Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LEADNEUROINTERSTIMSURESCAN28CM

Facility

$22,770.00

Service Code	HCPCS C1778
Hospital Charge Code	270692608
Hospital Revenue Code	278
Min. Negotiated Rate	$646.67
Max. Negotiated Rate	$11,385.00
Rate for Payer: Aetna Commercial	$8,652.60
Rate for Payer: Aetna Medicare Advantage	$6,831.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,806.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,806.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,554.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,806.35
Rate for Payer: Cigna Commercial	$11,385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,510.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,415.50
Rate for Payer: UnitedHealthcare Community & State	$719.53
Rate for Payer: Wellpoint Medicaid Managed Care	$646.67

LEADNEUROSTIMAVISTAMR56CM8MM

Facility

$14,500.00

Service Code	HCPCS C1778
Hospital Charge Code	270698495
Hospital Revenue Code	278
Min. Negotiated Rate	$411.80
Max. Negotiated Rate	$7,250.00
Rate for Payer: Aetna Commercial	$5,510.00
Rate for Payer: Aetna Medicare Advantage	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,697.50
Rate for Payer: Cigna Commercial	$7,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00
Rate for Payer: UnitedHealthcare Community & State	$458.20
Rate for Payer: Wellpoint Medicaid Managed Care	$411.80

LEADNEUROSTIMAVISTAMR56CM8MM

Facility

$14,500.00

Service Code	HCPCS C1778
Hospital Charge Code	270698495
Hospital Revenue Code	278
Min. Negotiated Rate	$2,175.00
Max. Negotiated Rate	$3,509.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00

LEAD, NEUROSTIMULATOR IMPLANT

Facility

$6,991.00

Hospital Charge Code	270332623
Hospital Revenue Code	278
Min. Negotiated Rate	$1,048.65
Max. Negotiated Rate	$1,691.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,398.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,691.82
Rate for Payer: Qualcare PPO/HMO/WC	$1,048.65

LEAD, NEUROSTIMULATOR IMPLANT

Facility

$6,991.00

Hospital Charge Code	270332623
Hospital Revenue Code	278
Min. Negotiated Rate	$198.54
Max. Negotiated Rate	$3,495.50
Rate for Payer: Aetna Commercial	$2,656.58
Rate for Payer: Aetna Medicare Advantage	$2,097.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,782.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,782.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,398.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,782.70
Rate for Payer: Cigna Commercial	$3,495.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,691.82
Rate for Payer: Qualcare PPO/HMO/WC	$1,048.65
Rate for Payer: UnitedHealthcare Community & State	$220.92
Rate for Payer: Wellpoint Medicaid Managed Care	$198.54

LEAD NON PLUSE OXIMETER W/9FT

Facility

$610.00

Hospital Charge Code	270674512
Hospital Revenue Code	272
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

LEAD NON PLUSE OXIMETER W/9FT

Facility

$610.00

Hospital Charge Code	270674512
Hospital Revenue Code	272
Min. Negotiated Rate	$17.32
Max. Negotiated Rate	$305.00
Rate for Payer: Aetna Commercial	$231.80
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.60
Rate for Payer: Oxford Commercial	$122.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Commercial	$122.00
Rate for Payer: UnitedHealthcare Community & State	$19.28
Rate for Payer: Wellpoint Medicaid Managed Care	$17.32

LEAD PACEMAKER CAPSURE 45 CM

Facility

$3,844.00

Service Code	HCPCS C1779
Hospital Charge Code	270623756N
Hospital Revenue Code	275
Min. Negotiated Rate	$576.60
Max. Negotiated Rate	$930.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$768.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$930.25
Rate for Payer: Qualcare PPO/HMO/WC	$576.60

LEAD PACEMAKER CAPSURE 45 CM

Facility

$3,844.00

Service Code	HCPCS C1779
Hospital Charge Code	270623756N
Hospital Revenue Code	275
Min. Negotiated Rate	$109.17
Max. Negotiated Rate	$1,922.00
Rate for Payer: Aetna Commercial	$1,460.72
Rate for Payer: Aetna Medicare Advantage	$1,153.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$980.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$980.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$768.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$980.22
Rate for Payer: Cigna Commercial	$1,922.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$930.25
Rate for Payer: Qualcare PPO/HMO/WC	$576.60
Rate for Payer: UnitedHealthcare Community & State	$121.47
Rate for Payer: Wellpoint Medicaid Managed Care	$109.17

LEAD PACEMAKER CAPSURE 52 CM

Facility

$4,324.85

Service Code	HCPCS C1779
Hospital Charge Code	270623124S
Hospital Revenue Code	275
Min. Negotiated Rate	$648.73
Max. Negotiated Rate	$1,046.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$864.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,046.61
Rate for Payer: Qualcare PPO/HMO/WC	$648.73

LEAD PACEMAKER CAPSURE 52 CM

Facility

$4,324.85

Service Code	HCPCS C1779
Hospital Charge Code	270623124N
Hospital Revenue Code	275
Min. Negotiated Rate	$648.73
Max. Negotiated Rate	$1,046.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$864.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,046.61
Rate for Payer: Qualcare PPO/HMO/WC	$648.73

LEAD PACEMAKER CAPSURE 52 CM

Facility

$4,324.85

Service Code	HCPCS C1779
Hospital Charge Code	270623124N
Hospital Revenue Code	275
Min. Negotiated Rate	$122.83
Max. Negotiated Rate	$2,162.43
Rate for Payer: Aetna Commercial	$1,643.44
Rate for Payer: Aetna Medicare Advantage	$1,297.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,102.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,102.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$864.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,102.84
Rate for Payer: Cigna Commercial	$2,162.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,046.61
Rate for Payer: Qualcare PPO/HMO/WC	$648.73
Rate for Payer: UnitedHealthcare Community & State	$136.67
Rate for Payer: Wellpoint Medicaid Managed Care	$122.83

LEAD PACEMAKER CAPSURE 52 CM

Facility

$4,324.85

Service Code	HCPCS C1779
Hospital Charge Code	270623124S
Hospital Revenue Code	275
Min. Negotiated Rate	$122.83
Max. Negotiated Rate	$2,162.43
Rate for Payer: Aetna Commercial	$1,643.44
Rate for Payer: Aetna Medicare Advantage	$1,297.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,102.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,102.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$864.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,102.84
Rate for Payer: Cigna Commercial	$2,162.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,046.61
Rate for Payer: Qualcare PPO/HMO/WC	$648.73
Rate for Payer: UnitedHealthcare Community & State	$136.67
Rate for Payer: Wellpoint Medicaid Managed Care	$122.83

LEAD PACEMAKER CAPSURE 58CM

Facility

$2,795.00

Service Code	HCPCS C1898
Hospital Charge Code	270622952S
Hospital Revenue Code	278
Min. Negotiated Rate	$419.25
Max. Negotiated Rate	$676.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$559.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$676.39
Rate for Payer: Qualcare PPO/HMO/WC	$419.25

LEAD PACEMAKER CAPSURE 58CM

Facility

$2,795.00

Service Code	HCPCS C1898
Hospital Charge Code	270622952S
Hospital Revenue Code	278
Min. Negotiated Rate	$79.38
Max. Negotiated Rate	$1,397.50
Rate for Payer: Aetna Commercial	$1,062.10
Rate for Payer: Aetna Medicare Advantage	$838.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$712.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$712.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$559.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$712.73
Rate for Payer: Cigna Commercial	$1,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$676.39
Rate for Payer: Qualcare PPO/HMO/WC	$419.25
Rate for Payer: UnitedHealthcare Community & State	$88.32
Rate for Payer: Wellpoint Medicaid Managed Care	$79.38

LEAD PACEMAKER CAPSURE 58CM

Facility

$3,125.00

Service Code	HCPCS C1898
Hospital Charge Code	270622952N
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

LEAD PACEMAKER CAPSURE 58CM

Facility

$2,795.00

Service Code	HCPCS C1898
Hospital Charge Code	270622952
Hospital Revenue Code	278
Min. Negotiated Rate	$79.38
Max. Negotiated Rate	$1,397.50
Rate for Payer: Aetna Commercial	$1,062.10
Rate for Payer: Aetna Medicare Advantage	$838.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$712.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$712.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$559.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$712.73
Rate for Payer: Cigna Commercial	$1,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$676.39
Rate for Payer: Qualcare PPO/HMO/WC	$419.25
Rate for Payer: UnitedHealthcare Community & State	$88.32
Rate for Payer: Wellpoint Medicaid Managed Care	$79.38

LEAD PACEMAKER CAPSURE 58CM

Facility

$3,125.00

Service Code	HCPCS C1898
Hospital Charge Code	270622952N
Hospital Revenue Code	278
Min. Negotiated Rate	$88.75
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$98.75
Rate for Payer: Wellpoint Medicaid Managed Care	$88.75

LEAD PACEMAKER CAPSURE 58CM

Facility

$2,795.00

Service Code	HCPCS C1898
Hospital Charge Code	270622952
Hospital Revenue Code	278
Min. Negotiated Rate	$419.25
Max. Negotiated Rate	$676.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$559.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$676.39
Rate for Payer: Qualcare PPO/HMO/WC	$419.25

LEAD PACEMAKER CAPSURE 85CM

Facility

$2,795.00

Service Code	HCPCS C1779
Hospital Charge Code	270681437
Hospital Revenue Code	278
Min. Negotiated Rate	$79.38
Max. Negotiated Rate	$1,397.50
Rate for Payer: Aetna Commercial	$1,062.10
Rate for Payer: Aetna Medicare Advantage	$838.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$712.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$712.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$559.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$712.73
Rate for Payer: Cigna Commercial	$1,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$676.39
Rate for Payer: Qualcare PPO/HMO/WC	$419.25
Rate for Payer: UnitedHealthcare Community & State	$88.32
Rate for Payer: Wellpoint Medicaid Managed Care	$79.38

LEAD PACEMAKER CAPSURE 85CM

Facility

$2,795.00

Service Code	HCPCS C1779
Hospital Charge Code	270681437N
Hospital Revenue Code	278
Min. Negotiated Rate	$79.38
Max. Negotiated Rate	$1,397.50
Rate for Payer: Aetna Commercial	$1,062.10
Rate for Payer: Aetna Medicare Advantage	$838.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$712.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$712.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$559.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$712.73
Rate for Payer: Cigna Commercial	$1,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$676.39
Rate for Payer: Qualcare PPO/HMO/WC	$419.25
Rate for Payer: UnitedHealthcare Community & State	$88.32
Rate for Payer: Wellpoint Medicaid Managed Care	$79.38

LEAD PACEMAKER CAPSURE 85CM

Facility

$2,795.00

Service Code	HCPCS C1779
Hospital Charge Code	270681437
Hospital Revenue Code	278
Min. Negotiated Rate	$419.25
Max. Negotiated Rate	$676.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$559.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$676.39
Rate for Payer: Qualcare PPO/HMO/WC	$419.25

LEAD PACEMAKER CAPSURE 85CM

Facility

$2,795.00

Service Code	HCPCS C1779
Hospital Charge Code	270681437N
Hospital Revenue Code	278
Min. Negotiated Rate	$419.25
Max. Negotiated Rate	$676.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$559.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$676.39
Rate for Payer: Qualcare PPO/HMO/WC	$419.25

LEAD PACEMAKER CAPSURE ATRIAL

Facility

$2,795.00

Service Code	HCPCS C1779
Hospital Charge Code	270623756S
Hospital Revenue Code	278
Min. Negotiated Rate	$79.38
Max. Negotiated Rate	$1,397.50
Rate for Payer: Aetna Commercial	$1,062.10
Rate for Payer: Aetna Medicare Advantage	$838.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$712.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$712.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$559.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$712.73
Rate for Payer: Cigna Commercial	$1,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$676.39
Rate for Payer: Qualcare PPO/HMO/WC	$419.25
Rate for Payer: UnitedHealthcare Community & State	$88.32
Rate for Payer: Wellpoint Medicaid Managed Care	$79.38

LEAD PACEMAKER CAPSURE ATRIAL

Facility

$3,000.00

Service Code	HCPCS C1779
Hospital Charge Code	270620989
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

Know your out-of-pocket cost for care.

All Charges