Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IR PTA PERPHRAL ARTRY OTHER S&

Facility

$22,441.00

Service Code	HCPCS 75962
Hospital Charge Code	2011180
Hospital Revenue Code	320
Min. Negotiated Rate	$3,366.15
Max. Negotiated Rate	$3,366.15
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.15

IR PTA RENAL OR VISCERAL EA AD

Facility

$2,282.00

Service Code	HCPCS 75968
Hospital Charge Code	7411740
Hospital Revenue Code	320
Min. Negotiated Rate	$342.30
Max. Negotiated Rate	$342.30
Rate for Payer: Qualcare PPO/HMO/WC	$342.30

IR PTA RENAL OR VISCERAL EA AD

Facility

$2,282.00

Service Code	HCPCS 75968
Hospital Charge Code	7411740
Hospital Revenue Code	320
Min. Negotiated Rate	$64.81
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$867.16
Rate for Payer: Aetna Medicare Advantage	$684.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$581.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$581.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$581.91
Rate for Payer: Cigna Commercial	$1,141.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$593.32
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$342.30
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$72.11
Rate for Payer: Wellpoint Medicaid Managed Care	$64.81

IR PTA RENAL OR VISCERAL EA AD

Facility

$2,282.00

Service Code	HCPCS 75968
Hospital Charge Code	2011288
Hospital Revenue Code	320
Min. Negotiated Rate	$64.81
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$867.16
Rate for Payer: Aetna Medicare Advantage	$684.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$581.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$581.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$581.91
Rate for Payer: Cigna Commercial	$1,141.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$593.32
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$342.30
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$72.11
Rate for Payer: Wellpoint Medicaid Managed Care	$64.81

IR PTA RENAL OR VISCERAL EA AD

Facility

$2,282.00

Service Code	HCPCS 75968
Hospital Charge Code	2011288
Hospital Revenue Code	320
Min. Negotiated Rate	$342.30
Max. Negotiated Rate	$342.30
Rate for Payer: Qualcare PPO/HMO/WC	$342.30

IR PTA RENAL OR VISCERAL INIT

Facility

$22,441.00

Service Code	HCPCS 75966
Hospital Charge Code	7411739
Hospital Revenue Code	320
Min. Negotiated Rate	$3,366.15
Max. Negotiated Rate	$3,366.15
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.15

IR PTA RENAL OR VISCERAL INIT

Facility

$22,441.00

Service Code	HCPCS 75966
Hospital Charge Code	5100355
Hospital Revenue Code	320
Min. Negotiated Rate	$637.32
Max. Negotiated Rate	$11,220.50
Rate for Payer: Aetna Commercial	$8,527.58
Rate for Payer: Aetna Medicare Advantage	$6,732.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,722.45
Rate for Payer: Cigna Commercial	$11,220.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,834.66
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.15
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$709.14
Rate for Payer: Wellpoint Medicaid Managed Care	$637.32

IR PTA RENAL OR VISCERAL INIT

Facility

$22,441.00

Service Code	HCPCS 75966
Hospital Charge Code	5100355
Hospital Revenue Code	320
Min. Negotiated Rate	$3,366.15
Max. Negotiated Rate	$3,366.15
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.15

IR PTA RENAL OR VISCERAL INIT

Facility

$22,441.00

Service Code	HCPCS 75966
Hospital Charge Code	7411739
Hospital Revenue Code	320
Min. Negotiated Rate	$637.32
Max. Negotiated Rate	$11,220.50
Rate for Payer: Aetna Commercial	$8,527.58
Rate for Payer: Aetna Medicare Advantage	$6,732.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,722.45
Rate for Payer: Cigna Commercial	$11,220.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,834.66
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.15
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$709.14
Rate for Payer: Wellpoint Medicaid Managed Care	$637.32

IR-PTA TIBIO ARTERY & BRANCHES

Facility

$10,595.00

Service Code	HCPCS 35470
Hospital Charge Code	2680150
Hospital Revenue Code	361
Min. Negotiated Rate	$1,589.25
Max. Negotiated Rate	$1,589.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,589.25

IR-PTA TIBIO ARTERY & BRANCHES

Facility

$10,595.00

Service Code	HCPCS 35470
Hospital Charge Code	2680150
Hospital Revenue Code	361
Min. Negotiated Rate	$300.90
Max. Negotiated Rate	$5,297.50
Rate for Payer: Aetna Commercial	$4,026.10
Rate for Payer: Aetna Medicare Advantage	$3,178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,701.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,701.72
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	$2,701.72
Rate for Payer: Cigna Commercial	$5,297.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,754.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,589.25
Rate for Payer: UnitedHealthcare Community & State	$334.80
Rate for Payer: Wellpoint Medicaid Managed Care	$300.90

IR PTA VENOUS

Facility

$22,441.00

Service Code	HCPCS 35476
Hospital Charge Code	7411410
Hospital Revenue Code	361
Min. Negotiated Rate	$3,366.15
Max. Negotiated Rate	$3,366.15
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.15

IR PTA VENOUS

Facility

$22,441.00

Service Code	HCPCS 35476
Hospital Charge Code	2011173
Hospital Revenue Code	361
Min. Negotiated Rate	$3,366.15
Max. Negotiated Rate	$3,366.15
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.15

IR PTA VENOUS

Facility

$22,441.00

Service Code	HCPCS 35476
Hospital Charge Code	2011173
Hospital Revenue Code	361
Min. Negotiated Rate	$637.32
Max. Negotiated Rate	$11,220.50
Rate for Payer: Aetna Commercial	$8,527.58
Rate for Payer: Aetna Medicare Advantage	$6,732.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.45
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	$5,722.45
Rate for Payer: Cigna Commercial	$11,220.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,834.66
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.15
Rate for Payer: UnitedHealthcare Community & State	$709.14
Rate for Payer: Wellpoint Medicaid Managed Care	$637.32

IR PTA VENOUS

Facility

$22,441.00

Service Code	HCPCS 35476
Hospital Charge Code	7411410
Hospital Revenue Code	361
Min. Negotiated Rate	$637.32
Max. Negotiated Rate	$11,220.50
Rate for Payer: Aetna Commercial	$8,527.58
Rate for Payer: Aetna Medicare Advantage	$6,732.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,722.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,722.45
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	$5,722.45
Rate for Payer: Cigna Commercial	$11,220.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,834.66
Rate for Payer: Qualcare PPO/HMO/WC	$3,366.15
Rate for Payer: UnitedHealthcare Community & State	$709.14
Rate for Payer: Wellpoint Medicaid Managed Care	$637.32

IR PTC STENT INTRO INT/EXT DRN

Facility

$12,976.00

Hospital Charge Code	2004471
Hospital Revenue Code	361
Min. Negotiated Rate	$1,946.40
Max. Negotiated Rate	$1,946.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.40

IR PTC STENT INTRO INT/EXT DRN

Facility

$12,976.00

Hospital Charge Code	2004471
Hospital Revenue Code	361
Min. Negotiated Rate	$368.52
Max. Negotiated Rate	$6,488.00
Rate for Payer: Aetna Commercial	$4,930.88
Rate for Payer: Aetna Medicare Advantage	$3,892.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,308.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,308.88
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	$3,308.88
Rate for Payer: Cigna Commercial	$6,488.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,373.76
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.40
Rate for Payer: UnitedHealthcare Community & State	$410.04
Rate for Payer: Wellpoint Medicaid Managed Care	$368.52

IR PULMONARY ARTERY CATH INTRO

Facility

$414.45

Service Code	HCPCS 36013
Hospital Charge Code	411036013
Hospital Revenue Code	361
Min. Negotiated Rate	$13.10
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

IR PULMONARY ARTERY CATH INTRO

Facility

$414.45

Service Code	HCPCS 36013
Hospital Charge Code	411036013
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

IR PULMONARY ARTERY CATH INTRO

Facility

$414.45

Service Code	HCPCS 36013
Hospital Charge Code	366836013
Hospital Revenue Code	361
Min. Negotiated Rate	$13.10
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

IR PULMONARY ARTERY CATH INTRO

Facility

$414.45

Service Code	HCPCS 36013
Hospital Charge Code	321036013
Hospital Revenue Code	361
Min. Negotiated Rate	$13.10
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

IR PULMONARY ARTERY CATH INTRO

Facility

$414.45

Service Code	HCPCS 36013
Hospital Charge Code	2004505
Hospital Revenue Code	361
Min. Negotiated Rate	$13.10
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

IR PULMONARY ARTERY CATH INTRO

Facility

$414.45

Service Code	HCPCS 36013
Hospital Charge Code	2004505
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

IR PULMONARY ARTERY CATH INTRO

Facility

$414.45

Service Code	HCPCS 36013
Hospital Charge Code	366836013
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

IR PULMONARY ARTERY CATH INTRO

Facility

$414.45

Service Code	HCPCS 36013
Hospital Charge Code	321036013
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

Know your out-of-pocket cost for care.

All Charges