Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MUPIROCIN OINT 2% 1GM EA

Facility

$34.37

Service Code	NDC 50268057260
Hospital Charge Code	606390194
Hospital Revenue Code	250
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$17.18
Rate for Payer: Aetna Commercial	$13.06
Rate for Payer: Aetna Medicare Advantage	$10.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.76
Rate for Payer: Cigna Commercial	$17.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.31
Rate for Payer: Oxford Commercial	$6.87
Rate for Payer: Qualcare PPO/HMO/WC	$5.16
Rate for Payer: UnitedHealthcare Commercial	$6.87
Rate for Payer: UnitedHealthcare Community & State	$0.83
Rate for Payer: Wellpoint Medicaid Managed Care	$0.91

MUPIROCIN OINT 2% 22GM

Facility

$227.85

Hospital Charge Code	60628994
Hospital Revenue Code	250
Min. Negotiated Rate	$5.49
Max. Negotiated Rate	$113.92
Rate for Payer: Aetna Commercial	$86.58
Rate for Payer: Aetna Medicare Advantage	$68.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.10
Rate for Payer: Cigna Commercial	$113.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.36
Rate for Payer: Oxford Commercial	$45.57
Rate for Payer: Qualcare PPO/HMO/WC	$34.18
Rate for Payer: UnitedHealthcare Commercial	$45.57
Rate for Payer: UnitedHealthcare Community & State	$5.49
Rate for Payer: Wellpoint Medicaid Managed Care	$6.04

MUPIROCIN OINT 2% 22GM

Facility

$227.85

Hospital Charge Code	60628994
Hospital Revenue Code	250
Min. Negotiated Rate	$34.18
Max. Negotiated Rate	$34.18
Rate for Payer: Qualcare PPO/HMO/WC	$34.18

MURO 128 2% OPTH DROP15ML

Facility

$115.58

Service Code	NDC 24208027615
Hospital Charge Code	60635474
Hospital Revenue Code	250
Min. Negotiated Rate	$2.79
Max. Negotiated Rate	$57.79
Rate for Payer: Aetna Commercial	$43.92
Rate for Payer: Aetna Medicare Advantage	$34.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.47
Rate for Payer: Cigna Commercial	$57.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.67
Rate for Payer: Oxford Commercial	$23.12
Rate for Payer: Qualcare PPO/HMO/WC	$17.34
Rate for Payer: UnitedHealthcare Commercial	$23.12
Rate for Payer: UnitedHealthcare Community & State	$2.79
Rate for Payer: Wellpoint Medicaid Managed Care	$3.06

MURO 128 2% OPTH DROP15ML

Facility

$115.58

Service Code	NDC 24208027615
Hospital Charge Code	60635474
Hospital Revenue Code	250
Min. Negotiated Rate	$17.34
Max. Negotiated Rate	$17.34
Rate for Payer: Qualcare PPO/HMO/WC	$17.34

MURO 128 5% OPHTH/15ML

Facility

$121.67

Service Code	NDC 24208027715
Hospital Charge Code	60633467
Hospital Revenue Code	250
Min. Negotiated Rate	$2.93
Max. Negotiated Rate	$60.84
Rate for Payer: Aetna Commercial	$46.23
Rate for Payer: Aetna Medicare Advantage	$36.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.03
Rate for Payer: Cigna Commercial	$60.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.50
Rate for Payer: Oxford Commercial	$24.33
Rate for Payer: Qualcare PPO/HMO/WC	$18.25
Rate for Payer: UnitedHealthcare Commercial	$24.33
Rate for Payer: UnitedHealthcare Community & State	$2.93
Rate for Payer: Wellpoint Medicaid Managed Care	$3.22

MURO 128 5% OPHTH/15ML

Facility

$121.67

Service Code	NDC 24208027715
Hospital Charge Code	60633467
Hospital Revenue Code	250
Min. Negotiated Rate	$18.25
Max. Negotiated Rate	$18.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.25

MUSCLE BX,DEEP

Facility

$13,615.50

Service Code	HCPCS 20205
Hospital Charge Code	16000538
Hospital Revenue Code	360
Min. Negotiated Rate	$328.13
Max. Negotiated Rate	$12,456.64
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,456.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,456.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,456.64
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,084.65
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$328.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$360.81

MUSCLE BX,DEEP

Facility

$13,615.50

Service Code	HCPCS 20205
Hospital Charge Code	16000538
Hospital Revenue Code	360
Min. Negotiated Rate	$2,042.33
Max. Negotiated Rate	$2,042.33
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33

MUSCLE BX; PERC NDL

Facility

$7,367.00

Service Code	HCPCS 20206
Hospital Charge Code	16000468
Hospital Revenue Code	360
Min. Negotiated Rate	$177.54
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,210.10
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,105.05
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$177.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$195.23

MUSCLE BX; PERC NDL

Facility

$7,367.00

Service Code	HCPCS 20206
Hospital Charge Code	16000468
Hospital Revenue Code	360
Min. Negotiated Rate	$1,105.05
Max. Negotiated Rate	$1,105.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,105.05

MUSCLE FLAP,LOWER EXTREMITY

Facility

$26,848.40

Service Code	HCPCS 15738
Hospital Charge Code	16000660
Hospital Revenue Code	360
Min. Negotiated Rate	$647.05
Max. Negotiated Rate	$15,196.98
Rate for Payer: Aetna Commercial	$11,451.31
Rate for Payer: Aetna Medicare Advantage	$13,640.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,196.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,196.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,210.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,196.98
Rate for Payer: Cigna Commercial	$8,439.01
Rate for Payer: Cigna Medicare Advantage	$4,210.04
Rate for Payer: Clover Medicare Advantage	$3,999.54
Rate for Payer: EmblemHealth Commercial	$12,630.12
Rate for Payer: Humana Medicare Advantage	$4,336.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,210.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,054.52
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,027.26
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$647.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,210.04
Rate for Payer: Wellcare Medicare Advantage	$4,210.04
Rate for Payer: Wellpoint Medicaid Managed Care	$711.48

MUSCLE FLAP,LOWER EXTREMITY

Facility

$26,848.40

Service Code	HCPCS 15738
Hospital Charge Code	16000660
Hospital Revenue Code	360
Min. Negotiated Rate	$4,027.26
Max. Negotiated Rate	$4,027.26
Rate for Payer: Qualcare PPO/HMO/WC	$4,027.26

MUSCLE FLAP,TRUNK

Facility

$26,848.40

Service Code	HCPCS 15734
Hospital Charge Code	16000599
Hospital Revenue Code	360
Min. Negotiated Rate	$647.05
Max. Negotiated Rate	$15,196.98
Rate for Payer: Aetna Commercial	$11,451.31
Rate for Payer: Aetna Medicare Advantage	$13,640.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,196.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,196.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,210.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,196.98
Rate for Payer: Cigna Commercial	$8,439.01
Rate for Payer: Cigna Medicare Advantage	$4,210.04
Rate for Payer: Clover Medicare Advantage	$3,999.54
Rate for Payer: EmblemHealth Commercial	$12,630.12
Rate for Payer: Humana Medicare Advantage	$4,336.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,210.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,054.52
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,027.26
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$647.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,210.04
Rate for Payer: Wellcare Medicare Advantage	$4,210.04
Rate for Payer: Wellpoint Medicaid Managed Care	$711.48

MUSCLE FLAP,TRUNK

Facility

$26,848.40

Service Code	HCPCS 15734
Hospital Charge Code	16000599
Hospital Revenue Code	360
Min. Negotiated Rate	$4,027.26
Max. Negotiated Rate	$4,027.26
Rate for Payer: Qualcare PPO/HMO/WC	$4,027.26

MUSCLE TEST 2 LIMBS

Facility

$470.30

Service Code	HCPCS 95861
Hospital Charge Code	1600000476
Hospital Revenue Code	360
Min. Negotiated Rate	$11.33
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.09
Rate for Payer: Qualcare PPO/HMO/WC	$70.55
Rate for Payer: UnitedHealthcare Community & State	$11.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$12.46

MUSCLE TEST 2 LIMBS

Facility

$470.30

Service Code	HCPCS 95861
Hospital Charge Code	1600000476
Hospital Revenue Code	360
Min. Negotiated Rate	$70.55
Max. Negotiated Rate	$70.55
Rate for Payer: Qualcare PPO/HMO/WC	$70.55

MUSC/TDN TRANSFER UPR A/E 1

Facility

$33,092.48

Service Code	HCPCS 24301
Hospital Charge Code	1600000820
Hospital Revenue Code	360
Min. Negotiated Rate	$797.53
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,927.74
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,963.87
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$797.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$876.95

MUSC/TDN TRANSFER UPR A/E 1

Facility

$33,092.48

Service Code	HCPCS 24301
Hospital Charge Code	1600000820
Hospital Revenue Code	360
Min. Negotiated Rate	$4,963.87
Max. Negotiated Rate	$4,963.87
Rate for Payer: Qualcare PPO/HMO/WC	$4,963.87

MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$26,615.53

Service Code	APR-DRG 9122
Min. Negotiated Rate	$26,093.66
Max. Negotiated Rate	$26,615.53
Rate for Payer: UnitedHealthcare Community & State	$26,093.66
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$26,615.53
Rate for Payer: Wellpoint Medicaid Managed Care	$26,093.66

MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$41,532.63

Service Code	APR-DRG 9123
Min. Negotiated Rate	$40,718.26
Max. Negotiated Rate	$41,532.63
Rate for Payer: UnitedHealthcare Community & State	$40,718.26
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$41,532.63
Rate for Payer: Wellpoint Medicaid Managed Care	$40,718.26

MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$25,285.23

Service Code	APR-DRG 9121
Min. Negotiated Rate	$24,789.44
Max. Negotiated Rate	$25,285.23
Rate for Payer: UnitedHealthcare Community & State	$24,789.44
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$25,285.23
Rate for Payer: Wellpoint Medicaid Managed Care	$24,789.44

MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$73,764.44

Service Code	APR-DRG 9124
Min. Negotiated Rate	$72,318.08
Max. Negotiated Rate	$73,764.44
Rate for Payer: UnitedHealthcare Community & State	$72,318.08
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$73,764.44
Rate for Payer: Wellpoint Medicaid Managed Care	$72,318.08

MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY

Facility

$9,339.13

Service Code	APR-DRG 3431
Min. Negotiated Rate	$9,156.01
Max. Negotiated Rate	$9,339.13
Rate for Payer: UnitedHealthcare Community & State	$9,156.01
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,339.13
Rate for Payer: Wellpoint Medicaid Managed Care	$9,156.01

MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY

Facility

$11,220.97

Service Code	APR-DRG 3432
Min. Negotiated Rate	$11,000.95
Max. Negotiated Rate	$11,220.97
Rate for Payer: UnitedHealthcare Community & State	$11,000.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,220.97
Rate for Payer: Wellpoint Medicaid Managed Care	$11,000.95

Know your out-of-pocket cost for care.

All Charges