Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

INTRODUCER SHEATH 6FR 11CM

Facility

$57.25

Service Code	HCPCS C1894
Hospital Charge Code	270624176
Hospital Revenue Code	278
Min. Negotiated Rate	$8.59
Max. Negotiated Rate	$13.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.85
Rate for Payer: Qualcare PPO/HMO/WC	$8.59

INTRODUCER SHEATH 6FR 11CM

Facility

$57.25

Service Code	HCPCS C1894
Hospital Charge Code	270624176
Hospital Revenue Code	278
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$28.62
Rate for Payer: Aetna Commercial	$21.75
Rate for Payer: Aetna Medicare Advantage	$17.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.60
Rate for Payer: Cigna Commercial	$28.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.85
Rate for Payer: Qualcare PPO/HMO/WC	$8.59
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.63

INTRODUCER SHEATH 6FR R/O 6CM

Facility

$1,287.50

Service Code	HCPCS C1894
Hospital Charge Code	270653781S
Hospital Revenue Code	278
Min. Negotiated Rate	$193.12
Max. Negotiated Rate	$311.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.57
Rate for Payer: Qualcare PPO/HMO/WC	$193.12

INTRODUCER SHEATH 6FR R/O 6CM

Facility

$1,287.50

Service Code	HCPCS C1894
Hospital Charge Code	270653781N
Hospital Revenue Code	278
Min. Negotiated Rate	$193.12
Max. Negotiated Rate	$311.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.57
Rate for Payer: Qualcare PPO/HMO/WC	$193.12

INTRODUCER SHEATH 6FR R/O 6CM

Facility

$1,287.50

Service Code	HCPCS C1894
Hospital Charge Code	270653781S
Hospital Revenue Code	278
Min. Negotiated Rate	$36.56
Max. Negotiated Rate	$643.75
Rate for Payer: Aetna Commercial	$489.25
Rate for Payer: Aetna Medicare Advantage	$386.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.31
Rate for Payer: Cigna Commercial	$643.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.57
Rate for Payer: Qualcare PPO/HMO/WC	$193.12
Rate for Payer: UnitedHealthcare Community & State	$40.69
Rate for Payer: Wellpoint Medicaid Managed Care	$36.56

INTRODUCER SHEATH 6FR R/O 6CM

Facility

$1,287.50

Service Code	HCPCS C1894
Hospital Charge Code	270653781N
Hospital Revenue Code	278
Min. Negotiated Rate	$36.56
Max. Negotiated Rate	$643.75
Rate for Payer: Aetna Commercial	$489.25
Rate for Payer: Aetna Medicare Advantage	$386.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.31
Rate for Payer: Cigna Commercial	$643.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.57
Rate for Payer: Qualcare PPO/HMO/WC	$193.12
Rate for Payer: UnitedHealthcare Community & State	$40.69
Rate for Payer: Wellpoint Medicaid Managed Care	$36.56

INTRODUCER SHEATH, ACCUSTIK

Facility

$623.00

Service Code	HCPCS C1894
Hospital Charge Code	2008105
Hospital Revenue Code	278
Min. Negotiated Rate	$93.45
Max. Negotiated Rate	$150.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.77
Rate for Payer: Qualcare PPO/HMO/WC	$93.45

INTRODUCER SHEATH, ACCUSTIK

Facility

$623.00

Service Code	HCPCS C1894
Hospital Charge Code	2008105
Hospital Revenue Code	278
Min. Negotiated Rate	$17.69
Max. Negotiated Rate	$311.50
Rate for Payer: Aetna Commercial	$236.74
Rate for Payer: Aetna Medicare Advantage	$186.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.87
Rate for Payer: Cigna Commercial	$311.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.77
Rate for Payer: Qualcare PPO/HMO/WC	$93.45
Rate for Payer: UnitedHealthcare Community & State	$19.69
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

INTRODUCER SURE SIGHT 9G

Facility

$4,868.75

Hospital Charge Code	270664831
Hospital Revenue Code	270
Min. Negotiated Rate	$138.27
Max. Negotiated Rate	$2,434.38
Rate for Payer: Aetna Commercial	$1,850.12
Rate for Payer: Aetna Medicare Advantage	$1,460.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,241.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,241.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,241.53
Rate for Payer: Cigna Commercial	$2,434.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,265.88
Rate for Payer: Oxford Commercial	$973.75
Rate for Payer: Qualcare PPO/HMO/WC	$730.31
Rate for Payer: UnitedHealthcare Commercial	$973.75
Rate for Payer: UnitedHealthcare Community & State	$153.85
Rate for Payer: Wellpoint Medicaid Managed Care	$138.27

INTRODUCER SURE SIGHT 9G

Facility

$4,868.75

Hospital Charge Code	270664831
Hospital Revenue Code	270
Min. Negotiated Rate	$730.31
Max. Negotiated Rate	$730.31
Rate for Payer: Qualcare PPO/HMO/WC	$730.31

INTRODUCER TEARAWAY SET 12 FR

Facility

$800.00

Hospital Charge Code	270669517
Hospital Revenue Code	272
Min. Negotiated Rate	$22.72
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.00
Rate for Payer: Oxford Commercial	$160.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Commercial	$160.00
Rate for Payer: UnitedHealthcare Community & State	$25.28
Rate for Payer: Wellpoint Medicaid Managed Care	$22.72

INTRODUCER TEARAWAY SET 12 FR

Facility

$800.00

Hospital Charge Code	270669517
Hospital Revenue Code	272
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

INTRODUCER THINWALL 19UT 7CM

Facility

$44.75

Service Code	HCPCS C1894
Hospital Charge Code	270669179C
Hospital Revenue Code	278
Min. Negotiated Rate	$6.71
Max. Negotiated Rate	$10.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.83
Rate for Payer: Qualcare PPO/HMO/WC	$6.71

INTRODUCER THINWALL 19UT 7CM

Facility

$44.75

Service Code	HCPCS C1894
Hospital Charge Code	270669179C
Hospital Revenue Code	278
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$22.38
Rate for Payer: Aetna Commercial	$17.00
Rate for Payer: Aetna Medicare Advantage	$13.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.41
Rate for Payer: Cigna Commercial	$22.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.83
Rate for Payer: Qualcare PPO/HMO/WC	$6.71
Rate for Payer: UnitedHealthcare Community & State	$1.41
Rate for Payer: Wellpoint Medicaid Managed Care	$1.27

INTRODUCER VIS 7f 55c 4037553H

Facility

$281.85

Hospital Charge Code	270629332
Hospital Revenue Code	272
Min. Negotiated Rate	$42.28
Max. Negotiated Rate	$42.28
Rate for Payer: Qualcare PPO/HMO/WC	$42.28

INTRODUCER VIS 7f 55c 4037553H

Facility

$281.85

Hospital Charge Code	270629332
Hospital Revenue Code	272
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$140.93
Rate for Payer: Aetna Commercial	$107.10
Rate for Payer: Aetna Medicare Advantage	$84.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.87
Rate for Payer: Cigna Commercial	$140.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.28
Rate for Payer: Oxford Commercial	$56.37
Rate for Payer: Qualcare PPO/HMO/WC	$42.28
Rate for Payer: UnitedHealthcare Commercial	$56.37
Rate for Payer: UnitedHealthcare Community & State	$8.91
Rate for Payer: Wellpoint Medicaid Managed Care	$8.00

INTRODUCER V-STICK 5FR STD

Facility

$90.00

Hospital Charge Code	270676898
Hospital Revenue Code	272
Min. Negotiated Rate	$2.56
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.40
Rate for Payer: Oxford Commercial	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$18.00
Rate for Payer: UnitedHealthcare Community & State	$2.84
Rate for Payer: Wellpoint Medicaid Managed Care	$2.56

INTRODUCER V-STICK 5FR STD

Facility

$90.00

Hospital Charge Code	270676898
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

INTRODUCER V-STICK 5FR STIFF

Facility

$90.00

Hospital Charge Code	270676899
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

INTRODUCER V-STICK 5FR STIFF

Facility

$90.00

Hospital Charge Code	270676899
Hospital Revenue Code	272
Min. Negotiated Rate	$2.56
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.40
Rate for Payer: Oxford Commercial	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$18.00
Rate for Payer: UnitedHealthcare Community & State	$2.84
Rate for Payer: Wellpoint Medicaid Managed Care	$2.56

INTRODUCER V-STICK 5FR STIFF

Facility

$90.00

Hospital Charge Code	270676899A
Hospital Revenue Code	272
Min. Negotiated Rate	$2.56
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.40
Rate for Payer: Oxford Commercial	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$18.00
Rate for Payer: UnitedHealthcare Community & State	$2.84
Rate for Payer: Wellpoint Medicaid Managed Care	$2.56

INTRODUCER V-STICK 5FR STIFF

Facility

$90.00

Hospital Charge Code	270676899A
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

INTRODUCE SURE SIGHT 9G

Facility

$4,868.75

Hospital Charge Code	270664837
Hospital Revenue Code	270
Min. Negotiated Rate	$730.31
Max. Negotiated Rate	$730.31
Rate for Payer: Qualcare PPO/HMO/WC	$730.31

INTRODUCE SURE SIGHT 9G

Facility

$4,868.75

Hospital Charge Code	270664837
Hospital Revenue Code	270
Min. Negotiated Rate	$138.27
Max. Negotiated Rate	$2,434.38
Rate for Payer: Aetna Commercial	$1,850.12
Rate for Payer: Aetna Medicare Advantage	$1,460.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,241.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,241.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,241.53
Rate for Payer: Cigna Commercial	$2,434.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,265.88
Rate for Payer: Oxford Commercial	$973.75
Rate for Payer: Qualcare PPO/HMO/WC	$730.31
Rate for Payer: UnitedHealthcare Commercial	$973.75
Rate for Payer: UnitedHealthcare Community & State	$153.85
Rate for Payer: Wellpoint Medicaid Managed Care	$138.27

INTRODUCTION OF CATH AORTA

Facility

$414.45

Service Code	HCPCS 36200
Hospital Charge Code	74110036
Hospital Revenue Code	361
Min. Negotiated Rate	$11.77
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$157.49
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
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	$105.68
Rate for Payer: Cigna Commercial	$207.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.76
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$13.10
Rate for Payer: Wellpoint Medicaid Managed Care	$11.77

Know your out-of-pocket cost for care.

All Charges