Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FLUPHENAZINE 2.5 MG TAB

Facility

$4.62

Service Code	NDC 51079048620
Hospital Charge Code	6027023
Hospital Revenue Code	251
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$0.69
Rate for Payer: Qualcare PPO/HMO/WC	$0.69

FLUPHENAZINE 2.5 MG TAB

Facility

$4.62

Service Code	NDC 51079048620
Hospital Charge Code	6027023
Hospital Revenue Code	251
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.31
Rate for Payer: Aetna Commercial	$1.76
Rate for Payer: Aetna Medicare Advantage	$1.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.18
Rate for Payer: Cigna Commercial	$2.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.92
Rate for Payer: Qualcare PPO/HMO/WC	$0.69
Rate for Payer: UnitedHealthcare Commercial	$0.92
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

FLUPHENAZINE 5MG/ML ORAL SOL

Facility

$21.04

Service Code	NDC 121065304
Hospital Charge Code	6063943111
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$10.52
Rate for Payer: Aetna Commercial	$8.00
Rate for Payer: Aetna Medicare Advantage	$6.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.37
Rate for Payer: Cigna Commercial	$10.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.47
Rate for Payer: Oxford Commercial	$4.21
Rate for Payer: Qualcare PPO/HMO/WC	$3.16
Rate for Payer: UnitedHealthcare Commercial	$4.21
Rate for Payer: UnitedHealthcare Community & State	$0.66
Rate for Payer: Wellpoint Medicaid Managed Care	$0.60

FLUPHENAZINE 5MG/ML ORAL SOL

Facility

$21.04

Service Code	NDC 121065304
Hospital Charge Code	6063943111
Hospital Revenue Code	250
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$3.16
Rate for Payer: Qualcare PPO/HMO/WC	$3.16

FLUPHENAZINE 5 MG TAB

Facility

$5.36

Service Code	NDC 51079048720
Hospital Charge Code	6027015
Hospital Revenue Code	251
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.80

FLUPHENAZINE 5 MG TAB

Facility

$5.36

Service Code	NDC 51079048720
Hospital Charge Code	6027015
Hospital Revenue Code	251
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$2.68
Rate for Payer: Aetna Commercial	$2.04
Rate for Payer: Aetna Medicare Advantage	$1.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.37
Rate for Payer: Cigna Commercial	$2.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.39
Rate for Payer: Oxford Commercial	$1.07
Rate for Payer: Qualcare PPO/HMO/WC	$0.80
Rate for Payer: UnitedHealthcare Commercial	$1.07
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

FLUPHENAZINE ELX 2.5MG/5ML

Facility

$21.44

Service Code	NDC 121065402
Hospital Charge Code	60627797
Hospital Revenue Code	250
Min. Negotiated Rate	$3.22
Max. Negotiated Rate	$3.22
Rate for Payer: Qualcare PPO/HMO/WC	$3.22

FLUPHENAZINE ELX 2.5MG/5ML

Facility

$21.44

Service Code	NDC 121065402
Hospital Charge Code	60627797
Hospital Revenue Code	250
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$10.72
Rate for Payer: Aetna Commercial	$8.15
Rate for Payer: Aetna Medicare Advantage	$6.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.47
Rate for Payer: Cigna Commercial	$10.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.57
Rate for Payer: Oxford Commercial	$4.29
Rate for Payer: Qualcare PPO/HMO/WC	$3.22
Rate for Payer: UnitedHealthcare Commercial	$4.29
Rate for Payer: UnitedHealthcare Community & State	$0.68
Rate for Payer: Wellpoint Medicaid Managed Care	$0.61

FLUPHENAZINE,URINE

Facility

$67.25

Service Code	HCPCS 80342
Hospital Charge Code	3000777
Hospital Revenue Code	301
Min. Negotiated Rate	$1.91
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$25.55
Rate for Payer: Aetna Medicare Advantage	$20.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.15
Rate for Payer: Cigna Commercial	$33.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.48
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.09
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.48
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

FLUPHENAZINE,URINE

Facility

$67.25

Service Code	HCPCS 80342
Hospital Charge Code	3000777
Hospital Revenue Code	301
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$10.09
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

FLURBIPROFEN 0.03% OPHTH SOLN

Facility

$261.97

Service Code	NDC 11980080103
Hospital Charge Code	60628088
Hospital Revenue Code	250
Min. Negotiated Rate	$39.30
Max. Negotiated Rate	$39.30
Rate for Payer: Qualcare PPO/HMO/WC	$39.30

FLURBIPROFEN 0.03% OPHTH SOLN

Facility

$261.97

Service Code	NDC 11980080103
Hospital Charge Code	60628088
Hospital Revenue Code	250
Min. Negotiated Rate	$7.44
Max. Negotiated Rate	$130.99
Rate for Payer: Aetna Commercial	$99.55
Rate for Payer: Aetna Medicare Advantage	$78.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.80
Rate for Payer: Cigna Commercial	$130.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.11
Rate for Payer: Oxford Commercial	$52.39
Rate for Payer: Qualcare PPO/HMO/WC	$39.30
Rate for Payer: UnitedHealthcare Commercial	$52.39
Rate for Payer: UnitedHealthcare Community & State	$8.28
Rate for Payer: Wellpoint Medicaid Managed Care	$7.44

FLUSH IMPIMG 1ST SCREW

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270694628
Hospital Revenue Code	278
Min. Negotiated Rate	$20.59
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Community & State	$22.91
Rate for Payer: Wellpoint Medicaid Managed Care	$20.59

FLUSH IMPIMG 1ST SCREW

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270694628
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

FLUSHING A PORTA CATH/PICC

Facility

$264.80

Service Code	HCPCS 96523
Hospital Charge Code	93500099
Hospital Revenue Code	761
Min. Negotiated Rate	$7.52
Max. Negotiated Rate	$254.22
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.22
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.85
Rate for Payer: Oxford Commercial	$52.96
Rate for Payer: Qualcare PPO/HMO/WC	$39.72
Rate for Payer: UnitedHealthcare Commercial	$52.96
Rate for Payer: UnitedHealthcare Community & State	$8.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$7.52

FLUSHING A PORTA CATH/PICC

Facility

$264.80

Service Code	HCPCS 96523
Hospital Charge Code	93500099
Hospital Revenue Code	761
Min. Negotiated Rate	$39.72
Max. Negotiated Rate	$39.72
Rate for Payer: Qualcare PPO/HMO/WC	$39.72

FLUTE TIP GUIDEWIRE LENGTH 400

Facility

$1,620.00

Service Code	HCPCS C1769
Hospital Charge Code	270687816
Hospital Revenue Code	278
Min. Negotiated Rate	$243.00
Max. Negotiated Rate	$392.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$324.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.04
Rate for Payer: Qualcare PPO/HMO/WC	$243.00

FLUTE TIP GUIDEWIRE LENGTH 400

Facility

$1,620.00

Service Code	HCPCS C1769
Hospital Charge Code	270687816
Hospital Revenue Code	278
Min. Negotiated Rate	$46.01
Max. Negotiated Rate	$810.00
Rate for Payer: Aetna Commercial	$615.60
Rate for Payer: Aetna Medicare Advantage	$486.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$413.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$413.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$413.10
Rate for Payer: Cigna Commercial	$810.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.04
Rate for Payer: Qualcare PPO/HMO/WC	$243.00
Rate for Payer: UnitedHealthcare Community & State	$51.19
Rate for Payer: Wellpoint Medicaid Managed Care	$46.01

FLUTICASONE & SALMETERL INH113

Facility

$1,027.91

Service Code	NDC 93360882
Hospital Charge Code	606390251
Hospital Revenue Code	250
Min. Negotiated Rate	$154.19
Max. Negotiated Rate	$154.19
Rate for Payer: Qualcare PPO/HMO/WC	$154.19

FLUTICASONE & SALMETERL INH113

Facility

$1,027.91

Service Code	NDC 93360882
Hospital Charge Code	606390251
Hospital Revenue Code	250
Min. Negotiated Rate	$29.19
Max. Negotiated Rate	$513.96
Rate for Payer: Aetna Commercial	$390.61
Rate for Payer: Aetna Medicare Advantage	$308.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$262.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$262.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$262.12
Rate for Payer: Cigna Commercial	$513.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$267.26
Rate for Payer: Oxford Commercial	$205.58
Rate for Payer: Qualcare PPO/HMO/WC	$154.19
Rate for Payer: UnitedHealthcare Commercial	$205.58
Rate for Payer: UnitedHealthcare Community & State	$32.48
Rate for Payer: Wellpoint Medicaid Managed Care	$29.19

FLUTICASONE & SALMETERL INH232

Facility

$1,027.91

Service Code	NDC 93360982
Hospital Charge Code	606390252
Hospital Revenue Code	250
Min. Negotiated Rate	$154.19
Max. Negotiated Rate	$154.19
Rate for Payer: Qualcare PPO/HMO/WC	$154.19

FLUTICASONE & SALMETERL INH232

Facility

$1,027.91

Service Code	NDC 93360982
Hospital Charge Code	606390252
Hospital Revenue Code	250
Min. Negotiated Rate	$29.19
Max. Negotiated Rate	$513.96
Rate for Payer: Aetna Commercial	$390.61
Rate for Payer: Aetna Medicare Advantage	$308.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$262.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$262.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$262.12
Rate for Payer: Cigna Commercial	$513.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$267.26
Rate for Payer: Oxford Commercial	$205.58
Rate for Payer: Qualcare PPO/HMO/WC	$154.19
Rate for Payer: UnitedHealthcare Commercial	$205.58
Rate for Payer: UnitedHealthcare Community & State	$32.48
Rate for Payer: Wellpoint Medicaid Managed Care	$29.19

FLUTICASONE & SALMETEROL INH55

Facility

$1,027.91

Service Code	NDC 93360782
Hospital Charge Code	606390250
Hospital Revenue Code	250
Min. Negotiated Rate	$29.19
Max. Negotiated Rate	$513.96
Rate for Payer: Aetna Commercial	$390.61
Rate for Payer: Aetna Medicare Advantage	$308.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$262.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$262.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$262.12
Rate for Payer: Cigna Commercial	$513.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$267.26
Rate for Payer: Oxford Commercial	$205.58
Rate for Payer: Qualcare PPO/HMO/WC	$154.19
Rate for Payer: UnitedHealthcare Commercial	$205.58
Rate for Payer: UnitedHealthcare Community & State	$32.48
Rate for Payer: Wellpoint Medicaid Managed Care	$29.19

FLUTICASONE & SALMETEROL INH55

Facility

$1,027.91

Service Code	NDC 93360782
Hospital Charge Code	606390250
Hospital Revenue Code	250
Min. Negotiated Rate	$154.19
Max. Negotiated Rate	$154.19
Rate for Payer: Qualcare PPO/HMO/WC	$154.19

FLU VAC PRESERVATIVE FREE >3 Y

Facility

$107.20

Service Code	HCPCS 90658
Hospital Charge Code	83652313
Hospital Revenue Code	636
Min. Negotiated Rate	$3.04
Max. Negotiated Rate	$74.80
Rate for Payer: Aetna Commercial	$40.74
Rate for Payer: Aetna Medicare Advantage	$32.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.34
Rate for Payer: Cigna Commercial	$53.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.94
Rate for Payer: Qualcare PPO/HMO/WC	$16.08
Rate for Payer: UnitedHealthcare Community & State	$3.39
Rate for Payer: Wellpoint Medicaid Managed Care	$3.04

Know your out-of-pocket cost for care.

All Charges