Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BALL NOSE GUIDE WIRE 100CM

Facility

$552.50

Service Code	HCPCS C1769
Hospital Charge Code	270679320
Hospital Revenue Code	278
Min. Negotiated Rate	$15.69
Max. Negotiated Rate	$276.25
Rate for Payer: Aetna Commercial	$209.95
Rate for Payer: Aetna Medicare Advantage	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.89
Rate for Payer: Cigna Commercial	$276.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.71
Rate for Payer: Qualcare PPO/HMO/WC	$82.88
Rate for Payer: UnitedHealthcare Community & State	$17.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.69

BALL NOSE GUIDE WIRE 100CM

Facility

$552.50

Service Code	HCPCS C1769
Hospital Charge Code	270679320
Hospital Revenue Code	278
Min. Negotiated Rate	$82.88
Max. Negotiated Rate	$133.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.71
Rate for Payer: Qualcare PPO/HMO/WC	$82.88

BALL NOSE GUIDE WIRE 80CM

Facility

$1,200.00

Service Code	HCPCS C1769
Hospital Charge Code	270686319
Hospital Revenue Code	278
Min. Negotiated Rate	$34.08
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$456.00
Rate for Payer: Aetna Medicare Advantage	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$306.00
Rate for Payer: Cigna Commercial	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.40
Rate for Payer: Qualcare PPO/HMO/WC	$180.00
Rate for Payer: UnitedHealthcare Community & State	$37.92
Rate for Payer: Wellpoint Medicaid Managed Care	$34.08

BALL NOSE GUIDE WIRE 80CM

Facility

$1,200.00

Service Code	HCPCS C1769
Hospital Charge Code	270686319
Hospital Revenue Code	278
Min. Negotiated Rate	$180.00
Max. Negotiated Rate	$290.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.40
Rate for Payer: Qualcare PPO/HMO/WC	$180.00

BALLN PC6.0x100 AB18W060100150

Facility

$1,125.00

Service Code	HCPCS C1725
Hospital Charge Code	270644459C
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BALLN PC6.0x100 AB18W060100150

Facility

$1,125.00

Service Code	HCPCS C1725
Hospital Charge Code	270644459C
Hospital Revenue Code	278
Min. Negotiated Rate	$31.95
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$31.95

BALLN PC 6.0x60 AB18W060060150

Facility

$1,125.00

Service Code	HCPCS C1725
Hospital Charge Code	270644236C
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BALLN PC 6.0x60 AB18W060060150

Facility

$1,125.00

Service Code	HCPCS C1725
Hospital Charge Code	270644236C
Hospital Revenue Code	278
Min. Negotiated Rate	$31.95
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$31.95

BALLN SPRNT1.25x06MM SPL12506X

Facility

$525.00

Service Code	HCPCS C1725
Hospital Charge Code	270650634C
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

BALLN SPRNT1.25x06MM SPL12506X

Facility

$525.00

Service Code	HCPCS C1725
Hospital Charge Code	270650634C
Hospital Revenue Code	278
Min. Negotiated Rate	$14.91
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$16.59
Rate for Payer: Wellpoint Medicaid Managed Care	$14.91

BALLN SPRNT 1.25x10M SPL12510X

Facility

$750.00

Service Code	HCPCS C1725
Hospital Charge Code	270650653C
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

BALLN SPRNT 1.25x10M SPL12510X

Facility

$750.00

Service Code	HCPCS C1725
Hospital Charge Code	270650653C
Hospital Revenue Code	278
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

BALLN STERL 4x40mm 135cm

Facility

$1,493.50

Service Code	HCPCS C1725
Hospital Charge Code	270639030C
Hospital Revenue Code	278
Min. Negotiated Rate	$42.42
Max. Negotiated Rate	$746.75
Rate for Payer: Aetna Commercial	$567.53
Rate for Payer: Aetna Medicare Advantage	$448.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$380.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$380.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$380.84
Rate for Payer: Cigna Commercial	$746.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.43
Rate for Payer: Qualcare PPO/HMO/WC	$224.03
Rate for Payer: UnitedHealthcare Community & State	$47.19
Rate for Payer: Wellpoint Medicaid Managed Care	$42.42

BALLN STERL 4x40mm 135cm

Facility

$1,493.50

Service Code	HCPCS C1725
Hospital Charge Code	270639030C
Hospital Revenue Code	278
Min. Negotiated Rate	$224.03
Max. Negotiated Rate	$361.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.43
Rate for Payer: Qualcare PPO/HMO/WC	$224.03

BALLONCATHOCCLSCEPTERC4X20MM

Facility

$8,125.00

Service Code	HCPCS C2628
Hospital Charge Code	270693919S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,218.75
Max. Negotiated Rate	$1,966.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,966.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75

BALLONCATHOCCLSCEPTERC4X20MM

Facility

$8,125.00

Service Code	HCPCS C2628
Hospital Charge Code	270693919S
Hospital Revenue Code	278
Min. Negotiated Rate	$230.75
Max. Negotiated Rate	$4,062.50
Rate for Payer: Aetna Commercial	$3,087.50
Rate for Payer: Aetna Medicare Advantage	$2,437.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,071.88
Rate for Payer: Cigna Commercial	$4,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,966.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75
Rate for Payer: UnitedHealthcare Community & State	$256.75
Rate for Payer: Wellpoint Medicaid Managed Care	$230.75

BALLON NCRS PTA AB14W020020150

Facility

$1,538.60

Service Code	HCPCS C1725
Hospital Charge Code	270643974A
Hospital Revenue Code	278
Min. Negotiated Rate	$43.70
Max. Negotiated Rate	$769.30
Rate for Payer: Aetna Commercial	$584.67
Rate for Payer: Aetna Medicare Advantage	$461.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$392.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$392.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$307.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$392.34
Rate for Payer: Cigna Commercial	$769.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.34
Rate for Payer: Qualcare PPO/HMO/WC	$230.79
Rate for Payer: UnitedHealthcare Community & State	$48.62
Rate for Payer: Wellpoint Medicaid Managed Care	$43.70

BALLON NCRS PTA AB14W020020150

Facility

$1,538.60

Service Code	HCPCS C1725
Hospital Charge Code	270643974C
Hospital Revenue Code	278
Min. Negotiated Rate	$230.79
Max. Negotiated Rate	$372.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$307.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.34
Rate for Payer: Qualcare PPO/HMO/WC	$230.79

BALLON NCRS PTA AB14W020020150

Facility

$1,538.60

Service Code	HCPCS C1725
Hospital Charge Code	270643974C
Hospital Revenue Code	278
Min. Negotiated Rate	$43.70
Max. Negotiated Rate	$769.30
Rate for Payer: Aetna Commercial	$584.67
Rate for Payer: Aetna Medicare Advantage	$461.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$392.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$392.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$307.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$392.34
Rate for Payer: Cigna Commercial	$769.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.34
Rate for Payer: Qualcare PPO/HMO/WC	$230.79
Rate for Payer: UnitedHealthcare Community & State	$48.62
Rate for Payer: Wellpoint Medicaid Managed Care	$43.70

BALLON NCRS PTA AB14W020020150

Facility

$1,538.60

Service Code	HCPCS C1725
Hospital Charge Code	270643974A
Hospital Revenue Code	278
Min. Negotiated Rate	$230.79
Max. Negotiated Rate	$372.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$307.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.34
Rate for Payer: Qualcare PPO/HMO/WC	$230.79

BALLON NCRS PTA AB14W020040150

Facility

$1,538.60

Service Code	HCPCS C1725
Hospital Charge Code	270644200A
Hospital Revenue Code	278
Min. Negotiated Rate	$230.79
Max. Negotiated Rate	$372.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$307.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.34
Rate for Payer: Qualcare PPO/HMO/WC	$230.79

BALLON NCRS PTA AB14W020040150

Facility

$1,538.60

Service Code	HCPCS C1725
Hospital Charge Code	270644200C
Hospital Revenue Code	278
Min. Negotiated Rate	$230.79
Max. Negotiated Rate	$372.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$307.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.34
Rate for Payer: Qualcare PPO/HMO/WC	$230.79

BALLON NCRS PTA AB14W020040150

Facility

$1,538.60

Service Code	HCPCS C1725
Hospital Charge Code	270644200A
Hospital Revenue Code	278
Min. Negotiated Rate	$43.70
Max. Negotiated Rate	$769.30
Rate for Payer: Aetna Commercial	$584.67
Rate for Payer: Aetna Medicare Advantage	$461.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$392.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$392.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$307.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$392.34
Rate for Payer: Cigna Commercial	$769.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.34
Rate for Payer: Qualcare PPO/HMO/WC	$230.79
Rate for Payer: UnitedHealthcare Community & State	$48.62
Rate for Payer: Wellpoint Medicaid Managed Care	$43.70

BALLON NCRS PTA AB14W020040150

Facility

$1,538.60

Service Code	HCPCS C1725
Hospital Charge Code	270644200C
Hospital Revenue Code	278
Min. Negotiated Rate	$43.70
Max. Negotiated Rate	$769.30
Rate for Payer: Aetna Commercial	$584.67
Rate for Payer: Aetna Medicare Advantage	$461.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$392.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$392.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$307.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$392.34
Rate for Payer: Cigna Commercial	$769.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.34
Rate for Payer: Qualcare PPO/HMO/WC	$230.79
Rate for Payer: UnitedHealthcare Community & State	$48.62
Rate for Payer: Wellpoint Medicaid Managed Care	$43.70

BALLON NCRS PTA AB14W020120150

Facility

$1,538.60

Service Code	HCPCS C1725
Hospital Charge Code	270644365C
Hospital Revenue Code	278
Min. Negotiated Rate	$230.79
Max. Negotiated Rate	$372.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$307.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.34
Rate for Payer: Qualcare PPO/HMO/WC	$230.79

Know your out-of-pocket cost for care.

All Charges