Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

MICRO ANIS 17 MM/3MM

Facility

$980.00

Hospital Charge Code	270703199
Hospital Revenue Code	278
Min. Negotiated Rate	$27.83
Max. Negotiated Rate	$490.00
Rate for Payer: Aetna Commercial	$372.40
Rate for Payer: Aetna Medicare Advantage	$294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.90
Rate for Payer: Cigna Commercial	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.16
Rate for Payer: Qualcare PPO/HMO/WC	$147.00
Rate for Payer: UnitedHealthcare Community & State	$30.97
Rate for Payer: Wellpoint Medicaid Managed Care	$27.83

MICRO ANIS 20MMX3.0MM

Facility

$1,000.00

Hospital Charge Code	270702602
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

MICRO ANIS 20MMX3.0MM

Facility

$1,000.00

Hospital Charge Code	270702602
Hospital Revenue Code	278
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

MICRO ANIS 22MMX3.0MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270702603
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

MICRO ANIS 22MMX3.0MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270702603
Hospital Revenue Code	278
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

MICROBE SUSCEPTIBLE MIC PLT

Facility

$138.14

Service Code	HCPCS 87186
Hospital Charge Code	401387186B
Hospital Revenue Code	306
Min. Negotiated Rate	$3.92
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$23.53
Rate for Payer: Aetna Medicare Advantage	$28.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.38
Rate for Payer: Cigna Commercial	$69.07
Rate for Payer: Cigna Medicare Advantage	$8.65
Rate for Payer: Clover Medicare Advantage	$8.22
Rate for Payer: EmblemHealth Commercial	$25.95
Rate for Payer: Humana Medicare Advantage	$8.91
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.92
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.72
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$6.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.65
Rate for Payer: Wellcare Medicare Advantage	$8.65
Rate for Payer: Wellpoint Medicaid Managed Care	$3.92

MICROBE SUSCEPTIBLE MIC PLT

Facility

$138.14

Service Code	HCPCS 87186
Hospital Charge Code	401387186B
Hospital Revenue Code	306
Min. Negotiated Rate	$20.72
Max. Negotiated Rate	$20.72
Rate for Payer: Qualcare PPO/HMO/WC	$20.72

MICROBIAL IDENT W/AMPLIFICATIO

Facility

$431.00

Service Code	HCPCS 87798
Hospital Charge Code	38476243
Hospital Revenue Code	306
Min. Negotiated Rate	$64.65
Max. Negotiated Rate	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

MICROBIAL IDENT W/AMPLIFICATIO

Facility

$431.00

Service Code	HCPCS 87798
Hospital Charge Code	38476243
Hospital Revenue Code	306
Min. Negotiated Rate	$12.24
Max. Negotiated Rate	$215.50
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.29
Rate for Payer: Cigna Commercial	$215.50
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.06
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$64.65
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$12.24

MICROBIOLOGY SPECIMEN BRUSH

Facility

$387.00

Hospital Charge Code	270330773
Hospital Revenue Code	272
Min. Negotiated Rate	$58.05
Max. Negotiated Rate	$58.05
Rate for Payer: Qualcare PPO/HMO/WC	$58.05

MICROBIOLOGY SPECIMEN BRUSH

Facility

$387.00

Hospital Charge Code	270330773
Hospital Revenue Code	272
Min. Negotiated Rate	$10.99
Max. Negotiated Rate	$193.50
Rate for Payer: Aetna Commercial	$147.06
Rate for Payer: Aetna Medicare Advantage	$116.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.69
Rate for Payer: Cigna Commercial	$193.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.62
Rate for Payer: Oxford Commercial	$77.40
Rate for Payer: Qualcare PPO/HMO/WC	$58.05
Rate for Payer: UnitedHealthcare Commercial	$77.40
Rate for Payer: UnitedHealthcare Community & State	$12.23
Rate for Payer: Wellpoint Medicaid Managed Care	$10.99

MICROBLATOR 30 ICW 1.4MM

Facility

$2,455.00

Hospital Charge Code	270675004
Hospital Revenue Code	272
Min. Negotiated Rate	$368.25
Max. Negotiated Rate	$368.25
Rate for Payer: Qualcare PPO/HMO/WC	$368.25

MICROBLATOR 30 ICW 1.4MM

Facility

$2,455.00

Hospital Charge Code	270675004
Hospital Revenue Code	272
Min. Negotiated Rate	$69.72
Max. Negotiated Rate	$1,227.50
Rate for Payer: Aetna Commercial	$932.90
Rate for Payer: Aetna Medicare Advantage	$736.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$626.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$626.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$626.02
Rate for Payer: Cigna Commercial	$1,227.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$638.30
Rate for Payer: Oxford Commercial	$491.00
Rate for Payer: Qualcare PPO/HMO/WC	$368.25
Rate for Payer: UnitedHealthcare Commercial	$491.00
Rate for Payer: UnitedHealthcare Community & State	$77.58
Rate for Payer: Wellpoint Medicaid Managed Care	$69.72

MICROCATHETER 135 CM 45 CM

Facility

$3,250.00

Hospital Charge Code	270683212
Hospital Revenue Code	272
Min. Negotiated Rate	$92.30
Max. Negotiated Rate	$1,625.00
Rate for Payer: Aetna Commercial	$1,235.00
Rate for Payer: Aetna Medicare Advantage	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.75
Rate for Payer: Cigna Commercial	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$845.00
Rate for Payer: Oxford Commercial	$650.00
Rate for Payer: Qualcare PPO/HMO/WC	$487.50
Rate for Payer: UnitedHealthcare Commercial	$650.00
Rate for Payer: UnitedHealthcare Community & State	$102.70
Rate for Payer: Wellpoint Medicaid Managed Care	$92.30

MICROCATHETER 135 CM 45 CM

Facility

$3,250.00

Hospital Charge Code	270683212
Hospital Revenue Code	272
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$487.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

MICROCATHETER 135 CM 45 CM

Facility

$3,250.00

Hospital Charge Code	270683212N
Hospital Revenue Code	272
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$487.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

MICROCATHETER 135 CM 45 CM

Facility

$3,250.00

Hospital Charge Code	270683212N
Hospital Revenue Code	272
Min. Negotiated Rate	$92.30
Max. Negotiated Rate	$1,625.00
Rate for Payer: Aetna Commercial	$1,235.00
Rate for Payer: Aetna Medicare Advantage	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.75
Rate for Payer: Cigna Commercial	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$845.00
Rate for Payer: Oxford Commercial	$650.00
Rate for Payer: Qualcare PPO/HMO/WC	$487.50
Rate for Payer: UnitedHealthcare Commercial	$650.00
Rate for Payer: UnitedHealthcare Community & State	$102.70
Rate for Payer: Wellpoint Medicaid Managed Care	$92.30

MICROCATHETER 135CM STR LANTER

Facility

$3,250.00

Hospital Charge Code	270683211N
Hospital Revenue Code	272
Min. Negotiated Rate	$92.30
Max. Negotiated Rate	$1,625.00
Rate for Payer: Aetna Commercial	$1,235.00
Rate for Payer: Aetna Medicare Advantage	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.75
Rate for Payer: Cigna Commercial	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$845.00
Rate for Payer: Oxford Commercial	$650.00
Rate for Payer: Qualcare PPO/HMO/WC	$487.50
Rate for Payer: UnitedHealthcare Commercial	$650.00
Rate for Payer: UnitedHealthcare Community & State	$102.70
Rate for Payer: Wellpoint Medicaid Managed Care	$92.30

MICROCATHETER 135CM STR LANTER

Facility

$3,250.00

Hospital Charge Code	270683211N
Hospital Revenue Code	272
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$487.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

MICROCATHETER 135CM STR LANTER

Facility

$3,250.00

Hospital Charge Code	270683211
Hospital Revenue Code	272
Min. Negotiated Rate	$92.30
Max. Negotiated Rate	$1,625.00
Rate for Payer: Aetna Commercial	$1,235.00
Rate for Payer: Aetna Medicare Advantage	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.75
Rate for Payer: Cigna Commercial	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$845.00
Rate for Payer: Oxford Commercial	$650.00
Rate for Payer: Qualcare PPO/HMO/WC	$487.50
Rate for Payer: UnitedHealthcare Commercial	$650.00
Rate for Payer: UnitedHealthcare Community & State	$102.70
Rate for Payer: Wellpoint Medicaid Managed Care	$92.30

MICROCATHETER 135CM STR LANTER

Facility

$3,250.00

Hospital Charge Code	270683211
Hospital Revenue Code	272
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$487.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

MICROCATHETER HEADWAY 21 PLUS

Facility

$6,000.00

Service Code	HCPCS C1887
Hospital Charge Code	270699999S
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

MICROCATHETER HEADWAY 21 PLUS

Facility

$6,000.00

Service Code	HCPCS C1887
Hospital Charge Code	270699999S
Hospital Revenue Code	278
Min. Negotiated Rate	$170.40
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$189.60
Rate for Payer: Wellpoint Medicaid Managed Care	$170.40

MICROCATHETER RENEGADE HI-FLO

Facility

$2,624.00

Service Code	HCPCS C1887
Hospital Charge Code	270662978
Hospital Revenue Code	278
Min. Negotiated Rate	$393.60
Max. Negotiated Rate	$635.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$524.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.01
Rate for Payer: Qualcare PPO/HMO/WC	$393.60

MICROCATHETER RENEGADE HI-FLO

Facility

$2,624.00

Service Code	HCPCS C1887
Hospital Charge Code	270662978
Hospital Revenue Code	278
Min. Negotiated Rate	$74.52
Max. Negotiated Rate	$1,312.00
Rate for Payer: Aetna Commercial	$997.12
Rate for Payer: Aetna Medicare Advantage	$787.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$524.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.12
Rate for Payer: Cigna Commercial	$1,312.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.01
Rate for Payer: Qualcare PPO/HMO/WC	$393.60
Rate for Payer: UnitedHealthcare Community & State	$82.92
Rate for Payer: Wellpoint Medicaid Managed Care	$74.52

Know your out-of-pocket cost for care.

All Charges