Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MUMPS AB (IGM), IFA

Facility

$164.00

Service Code	HCPCS 86735
Hospital Charge Code	3006774
Hospital Revenue Code	302
Min. Negotiated Rate	$4.35
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$35.50
Rate for Payer: Aetna Medicare Advantage	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.11
Rate for Payer: Cigna Commercial	$82.00
Rate for Payer: Cigna Medicare Advantage	$13.05
Rate for Payer: Clover Medicare Advantage	$12.40
Rate for Payer: EmblemHealth Commercial	$39.15
Rate for Payer: Humana Medicare Advantage	$13.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.05
Rate for Payer: Wellcare Medicare Advantage	$13.05
Rate for Payer: Wellpoint Medicaid Managed Care	$4.35

MUMPS AB (IGM), IFA

Facility

$164.00

Service Code	HCPCS 86735
Hospital Charge Code	3006774
Hospital Revenue Code	302
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$24.60
Rate for Payer: Qualcare PPO/HMO/WC	$24.60

MUMPS ANTIBODY

Facility

$602.00

Service Code	HCPCS 86735
Hospital Charge Code	38479107
Hospital Revenue Code	302
Min. Negotiated Rate	$90.30
Max. Negotiated Rate	$90.30
Rate for Payer: Qualcare PPO/HMO/WC	$90.30

MUMPS ANTIBODY

Facility

$602.00

Service Code	HCPCS 86735
Hospital Charge Code	38479107
Hospital Revenue Code	302
Min. Negotiated Rate	$10.44
Max. Negotiated Rate	$301.00
Rate for Payer: Aetna Commercial	$35.50
Rate for Payer: Aetna Medicare Advantage	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.11
Rate for Payer: Cigna Commercial	$301.00
Rate for Payer: Cigna Medicare Advantage	$13.05
Rate for Payer: Clover Medicare Advantage	$12.40
Rate for Payer: EmblemHealth Commercial	$39.15
Rate for Payer: Humana Medicare Advantage	$13.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.05
Rate for Payer: Wellcare Medicare Advantage	$13.05
Rate for Payer: Wellpoint Medicaid Managed Care	$15.95

MUMPS IGM

Facility

$667.59

Service Code	HCPCS 86735
Hospital Charge Code	39900384
Hospital Revenue Code	302
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

MUMPS IGM

Facility

$667.59

Service Code	HCPCS 86735
Hospital Charge Code	39900384
Hospital Revenue Code	302
Min. Negotiated Rate	$10.44
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$35.50
Rate for Payer: Aetna Medicare Advantage	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.11
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$13.05
Rate for Payer: Clover Medicare Advantage	$12.40
Rate for Payer: EmblemHealth Commercial	$39.15
Rate for Payer: Humana Medicare Advantage	$13.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.05
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	$10.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.05
Rate for Payer: Wellcare Medicare Advantage	$13.05
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

MUMPS SKIN TEST

Facility

$227.00

Hospital Charge Code	60634533
Hospital Revenue Code	250
Min. Negotiated Rate	$5.47
Max. Negotiated Rate	$113.50
Rate for Payer: Aetna Commercial	$86.26
Rate for Payer: Aetna Medicare Advantage	$68.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.88
Rate for Payer: Cigna Commercial	$113.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.10
Rate for Payer: Oxford Commercial	$45.40
Rate for Payer: Qualcare PPO/HMO/WC	$34.05
Rate for Payer: UnitedHealthcare Commercial	$45.40
Rate for Payer: UnitedHealthcare Community & State	$5.47
Rate for Payer: Wellpoint Medicaid Managed Care	$6.02

MUMPS SKIN TEST

Facility

$227.00

Hospital Charge Code	60634533
Hospital Revenue Code	250
Min. Negotiated Rate	$34.05
Max. Negotiated Rate	$34.05
Rate for Payer: Qualcare PPO/HMO/WC	$34.05

MUMPS SKIN TEST

Facility

$381.00

Hospital Charge Code	60635238
Hospital Revenue Code	250
Min. Negotiated Rate	$9.18
Max. Negotiated Rate	$190.50
Rate for Payer: Aetna Commercial	$144.78
Rate for Payer: Aetna Medicare Advantage	$114.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.16
Rate for Payer: Cigna Commercial	$190.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.30
Rate for Payer: Oxford Commercial	$76.20
Rate for Payer: Qualcare PPO/HMO/WC	$57.15
Rate for Payer: UnitedHealthcare Commercial	$76.20
Rate for Payer: UnitedHealthcare Community & State	$9.18
Rate for Payer: Wellpoint Medicaid Managed Care	$10.10

MUMPS SKIN TEST

Facility

$381.00

Hospital Charge Code	60635238
Hospital Revenue Code	250
Min. Negotiated Rate	$57.15
Max. Negotiated Rate	$57.15
Rate for Payer: Qualcare PPO/HMO/WC	$57.15

MUMPS VIRUS AB

Facility

$602.00

Service Code	HCPCS 86375
Hospital Charge Code	38476029
Hospital Revenue Code	302
Min. Negotiated Rate	$14.51
Max. Negotiated Rate	$301.00
Rate for Payer: Aetna Commercial	$228.76
Rate for Payer: Aetna Medicare Advantage	$180.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.51
Rate for Payer: Cigna Commercial	$301.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.51
Rate for Payer: Wellpoint Medicaid Managed Care	$15.95

MUMPS VIRUS AB

Facility

$602.00

Service Code	HCPCS 86375
Hospital Charge Code	38476029
Hospital Revenue Code	302
Min. Negotiated Rate	$90.30
Max. Negotiated Rate	$90.30
Rate for Payer: Qualcare PPO/HMO/WC	$90.30

MUMPS VIRUS ANTIBODY, IGG

Facility

$164.00

Service Code	HCPCS 86735
Hospital Charge Code	3009412
Hospital Revenue Code	302
Min. Negotiated Rate	$4.35
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$35.50
Rate for Payer: Aetna Medicare Advantage	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.11
Rate for Payer: Cigna Commercial	$82.00
Rate for Payer: Cigna Medicare Advantage	$13.05
Rate for Payer: Clover Medicare Advantage	$12.40
Rate for Payer: EmblemHealth Commercial	$39.15
Rate for Payer: Humana Medicare Advantage	$13.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.05
Rate for Payer: Wellcare Medicare Advantage	$13.05
Rate for Payer: Wellpoint Medicaid Managed Care	$4.35

MUMPS VIRUS ANTIBODY, IGG

Facility

$164.00

Service Code	HCPCS 86735
Hospital Charge Code	3009412
Hospital Revenue Code	302
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$24.60
Rate for Payer: Qualcare PPO/HMO/WC	$24.60

MUMPS VIRUS RNA,QL,RT-PCR (V-C

Facility

$342.64

Service Code	HCPCS 87790
Hospital Charge Code	397080015
Hospital Revenue Code	306
Min. Negotiated Rate	$51.40
Max. Negotiated Rate	$51.40
Rate for Payer: Qualcare PPO/HMO/WC	$51.40

MUMPS VIRUS RNA,QL,RT-PCR (V-C

Facility

$342.64

Service Code	HCPCS 87790
Hospital Charge Code	397080015
Hospital Revenue Code	306
Min. Negotiated Rate	$8.26
Max. Negotiated Rate	$171.32
Rate for Payer: Aetna Commercial	$130.20
Rate for Payer: Aetna Medicare Advantage	$102.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.37
Rate for Payer: Cigna Commercial	$171.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$8.26
Rate for Payer: Wellpoint Medicaid Managed Care	$9.08

MUPIROCIN 2 % CREAM

Facility

$380.76

Service Code	NDC 29152725
Hospital Charge Code	60628763
Hospital Revenue Code	250
Min. Negotiated Rate	$57.11
Max. Negotiated Rate	$57.11
Rate for Payer: Qualcare PPO/HMO/WC	$57.11

MUPIROCIN 2 % CREAM

Facility

$380.76

Service Code	NDC 29152725
Hospital Charge Code	60628763
Hospital Revenue Code	250
Min. Negotiated Rate	$9.18
Max. Negotiated Rate	$190.38
Rate for Payer: Aetna Commercial	$144.69
Rate for Payer: Aetna Medicare Advantage	$114.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.09
Rate for Payer: Cigna Commercial	$190.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.23
Rate for Payer: Oxford Commercial	$76.15
Rate for Payer: Qualcare PPO/HMO/WC	$57.11
Rate for Payer: UnitedHealthcare Commercial	$76.15
Rate for Payer: UnitedHealthcare Community & State	$9.18
Rate for Payer: Wellpoint Medicaid Managed Care	$10.09

MUPIROCIN 2 % OINTMENT

Facility

$80.40

Service Code	NDC 29152544
Hospital Charge Code	60628327
Hospital Revenue Code	250
Min. Negotiated Rate	$1.94
Max. Negotiated Rate	$40.20
Rate for Payer: Aetna Commercial	$30.55
Rate for Payer: Aetna Medicare Advantage	$24.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.50
Rate for Payer: Cigna Commercial	$40.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.12
Rate for Payer: Oxford Commercial	$16.08
Rate for Payer: Qualcare PPO/HMO/WC	$12.06
Rate for Payer: UnitedHealthcare Commercial	$16.08
Rate for Payer: UnitedHealthcare Community & State	$1.94
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

MUPIROCIN 2 % OINTMENT

Facility

$80.40

Service Code	NDC 29152544
Hospital Charge Code	60628327
Hospital Revenue Code	250
Min. Negotiated Rate	$12.06
Max. Negotiated Rate	$12.06
Rate for Payer: Qualcare PPO/HMO/WC	$12.06

MUPIROCIN 2% TOPICAL OIN UDOSE

Facility

$2.50

Hospital Charge Code	60629878
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

MUPIROCIN 2% TOPICAL OIN UDOSE

Facility

$2.50

Hospital Charge Code	60629878
Hospital Revenue Code	250
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$0.38
Rate for Payer: Qualcare PPO/HMO/WC	$0.38

MUPIROCIN OINT 2% 15GM

Facility

$122.90

Hospital Charge Code	6007595
Hospital Revenue Code	252
Min. Negotiated Rate	$18.43
Max. Negotiated Rate	$18.43
Rate for Payer: Qualcare PPO/HMO/WC	$18.43

MUPIROCIN OINT 2% 15GM

Facility

$122.90

Hospital Charge Code	6007595
Hospital Revenue Code	252
Min. Negotiated Rate	$2.96
Max. Negotiated Rate	$61.45
Rate for Payer: Aetna Commercial	$46.70
Rate for Payer: Aetna Medicare Advantage	$36.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.34
Rate for Payer: Cigna Commercial	$61.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.87
Rate for Payer: Oxford Commercial	$24.58
Rate for Payer: Qualcare PPO/HMO/WC	$18.43
Rate for Payer: UnitedHealthcare Commercial	$24.58
Rate for Payer: UnitedHealthcare Community & State	$2.96
Rate for Payer: Wellpoint Medicaid Managed Care	$3.26

MUPIROCIN OINT 2% 1GM EA

Facility

$34.37

Service Code	NDC 50268057260
Hospital Charge Code	606390194
Hospital Revenue Code	250
Min. Negotiated Rate	$5.16
Max. Negotiated Rate	$5.16
Rate for Payer: Qualcare PPO/HMO/WC	$5.16

Know your out-of-pocket cost for care.

All Charges