Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

INTRODUCER PINNA 5F 10 RSS502

Facility

$45.50

Service Code	HCPCS C1894
Hospital Charge Code	270642944S
Hospital Revenue Code	278
Min. Negotiated Rate	$6.83
Max. Negotiated Rate	$11.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.01
Rate for Payer: Qualcare PPO/HMO/WC	$6.83

INTRODUCER PINNA 5F 10 RSS502

Facility

$52.00

Service Code	HCPCS C1894
Hospital Charge Code	270642944C
Hospital Revenue Code	278
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$12.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.58
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

INTRODUCER PINNA 5F 10 RSS502

Facility

$52.00

Service Code	HCPCS C1894
Hospital Charge Code	270642944C
Hospital Revenue Code	278
Min. Negotiated Rate	$1.48
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.58
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Community & State	$1.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1.48

INTRODUCER PINNAC 7F 10 RSS702

Facility

$52.00

Service Code	HCPCS C1894
Hospital Charge Code	270642943C
Hospital Revenue Code	278
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$12.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.58
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

INTRODUCER PINNAC 7F 10 RSS702

Facility

$52.00

Service Code	HCPCS C1894
Hospital Charge Code	270642943C
Hospital Revenue Code	278
Min. Negotiated Rate	$1.48
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.58
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Community & State	$1.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1.48

INTRODUCER PINNACLE .038IN 8FR

Facility

$56.65

Service Code	HCPCS C1894
Hospital Charge Code	270683727
Hospital Revenue Code	278
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$13.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.71
Rate for Payer: Qualcare PPO/HMO/WC	$8.50

INTRODUCER PINNACLE .038IN 8FR

Facility

$56.65

Service Code	HCPCS C1894
Hospital Charge Code	270683727
Hospital Revenue Code	278
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$28.32
Rate for Payer: Aetna Commercial	$21.53
Rate for Payer: Aetna Medicare Advantage	$17.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.45
Rate for Payer: Cigna Commercial	$28.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.71
Rate for Payer: Qualcare PPO/HMO/WC	$8.50
Rate for Payer: UnitedHealthcare Community & State	$1.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1.61

INTRODUCER PINNACLE 6FR 10CM

Facility

$56.65

Service Code	HCPCS C1893
Hospital Charge Code	270642942N
Hospital Revenue Code	278
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$28.32
Rate for Payer: Aetna Commercial	$21.53
Rate for Payer: Aetna Medicare Advantage	$17.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.45
Rate for Payer: Cigna Commercial	$28.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.71
Rate for Payer: Qualcare PPO/HMO/WC	$8.50
Rate for Payer: UnitedHealthcare Community & State	$1.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1.61

INTRODUCER PINNACLE 6FR 10CM

Facility

$56.65

Service Code	HCPCS C1893
Hospital Charge Code	270642942N
Hospital Revenue Code	278
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$13.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.71
Rate for Payer: Qualcare PPO/HMO/WC	$8.50

INTRODUCER PINNACLE 6FR 25 CM

Facility

$1,294.00

Service Code	HCPCS C1894
Hospital Charge Code	270643051N
Hospital Revenue Code	278
Min. Negotiated Rate	$194.10
Max. Negotiated Rate	$313.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$258.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.15
Rate for Payer: Qualcare PPO/HMO/WC	$194.10

INTRODUCER PINNACLE 6FR 25 CM

Facility

$1,294.00

Service Code	HCPCS C1894
Hospital Charge Code	270643051N
Hospital Revenue Code	278
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$647.00
Rate for Payer: Aetna Commercial	$491.72
Rate for Payer: Aetna Medicare Advantage	$388.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$329.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$329.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$258.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$329.97
Rate for Payer: Cigna Commercial	$647.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.15
Rate for Payer: Qualcare PPO/HMO/WC	$194.10
Rate for Payer: UnitedHealthcare Community & State	$40.89
Rate for Payer: Wellpoint Medicaid Managed Care	$36.75

INTRODUCER PINNACLE 7FR 10CM

Facility

$52.00

Service Code	HCPCS C1894
Hospital Charge Code	270642943
Hospital Revenue Code	278
Min. Negotiated Rate	$1.48
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.58
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Community & State	$1.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1.48

INTRODUCER PINNACLE 7FR 10CM

Facility

$52.00

Service Code	HCPCS C1894
Hospital Charge Code	270642943
Hospital Revenue Code	278
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$12.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.58
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

INTRODUCER PINNACLE 7FR 10CM

Facility

$52.00

Service Code	HCPCS C1894
Hospital Charge Code	270642943S
Hospital Revenue Code	278
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$12.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.58
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

INTRODUCER PINNACLE 7FR 10CM

Facility

$52.00

Service Code	HCPCS C1894
Hospital Charge Code	270642943S
Hospital Revenue Code	278
Min. Negotiated Rate	$1.48
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.58
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Community & State	$1.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1.48

INTRODUCER PINNACLE 7FR 10CM

Facility

$566.50

Service Code	HCPCS C1894
Hospital Charge Code	270642943N
Hospital Revenue Code	278
Min. Negotiated Rate	$84.97
Max. Negotiated Rate	$137.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.09
Rate for Payer: Qualcare PPO/HMO/WC	$84.97

INTRODUCER PINNACLE 7FR 10CM

Facility

$566.50

Service Code	HCPCS C1894
Hospital Charge Code	270642943N
Hospital Revenue Code	278
Min. Negotiated Rate	$16.09
Max. Negotiated Rate	$283.25
Rate for Payer: Aetna Commercial	$215.27
Rate for Payer: Aetna Medicare Advantage	$169.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.46
Rate for Payer: Cigna Commercial	$283.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.09
Rate for Payer: Qualcare PPO/HMO/WC	$84.97
Rate for Payer: UnitedHealthcare Community & State	$17.90
Rate for Payer: Wellpoint Medicaid Managed Care	$16.09

INTRODUCER PINNACLE 7FR 25cm

Facility

$118.75

Service Code	HCPCS C1894
Hospital Charge Code	270643052
Hospital Revenue Code	278
Min. Negotiated Rate	$17.81
Max. Negotiated Rate	$28.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.74
Rate for Payer: Qualcare PPO/HMO/WC	$17.81

INTRODUCER PINNACLE 7FR 25cm

Facility

$118.75

Service Code	HCPCS C1894
Hospital Charge Code	270643052
Hospital Revenue Code	278
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$59.38
Rate for Payer: Aetna Commercial	$45.12
Rate for Payer: Aetna Medicare Advantage	$35.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.28
Rate for Payer: Cigna Commercial	$59.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.74
Rate for Payer: Qualcare PPO/HMO/WC	$17.81
Rate for Payer: UnitedHealthcare Community & State	$3.75
Rate for Payer: Wellpoint Medicaid Managed Care	$3.37

INTRODUCER PINNACLE 7FR 25 CM

Facility

$125.90

Service Code	HCPCS C1894
Hospital Charge Code	270643052S
Hospital Revenue Code	278
Min. Negotiated Rate	$18.89
Max. Negotiated Rate	$30.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.47
Rate for Payer: Qualcare PPO/HMO/WC	$18.89

INTRODUCER PINNACLE 7FR 25 CM

Facility

$125.90

Service Code	HCPCS C1894
Hospital Charge Code	270643052S
Hospital Revenue Code	278
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$62.95
Rate for Payer: Aetna Commercial	$47.84
Rate for Payer: Aetna Medicare Advantage	$37.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.10
Rate for Payer: Cigna Commercial	$62.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.47
Rate for Payer: Qualcare PPO/HMO/WC	$18.89
Rate for Payer: UnitedHealthcare Community & State	$3.98
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

INTRODUCER PINNACLE 7FR 25 CM

Facility

$125.90

Service Code	HCPCS C1894
Hospital Charge Code	270643052N
Hospital Revenue Code	278
Min. Negotiated Rate	$18.89
Max. Negotiated Rate	$30.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.47
Rate for Payer: Qualcare PPO/HMO/WC	$18.89

INTRODUCER PINNACLE 7FR 25 CM

Facility

$125.90

Service Code	HCPCS C1894
Hospital Charge Code	270643052N
Hospital Revenue Code	278
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$62.95
Rate for Payer: Aetna Commercial	$47.84
Rate for Payer: Aetna Medicare Advantage	$37.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.10
Rate for Payer: Cigna Commercial	$62.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.47
Rate for Payer: Qualcare PPO/HMO/WC	$18.89
Rate for Payer: UnitedHealthcare Community & State	$3.98
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

INTRODUCER PINNACLE 8F 25 CM

Facility

$1,294.00

Service Code	HCPCS C1894
Hospital Charge Code	270684952N
Hospital Revenue Code	278
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$647.00
Rate for Payer: Aetna Commercial	$491.72
Rate for Payer: Aetna Medicare Advantage	$388.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$329.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$329.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$258.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$329.97
Rate for Payer: Cigna Commercial	$647.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.15
Rate for Payer: Qualcare PPO/HMO/WC	$194.10
Rate for Payer: UnitedHealthcare Community & State	$40.89
Rate for Payer: Wellpoint Medicaid Managed Care	$36.75

INTRODUCER PINNACLE 8F 25 CM

Facility

$1,294.00

Service Code	HCPCS C1894
Hospital Charge Code	270684952N
Hospital Revenue Code	278
Min. Negotiated Rate	$194.10
Max. Negotiated Rate	$313.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$258.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.15
Rate for Payer: Qualcare PPO/HMO/WC	$194.10

Know your out-of-pocket cost for care.

All Charges