Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FORTE CNCLLOUS SCRW 4.0MMX26MM

Facility

$299.10

Hospital Charge Code	270663188
Hospital Revenue Code	278
Min. Negotiated Rate	$44.87
Max. Negotiated Rate	$72.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: Qualcare PPO/HMO/WC	$44.87

FORTE CNCLLOUS SCRW 4.0MMX26MM

Facility

$299.10

Hospital Charge Code	270663188
Hospital Revenue Code	278
Min. Negotiated Rate	$8.49
Max. Negotiated Rate	$149.55
Rate for Payer: Aetna Commercial	$113.66
Rate for Payer: Aetna Medicare Advantage	$89.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.27
Rate for Payer: Cigna Commercial	$149.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: Qualcare PPO/HMO/WC	$44.87
Rate for Payer: UnitedHealthcare Community & State	$9.45
Rate for Payer: Wellpoint Medicaid Managed Care	$8.49

FORTE CNCLLOUS SCRW 4.0MMX28MM

Facility

$299.10

Hospital Charge Code	270663189
Hospital Revenue Code	278
Min. Negotiated Rate	$8.49
Max. Negotiated Rate	$149.55
Rate for Payer: Aetna Commercial	$113.66
Rate for Payer: Aetna Medicare Advantage	$89.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.27
Rate for Payer: Cigna Commercial	$149.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: Qualcare PPO/HMO/WC	$44.87
Rate for Payer: UnitedHealthcare Community & State	$9.45
Rate for Payer: Wellpoint Medicaid Managed Care	$8.49

FORTE CNCLLOUS SCRW 4.0MMX28MM

Facility

$299.10

Hospital Charge Code	270663189
Hospital Revenue Code	278
Min. Negotiated Rate	$44.87
Max. Negotiated Rate	$72.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: Qualcare PPO/HMO/WC	$44.87

FORTEC XPS MOXY FIBER

Facility

$5,000.00

Hospital Charge Code	270657506
Hospital Revenue Code	272
Min. Negotiated Rate	$142.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.00
Rate for Payer: Oxford Commercial	$1,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Commercial	$1,000.00
Rate for Payer: UnitedHealthcare Community & State	$158.00
Rate for Payer: Wellpoint Medicaid Managed Care	$142.00

FORTEC XPS MOXY FIBER

Facility

$5,000.00

Hospital Charge Code	270657506
Hospital Revenue Code	272
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$750.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

FORTILINK 8CM

Facility

$0.01

Service Code	HCPCS C1889
Hospital Charge Code	270689963
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

FORTILINK 8CM

Facility

$0.01

Service Code	HCPCS C1889
Hospital Charge Code	270689963
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

FORTILINK-C CAGE 12X14X9MM 6D

Facility

$21,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270695702
Hospital Revenue Code	278
Min. Negotiated Rate	$3,225.00
Max. Negotiated Rate	$5,203.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,203.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00

FORTILINK-C CAGE 12X14X9MM 6D

Facility

$21,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270695702
Hospital Revenue Code	278
Min. Negotiated Rate	$610.60
Max. Negotiated Rate	$10,750.00
Rate for Payer: Aetna Commercial	$8,170.00
Rate for Payer: Aetna Medicare Advantage	$6,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,482.50
Rate for Payer: Cigna Commercial	$10,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,203.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00
Rate for Payer: UnitedHealthcare Community & State	$679.40
Rate for Payer: Wellpoint Medicaid Managed Care	$610.60

FORTITUDE CONVEX PEEK OPT CAGE

Facility

$2,657.00

Hospital Charge Code	270335904
Hospital Revenue Code	278
Min. Negotiated Rate	$398.55
Max. Negotiated Rate	$642.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$531.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$642.99
Rate for Payer: Qualcare PPO/HMO/WC	$398.55

FORTITUDE CONVEX PEEK OPT CAGE

Facility

$2,657.00

Hospital Charge Code	270335904
Hospital Revenue Code	278
Min. Negotiated Rate	$75.46
Max. Negotiated Rate	$1,328.50
Rate for Payer: Aetna Commercial	$1,009.66
Rate for Payer: Aetna Medicare Advantage	$797.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$677.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$677.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$531.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$677.53
Rate for Payer: Cigna Commercial	$1,328.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$642.99
Rate for Payer: Qualcare PPO/HMO/WC	$398.55
Rate for Payer: UnitedHealthcare Community & State	$83.96
Rate for Payer: Wellpoint Medicaid Managed Care	$75.46

FORTLINK 7CM

Facility

$0.01

Service Code	HCPCS C1889
Hospital Charge Code	270689962
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

FORTLINK 7CM

Facility

$0.01

Service Code	HCPCS C1889
Hospital Charge Code	270689962
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

FOSAPREPITANT DIMEGLUMIN 150MG

Facility

$2,065.95

Service Code	HCPCS J1453
Hospital Charge Code	60630084
Hospital Revenue Code	636
Min. Negotiated Rate	$309.89
Max. Negotiated Rate	$499.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$499.96
Rate for Payer: Qualcare PPO/HMO/WC	$309.89

FOSAPREPITANT DIMEGLUMIN 150MG

Facility

$2,065.95

Service Code	HCPCS J1453
Hospital Charge Code	60630084
Hospital Revenue Code	636
Min. Negotiated Rate	$58.67
Max. Negotiated Rate	$1,032.97
Rate for Payer: Aetna Commercial	$785.06
Rate for Payer: Aetna Medicare Advantage	$619.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$526.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$526.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$526.82
Rate for Payer: Cigna Commercial	$1,032.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$499.96
Rate for Payer: Qualcare PPO/HMO/WC	$309.89
Rate for Payer: UnitedHealthcare Community & State	$65.28
Rate for Payer: Wellpoint Medicaid Managed Care	$58.67

FOSFOMYCIN 3G

Facility

$267.45

Hospital Charge Code	60630235
Hospital Revenue Code	250
Min. Negotiated Rate	$40.12
Max. Negotiated Rate	$40.12
Rate for Payer: Qualcare PPO/HMO/WC	$40.12

FOSFOMYCIN 3G

Facility

$267.45

Hospital Charge Code	60630235
Hospital Revenue Code	250
Min. Negotiated Rate	$7.60
Max. Negotiated Rate	$133.72
Rate for Payer: Aetna Commercial	$101.63
Rate for Payer: Aetna Medicare Advantage	$80.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.20
Rate for Payer: Cigna Commercial	$133.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.54
Rate for Payer: Oxford Commercial	$53.49
Rate for Payer: Qualcare PPO/HMO/WC	$40.12
Rate for Payer: UnitedHealthcare Commercial	$53.49
Rate for Payer: UnitedHealthcare Community & State	$8.45
Rate for Payer: Wellpoint Medicaid Managed Care	$7.60

FOSFOMYCIN 3GM PACKET

Facility

$486.49

Service Code	NDC 456430001
Hospital Charge Code	6063943345
Hospital Revenue Code	250
Min. Negotiated Rate	$72.97
Max. Negotiated Rate	$72.97
Rate for Payer: Qualcare PPO/HMO/WC	$72.97

FOSFOMYCIN 3GM PACKET

Facility

$486.49

Service Code	NDC 456430001
Hospital Charge Code	6063943345
Hospital Revenue Code	250
Min. Negotiated Rate	$13.82
Max. Negotiated Rate	$243.25
Rate for Payer: Aetna Commercial	$184.87
Rate for Payer: Aetna Medicare Advantage	$145.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.05
Rate for Payer: Cigna Commercial	$243.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.49
Rate for Payer: Oxford Commercial	$97.30
Rate for Payer: Qualcare PPO/HMO/WC	$72.97
Rate for Payer: UnitedHealthcare Commercial	$97.30
Rate for Payer: UnitedHealthcare Community & State	$15.37
Rate for Payer: Wellpoint Medicaid Managed Care	$13.82

FOSPHENYTOIN 100 MG/2ML INJ

Facility

$192.83

Service Code	HCPCS Q2009
Hospital Charge Code	6017610
Hospital Revenue Code	636
Min. Negotiated Rate	$1.26
Max. Negotiated Rate	$46.66
Rate for Payer: Aetna Commercial	$3.62
Rate for Payer: Aetna Medicare Advantage	$4.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.82
Rate for Payer: Cigna Medicare Advantage	$1.33
Rate for Payer: Clover Medicare Advantage	$1.26
Rate for Payer: EmblemHealth Commercial	$3.99
Rate for Payer: Humana Medicare Advantage	$1.37
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.66
Rate for Payer: Qualcare PPO/HMO/WC	$28.92
Rate for Payer: UnitedHealthcare Community & State	$6.09
Rate for Payer: UnitedHealthcare Medicare Advantage	$1.33
Rate for Payer: Wellcare Medicare Advantage	$1.33
Rate for Payer: Wellpoint Medicaid Managed Care	$5.48

FOSPHENYTOIN 100 MG/2ML INJ

Facility

$192.83

Service Code	HCPCS Q2009
Hospital Charge Code	6017610
Hospital Revenue Code	636
Min. Negotiated Rate	$28.92
Max. Negotiated Rate	$46.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.66
Rate for Payer: Qualcare PPO/HMO/WC	$28.92

FOSPHENYTOIN 500 MG/10ML INJ

Facility

$578.41

Service Code	HCPCS Q2009
Hospital Charge Code	6017628
Hospital Revenue Code	636
Min. Negotiated Rate	$1.26
Max. Negotiated Rate	$139.98
Rate for Payer: Aetna Commercial	$3.62
Rate for Payer: Aetna Medicare Advantage	$4.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.82
Rate for Payer: Cigna Medicare Advantage	$1.33
Rate for Payer: Clover Medicare Advantage	$1.26
Rate for Payer: EmblemHealth Commercial	$3.99
Rate for Payer: Humana Medicare Advantage	$1.37
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.98
Rate for Payer: Qualcare PPO/HMO/WC	$86.76
Rate for Payer: UnitedHealthcare Community & State	$18.28
Rate for Payer: UnitedHealthcare Medicare Advantage	$1.33
Rate for Payer: Wellcare Medicare Advantage	$1.33
Rate for Payer: Wellpoint Medicaid Managed Care	$16.43

FOSPHENYTOIN 500 MG/10ML INJ

Facility

$578.41

Service Code	HCPCS Q2009
Hospital Charge Code	6017628
Hospital Revenue Code	636
Min. Negotiated Rate	$86.76
Max. Negotiated Rate	$139.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.98
Rate for Payer: Qualcare PPO/HMO/WC	$86.76

FP 1ST DEGREE INITIAL TREAT

Facility

$1,083.25

Service Code	HCPCS 16000
Hospital Charge Code	87502510
Hospital Revenue Code	761
Min. Negotiated Rate	$162.49
Max. Negotiated Rate	$162.49
Rate for Payer: Qualcare PPO/HMO/WC	$162.49

Know your out-of-pocket cost for care.

All Charges