Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FUNGITELL

Facility

$390.00

Service Code	HCPCS 87449
Hospital Charge Code	3038125
Hospital Revenue Code	300
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FUNGITELL

Facility

$390.00

Service Code	HCPCS 87449
Hospital Charge Code	3038125
Hospital Revenue Code	300
Min. Negotiated Rate	$9.58
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.59
Rate for Payer: Aetna Medicare Advantage	$38.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.46
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$11.98
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.98
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	$9.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Medicare Advantage	$11.98
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

FUNGITELL (1-3)B-D-GLUCAN ASSA

Facility

$390.00

Service Code	HCPCS 87449
Hospital Charge Code	401187449
Hospital Revenue Code	306
Min. Negotiated Rate	$9.58
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.59
Rate for Payer: Aetna Medicare Advantage	$38.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.46
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$11.98
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.98
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	$9.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Medicare Advantage	$11.98
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

FUNGITELL (1-3)B-D-GLUCAN ASSA

Facility

$390.00

Service Code	HCPCS 87449
Hospital Charge Code	401187449
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FUNGUS CULTURE BLOOD

Facility

$63.00

Service Code	HCPCS 87103
Hospital Charge Code	38478095
Hospital Revenue Code	309
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$55.65
Rate for Payer: Aetna Medicare Advantage	$66.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.22
Rate for Payer: Cigna Commercial	$31.50
Rate for Payer: Cigna Medicare Advantage	$20.46
Rate for Payer: Clover Medicare Advantage	$19.44
Rate for Payer: EmblemHealth Commercial	$61.38
Rate for Payer: Humana Medicare Advantage	$21.07
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.38
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.45
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.46
Rate for Payer: Wellcare Medicare Advantage	$20.46
Rate for Payer: Wellpoint Medicaid Managed Care	$1.79

FUNGUS CULTURE BLOOD

Facility

$63.00

Service Code	HCPCS 87103
Hospital Charge Code	38478095
Hospital Revenue Code	309
Min. Negotiated Rate	$9.45
Max. Negotiated Rate	$9.45
Rate for Payer: Qualcare PPO/HMO/WC	$9.45

FUNGUS CULTURE, OTHER

Facility

$222.00

Service Code	HCPCS 87102
Hospital Charge Code	38475086
Hospital Revenue Code	309
Min. Negotiated Rate	$33.30
Max. Negotiated Rate	$33.30
Rate for Payer: Qualcare PPO/HMO/WC	$33.30

FUNGUS CULTURE, OTHER

Facility

$222.00

Service Code	HCPCS 87102
Hospital Charge Code	38475086
Hospital Revenue Code	309
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$22.88
Rate for Payer: Aetna Medicare Advantage	$27.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.51
Rate for Payer: Cigna Commercial	$111.00
Rate for Payer: Cigna Medicare Advantage	$8.41
Rate for Payer: Clover Medicare Advantage	$7.99
Rate for Payer: EmblemHealth Commercial	$25.23
Rate for Payer: Humana Medicare Advantage	$8.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.72
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.30
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$6.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.41
Rate for Payer: Wellcare Medicare Advantage	$8.41
Rate for Payer: Wellpoint Medicaid Managed Care	$6.30

FUNGUS,DIRECT EXAMINATION (KOH

Facility

$390.00

Service Code	HCPCS 87220
Hospital Charge Code	39900495
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FUNGUS,DIRECT EXAMINATION (KOH

Facility

$390.00

Service Code	HCPCS 87220
Hospital Charge Code	39900495
Hospital Revenue Code	309
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$11.61
Rate for Payer: Aetna Medicare Advantage	$13.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.49
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$4.27
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.27
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	$3.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.27
Rate for Payer: Wellcare Medicare Advantage	$4.27
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

Fungus (Mycology) Culture

Facility

$390.00

Service Code	HCPCS 87101
Hospital Charge Code	39888012
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Fungus (Mycology) Culture

Facility

$390.00

Service Code	HCPCS 87101
Hospital Charge Code	39888012
Hospital Revenue Code	309
Min. Negotiated Rate	$6.17
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$20.97
Rate for Payer: Aetna Medicare Advantage	$24.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.97
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$7.71
Rate for Payer: Clover Medicare Advantage	$7.32
Rate for Payer: EmblemHealth Commercial	$23.13
Rate for Payer: Humana Medicare Advantage	$7.94
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.71
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	$6.17
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.71
Rate for Payer: Wellcare Medicare Advantage	$7.71
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

FUNGUS SMEAR - INDIA INK

Facility

$189.00

Service Code	HCPCS 87210
Hospital Charge Code	38475056
Hospital Revenue Code	309
Min. Negotiated Rate	$3.96
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$15.83
Rate for Payer: Aetna Medicare Advantage	$18.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.11
Rate for Payer: Cigna Commercial	$94.50
Rate for Payer: Cigna Medicare Advantage	$5.82
Rate for Payer: Clover Medicare Advantage	$5.53
Rate for Payer: EmblemHealth Commercial	$17.46
Rate for Payer: Humana Medicare Advantage	$5.99
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.14
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.35
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.66
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.82
Rate for Payer: Wellcare Medicare Advantage	$5.82
Rate for Payer: Wellpoint Medicaid Managed Care	$5.37

FUNGUS SMEAR - INDIA INK

Facility

$189.00

Service Code	HCPCS 87210
Hospital Charge Code	38475056
Hospital Revenue Code	309
Min. Negotiated Rate	$28.35
Max. Negotiated Rate	$28.35
Rate for Payer: Qualcare PPO/HMO/WC	$28.35

FUNGUS SMEAR KOH

Facility

$189.00

Service Code	HCPCS 87210
Hospital Charge Code	38475008
Hospital Revenue Code	309
Min. Negotiated Rate	$3.96
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$15.83
Rate for Payer: Aetna Medicare Advantage	$18.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.11
Rate for Payer: Cigna Commercial	$94.50
Rate for Payer: Cigna Medicare Advantage	$5.82
Rate for Payer: Clover Medicare Advantage	$5.53
Rate for Payer: EmblemHealth Commercial	$17.46
Rate for Payer: Humana Medicare Advantage	$5.99
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.14
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.35
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.66
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.82
Rate for Payer: Wellcare Medicare Advantage	$5.82
Rate for Payer: Wellpoint Medicaid Managed Care	$5.37

FUNGUS SMEAR KOH

Facility

$189.00

Service Code	HCPCS 87210
Hospital Charge Code	38475008
Hospital Revenue Code	309
Min. Negotiated Rate	$28.35
Max. Negotiated Rate	$28.35
Rate for Payer: Qualcare PPO/HMO/WC	$28.35

FUROSEMIDE 100 MG/10ML INJ

Facility

$18.83

Service Code	HCPCS J1941
Hospital Charge Code	60627964
Hospital Revenue Code	636
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$9.41
Rate for Payer: Aetna Commercial	$7.16
Rate for Payer: Aetna Medicare Advantage	$5.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.80
Rate for Payer: Cigna Commercial	$9.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.56
Rate for Payer: Qualcare PPO/HMO/WC	$2.82
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

FUROSEMIDE 100 MG/10ML INJ

Facility

$18.83

Service Code	HCPCS J1941
Hospital Charge Code	60627964
Hospital Revenue Code	636
Min. Negotiated Rate	$2.82
Max. Negotiated Rate	$4.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.56
Rate for Payer: Qualcare PPO/HMO/WC	$2.82

FUROSEMIDE 10 MG/ML LIQ (60ML)

Facility

$60.97

Service Code	NDC 54329446
Hospital Charge Code	60627965
Hospital Revenue Code	250
Min. Negotiated Rate	$1.73
Max. Negotiated Rate	$30.48
Rate for Payer: Aetna Commercial	$23.17
Rate for Payer: Aetna Medicare Advantage	$18.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.55
Rate for Payer: Cigna Commercial	$30.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.85
Rate for Payer: Oxford Commercial	$12.19
Rate for Payer: Qualcare PPO/HMO/WC	$9.15
Rate for Payer: UnitedHealthcare Commercial	$12.19
Rate for Payer: UnitedHealthcare Community & State	$1.93
Rate for Payer: Wellpoint Medicaid Managed Care	$1.73

FUROSEMIDE 10 MG/ML LIQ (60ML)

Facility

$60.97

Service Code	NDC 54329446
Hospital Charge Code	60627965
Hospital Revenue Code	250
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$9.15

FUROSEMIDE 20 MG/2ML INJ

Facility

$21.98

Service Code	HCPCS J1941
Hospital Charge Code	6002547
Hospital Revenue Code	636
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$5.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.32
Rate for Payer: Qualcare PPO/HMO/WC	$3.30

FUROSEMIDE 20 MG/2ML INJ

Facility

$21.98

Service Code	HCPCS J1941
Hospital Charge Code	6002547
Hospital Revenue Code	636
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$10.99
Rate for Payer: Aetna Commercial	$8.35
Rate for Payer: Aetna Medicare Advantage	$6.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.60
Rate for Payer: Cigna Commercial	$10.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.32
Rate for Payer: Qualcare PPO/HMO/WC	$3.30
Rate for Payer: UnitedHealthcare Community & State	$0.69
Rate for Payer: Wellpoint Medicaid Managed Care	$0.62

FUROSEMIDE 20 MG TAB

Facility

$4.00

Service Code	NDC 54829725
Hospital Charge Code	6023071
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

FUROSEMIDE 20 MG TAB

Facility

$4.00

Service Code	NDC 54829725
Hospital Charge Code	6023071
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

FUROSEMIDE 40 MG/4ML INJ

Facility

$14.67

Service Code	HCPCS J1941
Hospital Charge Code	60627967
Hospital Revenue Code	636
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$7.33
Rate for Payer: Aetna Commercial	$5.57
Rate for Payer: Aetna Medicare Advantage	$4.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.74
Rate for Payer: Cigna Commercial	$7.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.55
Rate for Payer: Qualcare PPO/HMO/WC	$2.20
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.42

Know your out-of-pocket cost for care.

All Charges