Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

INTRODUCTION OF CATH AORTA

Facility

$414.45

Service Code	HCPCS 36200
Hospital Charge Code	5100310
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

INTRODUCTION OF CATH AORTA

Facility

$414.45

Service Code	HCPCS 36200
Hospital Charge Code	74110036
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

INTRODUCTION OF CATH AORTA

Facility

$414.45

Service Code	HCPCS 36200
Hospital Charge Code	5100310
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

INTRODUCTION OF CATH AORTA

Facility

$414.45

Service Code	HCPCS 36200
Hospital Charge Code	366836200
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

INTRODUCTION OF CATH AORTA

Facility

$414.45

Service Code	HCPCS 36200
Hospital Charge Code	366836200
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

INTROD VISBRIT 8F 55C 4038553H

Facility

$281.85

Service Code	HCPCS C1887
Hospital Charge Code	270624373
Hospital Revenue Code	278
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) NJ Health	$56.37
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	$68.21
Rate for Payer: Qualcare PPO/HMO/WC	$42.28
Rate for Payer: UnitedHealthcare Community & State	$8.91
Rate for Payer: Wellpoint Medicaid Managed Care	$8.00

INTROD VISBRIT 8F 55C 4038553H

Facility

$620.00

Service Code	HCPCS C1887
Hospital Charge Code	270624373N
Hospital Revenue Code	278
Min. Negotiated Rate	$93.00
Max. Negotiated Rate	$150.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.04
Rate for Payer: Qualcare PPO/HMO/WC	$93.00

INTROD VISBRIT 8F 55C 4038553H

Facility

$281.85

Service Code	HCPCS C1887
Hospital Charge Code	270624373
Hospital Revenue Code	278
Min. Negotiated Rate	$42.28
Max. Negotiated Rate	$68.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.21
Rate for Payer: Qualcare PPO/HMO/WC	$42.28

INTROD VISBRIT 8F 55C 4038553H

Facility

$620.00

Service Code	HCPCS C1887
Hospital Charge Code	270624373N
Hospital Revenue Code	278
Min. Negotiated Rate	$17.61
Max. Negotiated Rate	$310.00
Rate for Payer: Aetna Commercial	$235.60
Rate for Payer: Aetna Medicare Advantage	$186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.10
Rate for Payer: Cigna Commercial	$310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.04
Rate for Payer: Qualcare PPO/HMO/WC	$93.00
Rate for Payer: UnitedHealthcare Community & State	$19.59
Rate for Payer: Wellpoint Medicaid Managed Care	$17.61

INTRO GUIDEESHEATH 6FX10

Facility

$247.50

Service Code	HCPCS C1766
Hospital Charge Code	270658268
Hospital Revenue Code	278
Min. Negotiated Rate	$7.03
Max. Negotiated Rate	$123.75
Rate for Payer: Aetna Commercial	$94.05
Rate for Payer: Aetna Medicare Advantage	$74.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.11
Rate for Payer: Cigna Commercial	$123.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.90
Rate for Payer: Qualcare PPO/HMO/WC	$37.12
Rate for Payer: UnitedHealthcare Community & State	$7.82
Rate for Payer: Wellpoint Medicaid Managed Care	$7.03

INTRO GUIDEESHEATH 6FX10

Facility

$247.50

Service Code	HCPCS C1766
Hospital Charge Code	270658268
Hospital Revenue Code	278
Min. Negotiated Rate	$37.12
Max. Negotiated Rate	$59.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.90
Rate for Payer: Qualcare PPO/HMO/WC	$37.12

Intro Guidesheath 5fx10

Facility

$247.50

Service Code	HCPCS C1766
Hospital Charge Code	270658270
Hospital Revenue Code	278
Min. Negotiated Rate	$7.03
Max. Negotiated Rate	$123.75
Rate for Payer: Aetna Commercial	$94.05
Rate for Payer: Aetna Medicare Advantage	$74.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.11
Rate for Payer: Cigna Commercial	$123.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.90
Rate for Payer: Qualcare PPO/HMO/WC	$37.12
Rate for Payer: UnitedHealthcare Community & State	$7.82
Rate for Payer: Wellpoint Medicaid Managed Care	$7.03

Intro Guidesheath 5fx10

Facility

$247.50

Service Code	HCPCS C1766
Hospital Charge Code	270658270
Hospital Revenue Code	278
Min. Negotiated Rate	$37.12
Max. Negotiated Rate	$59.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.90
Rate for Payer: Qualcare PPO/HMO/WC	$37.12

INTRO KIT MINI STICK 5FRX10M

Facility

$109.20

Service Code	HCPCS C1894
Hospital Charge Code	270686149S
Hospital Revenue Code	278
Min. Negotiated Rate	$16.38
Max. Negotiated Rate	$26.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.43
Rate for Payer: Qualcare PPO/HMO/WC	$16.38

INTRO KIT MINI STICK 5FRX10M

Facility

$109.20

Service Code	HCPCS C1894
Hospital Charge Code	278686149S
Hospital Revenue Code	278
Min. Negotiated Rate	$16.38
Max. Negotiated Rate	$26.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.43
Rate for Payer: Qualcare PPO/HMO/WC	$16.38

INTRO KIT MINI STICK 5FRX10M

Facility

$109.20

Service Code	HCPCS C1894
Hospital Charge Code	278686149S
Hospital Revenue Code	278
Min. Negotiated Rate	$3.10
Max. Negotiated Rate	$54.60
Rate for Payer: Aetna Commercial	$41.50
Rate for Payer: Aetna Medicare Advantage	$32.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.85
Rate for Payer: Cigna Commercial	$54.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.43
Rate for Payer: Qualcare PPO/HMO/WC	$16.38
Rate for Payer: UnitedHealthcare Community & State	$3.45
Rate for Payer: Wellpoint Medicaid Managed Care	$3.10

INTRO KIT MINI STICK 5FRX10M

Facility

$109.20

Service Code	HCPCS C1894
Hospital Charge Code	270686149S
Hospital Revenue Code	278
Min. Negotiated Rate	$3.10
Max. Negotiated Rate	$54.60
Rate for Payer: Aetna Commercial	$41.50
Rate for Payer: Aetna Medicare Advantage	$32.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.85
Rate for Payer: Cigna Commercial	$54.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.43
Rate for Payer: Qualcare PPO/HMO/WC	$16.38
Rate for Payer: UnitedHealthcare Community & State	$3.45
Rate for Payer: Wellpoint Medicaid Managed Care	$3.10

INTROPIN/80MG/1ML

Facility

$27.40

Service Code	NDC 517190525
Hospital Charge Code	60633188
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$13.70
Rate for Payer: Aetna Commercial	$10.41
Rate for Payer: Aetna Medicare Advantage	$8.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.99
Rate for Payer: Cigna Commercial	$13.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.12
Rate for Payer: Oxford Commercial	$5.48
Rate for Payer: Qualcare PPO/HMO/WC	$4.11
Rate for Payer: UnitedHealthcare Commercial	$5.48
Rate for Payer: UnitedHealthcare Community & State	$0.87
Rate for Payer: Wellpoint Medicaid Managed Care	$0.78

INTROPIN/80MG/1ML

Facility

$27.40

Service Code	NDC 517190525
Hospital Charge Code	60633188
Hospital Revenue Code	250
Min. Negotiated Rate	$4.11
Max. Negotiated Rate	$4.11
Rate for Payer: Qualcare PPO/HMO/WC	$4.11

INTRO VISTABRIT 7FR 4037553A

Facility

$620.00

Service Code	HCPCS C1887
Hospital Charge Code	270624008C
Hospital Revenue Code	278
Min. Negotiated Rate	$93.00
Max. Negotiated Rate	$150.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.04
Rate for Payer: Qualcare PPO/HMO/WC	$93.00

INTRO VISTABRIT 7FR 4037553A

Facility

$620.00

Service Code	HCPCS C1887
Hospital Charge Code	270624008C
Hospital Revenue Code	278
Min. Negotiated Rate	$17.61
Max. Negotiated Rate	$310.00
Rate for Payer: Aetna Commercial	$235.60
Rate for Payer: Aetna Medicare Advantage	$186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.10
Rate for Payer: Cigna Commercial	$310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.04
Rate for Payer: Qualcare PPO/HMO/WC	$93.00
Rate for Payer: UnitedHealthcare Community & State	$19.59
Rate for Payer: Wellpoint Medicaid Managed Care	$17.61

INTRO VISTABRIT 7FR 4037553A

Facility

$620.00

Service Code	HCPCS C1887
Hospital Charge Code	270624008A
Hospital Revenue Code	278
Min. Negotiated Rate	$17.61
Max. Negotiated Rate	$310.00
Rate for Payer: Aetna Commercial	$235.60
Rate for Payer: Aetna Medicare Advantage	$186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.10
Rate for Payer: Cigna Commercial	$310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.04
Rate for Payer: Qualcare PPO/HMO/WC	$93.00
Rate for Payer: UnitedHealthcare Community & State	$19.59
Rate for Payer: Wellpoint Medicaid Managed Care	$17.61

INTRO VISTABRIT 7FR 4037553A

Facility

$620.00

Service Code	HCPCS C1887
Hospital Charge Code	270624008A
Hospital Revenue Code	278
Min. Negotiated Rate	$93.00
Max. Negotiated Rate	$150.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.04
Rate for Payer: Qualcare PPO/HMO/WC	$93.00

INTRO VISTABRITE 8FR 403-8553A

Facility

$650.00

Service Code	HCPCS C1887
Hospital Charge Code	270624374N
Hospital Revenue Code	278
Min. Negotiated Rate	$18.46
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Community & State	$20.54
Rate for Payer: Wellpoint Medicaid Managed Care	$18.46

INTRO VISTABRITE 8FR 403-8553A

Facility

$650.00

Service Code	HCPCS C1887
Hospital Charge Code	270624374N
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

Know your out-of-pocket cost for care.

All Charges