Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LEAD QUAD COMPACT 33cml 389133

Facility

$8,200.00

Service Code	HCPCS C1779
Hospital Charge Code	270633682
Hospital Revenue Code	275
Min. Negotiated Rate	$232.88
Max. Negotiated Rate	$4,100.00
Rate for Payer: Aetna Commercial	$3,116.00
Rate for Payer: Aetna Medicare Advantage	$2,460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,091.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,091.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,640.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,091.00
Rate for Payer: Cigna Commercial	$4,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,984.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,230.00
Rate for Payer: UnitedHealthcare Community & State	$259.12
Rate for Payer: Wellpoint Medicaid Managed Care	$232.88

LEADSET 5-LEAD W/CLIP

Facility

$138.70

Hospital Charge Code	270682371
Hospital Revenue Code	272
Min. Negotiated Rate	$20.80
Max. Negotiated Rate	$20.80
Rate for Payer: Qualcare PPO/HMO/WC	$20.80

LEADSET 5-LEAD W/CLIP

Facility

$138.70

Hospital Charge Code	270682371
Hospital Revenue Code	272
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$69.35
Rate for Payer: Aetna Commercial	$52.71
Rate for Payer: Aetna Medicare Advantage	$41.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.37
Rate for Payer: Cigna Commercial	$69.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.06
Rate for Payer: Oxford Commercial	$27.74
Rate for Payer: Qualcare PPO/HMO/WC	$20.80
Rate for Payer: UnitedHealthcare Commercial	$27.74
Rate for Payer: UnitedHealthcare Community & State	$4.38
Rate for Payer: Wellpoint Medicaid Managed Care	$3.94

LEAD TENDRIL SDX 52

Facility

$4,040.00

Service Code	HCPCS C1898
Hospital Charge Code	270655924
Hospital Revenue Code	275
Min. Negotiated Rate	$606.00
Max. Negotiated Rate	$977.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$808.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$977.68
Rate for Payer: Qualcare PPO/HMO/WC	$606.00

LEAD TENDRIL SDX 52

Facility

$4,040.00

Service Code	HCPCS C1898
Hospital Charge Code	270655924
Hospital Revenue Code	275
Min. Negotiated Rate	$114.74
Max. Negotiated Rate	$2,020.00
Rate for Payer: Aetna Commercial	$1,535.20
Rate for Payer: Aetna Medicare Advantage	$1,212.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,030.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,030.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$808.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,030.20
Rate for Payer: Cigna Commercial	$2,020.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$977.68
Rate for Payer: Qualcare PPO/HMO/WC	$606.00
Rate for Payer: UnitedHealthcare Community & State	$127.66
Rate for Payer: Wellpoint Medicaid Managed Care	$114.74

LEAD TENDRIL SDX 52CM

Facility

$3,000.00

Hospital Charge Code	270639704
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

LEAD TENDRIL SDX 52CM

Facility

$3,000.00

Hospital Charge Code	270639704
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 TENDRIL SDX 58CM

Facility

$4,040.00

Hospital Charge Code	270669324
Hospital Revenue Code	275
Min. Negotiated Rate	$114.74
Max. Negotiated Rate	$2,020.00
Rate for Payer: Aetna Commercial	$1,535.20
Rate for Payer: Aetna Medicare Advantage	$1,212.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,030.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,030.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$808.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,030.20
Rate for Payer: Cigna Commercial	$2,020.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$977.68
Rate for Payer: Qualcare PPO/HMO/WC	$606.00
Rate for Payer: UnitedHealthcare Community & State	$127.66
Rate for Payer: Wellpoint Medicaid Managed Care	$114.74

LEAD TENDRIL SDX 58CM

Facility

$4,040.00

Hospital Charge Code	270669324
Hospital Revenue Code	275
Min. Negotiated Rate	$606.00
Max. Negotiated Rate	$977.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$808.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$977.68
Rate for Payer: Qualcare PPO/HMO/WC	$606.00

LEAD TENDRIL STS 58CM

Facility

$2,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270669000
Hospital Revenue Code	278
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$63.20
Rate for Payer: Wellpoint Medicaid Managed Care	$56.80

LEAD TENDRIL STS 58CM

Facility

$2,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270669000
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

LEAD TILDA R60

Facility

$2,125.00

Service Code	HCPCS C1898
Hospital Charge Code	270657602
Hospital Revenue Code	278
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$514.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

LEAD TILDA R60

Facility

$2,125.00

Service Code	HCPCS C1898
Hospital Charge Code	270657602
Hospital Revenue Code	278
Min. Negotiated Rate	$60.35
Max. Negotiated Rate	$1,062.50
Rate for Payer: Aetna Commercial	$807.50
Rate for Payer: Aetna Medicare Advantage	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$541.88
Rate for Payer: Cigna Commercial	$1,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: Qualcare PPO/HMO/WC	$318.75
Rate for Payer: UnitedHealthcare Community & State	$67.15
Rate for Payer: Wellpoint Medicaid Managed Care	$60.35

LEAD TRIAL LEAD 60 CM

Facility

$6,475.00

Service Code	HCPCS C1778
Hospital Charge Code	270683667S
Hospital Revenue Code	278
Min. Negotiated Rate	$183.89
Max. Negotiated Rate	$3,237.50
Rate for Payer: Aetna Commercial	$2,460.50
Rate for Payer: Aetna Medicare Advantage	$1,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,651.12
Rate for Payer: Cigna Commercial	$3,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: Qualcare PPO/HMO/WC	$971.25
Rate for Payer: UnitedHealthcare Community & State	$204.61
Rate for Payer: Wellpoint Medicaid Managed Care	$183.89

LEAD TRIAL LEAD 60 CM

Facility

$6,475.00

Service Code	HCPCS C1778
Hospital Charge Code	270683667
Hospital Revenue Code	278
Min. Negotiated Rate	$183.89
Max. Negotiated Rate	$3,237.50
Rate for Payer: Aetna Commercial	$2,460.50
Rate for Payer: Aetna Medicare Advantage	$1,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,651.12
Rate for Payer: Cigna Commercial	$3,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: Qualcare PPO/HMO/WC	$971.25
Rate for Payer: UnitedHealthcare Community & State	$204.61
Rate for Payer: Wellpoint Medicaid Managed Care	$183.89

LEAD TRIAL LEAD 60 CM

Facility

$6,475.00

Service Code	HCPCS C1778
Hospital Charge Code	270683667
Hospital Revenue Code	278
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$1,566.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

LEAD TRIAL LEAD 60 CM

Facility

$6,475.00

Service Code	HCPCS C1778
Hospital Charge Code	270683667S
Hospital Revenue Code	278
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$1,566.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

LEAD UMRI PR/LPA1200M/46

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270683491
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 UMRI PR/LPA1200M/46

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270683491
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

LEAD URINE

Facility

$257.00

Service Code	HCPCS 83655
Hospital Charge Code	38479439
Hospital Revenue Code	301
Min. Negotiated Rate	$38.55
Max. Negotiated Rate	$38.55
Rate for Payer: Qualcare PPO/HMO/WC	$38.55

LEAD URINE

Facility

$257.00

Service Code	HCPCS 83655
Hospital Charge Code	38479439
Hospital Revenue Code	301
Min. Negotiated Rate	$7.30
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$32.94
Rate for Payer: Aetna Medicare Advantage	$39.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.93
Rate for Payer: Cigna Commercial	$128.50
Rate for Payer: Cigna Medicare Advantage	$12.11
Rate for Payer: Clover Medicare Advantage	$11.50
Rate for Payer: EmblemHealth Commercial	$36.33
Rate for Payer: Humana Medicare Advantage	$12.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.82
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.55
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.11
Rate for Payer: Wellcare Medicare Advantage	$12.11
Rate for Payer: Wellpoint Medicaid Managed Care	$7.30

LEAD, URINE

Facility

$257.00

Service Code	HCPCS 83655
Hospital Charge Code	38472449
Hospital Revenue Code	301
Min. Negotiated Rate	$7.30
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$32.94
Rate for Payer: Aetna Medicare Advantage	$39.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.93
Rate for Payer: Cigna Commercial	$128.50
Rate for Payer: Cigna Medicare Advantage	$12.11
Rate for Payer: Clover Medicare Advantage	$11.50
Rate for Payer: EmblemHealth Commercial	$36.33
Rate for Payer: Humana Medicare Advantage	$12.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.82
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.55
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.11
Rate for Payer: Wellcare Medicare Advantage	$12.11
Rate for Payer: Wellpoint Medicaid Managed Care	$7.30

LEAD, URINE

Facility

$257.00

Service Code	HCPCS 83655
Hospital Charge Code	38472449
Hospital Revenue Code	301
Min. Negotiated Rate	$38.55
Max. Negotiated Rate	$38.55
Rate for Payer: Qualcare PPO/HMO/WC	$38.55

LEAD US MA

Facility

$3,311.05

Hospital Charge Code	270657304
Hospital Revenue Code	275
Min. Negotiated Rate	$496.66
Max. Negotiated Rate	$801.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$662.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$801.27
Rate for Payer: Qualcare PPO/HMO/WC	$496.66

LEAD US MA

Facility

$3,311.05

Hospital Charge Code	270657304
Hospital Revenue Code	275
Min. Negotiated Rate	$94.03
Max. Negotiated Rate	$1,655.53
Rate for Payer: Aetna Commercial	$1,258.20
Rate for Payer: Aetna Medicare Advantage	$993.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$844.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$844.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$662.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$844.32
Rate for Payer: Cigna Commercial	$1,655.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$801.27
Rate for Payer: Qualcare PPO/HMO/WC	$496.66
Rate for Payer: UnitedHealthcare Community & State	$104.63
Rate for Payer: Wellpoint Medicaid Managed Care	$94.03

Know your out-of-pocket cost for care.

All Charges