Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PACEMAKER ADAPTA SR ADSR01

Facility

$25,945.00

Service Code	HCPCS C1786
Hospital Charge Code	270638414N
Hospital Revenue Code	275
Min. Negotiated Rate	$3,891.75
Max. Negotiated Rate	$6,278.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,189.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,278.69
Rate for Payer: Qualcare PPO/HMO/WC	$3,891.75

PACEMAKER ADAPTA SR ADSR01

Facility

$16,795.00

Service Code	HCPCS C1786
Hospital Charge Code	270638414C
Hospital Revenue Code	275
Min. Negotiated Rate	$2,519.25
Max. Negotiated Rate	$4,064.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,064.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,519.25

PACEMAKER ADAPTA SR ADSR01

Facility

$25,945.00

Service Code	HCPCS C1786
Hospital Charge Code	270638414N
Hospital Revenue Code	275
Min. Negotiated Rate	$736.84
Max. Negotiated Rate	$12,972.50
Rate for Payer: Aetna Commercial	$9,859.10
Rate for Payer: Aetna Medicare Advantage	$7,783.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,615.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,615.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,615.98
Rate for Payer: Cigna Commercial	$12,972.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,278.69
Rate for Payer: Qualcare PPO/HMO/WC	$3,891.75
Rate for Payer: UnitedHealthcare Community & State	$819.86
Rate for Payer: Wellpoint Medicaid Managed Care	$736.84

PACEMAKER ADAPTA SR ADSR01

Facility

$16,795.00

Service Code	HCPCS C1786
Hospital Charge Code	270638414C
Hospital Revenue Code	275
Min. Negotiated Rate	$476.98
Max. Negotiated Rate	$8,397.50
Rate for Payer: Aetna Commercial	$6,382.10
Rate for Payer: Aetna Medicare Advantage	$5,038.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,282.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,282.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,359.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,282.73
Rate for Payer: Cigna Commercial	$8,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,064.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,519.25
Rate for Payer: UnitedHealthcare Community & State	$530.72
Rate for Payer: Wellpoint Medicaid Managed Care	$476.98

PACEMAKER ADVISA DR MRI

Facility

$26,425.00

Service Code	HCPCS C1785
Hospital Charge Code	270663723
Hospital Revenue Code	275
Min. Negotiated Rate	$750.47
Max. Negotiated Rate	$13,212.50
Rate for Payer: Aetna Commercial	$10,041.50
Rate for Payer: Aetna Medicare Advantage	$7,927.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,738.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,738.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,738.38
Rate for Payer: Cigna Commercial	$13,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,394.85
Rate for Payer: Qualcare PPO/HMO/WC	$3,963.75
Rate for Payer: UnitedHealthcare Community & State	$835.03
Rate for Payer: Wellpoint Medicaid Managed Care	$750.47

PACEMAKER ADVISA DR MRI

Facility

$26,425.00

Service Code	HCPCS C1785
Hospital Charge Code	270663723
Hospital Revenue Code	275
Min. Negotiated Rate	$3,963.75
Max. Negotiated Rate	$6,394.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,285.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,394.85
Rate for Payer: Qualcare PPO/HMO/WC	$3,963.75

PACEMAKER ADVISA SR

Facility

$20,975.00

Service Code	HCPCS C1786
Hospital Charge Code	270676130
Hospital Revenue Code	275
Min. Negotiated Rate	$3,146.25
Max. Negotiated Rate	$5,075.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,075.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,146.25

PACEMAKER ADVISA SR

Facility

$20,975.00

Service Code	HCPCS C1786
Hospital Charge Code	270676130
Hospital Revenue Code	275
Min. Negotiated Rate	$595.69
Max. Negotiated Rate	$10,487.50
Rate for Payer: Aetna Commercial	$7,970.50
Rate for Payer: Aetna Medicare Advantage	$6,292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,348.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,348.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,348.62
Rate for Payer: Cigna Commercial	$10,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,075.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,146.25
Rate for Payer: UnitedHealthcare Community & State	$662.81
Rate for Payer: Wellpoint Medicaid Managed Care	$595.69

PACEMAKER ALTURA 60DDDR S603DR

Facility

$32,000.00

Service Code	HCPCS C1785
Hospital Charge Code	270661811
Hospital Revenue Code	275
Min. Negotiated Rate	$4,800.00
Max. Negotiated Rate	$7,744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,744.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00

PACEMAKER ALTURA 60DDDR S603DR

Facility

$32,000.00

Service Code	HCPCS C1785
Hospital Charge Code	270661811
Hospital Revenue Code	275
Min. Negotiated Rate	$908.80
Max. Negotiated Rate	$16,000.00
Rate for Payer: Aetna Commercial	$12,160.00
Rate for Payer: Aetna Medicare Advantage	$9,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,160.00
Rate for Payer: Cigna Commercial	$16,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,744.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00
Rate for Payer: UnitedHealthcare Community & State	$1,011.20
Rate for Payer: Wellpoint Medicaid Managed Care	$908.80

PACEMAKER ANALYSIS TELETRACE

Facility

$968.00

Hospital Charge Code	270331423
Hospital Revenue Code	272
Min. Negotiated Rate	$145.20
Max. Negotiated Rate	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$145.20

PACEMAKER ANALYSIS TELETRACE

Facility

$968.00

Hospital Charge Code	270331423
Hospital Revenue Code	272
Min. Negotiated Rate	$27.49
Max. Negotiated Rate	$484.00
Rate for Payer: Aetna Commercial	$367.84
Rate for Payer: Aetna Medicare Advantage	$290.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$246.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$246.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$246.84
Rate for Payer: Cigna Commercial	$484.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$251.68
Rate for Payer: Oxford Commercial	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$145.20
Rate for Payer: UnitedHealthcare Commercial	$193.60
Rate for Payer: UnitedHealthcare Community & State	$30.59
Rate for Payer: Wellpoint Medicaid Managed Care	$27.49

PACEMAKER ASSURITY DR-RF

Facility

$29,750.00

Service Code	HCPCS C1785
Hospital Charge Code	270675969
Hospital Revenue Code	275
Min. Negotiated Rate	$4,462.50
Max. Negotiated Rate	$7,199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,199.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,462.50

PACEMAKER ASSURITY DR-RF

Facility

$29,750.00

Service Code	HCPCS C1785
Hospital Charge Code	270675969
Hospital Revenue Code	275
Min. Negotiated Rate	$844.90
Max. Negotiated Rate	$14,875.00
Rate for Payer: Aetna Commercial	$11,305.00
Rate for Payer: Aetna Medicare Advantage	$8,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,586.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,586.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,586.25
Rate for Payer: Cigna Commercial	$14,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,199.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,462.50
Rate for Payer: UnitedHealthcare Community & State	$940.10
Rate for Payer: Wellpoint Medicaid Managed Care	$844.90

PACEMAKER ASSURITY MRI

Facility

$27,475.00

Service Code	HCPCS C1785
Hospital Charge Code	270681728S
Hospital Revenue Code	275
Min. Negotiated Rate	$780.29
Max. Negotiated Rate	$13,737.50
Rate for Payer: Aetna Commercial	$10,440.50
Rate for Payer: Aetna Medicare Advantage	$8,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,006.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,006.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,006.12
Rate for Payer: Cigna Commercial	$13,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,648.95
Rate for Payer: Qualcare PPO/HMO/WC	$4,121.25
Rate for Payer: UnitedHealthcare Community & State	$868.21
Rate for Payer: Wellpoint Medicaid Managed Care	$780.29

PACEMAKER ASSURITY MRI

Facility

$27,475.00

Service Code	HCPCS C1785
Hospital Charge Code	270681728S
Hospital Revenue Code	275
Min. Negotiated Rate	$4,121.25
Max. Negotiated Rate	$6,648.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,648.95
Rate for Payer: Qualcare PPO/HMO/WC	$4,121.25

PACEMAKER ASSURITY MRI

Facility

$15,000.00

Service Code	HCPCS C1785
Hospital Charge Code	270681728
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

PACEMAKER ASSURITY MRI

Facility

$27,475.00

Service Code	HCPCS C1785
Hospital Charge Code	270681728N
Hospital Revenue Code	275
Min. Negotiated Rate	$780.29
Max. Negotiated Rate	$13,737.50
Rate for Payer: Aetna Commercial	$10,440.50
Rate for Payer: Aetna Medicare Advantage	$8,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,006.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,006.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,006.12
Rate for Payer: Cigna Commercial	$13,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,648.95
Rate for Payer: Qualcare PPO/HMO/WC	$4,121.25
Rate for Payer: UnitedHealthcare Community & State	$868.21
Rate for Payer: Wellpoint Medicaid Managed Care	$780.29

PACEMAKER ASSURITY MRI

Facility

$27,475.00

Service Code	HCPCS C1785
Hospital Charge Code	270681728N
Hospital Revenue Code	275
Min. Negotiated Rate	$4,121.25
Max. Negotiated Rate	$6,648.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,648.95
Rate for Payer: Qualcare PPO/HMO/WC	$4,121.25

PACEMAKER ASSURITY MRI

Facility

$15,000.00

Service Code	HCPCS C1785
Hospital Charge Code	270681728
Hospital Revenue Code	278
Min. Negotiated Rate	$426.00
Max. Negotiated Rate	$7,500.00
Rate for Payer: Aetna Commercial	$5,700.00
Rate for Payer: Aetna Medicare Advantage	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,825.00
Rate for Payer: Cigna Commercial	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00
Rate for Payer: UnitedHealthcare Community & State	$474.00
Rate for Payer: Wellpoint Medicaid Managed Care	$426.00

PACEMAKER ASSURITY SNG CHAMBER

Facility

$22,475.00

Service Code	HCPCS C1786
Hospital Charge Code	270675853
Hospital Revenue Code	275
Min. Negotiated Rate	$638.29
Max. Negotiated Rate	$11,237.50
Rate for Payer: Aetna Commercial	$8,540.50
Rate for Payer: Aetna Medicare Advantage	$6,742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,731.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,731.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,731.12
Rate for Payer: Cigna Commercial	$11,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,438.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,371.25
Rate for Payer: UnitedHealthcare Community & State	$710.21
Rate for Payer: Wellpoint Medicaid Managed Care	$638.29

PACEMAKER ASSURITY SNG CHAMBER

Facility

$22,475.00

Service Code	HCPCS C1786
Hospital Charge Code	270675853
Hospital Revenue Code	275
Min. Negotiated Rate	$3,371.25
Max. Negotiated Rate	$5,438.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,438.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,371.25

PACEMAKER AZURE S SR MRI IPG

Facility

$18,683.50

Service Code	HCPCS C1786
Hospital Charge Code	270686726
Hospital Revenue Code	275
Min. Negotiated Rate	$530.61
Max. Negotiated Rate	$9,341.75
Rate for Payer: Aetna Commercial	$7,099.73
Rate for Payer: Aetna Medicare Advantage	$5,605.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,764.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,764.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,736.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,764.29
Rate for Payer: Cigna Commercial	$9,341.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,521.41
Rate for Payer: Qualcare PPO/HMO/WC	$2,802.53
Rate for Payer: UnitedHealthcare Community & State	$590.40
Rate for Payer: Wellpoint Medicaid Managed Care	$530.61

PACEMAKER AZURE S SR MRI IPG

Facility

$18,683.50

Service Code	HCPCS C1786
Hospital Charge Code	270686726
Hospital Revenue Code	275
Min. Negotiated Rate	$2,802.53
Max. Negotiated Rate	$4,521.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,736.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,521.41
Rate for Payer: Qualcare PPO/HMO/WC	$2,802.53

PACEMAKER CRTP QUADRA ALLURE

Facility

$39,500.00

Service Code	HCPCS C2621
Hospital Charge Code	270699082S
Hospital Revenue Code	275
Min. Negotiated Rate	$1,121.80
Max. Negotiated Rate	$19,750.00
Rate for Payer: Aetna Commercial	$15,010.00
Rate for Payer: Aetna Medicare Advantage	$11,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,072.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,072.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,072.50
Rate for Payer: Cigna Commercial	$19,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,925.00
Rate for Payer: UnitedHealthcare Community & State	$1,248.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1,121.80

Know your out-of-pocket cost for care.

All Charges