Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

GUIDE CATH 7F XB 3.5 SH

Facility

$220.00

Service Code	HCPCS C1887
Hospital Charge Code	270636380
Hospital Revenue Code	278
Min. Negotiated Rate	$6.25
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$83.60
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: Qualcare PPO/HMO/WC	$33.00
Rate for Payer: UnitedHealthcare Community & State	$6.95
Rate for Payer: Wellpoint Medicaid Managed Care	$6.25

GUIDE CATH 7F XB 4.0

Facility

$56.00

Service Code	HCPCS C1887
Hospital Charge Code	270636381
Hospital Revenue Code	278
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$13.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.55
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

GUIDE CATH 7F XB 4.0

Facility

$56.00

Service Code	HCPCS C1887
Hospital Charge Code	270636381
Hospital Revenue Code	278
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$28.00
Rate for Payer: Aetna Commercial	$21.28
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.28
Rate for Payer: Cigna Commercial	$28.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.55
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Community & State	$1.77
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

GUIDE CATHET FLUID DRAINAGE

Facility

$2,291.40

Service Code	HCPCS 10030
Hospital Charge Code	16000404
Hospital Revenue Code	360
Min. Negotiated Rate	$343.71
Max. Negotiated Rate	$343.71
Rate for Payer: Qualcare PPO/HMO/WC	$343.71

GUIDE CATHET FLUID DRAINAGE

Facility

$2,291.40

Service Code	HCPCS 10030
Hospital Charge Code	16000404
Hospital Revenue Code	360
Min. Negotiated Rate	$65.08
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,051.74
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$595.76
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$343.71
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$72.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$65.08

GUIDE CATHET FLUID DRAINAGE

Facility

$5,102.15

Service Code	HCPCS 10030
Hospital Charge Code	366810030
Hospital Revenue Code	361
Min. Negotiated Rate	$765.32
Max. Negotiated Rate	$765.32
Rate for Payer: Qualcare PPO/HMO/WC	$765.32

GUIDE CATHET FLUID DRAINAGE

Facility

$5,102.15

Service Code	HCPCS 10030
Hospital Charge Code	366810030
Hospital Revenue Code	361
Min. Negotiated Rate	$144.90
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,051.74
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.56
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.32
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$161.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$144.90

GUIDE CATHET FLUID DRAINAGE

Facility

$5,102.15

Service Code	HCPCS 10030
Hospital Charge Code	411010030
Hospital Revenue Code	361
Min. Negotiated Rate	$144.90
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,051.74
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.56
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.32
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$161.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$144.90

GUIDE CATHET FLUID DRAINAGE

Facility

$5,102.15

Service Code	HCPCS 10030
Hospital Charge Code	411010030
Hospital Revenue Code	361
Min. Negotiated Rate	$765.32
Max. Negotiated Rate	$765.32
Rate for Payer: Qualcare PPO/HMO/WC	$765.32

GUIDE CATH JL 4.0 SH 6F

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636295
Hospital Revenue Code	278
Min. Negotiated Rate	$6.82
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Community & State	$7.58
Rate for Payer: Wellpoint Medicaid Managed Care	$6.82

GUIDE CATH JL 4.0 SH 6F

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636295
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

GUIDE CATH XB 3.5 SH 6F

Facility

$54.95

Service Code	HCPCS C1887
Hospital Charge Code	270636335N
Hospital Revenue Code	278
Min. Negotiated Rate	$8.24
Max. Negotiated Rate	$13.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.30
Rate for Payer: Qualcare PPO/HMO/WC	$8.24

GUIDE CATH XB 3.5 SH 6F

Facility

$54.95

Service Code	HCPCS C1887
Hospital Charge Code	270636335N
Hospital Revenue Code	278
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$27.48
Rate for Payer: Aetna Commercial	$20.88
Rate for Payer: Aetna Medicare Advantage	$16.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.01
Rate for Payer: Cigna Commercial	$27.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.30
Rate for Payer: Qualcare PPO/HMO/WC	$8.24
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.56

GUIDE CATH XB 3.5 SH 6F

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636335
Hospital Revenue Code	278
Min. Negotiated Rate	$6.82
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Community & State	$7.58
Rate for Payer: Wellpoint Medicaid Managed Care	$6.82

GUIDE CATH XB 3.5 SH 6F

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636335
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

GUIDE COMPRESSION IMPLANT SIZE

Facility

$300.00

Hospital Charge Code	270672145
Hospital Revenue Code	272
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.00
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$60.00
Rate for Payer: UnitedHealthcare Community & State	$9.48
Rate for Payer: Wellpoint Medicaid Managed Care	$8.52

GUIDE COMPRESSION IMPLANT SIZE

Facility

$300.00

Hospital Charge Code	270672145
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

GUIDE CONSTANT TIBIAL

Facility

$9,160.00

Hospital Charge Code	270691450
Hospital Revenue Code	272
Min. Negotiated Rate	$260.14
Max. Negotiated Rate	$4,580.00
Rate for Payer: Aetna Commercial	$3,480.80
Rate for Payer: Aetna Medicare Advantage	$2,748.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,335.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,335.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,335.80
Rate for Payer: Cigna Commercial	$4,580.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,381.60
Rate for Payer: Oxford Commercial	$1,832.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,374.00
Rate for Payer: UnitedHealthcare Commercial	$1,832.00
Rate for Payer: UnitedHealthcare Community & State	$289.46
Rate for Payer: Wellpoint Medicaid Managed Care	$260.14

GUIDE CONSTANT TIBIAL

Facility

$9,160.00

Hospital Charge Code	270691450
Hospital Revenue Code	272
Min. Negotiated Rate	$1,374.00
Max. Negotiated Rate	$1,374.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,374.00

GUIDED PERCUT DRG PLMT OF CATH

Facility

$9,500.00

Service Code	HCPCS 75989
Hospital Charge Code	2200511
Hospital Revenue Code	350
Min. Negotiated Rate	$216.15
Max. Negotiated Rate	$4,750.00
Rate for Payer: Aetna Commercial	$3,610.00
Rate for Payer: Aetna Medicare Advantage	$2,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.50
Rate for Payer: Cigna Commercial	$4,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,470.00
Rate for Payer: Oxford Commercial	$3,774.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$3,916.00
Rate for Payer: UnitedHealthcare Community & State	$300.20
Rate for Payer: Wellpoint Medicaid Managed Care	$269.80

GUIDED PERCUT DRG PLMT OF CATH

Facility

$9,500.00

Service Code	HCPCS 75989
Hospital Charge Code	2200511
Hospital Revenue Code	350
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

GUIDE DRILL 2.0MM UNIVERSAL

Facility

$1,668.60

Hospital Charge Code	270678119
Hospital Revenue Code	272
Min. Negotiated Rate	$250.29
Max. Negotiated Rate	$250.29
Rate for Payer: Qualcare PPO/HMO/WC	$250.29

GUIDE DRILL 2.0MM UNIVERSAL

Facility

$1,668.60

Hospital Charge Code	270678119
Hospital Revenue Code	272
Min. Negotiated Rate	$47.39
Max. Negotiated Rate	$834.30
Rate for Payer: Aetna Commercial	$634.07
Rate for Payer: Aetna Medicare Advantage	$500.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$425.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$425.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$425.49
Rate for Payer: Cigna Commercial	$834.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.84
Rate for Payer: Oxford Commercial	$333.72
Rate for Payer: Qualcare PPO/HMO/WC	$250.29
Rate for Payer: UnitedHealthcare Commercial	$333.72
Rate for Payer: UnitedHealthcare Community & State	$52.73
Rate for Payer: Wellpoint Medicaid Managed Care	$47.39

GUIDE DRILL 2.4MM UNIVERSAL

Facility

$1,668.60

Hospital Charge Code	270677800
Hospital Revenue Code	272
Min. Negotiated Rate	$47.39
Max. Negotiated Rate	$834.30
Rate for Payer: Aetna Commercial	$634.07
Rate for Payer: Aetna Medicare Advantage	$500.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$425.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$425.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$425.49
Rate for Payer: Cigna Commercial	$834.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.84
Rate for Payer: Oxford Commercial	$333.72
Rate for Payer: Qualcare PPO/HMO/WC	$250.29
Rate for Payer: UnitedHealthcare Commercial	$333.72
Rate for Payer: UnitedHealthcare Community & State	$52.73
Rate for Payer: Wellpoint Medicaid Managed Care	$47.39

GUIDE DRILL 2.4MM UNIVERSAL

Facility

$1,668.60

Hospital Charge Code	270677800
Hospital Revenue Code	272
Min. Negotiated Rate	$250.29
Max. Negotiated Rate	$250.29
Rate for Payer: Qualcare PPO/HMO/WC	$250.29

Know your out-of-pocket cost for care.

All Charges