Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LEAD PACEMAKER CAPSURE ATRIAL

Facility

$3,000.00

Service Code	HCPCS C1779
Hospital Charge Code	270620989
Hospital Revenue Code	278
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$94.80
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

LEAD PACEMAKER CAPSURE ATRIAL

Facility

$2,795.00

Service Code	HCPCS C1779
Hospital Charge Code	270623756S
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 TRANSV 52CM

Facility

$3,175.00

Hospital Charge Code	270676906
Hospital Revenue Code	278
Min. Negotiated Rate	$90.17
Max. Negotiated Rate	$1,587.50
Rate for Payer: Aetna Commercial	$1,206.50
Rate for Payer: Aetna Medicare Advantage	$952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$809.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$809.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$635.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$809.62
Rate for Payer: Cigna Commercial	$1,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$768.35
Rate for Payer: Qualcare PPO/HMO/WC	$476.25
Rate for Payer: UnitedHealthcare Community & State	$100.33
Rate for Payer: Wellpoint Medicaid Managed Care	$90.17

LEAD PACEMAKER TRANSV 52CM

Facility

$3,175.00

Hospital Charge Code	270676906
Hospital Revenue Code	278
Min. Negotiated Rate	$476.25
Max. Negotiated Rate	$768.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$635.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$768.35
Rate for Payer: Qualcare PPO/HMO/WC	$476.25

LEAD PACEMAKER TRANSV 58CM

Facility

$3,175.00

Service Code	HCPCS C1779
Hospital Charge Code	270677275S
Hospital Revenue Code	278
Min. Negotiated Rate	$476.25
Max. Negotiated Rate	$768.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$635.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$768.35
Rate for Payer: Qualcare PPO/HMO/WC	$476.25

LEAD PACEMAKER TRANSV 58CM

Facility

$3,175.00

Service Code	HCPCS C1779
Hospital Charge Code	270677275S
Hospital Revenue Code	278
Min. Negotiated Rate	$90.17
Max. Negotiated Rate	$1,587.50
Rate for Payer: Aetna Commercial	$1,206.50
Rate for Payer: Aetna Medicare Advantage	$952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$809.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$809.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$635.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$809.62
Rate for Payer: Cigna Commercial	$1,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$768.35
Rate for Payer: Qualcare PPO/HMO/WC	$476.25
Rate for Payer: UnitedHealthcare Community & State	$100.33
Rate for Payer: Wellpoint Medicaid Managed Care	$90.17

LEAD PACEMAKER TRANSV 58CM

Facility

$3,175.00

Service Code	HCPCS C1779
Hospital Charge Code	270677275
Hospital Revenue Code	278
Min. Negotiated Rate	$90.17
Max. Negotiated Rate	$1,587.50
Rate for Payer: Aetna Commercial	$1,206.50
Rate for Payer: Aetna Medicare Advantage	$952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$809.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$809.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$635.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$809.62
Rate for Payer: Cigna Commercial	$1,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$768.35
Rate for Payer: Qualcare PPO/HMO/WC	$476.25
Rate for Payer: UnitedHealthcare Community & State	$100.33
Rate for Payer: Wellpoint Medicaid Managed Care	$90.17

LEAD PACEMAKER TRANSV 58CM

Facility

$3,175.00

Service Code	HCPCS C1779
Hospital Charge Code	270677275
Hospital Revenue Code	278
Min. Negotiated Rate	$476.25
Max. Negotiated Rate	$768.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$635.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$768.35
Rate for Payer: Qualcare PPO/HMO/WC	$476.25

LEAD PACING GUIDANT 53M 358754

Facility

$4,000.00

Service Code	HCPCS C1779
Hospital Charge Code	270661812
Hospital Revenue Code	275
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

LEAD PACING GUIDANT 53M 358754

Facility

$4,000.00

Service Code	HCPCS C1779
Hospital Charge Code	270661812
Hospital Revenue Code	275
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

LEAD PACING GUIDAT 60CM 358764

Facility

$4,000.00

Service Code	HCPCS C1779
Hospital Charge Code	270661813
Hospital Revenue Code	275
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

LEAD PACING GUIDAT 60CM 358764

Facility

$4,000.00

Service Code	HCPCS C1779
Hospital Charge Code	270661813
Hospital Revenue Code	275
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

LEAD PACING INGEVITY 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270695957S
Hospital Revenue Code	275
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

LEAD PACING INGEVITY 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270695957S
Hospital Revenue Code	275
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

LEAD PACING INGEVITY 59CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270695958S
Hospital Revenue Code	275
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

LEAD PACING INGEVITY 59CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270695958S
Hospital Revenue Code	275
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

LEAD PACING PERM BIP 4.1F 69CM

Facility

$3,300.00

Service Code	HCPCS C1898
Hospital Charge Code	270699655C
Hospital Revenue Code	278
Min. Negotiated Rate	$93.72
Max. Negotiated Rate	$1,650.00
Rate for Payer: Aetna Commercial	$1,254.00
Rate for Payer: Aetna Medicare Advantage	$990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$841.50
Rate for Payer: Cigna Commercial	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.60
Rate for Payer: Qualcare PPO/HMO/WC	$495.00
Rate for Payer: UnitedHealthcare Community & State	$104.28
Rate for Payer: Wellpoint Medicaid Managed Care	$93.72

LEAD PACING PERM BIP 4.1F 69CM

Facility

$3,300.00

Service Code	HCPCS C1898
Hospital Charge Code	270699655C
Hospital Revenue Code	278
Min. Negotiated Rate	$495.00
Max. Negotiated Rate	$798.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.60
Rate for Payer: Qualcare PPO/HMO/WC	$495.00

LEAD PM CAPSUREFX NOVUS 507645

Facility

$2,795.00

Service Code	HCPCS C1779
Hospital Charge Code	270623756
Hospital Revenue Code	275
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 PM CAPSUREFX NOVUS 507645

Facility

$2,795.00

Service Code	HCPCS C1779
Hospital Charge Code	270623756
Hospital Revenue Code	275
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,PMKR,OTHER THAN TRNSV VDD

Facility

$5,617.00

Hospital Charge Code	270335351
Hospital Revenue Code	275
Min. Negotiated Rate	$842.55
Max. Negotiated Rate	$1,359.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,123.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,359.31
Rate for Payer: Qualcare PPO/HMO/WC	$842.55

LEAD,PMKR,OTHER THAN TRNSV VDD

Facility

$5,617.00

Hospital Charge Code	270335351
Hospital Revenue Code	275
Min. Negotiated Rate	$159.52
Max. Negotiated Rate	$2,808.50
Rate for Payer: Aetna Commercial	$2,134.46
Rate for Payer: Aetna Medicare Advantage	$1,685.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,432.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,432.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,123.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,432.34
Rate for Payer: Cigna Commercial	$2,808.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,359.31
Rate for Payer: Qualcare PPO/HMO/WC	$842.55
Rate for Payer: UnitedHealthcare Community & State	$177.50
Rate for Payer: Wellpoint Medicaid Managed Care	$159.52

LEAD, PMKR,TRANSVENOUS VDD

Facility

$2,381.00

Hospital Charge Code	270335451
Hospital Revenue Code	275
Min. Negotiated Rate	$67.62
Max. Negotiated Rate	$1,190.50
Rate for Payer: Aetna Commercial	$904.78
Rate for Payer: Aetna Medicare Advantage	$714.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$607.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$607.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$476.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$607.15
Rate for Payer: Cigna Commercial	$1,190.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$576.20
Rate for Payer: Qualcare PPO/HMO/WC	$357.15
Rate for Payer: UnitedHealthcare Community & State	$75.24
Rate for Payer: Wellpoint Medicaid Managed Care	$67.62

LEAD, PMKR,TRANSVENOUS VDD

Facility

$2,381.00

Hospital Charge Code	270335451
Hospital Revenue Code	275
Min. Negotiated Rate	$357.15
Max. Negotiated Rate	$576.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$476.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$576.20
Rate for Payer: Qualcare PPO/HMO/WC	$357.15

LEAD QUAD COMPACT 33cml 389133

Facility

$8,200.00

Service Code	HCPCS C1779
Hospital Charge Code	270633682
Hospital Revenue Code	275
Min. Negotiated Rate	$1,230.00
Max. Negotiated Rate	$1,984.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,640.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,984.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,230.00

Know your out-of-pocket cost for care.

All Charges