Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

METHIMAZOLE 5 MG TAB

Facility

$4.00

Service Code	NDC 49884064001
Hospital Charge Code	60628264
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

METHOCARBAMOL 500 MG TAB

Facility

$4.00

Service Code	NDC 31722053301
Hospital Charge Code	60627486
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

METHOCARBAMOL 500 MG TAB

Facility

$4.00

Service Code	NDC 31722053301
Hospital Charge Code	60627486
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

METHOCARBAMOL 750 MG TAB

Facility

$4.89

Service Code	NDC 31722053401
Hospital Charge Code	60627487
Hospital Revenue Code	250
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$0.73
Rate for Payer: Qualcare PPO/HMO/WC	$0.73

METHOCARBAMOL 750 MG TAB

Facility

$4.89

Service Code	NDC 31722053401
Hospital Charge Code	60627487
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.44
Rate for Payer: Aetna Commercial	$1.86
Rate for Payer: Aetna Medicare Advantage	$1.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.25
Rate for Payer: Cigna Commercial	$2.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.27
Rate for Payer: Oxford Commercial	$0.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.73
Rate for Payer: UnitedHealthcare Commercial	$0.98
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

METHOHEXITAL NA 500MG INJ

Facility

$434.90

Service Code	NDC 54569391200
Hospital Charge Code	6063943065
Hospital Revenue Code	250
Min. Negotiated Rate	$12.35
Max. Negotiated Rate	$217.45
Rate for Payer: Aetna Commercial	$165.26
Rate for Payer: Aetna Medicare Advantage	$130.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.90
Rate for Payer: Cigna Commercial	$217.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.07
Rate for Payer: Oxford Commercial	$86.98
Rate for Payer: Qualcare PPO/HMO/WC	$65.23
Rate for Payer: UnitedHealthcare Commercial	$86.98
Rate for Payer: UnitedHealthcare Community & State	$13.74
Rate for Payer: Wellpoint Medicaid Managed Care	$12.35

METHOHEXITAL NA 500MG INJ

Facility

$434.90

Service Code	NDC 54569391200
Hospital Charge Code	6063943065
Hospital Revenue Code	250
Min. Negotiated Rate	$65.23
Max. Negotiated Rate	$65.23
Rate for Payer: Qualcare PPO/HMO/WC	$65.23

METHOTREXATE 2.5 MG TAB

Facility

$41.81

Service Code	NDC 378001401
Hospital Charge Code	60631731
Hospital Revenue Code	250
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$20.91
Rate for Payer: Aetna Commercial	$15.89
Rate for Payer: Aetna Medicare Advantage	$12.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.66
Rate for Payer: Cigna Commercial	$20.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.87
Rate for Payer: Oxford Commercial	$8.36
Rate for Payer: Qualcare PPO/HMO/WC	$6.27
Rate for Payer: UnitedHealthcare Commercial	$8.36
Rate for Payer: UnitedHealthcare Community & State	$1.32
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

METHOTREXATE 2.5 MG TAB

Facility

$41.81

Service Code	NDC 378001401
Hospital Charge Code	60631731
Hospital Revenue Code	250
Min. Negotiated Rate	$6.27
Max. Negotiated Rate	$6.27
Rate for Payer: Qualcare PPO/HMO/WC	$6.27

METHOTREXATE 50 MG/2 ML INJ

Facility

$169.51

Service Code	HCPCS J9260
Hospital Charge Code	60627400
Hospital Revenue Code	636
Min. Negotiated Rate	$25.43
Max. Negotiated Rate	$41.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.02
Rate for Payer: Qualcare PPO/HMO/WC	$25.43

METHOTREXATE 50 MG/2 ML INJ

Facility

$169.51

Service Code	HCPCS J9260
Hospital Charge Code	60627400
Hospital Revenue Code	636
Min. Negotiated Rate	$4.81
Max. Negotiated Rate	$84.75
Rate for Payer: Aetna Commercial	$64.41
Rate for Payer: Aetna Medicare Advantage	$50.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.23
Rate for Payer: Cigna Commercial	$84.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.02
Rate for Payer: Qualcare PPO/HMO/WC	$25.43
Rate for Payer: UnitedHealthcare Community & State	$5.36
Rate for Payer: Wellpoint Medicaid Managed Care	$4.81

METHOTREXATE PF 25MG/ML INJ

Facility

$17.69

Service Code	HCPCS J9260
Hospital Charge Code	6063943132
Hospital Revenue Code	636
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$8.85
Rate for Payer: Aetna Commercial	$6.72
Rate for Payer: Aetna Medicare Advantage	$5.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.51
Rate for Payer: Cigna Commercial	$8.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.28
Rate for Payer: Qualcare PPO/HMO/WC	$2.65
Rate for Payer: UnitedHealthcare Community & State	$0.56
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

METHOTREXATE PF 25MG/ML INJ

Facility

$17.69

Service Code	HCPCS J9260
Hospital Charge Code	6063943132
Hospital Revenue Code	636
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$4.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.28
Rate for Payer: Qualcare PPO/HMO/WC	$2.65

METHSUXIMIDE

Facility

$104.00

Service Code	HCPCS 80339
Hospital Charge Code	38477127
Hospital Revenue Code	301
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$39.52
Rate for Payer: Aetna Medicare Advantage	$31.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.52
Rate for Payer: Cigna Commercial	$52.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.04
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.60
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.66
Rate for Payer: Wellpoint Medicaid Managed Care	$2.95

METHSUXIMIDE

Facility

$104.00

Service Code	HCPCS 80339
Hospital Charge Code	38477127
Hospital Revenue Code	301
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.60

METHSUXIMIDE AS METAB

Facility

$132.50

Service Code	HCPCS 80339
Hospital Charge Code	3035147
Hospital Revenue Code	301
Min. Negotiated Rate	$3.76
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$50.35
Rate for Payer: Aetna Medicare Advantage	$39.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.79
Rate for Payer: Cigna Commercial	$66.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.45
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.88
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.66
Rate for Payer: Wellpoint Medicaid Managed Care	$3.76

METHSUXIMIDE AS METAB

Facility

$132.50

Service Code	HCPCS 80339
Hospital Charge Code	3035147
Hospital Revenue Code	301
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$19.88
Rate for Payer: Qualcare PPO/HMO/WC	$19.88

METHYLDOPA/250MG/TAB

Facility

$4.00

Service Code	NDC 51079020020
Hospital Charge Code	60633399
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

METHYLDOPA/250MG/TAB

Facility

$4.00

Service Code	NDC 51079020020
Hospital Charge Code	60633399
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

METHYLDOPA/500MG/TAB

Facility

$8.71

Service Code	NDC 93293201
Hospital Charge Code	60633396
Hospital Revenue Code	250
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$4.36
Rate for Payer: Aetna Commercial	$3.31
Rate for Payer: Aetna Medicare Advantage	$2.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.22
Rate for Payer: Cigna Commercial	$4.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.26
Rate for Payer: Oxford Commercial	$1.74
Rate for Payer: Qualcare PPO/HMO/WC	$1.31
Rate for Payer: UnitedHealthcare Commercial	$1.74
Rate for Payer: UnitedHealthcare Community & State	$0.28
Rate for Payer: Wellpoint Medicaid Managed Care	$0.25

METHYLDOPA/500MG/TAB

Facility

$8.71

Service Code	NDC 93293201
Hospital Charge Code	60633396
Hospital Revenue Code	250
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$1.31
Rate for Payer: Qualcare PPO/HMO/WC	$1.31

METHYLDOPATE INJ 250MG/5ML

Facility

$335.00

Service Code	HCPCS J0210
Hospital Charge Code	60627639
Hospital Revenue Code	636
Min. Negotiated Rate	$9.51
Max. Negotiated Rate	$167.50
Rate for Payer: Aetna Commercial	$127.30
Rate for Payer: Aetna Medicare Advantage	$100.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.42
Rate for Payer: Cigna Commercial	$167.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.07
Rate for Payer: Qualcare PPO/HMO/WC	$50.25
Rate for Payer: UnitedHealthcare Community & State	$10.59
Rate for Payer: Wellpoint Medicaid Managed Care	$9.51

METHYLDOPATE INJ 250MG/5ML

Facility

$335.00

Service Code	HCPCS J0210
Hospital Charge Code	60627639
Hospital Revenue Code	636
Min. Negotiated Rate	$50.25
Max. Negotiated Rate	$81.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.07
Rate for Payer: Qualcare PPO/HMO/WC	$50.25

METHYLENE BLUE 10MG/ML 1ML INJ

Facility

$52.33

Service Code	HCPCS Q9968
Hospital Charge Code	60632334
Hospital Revenue Code	636
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$37.33
Rate for Payer: Aetna Commercial	$27.99
Rate for Payer: Aetna Medicare Advantage	$33.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.33
Rate for Payer: Cigna Medicare Advantage	$10.29
Rate for Payer: Clover Medicare Advantage	$9.78
Rate for Payer: EmblemHealth Commercial	$30.87
Rate for Payer: Humana Medicare Advantage	$10.60
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.66
Rate for Payer: Qualcare PPO/HMO/WC	$7.85
Rate for Payer: UnitedHealthcare Community & State	$1.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.29
Rate for Payer: Wellcare Medicare Advantage	$10.29
Rate for Payer: Wellpoint Medicaid Managed Care	$1.49

METHYLENE BLUE 10MG/ML 1ML INJ

Facility

$52.33

Service Code	HCPCS Q9968
Hospital Charge Code	60632334
Hospital Revenue Code	636
Min. Negotiated Rate	$7.85
Max. Negotiated Rate	$12.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.66
Rate for Payer: Qualcare PPO/HMO/WC	$7.85

Know your out-of-pocket cost for care.

All Charges