Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PACEMAKER CRTP QUADRA ALLURE

Facility

$39,500.00

Service Code	HCPCS C2621
Hospital Charge Code	270699082S
Hospital Revenue Code	275
Min. Negotiated Rate	$5,925.00
Max. Negotiated Rate	$9,559.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,925.00

PACEMAKER DEFIB VISIA AF IS1/D

Facility

$84,785.00

Service Code	HCPCS C1722
Hospital Charge Code	270684662
Hospital Revenue Code	275
Min. Negotiated Rate	$2,407.89
Max. Negotiated Rate	$42,392.50
Rate for Payer: Aetna Commercial	$32,218.30
Rate for Payer: Aetna Medicare Advantage	$25,435.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,620.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,620.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16,957.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21,620.17
Rate for Payer: Cigna Commercial	$42,392.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20,517.97
Rate for Payer: Qualcare PPO/HMO/WC	$12,717.75
Rate for Payer: UnitedHealthcare Community & State	$2,679.21
Rate for Payer: Wellpoint Medicaid Managed Care	$2,407.89

PACEMAKER DEFIB VISIA AF IS1/D

Facility

$84,785.00

Service Code	HCPCS C1722
Hospital Charge Code	270684662N
Hospital Revenue Code	275
Min. Negotiated Rate	$12,717.75
Max. Negotiated Rate	$20,517.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16,957.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20,517.97
Rate for Payer: Qualcare PPO/HMO/WC	$12,717.75

PACEMAKER DEFIB VISIA AF IS1/D

Facility

$84,785.00

Service Code	HCPCS C1722
Hospital Charge Code	270684662N
Hospital Revenue Code	275
Min. Negotiated Rate	$2,407.89
Max. Negotiated Rate	$42,392.50
Rate for Payer: Aetna Commercial	$32,218.30
Rate for Payer: Aetna Medicare Advantage	$25,435.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,620.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,620.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16,957.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21,620.17
Rate for Payer: Cigna Commercial	$42,392.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20,517.97
Rate for Payer: Qualcare PPO/HMO/WC	$12,717.75
Rate for Payer: UnitedHealthcare Community & State	$2,679.21
Rate for Payer: Wellpoint Medicaid Managed Care	$2,407.89

PACEMAKER DEFIB VISIA AF IS1/D

Facility

$84,785.00

Service Code	HCPCS C1722
Hospital Charge Code	270684662
Hospital Revenue Code	275
Min. Negotiated Rate	$12,717.75
Max. Negotiated Rate	$20,517.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16,957.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20,517.97
Rate for Payer: Qualcare PPO/HMO/WC	$12,717.75

PACEMAKER DR CHAM ICV1122

Facility

$23,213.25

Service Code	HCPCS C1785
Hospital Charge Code	270660759
Hospital Revenue Code	275
Min. Negotiated Rate	$659.26
Max. Negotiated Rate	$11,606.62
Rate for Payer: Aetna Commercial	$8,821.03
Rate for Payer: Aetna Medicare Advantage	$6,963.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,919.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,919.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,642.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,919.38
Rate for Payer: Cigna Commercial	$11,606.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,617.61
Rate for Payer: Qualcare PPO/HMO/WC	$3,481.99
Rate for Payer: UnitedHealthcare Community & State	$733.54
Rate for Payer: Wellpoint Medicaid Managed Care	$659.26

PACEMAKER DR CHAM ICV1122

Facility

$23,213.25

Service Code	HCPCS C1785
Hospital Charge Code	270660759
Hospital Revenue Code	275
Min. Negotiated Rate	$3,481.99
Max. Negotiated Rate	$5,617.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,642.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,617.61
Rate for Payer: Qualcare PPO/HMO/WC	$3,481.99

PACEMAKER,DUALCHAMB NONRATE RE

Facility

$19,648.00

Hospital Charge Code	270335547
Hospital Revenue Code	275
Min. Negotiated Rate	$2,947.20
Max. Negotiated Rate	$4,754.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,929.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,754.82
Rate for Payer: Qualcare PPO/HMO/WC	$2,947.20

PACEMAKER,DUALCHAMB NONRATE RE

Facility

$19,648.00

Hospital Charge Code	270335547
Hospital Revenue Code	275
Min. Negotiated Rate	$558.00
Max. Negotiated Rate	$9,824.00
Rate for Payer: Aetna Commercial	$7,466.24
Rate for Payer: Aetna Medicare Advantage	$5,894.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,010.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,010.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,929.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,010.24
Rate for Payer: Cigna Commercial	$9,824.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,754.82
Rate for Payer: Qualcare PPO/HMO/WC	$2,947.20
Rate for Payer: UnitedHealthcare Community & State	$620.88
Rate for Payer: Wellpoint Medicaid Managed Care	$558.00

PACEMAKER DUAL CHMBR EVIA DR-T

Facility

$20,815.00

Service Code	HCPCS C1785
Hospital Charge Code	270675164
Hospital Revenue Code	275
Min. Negotiated Rate	$3,122.25
Max. Negotiated Rate	$5,037.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,163.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,037.23
Rate for Payer: Qualcare PPO/HMO/WC	$3,122.25

PACEMAKER DUAL CHMBR EVIA DR-T

Facility

$20,815.00

Service Code	HCPCS C1785
Hospital Charge Code	270675164
Hospital Revenue Code	275
Min. Negotiated Rate	$591.15
Max. Negotiated Rate	$10,407.50
Rate for Payer: Aetna Commercial	$7,909.70
Rate for Payer: Aetna Medicare Advantage	$6,244.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,307.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,307.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,163.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,307.82
Rate for Payer: Cigna Commercial	$10,407.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,037.23
Rate for Payer: Qualcare PPO/HMO/WC	$3,122.25
Rate for Payer: UnitedHealthcare Community & State	$657.75
Rate for Payer: Wellpoint Medicaid Managed Care	$591.15

PACEMAKER EDORA 8 DR-T DUAL

Facility

$34,975.00

Service Code	HCPCS C1785
Hospital Charge Code	270687371
Hospital Revenue Code	275
Min. Negotiated Rate	$5,246.25
Max. Negotiated Rate	$8,463.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,463.95
Rate for Payer: Qualcare PPO/HMO/WC	$5,246.25

PACEMAKER EDORA 8 DR-T DUAL

Facility

$34,975.00

Service Code	HCPCS C1785
Hospital Charge Code	270687371
Hospital Revenue Code	275
Min. Negotiated Rate	$993.29
Max. Negotiated Rate	$17,487.50
Rate for Payer: Aetna Commercial	$13,290.50
Rate for Payer: Aetna Medicare Advantage	$10,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,918.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,918.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,918.62
Rate for Payer: Cigna Commercial	$17,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,463.95
Rate for Payer: Qualcare PPO/HMO/WC	$5,246.25
Rate for Payer: UnitedHealthcare Community & State	$1,105.21
Rate for Payer: Wellpoint Medicaid Managed Care	$993.29

PACEMAKER EVIA DR-T

Facility

$20,815.00

Hospital Charge Code	270675681
Hospital Revenue Code	275
Min. Negotiated Rate	$3,122.25
Max. Negotiated Rate	$5,037.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,163.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,037.23
Rate for Payer: Qualcare PPO/HMO/WC	$3,122.25

PACEMAKER EVIA DR-T

Facility

$20,815.00

Hospital Charge Code	270675681
Hospital Revenue Code	275
Min. Negotiated Rate	$591.15
Max. Negotiated Rate	$10,407.50
Rate for Payer: Aetna Commercial	$7,909.70
Rate for Payer: Aetna Medicare Advantage	$6,244.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,307.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,307.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,163.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,307.82
Rate for Payer: Cigna Commercial	$10,407.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,037.23
Rate for Payer: Qualcare PPO/HMO/WC	$3,122.25
Rate for Payer: UnitedHealthcare Community & State	$657.75
Rate for Payer: Wellpoint Medicaid Managed Care	$591.15

PACEMAKER EVIA SR-T

Facility

$18,915.00

Service Code	HCPCS C1786
Hospital Charge Code	270673069
Hospital Revenue Code	275
Min. Negotiated Rate	$537.19
Max. Negotiated Rate	$9,457.50
Rate for Payer: Aetna Commercial	$7,187.70
Rate for Payer: Aetna Medicare Advantage	$5,674.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,823.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,823.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,783.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,823.32
Rate for Payer: Cigna Commercial	$9,457.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,577.43
Rate for Payer: Qualcare PPO/HMO/WC	$2,837.25
Rate for Payer: UnitedHealthcare Community & State	$597.71
Rate for Payer: Wellpoint Medicaid Managed Care	$537.19

PACEMAKER EVIA SR-T

Facility

$18,915.00

Service Code	HCPCS C1786
Hospital Charge Code	270673069
Hospital Revenue Code	275
Min. Negotiated Rate	$2,837.25
Max. Negotiated Rate	$4,577.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,783.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,577.43
Rate for Payer: Qualcare PPO/HMO/WC	$2,837.25

PACEMAKER GENERATOR

Facility

$34,975.00

Hospital Charge Code	270703090
Hospital Revenue Code	278
Min. Negotiated Rate	$993.29
Max. Negotiated Rate	$17,487.50
Rate for Payer: Aetna Commercial	$13,290.50
Rate for Payer: Aetna Medicare Advantage	$10,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,918.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,918.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,918.62
Rate for Payer: Cigna Commercial	$17,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,463.95
Rate for Payer: Qualcare PPO/HMO/WC	$5,246.25
Rate for Payer: UnitedHealthcare Community & State	$1,105.21
Rate for Payer: Wellpoint Medicaid Managed Care	$993.29

PACEMAKER GENERATOR

Facility

$34,975.00

Hospital Charge Code	270703090
Hospital Revenue Code	278
Min. Negotiated Rate	$5,246.25
Max. Negotiated Rate	$8,463.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,463.95
Rate for Payer: Qualcare PPO/HMO/WC	$5,246.25

PACEMAKER IMPLANT NO SING/DUAL

Facility

$37,009.00

Hospital Charge Code	270335099
Hospital Revenue Code	275
Min. Negotiated Rate	$1,051.06
Max. Negotiated Rate	$18,504.50
Rate for Payer: Aetna Commercial	$14,063.42
Rate for Payer: Aetna Medicare Advantage	$11,102.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,437.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,437.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,401.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,437.30
Rate for Payer: Cigna Commercial	$18,504.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,956.18
Rate for Payer: Qualcare PPO/HMO/WC	$5,551.35
Rate for Payer: UnitedHealthcare Community & State	$1,169.48
Rate for Payer: Wellpoint Medicaid Managed Care	$1,051.06

PACEMAKER IMPLANT NO SING/DUAL

Facility

$37,009.00

Hospital Charge Code	270335099
Hospital Revenue Code	275
Min. Negotiated Rate	$5,551.35
Max. Negotiated Rate	$8,956.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,401.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,956.18
Rate for Payer: Qualcare PPO/HMO/WC	$5,551.35

PACEMAKER INGENIO DR IS1 K173

Facility

$36,000.00

Service Code	HCPCS C1785
Hospital Charge Code	270648711
Hospital Revenue Code	275
Min. Negotiated Rate	$5,400.00
Max. Negotiated Rate	$8,712.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,712.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,400.00

PACEMAKER INGENIO DR IS1 K173

Facility

$36,000.00

Service Code	HCPCS C1785
Hospital Charge Code	270648711
Hospital Revenue Code	275
Min. Negotiated Rate	$1,022.40
Max. Negotiated Rate	$18,000.00
Rate for Payer: Aetna Commercial	$13,680.00
Rate for Payer: Aetna Medicare Advantage	$10,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,180.00
Rate for Payer: Cigna Commercial	$18,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,712.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,400.00
Rate for Payer: UnitedHealthcare Community & State	$1,137.60
Rate for Payer: Wellpoint Medicaid Managed Care	$1,022.40

PACEMAKER INGENIO SINGLE CHAMB

Facility

$33,500.00

Service Code	HCPCS C1786
Hospital Charge Code	270665529
Hospital Revenue Code	275
Min. Negotiated Rate	$5,025.00
Max. Negotiated Rate	$8,107.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,107.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,025.00

PACEMAKER INGENIO SINGLE CHAMB

Facility

$33,500.00

Service Code	HCPCS C1786
Hospital Charge Code	270665529
Hospital Revenue Code	275
Min. Negotiated Rate	$951.40
Max. Negotiated Rate	$16,750.00
Rate for Payer: Aetna Commercial	$12,730.00
Rate for Payer: Aetna Medicare Advantage	$10,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,542.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,542.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,542.50
Rate for Payer: Cigna Commercial	$16,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,107.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,025.00
Rate for Payer: UnitedHealthcare Community & State	$1,058.60
Rate for Payer: Wellpoint Medicaid Managed Care	$951.40

Know your out-of-pocket cost for care.

All Charges