37.48
Max. Negotiated Rate	$1,021.11
Rate for Payer: Aetna Commercial	$769.43
Rate for Payer: Aetna Medicare Advantage	$916.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,021.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,021.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$282.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,021.11
Rate for Payer: Cigna Commercial	$707.20
Rate for Payer: Cigna Medicare Advantage	$282.88
Rate for Payer: Clover Medicare Advantage	$268.74
Rate for Payer: EmblemHealth Commercial	$848.64
Rate for Payer: Humana Medicare Advantage	$291.37
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$282.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$424.32
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$212.16
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$226.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$282.88
Rate for Payer: Wellcare Medicare Advantage	$282.88
Rate for Payer: Wellpoint Medicaid Managed Care	$37.48

MOPS FEMORA CONDYLE MED

Facility

$59,800.00

Hospital Charge Code	270688279
Hospital Revenue Code	278
Min. Negotiated Rate	$1,441.18
Max. Negotiated Rate	$29,900.00
Rate for Payer: Aetna Commercial	$22,724.00
Rate for Payer: Aetna Medicare Advantage	$17,940.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,249.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,249.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,249.00
Rate for Payer: Cigna Commercial	$29,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,471.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13,156.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,970.00
Rate for Payer: UnitedHealthcare Community & State	$1,441.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1,584.70

MOPS FEMORA CONDYLE MED

Facility

$59,800.00

Hospital Charge Code	270688279
Hospital Revenue Code	278
Min. Negotiated Rate	$8,970.00
Max. Negotiated Rate	$14,471.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,960.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,471.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13,156.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,970.00

MORCELLATOR GYN DISP 15 MX0100

Facility

$2,945.00

Hospital Charge Code	270638551
Hospital Revenue Code	270
Min. Negotiated Rate	$441.75
Max. Negotiated Rate	$441.75
Rate for Payer: Qualcare PPO/HMO/WC	$441.75

MORCELLATOR GYN DISP 15 MX0100

Facility

$2,945.00

Hospital Charge Code	270638551
Hospital Revenue Code	270
Min. Negotiated Rate	$70.97
Max. Negotiated Rate	$1,472.50
Rate for Payer: Aetna Commercial	$1,119.10
Rate for Payer: Aetna Medicare Advantage	$883.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$750.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$750.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$750.98
Rate for Payer: Cigna Commercial	$1,472.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$883.50
Rate for Payer: Oxford Commercial	$589.00
Rate for Payer: Qualcare PPO/HMO/WC	$441.75
Rate for Payer: UnitedHealthcare Commercial	$589.00
Rate for Payer: UnitedHealthcare Community & State	$70.97
Rate for Payer: Wellpoint Medicaid Managed Care	$78.04

MORCELLATOR TIS 15 DISP DV0015

Facility

$2,624.00

Hospital Charge Code	270637619
Hospital Revenue Code	272
Min. Negotiated Rate	$63.24
Max. Negotiated Rate	$1,312.00
Rate for Payer: Aetna Commercial	$997.12
Rate for Payer: Aetna Medicare Advantage	$787.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.12
Rate for Payer: Cigna Commercial	$1,312.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$787.20
Rate for Payer: Oxford Commercial	$524.80
Rate for Payer: Qualcare PPO/HMO/WC	$393.60
Rate for Payer: UnitedHealthcare Commercial	$524.80
Rate for Payer: UnitedHealthcare Community & State	$63.24
Rate for Payer: Wellpoint Medicaid Managed Care	$69.54

MORCELLATOR TIS 15 DISP DV0015

Facility

$2,624.00

Hospital Charge Code	270637619
Hospital Revenue Code	272
Min. Negotiated Rate	$393.60
Max. Negotiated Rate	$393.60
Rate for Payer: Qualcare PPO/HMO/WC	$393.60

MORICIZINE 300 MG TAB

Facility

$11.25

Hospital Charge Code	60628656
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

MORICIZINE 300 MG TAB

Facility

$11.25

Hospital Charge Code	60628656
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$4.28
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.38
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$2.25
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

MORPHINE

Facility

$291.00

Service Code	HCPCS 80361
Hospital Charge Code	38472512
Hospital Revenue Code	301
Min. Negotiated Rate	$7.71
Max. Negotiated Rate	$145.50
Rate for Payer: Aetna Commercial	$110.58
Rate for Payer: Aetna Medicare Advantage	$87.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.20
Rate for Payer: Cigna Commercial	$145.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$7.71

MORPHINE

Facility

$291.00

Service Code	HCPCS 80361
Hospital Charge Code	38472512
Hospital Revenue Code	301
Min. Negotiated Rate	$43.65
Max. Negotiated Rate	$43.65
Rate for Payer: Qualcare PPO/HMO/WC	$43.65

MORPHINE 100 MG/4 ML

Facility

$85.56

Service Code	HCPCS J2270
Hospital Charge Code	60630077
Hospital Revenue Code	636
Min. Negotiated Rate	$12.83
Max. Negotiated Rate	$20.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.71
Rate for Payer: Qualcare PPO/HMO/WC	$12.83

MORPHINE 100 MG/4 ML

Facility

$85.56

Service Code	HCPCS J2270
Hospital Charge Code	60630077
Hospital Revenue Code	636
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$42.78
Rate for Payer: Aetna Commercial	$32.51
Rate for Payer: Aetna Medicare Advantage	$25.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.82
Rate for Payer: Cigna Commercial	$42.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.71
Rate for Payer: Qualcare PPO/HMO/WC	$12.83
Rate for Payer: UnitedHealthcare Community & State	$2.06
Rate for Payer: Wellpoint Medicaid Managed Care	$2.27

MORPHINE 100 MG/4 ML INJ

Facility

$69.00

Hospital Charge Code	60634956
Hospital Revenue Code	636
Min. Negotiated Rate	$10.35
Max. Negotiated Rate	$16.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.70
Rate for Payer: Qualcare PPO/HMO/WC	$10.35

Know your out-of-pocket cost for care.

All Charges