Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MUCOMYST 20% INHAL/4ML

Facility

$51.00

Hospital Charge Code	60633462
Hospital Revenue Code	250
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$7.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.65

MUCOMYST 20% INHAL/4ML

Facility

$51.00

Hospital Charge Code	60633462
Hospital Revenue Code	250
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$25.50
Rate for Payer: Aetna Commercial	$19.38
Rate for Payer: Aetna Medicare Advantage	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.01
Rate for Payer: Cigna Commercial	$25.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.30
Rate for Payer: Oxford Commercial	$10.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.65
Rate for Payer: UnitedHealthcare Commercial	$10.20
Rate for Payer: UnitedHealthcare Community & State	$1.23
Rate for Payer: Wellpoint Medicaid Managed Care	$1.35

MUGA SCAN

Facility

$1,321.00

Service Code	HCPCS 78473
Hospital Charge Code	74116006
Hospital Revenue Code	341
Min. Negotiated Rate	$31.84
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$1,291.84
Rate for Payer: Aetna Medicare Advantage	$1,538.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$474.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,714.39
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: Cigna Medicare Advantage	$332.46
Rate for Payer: Clover Medicare Advantage	$451.19
Rate for Payer: EmblemHealth Commercial	$1,424.82
Rate for Payer: Humana Medicare Advantage	$489.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$474.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.30
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$198.15
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$31.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$474.94
Rate for Payer: Wellcare Medicare Advantage	$474.94
Rate for Payer: Wellpoint Medicaid Managed Care	$35.01

MUGA SCAN

Facility

$1,579.25

Service Code	HCPCS 78472
Hospital Charge Code	94053020
Hospital Revenue Code	341
Min. Negotiated Rate	$38.06
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$1,291.84
Rate for Payer: Aetna Medicare Advantage	$1,538.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$474.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,714.39
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: Cigna Medicare Advantage	$332.46
Rate for Payer: Clover Medicare Advantage	$451.19
Rate for Payer: EmblemHealth Commercial	$1,424.82
Rate for Payer: Humana Medicare Advantage	$489.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$474.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$473.77
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$236.89
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$38.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$474.94
Rate for Payer: Wellcare Medicare Advantage	$474.94
Rate for Payer: Wellpoint Medicaid Managed Care	$41.85

MUGA SCAN

Facility

$1,579.25

Service Code	HCPCS 78472
Hospital Charge Code	5309010
Hospital Revenue Code	341
Min. Negotiated Rate	$236.89
Max. Negotiated Rate	$236.89
Rate for Payer: Qualcare PPO/HMO/WC	$236.89

MUGA SCAN

Facility

$1,321.00

Service Code	HCPCS 78473
Hospital Charge Code	74116006
Hospital Revenue Code	341
Min. Negotiated Rate	$198.15
Max. Negotiated Rate	$198.15
Rate for Payer: Qualcare PPO/HMO/WC	$198.15

MUGA SCAN

Facility

$1,321.00

Service Code	HCPCS 78473
Hospital Charge Code	74117006
Hospital Revenue Code	341
Min. Negotiated Rate	$198.15
Max. Negotiated Rate	$198.15
Rate for Payer: Qualcare PPO/HMO/WC	$198.15

MUGA SCAN

Facility

$1,321.00

Service Code	HCPCS 78473
Hospital Charge Code	74115006
Hospital Revenue Code	341
Min. Negotiated Rate	$198.15
Max. Negotiated Rate	$198.15
Rate for Payer: Qualcare PPO/HMO/WC	$198.15

MUGA SCAN

Facility

$1,579.25

Service Code	HCPCS 78472
Hospital Charge Code	5309010
Hospital Revenue Code	341
Min. Negotiated Rate	$38.06
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$1,291.84
Rate for Payer: Aetna Medicare Advantage	$1,538.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$474.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,714.39
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: Cigna Medicare Advantage	$332.46
Rate for Payer: Clover Medicare Advantage	$451.19
Rate for Payer: EmblemHealth Commercial	$1,424.82
Rate for Payer: Humana Medicare Advantage	$489.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$474.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$473.77
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$236.89
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$38.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$474.94
Rate for Payer: Wellcare Medicare Advantage	$474.94
Rate for Payer: Wellpoint Medicaid Managed Care	$41.85

MUGA SCAN

Facility

$1,321.00

Service Code	HCPCS 78473
Hospital Charge Code	74117006
Hospital Revenue Code	341
Min. Negotiated Rate	$31.84
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$1,291.84
Rate for Payer: Aetna Medicare Advantage	$1,538.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$474.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,714.39
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: Cigna Medicare Advantage	$332.46
Rate for Payer: Clover Medicare Advantage	$451.19
Rate for Payer: EmblemHealth Commercial	$1,424.82
Rate for Payer: Humana Medicare Advantage	$489.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$474.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.30
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$198.15
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$31.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$474.94
Rate for Payer: Wellcare Medicare Advantage	$474.94
Rate for Payer: Wellpoint Medicaid Managed Care	$35.01

MUGA SCAN

Facility

$1,579.25

Service Code	HCPCS 78472
Hospital Charge Code	94053020
Hospital Revenue Code	341
Min. Negotiated Rate	$236.89
Max. Negotiated Rate	$236.89
Rate for Payer: Qualcare PPO/HMO/WC	$236.89

MUGA SCAN

Facility

$1,321.00

Service Code	HCPCS 78473
Hospital Charge Code	74115006
Hospital Revenue Code	341
Min. Negotiated Rate	$31.84
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$1,291.84
Rate for Payer: Aetna Medicare Advantage	$1,538.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$474.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,714.39
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: Cigna Medicare Advantage	$332.46
Rate for Payer: Clover Medicare Advantage	$451.19
Rate for Payer: EmblemHealth Commercial	$1,424.82
Rate for Payer: Humana Medicare Advantage	$489.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$474.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.30
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$198.15
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$31.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$474.94
Rate for Payer: Wellcare Medicare Advantage	$474.94
Rate for Payer: Wellpoint Medicaid Managed Care	$35.01

MUILTILOC CAP

Facility

$2,085.00

Hospital Charge Code	270687780
Hospital Revenue Code	272
Min. Negotiated Rate	$50.25
Max. Negotiated Rate	$1,042.50
Rate for Payer: Aetna Commercial	$792.30
Rate for Payer: Aetna Medicare Advantage	$625.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$531.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$531.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$531.67
Rate for Payer: Cigna Commercial	$1,042.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$625.50
Rate for Payer: Oxford Commercial	$417.00
Rate for Payer: Qualcare PPO/HMO/WC	$312.75
Rate for Payer: UnitedHealthcare Commercial	$417.00
Rate for Payer: UnitedHealthcare Community & State	$50.25
Rate for Payer: Wellpoint Medicaid Managed Care	$55.25

MUILTILOC CAP

Facility

$2,085.00

Hospital Charge Code	270687780
Hospital Revenue Code	272
Min. Negotiated Rate	$312.75
Max. Negotiated Rate	$312.75
Rate for Payer: Qualcare PPO/HMO/WC	$312.75

MULCH ATK BONE 10.5 20 906320

Facility

$1,915.25

Hospital Charge Code	270610576
Hospital Revenue Code	278
Min. Negotiated Rate	$287.29
Max. Negotiated Rate	$463.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$463.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$421.36
Rate for Payer: Qualcare PPO/HMO/WC	$287.29

MULCH ATK BONE 10.5 20 906320

Facility

$1,915.25

Hospital Charge Code	270610576
Hospital Revenue Code	278
Min. Negotiated Rate	$46.16
Max. Negotiated Rate	$957.62
Rate for Payer: Aetna Commercial	$727.79
Rate for Payer: Aetna Medicare Advantage	$574.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$488.39
Rate for Payer: Cigna Commercial	$957.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$463.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$421.36
Rate for Payer: Qualcare PPO/HMO/WC	$287.29
Rate for Payer: UnitedHealthcare Community & State	$46.16
Rate for Payer: Wellpoint Medicaid Managed Care	$50.75

MULTFX S-ULRA5.5MM KNTLS ANCHR

Facility

$5,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270681094
Hospital Revenue Code	278
Min. Negotiated Rate	$136.16
Max. Negotiated Rate	$2,825.00
Rate for Payer: Aetna Commercial	$2,147.00
Rate for Payer: Aetna Medicare Advantage	$1,695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,440.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,440.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,440.75
Rate for Payer: Cigna Commercial	$2,825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,367.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,243.00
Rate for Payer: Qualcare PPO/HMO/WC	$847.50
Rate for Payer: UnitedHealthcare Community & State	$136.16
Rate for Payer: Wellpoint Medicaid Managed Care	$149.72

MULTFX S-ULRA5.5MM KNTLS ANCHR

Facility

$5,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270681094
Hospital Revenue Code	278
Min. Negotiated Rate	$847.50
Max. Negotiated Rate	$1,367.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,367.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,243.00
Rate for Payer: Qualcare PPO/HMO/WC	$847.50

MULTI ABSORBER MEDISORB EF

Facility

$78.80

Hospital Charge Code	270666032
Hospital Revenue Code	272
Min. Negotiated Rate	$1.90
Max. Negotiated Rate	$39.40
Rate for Payer: Aetna Commercial	$29.94
Rate for Payer: Aetna Medicare Advantage	$23.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.09
Rate for Payer: Cigna Commercial	$39.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.64
Rate for Payer: Oxford Commercial	$15.76
Rate for Payer: Qualcare PPO/HMO/WC	$11.82
Rate for Payer: UnitedHealthcare Commercial	$15.76
Rate for Payer: UnitedHealthcare Community & State	$1.90
Rate for Payer: Wellpoint Medicaid Managed Care	$2.09

MULTI ABSORBER MEDISORB EF

Facility

$78.80

Hospital Charge Code	270666032
Hospital Revenue Code	272
Min. Negotiated Rate	$11.82
Max. Negotiated Rate	$11.82
Rate for Payer: Qualcare PPO/HMO/WC	$11.82

MULTI-ELECTROLYTE CONCEN.INJ

Facility

$12.00

Hospital Charge Code	60628659
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

MULTI-ELECTROLYTE CONCEN.INJ

Facility

$12.00

Hospital Charge Code	60628659
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

MULTI-ELECTROLYTE R CONCEN INJ

Facility

$12.00

Hospital Charge Code	60628660
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

MULTI-ELECTROLYTE R CONCEN INJ

Facility

$12.00

Hospital Charge Code	60628660
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

MULTI-FAMILY

Facility

$336.35

Service Code	HCPCS 90849
Hospital Charge Code	84518025
Hospital Revenue Code	912
Min. Negotiated Rate	$8.11
Max. Negotiated Rate	$761.18
Rate for Payer: Aetna Commercial	$573.57
Rate for Payer: Aetna Medicare Advantage	$683.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$210.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$761.18
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: Cigna Medicare Advantage	$210.87
Rate for Payer: Clover Medicare Advantage	$200.33
Rate for Payer: EmblemHealth Commercial	$632.61
Rate for Payer: Humana Medicare Advantage	$217.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$210.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.91
Rate for Payer: Qualcare PPO/HMO/WC	$50.45
Rate for Payer: UnitedHealthcare Community & State	$8.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.87
Rate for Payer: Wellcare Medicare Advantage	$210.87
Rate for Payer: Wellpoint Medicaid Managed Care	$8.91

Know your out-of-pocket cost for care.

All Charges