Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FERMOAL COMP POST STB SZ 3.5 L

Facility

$7,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270685336
Hospital Revenue Code	278
Min. Negotiated Rate	$220.10
Max. Negotiated Rate	$3,875.00
Rate for Payer: Aetna Commercial	$2,945.00
Rate for Payer: Aetna Medicare Advantage	$2,325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,976.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,976.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,976.25
Rate for Payer: Cigna Commercial	$3,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.50
Rate for Payer: UnitedHealthcare Community & State	$244.90
Rate for Payer: Wellpoint Medicaid Managed Care	$220.10

FERMOAL COMP POST STB SZ 3 LEF

Facility

$7,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270684770
Hospital Revenue Code	278
Min. Negotiated Rate	$220.10
Max. Negotiated Rate	$3,875.00
Rate for Payer: Aetna Commercial	$2,945.00
Rate for Payer: Aetna Medicare Advantage	$2,325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,976.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,976.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,976.25
Rate for Payer: Cigna Commercial	$3,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.50
Rate for Payer: UnitedHealthcare Community & State	$244.90
Rate for Payer: Wellpoint Medicaid Managed Care	$220.10

FERMOAL COMP POST STB SZ 3 LEF

Facility

$7,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270684770
Hospital Revenue Code	278
Min. Negotiated Rate	$1,162.50
Max. Negotiated Rate	$1,875.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.50

FERMORAL HEAD 12/14 TAPER 7MM

Facility

$2,000.00

Hospital Charge Code	270675289
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

FERMORAL HEAD 12/14 TAPER 7MM

Facility

$2,000.00

Hospital Charge Code	270675289
Hospital Revenue Code	278
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$63.20
Rate for Payer: Wellpoint Medicaid Managed Care	$56.80

FERMORAL HEAD CEREMIC BIOLOX D

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270688631
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

FERMORAL HEAD CEREMIC BIOLOX D

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270688631
Hospital Revenue Code	278
Min. Negotiated Rate	$71.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$79.00
Rate for Payer: Wellpoint Medicaid Managed Care	$71.00

FERMORAL HEAD COCR -3.5x36MM

Facility

$3,311.05

Hospital Charge Code	270675769
Hospital Revenue Code	278
Min. Negotiated Rate	$496.66
Max. Negotiated Rate	$801.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$662.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$801.27
Rate for Payer: Qualcare PPO/HMO/WC	$496.66

FERMORAL HEAD COCR -3.5x36MM

Facility

$3,311.05

Hospital Charge Code	270675769
Hospital Revenue Code	278
Min. Negotiated Rate	$94.03
Max. Negotiated Rate	$1,655.53
Rate for Payer: Aetna Commercial	$1,258.20
Rate for Payer: Aetna Medicare Advantage	$993.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$844.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$844.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$662.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$844.32
Rate for Payer: Cigna Commercial	$1,655.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$801.27
Rate for Payer: Qualcare PPO/HMO/WC	$496.66
Rate for Payer: UnitedHealthcare Community & State	$104.63
Rate for Payer: Wellpoint Medicaid Managed Care	$94.03

FERMORAL NAIL 12 MM TI CANN

Facility

$16,295.00

Service Code	HCPCS C1713
Hospital Charge Code	270687125
Hospital Revenue Code	278
Min. Negotiated Rate	$462.78
Max. Negotiated Rate	$8,147.50
Rate for Payer: Aetna Commercial	$6,192.10
Rate for Payer: Aetna Medicare Advantage	$4,888.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,155.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,155.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,155.23
Rate for Payer: Cigna Commercial	$8,147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.25
Rate for Payer: UnitedHealthcare Community & State	$514.92
Rate for Payer: Wellpoint Medicaid Managed Care	$462.78

FERMORAL NAIL 12 MM TI CANN

Facility

$16,295.00

Service Code	HCPCS C1713
Hospital Charge Code	270687125
Hospital Revenue Code	278
Min. Negotiated Rate	$2,444.25
Max. Negotiated Rate	$3,943.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,943.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,444.25

FERMORAL TAP STEM EXT OFF-SZ 2

Facility

$7,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270669093
Hospital Revenue Code	278
Min. Negotiated Rate	$203.63
Max. Negotiated Rate	$3,585.00
Rate for Payer: Aetna Commercial	$2,724.60
Rate for Payer: Aetna Medicare Advantage	$2,151.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,828.35
Rate for Payer: Cigna Commercial	$3,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50
Rate for Payer: UnitedHealthcare Community & State	$226.57
Rate for Payer: Wellpoint Medicaid Managed Care	$203.63

FERMORAL TAP STEM EXT OFF-SZ 2

Facility

$7,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270669093
Hospital Revenue Code	278
Min. Negotiated Rate	$1,075.50
Max. Negotiated Rate	$1,735.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50

FERMORAL TAP STEM EXT OFF-SZ 4

Facility

$7,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270669095
Hospital Revenue Code	278
Min. Negotiated Rate	$203.63
Max. Negotiated Rate	$3,585.00
Rate for Payer: Aetna Commercial	$2,724.60
Rate for Payer: Aetna Medicare Advantage	$2,151.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,828.35
Rate for Payer: Cigna Commercial	$3,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50
Rate for Payer: UnitedHealthcare Community & State	$226.57
Rate for Payer: Wellpoint Medicaid Managed Care	$203.63

FERMORAL TAP STEM EXT OFF-SZ 4

Facility

$7,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270669095
Hospital Revenue Code	278
Min. Negotiated Rate	$1,075.50
Max. Negotiated Rate	$1,735.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50

FERMORAL TAP STEM EXT OFF-SZ 5

Facility

$7,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270669096
Hospital Revenue Code	278
Min. Negotiated Rate	$203.63
Max. Negotiated Rate	$3,585.00
Rate for Payer: Aetna Commercial	$2,724.60
Rate for Payer: Aetna Medicare Advantage	$2,151.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,828.35
Rate for Payer: Cigna Commercial	$3,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50
Rate for Payer: UnitedHealthcare Community & State	$226.57
Rate for Payer: Wellpoint Medicaid Managed Care	$203.63

FERMORAL TAP STEM EXT OFF-SZ 5

Facility

$7,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270669096
Hospital Revenue Code	278
Min. Negotiated Rate	$1,075.50
Max. Negotiated Rate	$1,735.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50

FERRIC CITRATE 210 MG TAB

Facility

$27.65

Hospital Charge Code	606390071
Hospital Revenue Code	250
Min. Negotiated Rate	$4.15
Max. Negotiated Rate	$4.15
Rate for Payer: Qualcare PPO/HMO/WC	$4.15

FERRIC CITRATE 210 MG TAB

Facility

$27.65

Hospital Charge Code	606390071
Hospital Revenue Code	250
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$13.82
Rate for Payer: Aetna Commercial	$10.51
Rate for Payer: Aetna Medicare Advantage	$8.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.05
Rate for Payer: Cigna Commercial	$13.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.19
Rate for Payer: Oxford Commercial	$5.53
Rate for Payer: Qualcare PPO/HMO/WC	$4.15
Rate for Payer: UnitedHealthcare Commercial	$5.53
Rate for Payer: UnitedHealthcare Community & State	$0.87
Rate for Payer: Wellpoint Medicaid Managed Care	$0.79

FERRIC SUBSULFATE 30 ML

Facility

$16.75

Service Code	NDC 10481011202
Hospital Charge Code	6023411
Hospital Revenue Code	250
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$2.51
Rate for Payer: Qualcare PPO/HMO/WC	$2.51

FERRIC SUBSULFATE 30 ML

Facility

$16.75

Service Code	NDC 10481011202
Hospital Charge Code	6023411
Hospital Revenue Code	250
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$8.38
Rate for Payer: Aetna Commercial	$6.37
Rate for Payer: Aetna Medicare Advantage	$5.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.27
Rate for Payer: Cigna Commercial	$8.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.36
Rate for Payer: Oxford Commercial	$3.35
Rate for Payer: Qualcare PPO/HMO/WC	$2.51
Rate for Payer: UnitedHealthcare Commercial	$3.35
Rate for Payer: UnitedHealthcare Community & State	$0.53
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

FERRIC SUBSULFATE 8ML

Facility

$95.95

Hospital Charge Code	606390573
Hospital Revenue Code	250
Min. Negotiated Rate	$2.72
Max. Negotiated Rate	$47.98
Rate for Payer: Aetna Commercial	$36.46
Rate for Payer: Aetna Medicare Advantage	$28.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.47
Rate for Payer: Cigna Commercial	$47.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.95
Rate for Payer: Oxford Commercial	$19.19
Rate for Payer: Qualcare PPO/HMO/WC	$14.39
Rate for Payer: UnitedHealthcare Commercial	$19.19
Rate for Payer: UnitedHealthcare Community & State	$3.03
Rate for Payer: Wellpoint Medicaid Managed Care	$2.72

FERRIC SUBSULFATE 8ML

Facility

$95.95

Hospital Charge Code	606390573
Hospital Revenue Code	250
Min. Negotiated Rate	$14.39
Max. Negotiated Rate	$14.39
Rate for Payer: Qualcare PPO/HMO/WC	$14.39

FERRIC SUBSULFATE SOL

Facility

$125.63

Service Code	NDC 10481011202
Hospital Charge Code	60628446
Hospital Revenue Code	250
Min. Negotiated Rate	$18.84
Max. Negotiated Rate	$18.84
Rate for Payer: Qualcare PPO/HMO/WC	$18.84

FERRIC SUBSULFATE SOL

Facility

$125.63

Service Code	NDC 10481011202
Hospital Charge Code	60628446
Hospital Revenue Code	250
Min. Negotiated Rate	$3.57
Max. Negotiated Rate	$62.81
Rate for Payer: Aetna Commercial	$47.74
Rate for Payer: Aetna Medicare Advantage	$37.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.04
Rate for Payer: Cigna Commercial	$62.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.66
Rate for Payer: Oxford Commercial	$25.13
Rate for Payer: Qualcare PPO/HMO/WC	$18.84
Rate for Payer: UnitedHealthcare Commercial	$25.13
Rate for Payer: UnitedHealthcare Community & State	$3.97
Rate for Payer: Wellpoint Medicaid Managed Care	$3.57

Know your out-of-pocket cost for care.

All Charges