Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FERRIS SMITH IVD RONGEUR 6 X 1

Facility

$3,915.00

Hospital Charge Code	270688733
Hospital Revenue Code	272
Min. Negotiated Rate	$111.19
Max. Negotiated Rate	$1,957.50
Rate for Payer: Aetna Commercial	$1,487.70
Rate for Payer: Aetna Medicare Advantage	$1,174.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$998.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$998.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$998.33
Rate for Payer: Cigna Commercial	$1,957.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,017.90
Rate for Payer: Oxford Commercial	$783.00
Rate for Payer: Qualcare PPO/HMO/WC	$587.25
Rate for Payer: UnitedHealthcare Commercial	$783.00
Rate for Payer: UnitedHealthcare Community & State	$123.71
Rate for Payer: Wellpoint Medicaid Managed Care	$111.19

FERRIS SMITH IVD RONGEUR 6 X 1

Facility

$3,915.00

Hospital Charge Code	270688733
Hospital Revenue Code	272
Min. Negotiated Rate	$587.25
Max. Negotiated Rate	$587.25
Rate for Payer: Qualcare PPO/HMO/WC	$587.25

FERRITIN

Facility

$491.40

Service Code	HCPCS 82728
Hospital Charge Code	38472278
Hospital Revenue Code	301
Min. Negotiated Rate	$10.90
Max. Negotiated Rate	$245.70
Rate for Payer: Aetna Commercial	$37.07
Rate for Payer: Aetna Medicare Advantage	$44.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.44
Rate for Payer: Cigna Commercial	$245.70
Rate for Payer: Cigna Medicare Advantage	$13.63
Rate for Payer: Clover Medicare Advantage	$12.95
Rate for Payer: EmblemHealth Commercial	$40.89
Rate for Payer: Humana Medicare Advantage	$14.04
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.76
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$73.71
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.63
Rate for Payer: Wellcare Medicare Advantage	$13.63
Rate for Payer: Wellpoint Medicaid Managed Care	$13.96

FERRITIN

Facility

$491.40

Service Code	HCPCS 82728
Hospital Charge Code	38472278
Hospital Revenue Code	301
Min. Negotiated Rate	$73.71
Max. Negotiated Rate	$73.71
Rate for Payer: Qualcare PPO/HMO/WC	$73.71

FERRITIN

Facility

$1,087.80

Service Code	HCPCS 82728
Hospital Charge Code	39888004
Hospital Revenue Code	301
Min. Negotiated Rate	$10.90
Max. Negotiated Rate	$543.90
Rate for Payer: Aetna Commercial	$37.07
Rate for Payer: Aetna Medicare Advantage	$44.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.44
Rate for Payer: Cigna Commercial	$543.90
Rate for Payer: Cigna Medicare Advantage	$13.63
Rate for Payer: Clover Medicare Advantage	$12.95
Rate for Payer: EmblemHealth Commercial	$40.89
Rate for Payer: Humana Medicare Advantage	$14.04
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$282.83
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$163.17
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.63
Rate for Payer: Wellcare Medicare Advantage	$13.63
Rate for Payer: Wellpoint Medicaid Managed Care	$30.89

FERRITIN

Facility

$635.48

Service Code	HCPCS 82728
Hospital Charge Code	39900412
Hospital Revenue Code	301
Min. Negotiated Rate	$95.32
Max. Negotiated Rate	$95.32
Rate for Payer: Qualcare PPO/HMO/WC	$95.32

FERRITIN

Facility

$1,087.80

Service Code	HCPCS 82728
Hospital Charge Code	39888004
Hospital Revenue Code	301
Min. Negotiated Rate	$163.17
Max. Negotiated Rate	$163.17
Rate for Payer: Qualcare PPO/HMO/WC	$163.17

FERRITIN

Facility

$635.48

Service Code	HCPCS 82728
Hospital Charge Code	39900412
Hospital Revenue Code	301
Min. Negotiated Rate	$10.90
Max. Negotiated Rate	$317.74
Rate for Payer: Aetna Commercial	$37.07
Rate for Payer: Aetna Medicare Advantage	$44.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.44
Rate for Payer: Cigna Commercial	$317.74
Rate for Payer: Cigna Medicare Advantage	$13.63
Rate for Payer: Clover Medicare Advantage	$12.95
Rate for Payer: EmblemHealth Commercial	$40.89
Rate for Payer: Humana Medicare Advantage	$14.04
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.22
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$95.32
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.63
Rate for Payer: Wellcare Medicare Advantage	$13.63
Rate for Payer: Wellpoint Medicaid Managed Care	$18.05

FERRLICIT INJ 62.5/5ML

Facility

$255.67

Service Code	HCPCS J2916
Hospital Charge Code	60635333
Hospital Revenue Code	636
Min. Negotiated Rate	$7.26
Max. Negotiated Rate	$127.83
Rate for Payer: Aetna Commercial	$97.15
Rate for Payer: Aetna Medicare Advantage	$76.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.20
Rate for Payer: Cigna Commercial	$127.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.87
Rate for Payer: Qualcare PPO/HMO/WC	$38.35
Rate for Payer: UnitedHealthcare Community & State	$8.08
Rate for Payer: Wellpoint Medicaid Managed Care	$7.26

FERRLICIT INJ 62.5/5ML

Facility

$255.67

Service Code	HCPCS J2916
Hospital Charge Code	60635333
Hospital Revenue Code	636
Min. Negotiated Rate	$38.35
Max. Negotiated Rate	$61.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.87
Rate for Payer: Qualcare PPO/HMO/WC	$38.35

FERROUS GLUCONATE TAB 325MG

Facility

$4.00

Service Code	NDC 574050811
Hospital Charge Code	60627499
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

FERROUS GLUCONATE TAB 325MG

Facility

$4.00

Service Code	NDC 574050811
Hospital Charge Code	60627499
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

FERROUS SULFATE 15MG/ML DROPS

Facility

$4.00

Service Code	NDC 39328005750
Hospital Charge Code	606390132
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

FERROUS SULFATE 15MG/ML DROPS

Facility

$4.00

Service Code	NDC 39328005750
Hospital Charge Code	606390132
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

FERROUS SULFATE 220 MG/5 ML ML

Facility

$4.00

Service Code	NDC 50383077816
Hospital Charge Code	6063943200
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

FERROUS SULFATE 220 MG/5 ML ML

Facility

$4.00

Service Code	NDC 50383077816
Hospital Charge Code	6063943200
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

FERROUS SULFATE 325MG EC TAB

Facility

$4.00

Service Code	NDC 46017009712
Hospital Charge Code	60631451
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

FERROUS SULFATE 325MG EC TAB

Facility

$4.00

Service Code	NDC 46017009712
Hospital Charge Code	60631451
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

FERROUS SULFATE LQ 300MG/5ML

Facility

$27.27

Service Code	NDC 121053005
Hospital Charge Code	60627501
Hospital Revenue Code	250
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$13.63
Rate for Payer: Aetna Commercial	$10.36
Rate for Payer: Aetna Medicare Advantage	$8.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.95
Rate for Payer: Cigna Commercial	$13.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.09
Rate for Payer: Oxford Commercial	$5.45
Rate for Payer: Qualcare PPO/HMO/WC	$4.09
Rate for Payer: UnitedHealthcare Commercial	$5.45
Rate for Payer: UnitedHealthcare Community & State	$0.86
Rate for Payer: Wellpoint Medicaid Managed Care	$0.77

FERROUS SULFATE LQ 300MG/5ML

Facility

$27.27

Service Code	NDC 121053005
Hospital Charge Code	60627501
Hospital Revenue Code	250
Min. Negotiated Rate	$4.09
Max. Negotiated Rate	$4.09
Rate for Payer: Qualcare PPO/HMO/WC	$4.09

FERUMOXYTOL 510MG

Facility

$269.94

Service Code	HCPCS Q0138
Hospital Charge Code	60639603
Hospital Revenue Code	636
Min. Negotiated Rate	$40.49
Max. Negotiated Rate	$65.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.33
Rate for Payer: Qualcare PPO/HMO/WC	$40.49

FERUMOXYTOL 510MG

Facility

$269.94

Service Code	HCPCS Q0138
Hospital Charge Code	60639603
Hospital Revenue Code	636
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$65.33
Rate for Payer: Aetna Commercial	$0.63
Rate for Payer: Aetna Medicare Advantage	$0.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$0.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.83
Rate for Payer: Cigna Medicare Advantage	$0.23
Rate for Payer: Clover Medicare Advantage	$0.22
Rate for Payer: EmblemHealth Commercial	$0.69
Rate for Payer: Humana Medicare Advantage	$0.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$0.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.33
Rate for Payer: Qualcare PPO/HMO/WC	$40.49
Rate for Payer: UnitedHealthcare Community & State	$8.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$0.23
Rate for Payer: Wellcare Medicare Advantage	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.67

FETAL BIOPHYSICAL WNST

Facility

$1,724.80

Service Code	HCPCS 76818
Hospital Charge Code	83653085
Hospital Revenue Code	402
Min. Negotiated Rate	$258.72
Max. Negotiated Rate	$258.72
Rate for Payer: Qualcare PPO/HMO/WC	$258.72

FETAL BIOPHYSICAL WNST

Facility

$1,724.80

Service Code	HCPCS 76818
Hospital Charge Code	83653085
Hospital Revenue Code	402
Min. Negotiated Rate	$48.98
Max. Negotiated Rate	$2,904.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.45
Rate for Payer: Oxford Commercial	$2,697.00
Rate for Payer: Qualcare PPO/HMO/WC	$258.72
Rate for Payer: UnitedHealthcare Commercial	$2,904.00
Rate for Payer: UnitedHealthcare Community & State	$54.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$48.98

FETAL BIOPHYSICAL WNST EA ADTL

Facility

$1,724.80

Service Code	HCPCS 76818
Hospital Charge Code	74308355
Hospital Revenue Code	402
Min. Negotiated Rate	$48.98
Max. Negotiated Rate	$2,904.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.45
Rate for Payer: Oxford Commercial	$2,697.00
Rate for Payer: Qualcare PPO/HMO/WC	$258.72
Rate for Payer: UnitedHealthcare Commercial	$2,904.00
Rate for Payer: UnitedHealthcare Community & State	$54.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$48.98

Know your out-of-pocket cost for care.

All Charges