Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FIBRINOGEN, QUANT

Facility

$667.59

Service Code	HCPCS 85384
Hospital Charge Code	3001302
Hospital Revenue Code	305
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

FIBRINOLYTIC FACTRS/INHIB PLAS

Facility

$121.00

Service Code	HCPCS 85415
Hospital Charge Code	38477145
Hospital Revenue Code	305
Min. Negotiated Rate	$3.44
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$46.76
Rate for Payer: Aetna Medicare Advantage	$55.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.36
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: Cigna Medicare Advantage	$17.19
Rate for Payer: Clover Medicare Advantage	$16.33
Rate for Payer: EmblemHealth Commercial	$51.57
Rate for Payer: Humana Medicare Advantage	$17.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.46
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.19
Rate for Payer: Wellcare Medicare Advantage	$17.19
Rate for Payer: Wellpoint Medicaid Managed Care	$3.44

FIBRINOLYTIC FACTRS/INHIB PLAS

Facility

$121.00

Service Code	HCPCS 85415
Hospital Charge Code	38477145
Hospital Revenue Code	305
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

FIBRINOLYTIC PLASMINOGEN

Facility

$390.00

Service Code	HCPCS 85420
Hospital Charge Code	401485420
Hospital Revenue Code	305
Min. Negotiated Rate	$5.22
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$17.76
Rate for Payer: Aetna Medicare Advantage	$21.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.69
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$6.53
Rate for Payer: Clover Medicare Advantage	$6.20
Rate for Payer: EmblemHealth Commercial	$19.59
Rate for Payer: Humana Medicare Advantage	$6.73
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$5.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.53
Rate for Payer: Wellcare Medicare Advantage	$6.53
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

FIBRINOLYTIC PLASMINOGEN

Facility

$390.00

Service Code	HCPCS 85420
Hospital Charge Code	401485420
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FIBRIN SPLIT PRODUCTS

Facility

$390.00

Service Code	HCPCS 85362
Hospital Charge Code	3002946
Hospital Revenue Code	305
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$18.74
Rate for Payer: Aetna Medicare Advantage	$22.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.99
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$6.89
Rate for Payer: Clover Medicare Advantage	$6.55
Rate for Payer: EmblemHealth Commercial	$20.67
Rate for Payer: Humana Medicare Advantage	$7.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$5.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.89
Rate for Payer: Wellcare Medicare Advantage	$6.89
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

FIBRIN SPLIT PRODUCTS

Facility

$390.00

Service Code	HCPCS 85362
Hospital Charge Code	3002946
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FIBROGEN ACTIVITY

Facility

$390.00

Service Code	HCPCS 85384
Hospital Charge Code	401485384
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FIBROGEN ACTIVITY

Facility

$390.00

Service Code	HCPCS 85384
Hospital Charge Code	401485384
Hospital Revenue Code	305
Min. Negotiated Rate	$7.78
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$26.44
Rate for Payer: Aetna Medicare Advantage	$31.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.26
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$9.72
Rate for Payer: Clover Medicare Advantage	$9.23
Rate for Payer: EmblemHealth Commercial	$29.16
Rate for Payer: Humana Medicare Advantage	$10.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$7.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.72
Rate for Payer: Wellcare Medicare Advantage	$9.72
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

FIBULA ANATOMIC LOCK RIGHT 4H

Facility

$3,172.00

Service Code	HCPCS C1713
Hospital Charge Code	270681981
Hospital Revenue Code	278
Min. Negotiated Rate	$475.80
Max. Negotiated Rate	$767.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$634.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$767.62
Rate for Payer: Qualcare PPO/HMO/WC	$475.80

FIBULA ANATOMIC LOCK RIGHT 4H

Facility

$3,172.00

Service Code	HCPCS C1713
Hospital Charge Code	270681981
Hospital Revenue Code	278
Min. Negotiated Rate	$90.08
Max. Negotiated Rate	$1,586.00
Rate for Payer: Aetna Commercial	$1,205.36
Rate for Payer: Aetna Medicare Advantage	$951.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$808.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$808.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$634.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$808.86
Rate for Payer: Cigna Commercial	$1,586.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$767.62
Rate for Payer: Qualcare PPO/HMO/WC	$475.80
Rate for Payer: UnitedHealthcare Community & State	$100.24
Rate for Payer: Wellpoint Medicaid Managed Care	$90.08

FIBULA COMP LOCK PLATE 10H

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270685141
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

FIBULA COMP LOCK PLATE 10H

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270685141
Hospital Revenue Code	278
Min. Negotiated Rate	$46.15
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Community & State	$51.35
Rate for Payer: Wellpoint Medicaid Managed Care	$46.15

FIBULAR ANATOMIC LOCK RIGHT 3H

Facility

$3,867.50

Service Code	HCPCS C1776
Hospital Charge Code	270685944
Hospital Revenue Code	278
Min. Negotiated Rate	$109.84
Max. Negotiated Rate	$1,933.75
Rate for Payer: Aetna Commercial	$1,469.65
Rate for Payer: Aetna Medicare Advantage	$1,160.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$986.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$986.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$773.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$986.21
Rate for Payer: Cigna Commercial	$1,933.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$935.93
Rate for Payer: Qualcare PPO/HMO/WC	$580.12
Rate for Payer: UnitedHealthcare Community & State	$122.21
Rate for Payer: Wellpoint Medicaid Managed Care	$109.84

FIBULAR ANATOMIC LOCK RIGHT 3H

Facility

$3,867.50

Service Code	HCPCS C1776
Hospital Charge Code	270685944
Hospital Revenue Code	278
Min. Negotiated Rate	$580.12
Max. Negotiated Rate	$935.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$773.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$935.93
Rate for Payer: Qualcare PPO/HMO/WC	$580.12

FIBULAR PLATE STRAIGHT 3 HOLE

Facility

$3,435.00

Service Code	HCPCS C1713
Hospital Charge Code	270701710
Hospital Revenue Code	278
Min. Negotiated Rate	$97.55
Max. Negotiated Rate	$1,717.50
Rate for Payer: Aetna Commercial	$1,305.30
Rate for Payer: Aetna Medicare Advantage	$1,030.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$875.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$875.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$687.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$875.92
Rate for Payer: Cigna Commercial	$1,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$831.27
Rate for Payer: Qualcare PPO/HMO/WC	$515.25
Rate for Payer: UnitedHealthcare Community & State	$108.55
Rate for Payer: Wellpoint Medicaid Managed Care	$97.55

FIBULAR PLATE STRAIGHT 3 HOLE

Facility

$3,435.00

Service Code	HCPCS C1713
Hospital Charge Code	270701710
Hospital Revenue Code	278
Min. Negotiated Rate	$515.25
Max. Negotiated Rate	$831.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$687.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$831.27
Rate for Payer: Qualcare PPO/HMO/WC	$515.25

FIBULAR SEGMENT

Facility

$3,292.50

Hospital Charge Code	270662381
Hospital Revenue Code	270
Min. Negotiated Rate	$93.51
Max. Negotiated Rate	$1,646.25
Rate for Payer: Aetna Commercial	$1,251.15
Rate for Payer: Aetna Medicare Advantage	$987.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$839.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$839.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$839.59
Rate for Payer: Cigna Commercial	$1,646.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$856.05
Rate for Payer: Oxford Commercial	$658.50
Rate for Payer: Qualcare PPO/HMO/WC	$493.88
Rate for Payer: UnitedHealthcare Commercial	$658.50
Rate for Payer: UnitedHealthcare Community & State	$104.04
Rate for Payer: Wellpoint Medicaid Managed Care	$93.51

FIBULAR SEGMENT

Facility

$3,292.50

Hospital Charge Code	270662381
Hospital Revenue Code	270
Min. Negotiated Rate	$493.88
Max. Negotiated Rate	$493.88
Rate for Payer: Qualcare PPO/HMO/WC	$493.88

FIBULOCK REMOVAL KIT

Facility

$8,125.00

Service Code	HCPCS A4649
Hospital Charge Code	270699330
Hospital Revenue Code	272
Min. Negotiated Rate	$230.75
Max. Negotiated Rate	$4,062.50
Rate for Payer: Aetna Commercial	$3,087.50
Rate for Payer: Aetna Medicare Advantage	$2,437.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,071.88
Rate for Payer: Cigna Commercial	$4,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,112.50
Rate for Payer: Oxford Commercial	$1,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75
Rate for Payer: UnitedHealthcare Commercial	$1,625.00
Rate for Payer: UnitedHealthcare Community & State	$256.75
Rate for Payer: Wellpoint Medicaid Managed Care	$230.75

FIBULOCK REMOVAL KIT

Facility

$8,125.00

Service Code	HCPCS A4649
Hospital Charge Code	270699330
Hospital Revenue Code	272
Min. Negotiated Rate	$1,218.75
Max. Negotiated Rate	$1,218.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75

FIDAXOMICIN 200 MG TAB

Facility

$1,329.68

Service Code	NDC 52015008001
Hospital Charge Code	60630096
Hospital Revenue Code	250
Min. Negotiated Rate	$37.76
Max. Negotiated Rate	$664.84
Rate for Payer: Aetna Commercial	$505.28
Rate for Payer: Aetna Medicare Advantage	$398.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$339.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$339.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$339.07
Rate for Payer: Cigna Commercial	$664.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$345.72
Rate for Payer: Oxford Commercial	$265.94
Rate for Payer: Qualcare PPO/HMO/WC	$199.45
Rate for Payer: UnitedHealthcare Commercial	$265.94
Rate for Payer: UnitedHealthcare Community & State	$42.02
Rate for Payer: Wellpoint Medicaid Managed Care	$37.76

FIDAXOMICIN 200 MG TAB

Facility

$1,329.68

Service Code	NDC 52015008001
Hospital Charge Code	60630096
Hospital Revenue Code	250
Min. Negotiated Rate	$199.45
Max. Negotiated Rate	$199.45
Rate for Payer: Qualcare PPO/HMO/WC	$199.45

FILARIASIS,BLOOD

Facility

$162.00

Service Code	HCPCS 87207
Hospital Charge Code	38475093
Hospital Revenue Code	309
Min. Negotiated Rate	$24.30
Max. Negotiated Rate	$24.30
Rate for Payer: Qualcare PPO/HMO/WC	$24.30

FILARIASIS,BLOOD

Facility

$162.00

Service Code	HCPCS 87207
Hospital Charge Code	38475093
Hospital Revenue Code	309
Min. Negotiated Rate	$4.60
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$16.29
Rate for Payer: Aetna Medicare Advantage	$19.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.73
Rate for Payer: Cigna Commercial	$81.00
Rate for Payer: Cigna Medicare Advantage	$5.99
Rate for Payer: Clover Medicare Advantage	$5.69
Rate for Payer: EmblemHealth Commercial	$17.97
Rate for Payer: Humana Medicare Advantage	$6.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.12
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.30
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.99
Rate for Payer: Wellcare Medicare Advantage	$5.99
Rate for Payer: Wellpoint Medicaid Managed Care	$4.60

Know your out-of-pocket cost for care.

All Charges