Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PORT BIOFLO 8FR PASV VALVED

Facility

$3,359.00

Hospital Charge Code	270673516
Hospital Revenue Code	279
Min. Negotiated Rate	$503.85
Max. Negotiated Rate	$503.85
Rate for Payer: Qualcare PPO/HMO/WC	$503.85

PORT BIOFLO 8FR PASV VALVED

Facility

$3,359.00

Hospital Charge Code	270673516
Hospital Revenue Code	279
Min. Negotiated Rate	$95.40
Max. Negotiated Rate	$1,679.50
Rate for Payer: Aetna Commercial	$1,276.42
Rate for Payer: Aetna Medicare Advantage	$1,007.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$856.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$856.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$856.54
Rate for Payer: Cigna Commercial	$1,679.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$873.34
Rate for Payer: Oxford Commercial	$671.80
Rate for Payer: Qualcare PPO/HMO/WC	$503.85
Rate for Payer: UnitedHealthcare Commercial	$671.80
Rate for Payer: UnitedHealthcare Community & State	$106.14
Rate for Payer: Wellpoint Medicaid Managed Care	$95.40

PORT,INDWELLING (IMPLANTABLE)

Facility

$21.40

Service Code	HCPCS C1751
Hospital Charge Code	4800885
Hospital Revenue Code	278
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$10.70
Rate for Payer: Aetna Commercial	$8.13
Rate for Payer: Aetna Medicare Advantage	$6.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.46
Rate for Payer: Cigna Commercial	$10.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.18
Rate for Payer: Qualcare PPO/HMO/WC	$3.21
Rate for Payer: UnitedHealthcare Community & State	$0.68
Rate for Payer: Wellpoint Medicaid Managed Care	$0.61

PORT,INDWELLING (IMPLANTABLE)

Facility

$21.40

Service Code	HCPCS C1751
Hospital Charge Code	4800885
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.18
Rate for Payer: Qualcare PPO/HMO/WC	$3.21

PORT MRI DUAL IMPLANT BARD 10F

Facility

$6,375.55

Hospital Charge Code	270662643
Hospital Revenue Code	278
Min. Negotiated Rate	$181.07
Max. Negotiated Rate	$3,187.78
Rate for Payer: Aetna Commercial	$2,422.71
Rate for Payer: Aetna Medicare Advantage	$1,912.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,625.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,625.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,625.77
Rate for Payer: Cigna Commercial	$3,187.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.88
Rate for Payer: Qualcare PPO/HMO/WC	$956.33
Rate for Payer: UnitedHealthcare Community & State	$201.47
Rate for Payer: Wellpoint Medicaid Managed Care	$181.07

PORT MRI DUAL IMPLANT BARD 10F

Facility

$6,375.55

Hospital Charge Code	270662643
Hospital Revenue Code	278
Min. Negotiated Rate	$956.33
Max. Negotiated Rate	$1,542.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.88
Rate for Payer: Qualcare PPO/HMO/WC	$956.33

PORT PLUGS SPECTRA SPARE

Facility

$375.00

Hospital Charge Code	270679695
Hospital Revenue Code	272
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$75.00
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

PORT PLUGS SPECTRA SPARE

Facility

$375.00

Hospital Charge Code	270679695
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

PORT POWER IMPLANTABLE 1708000

Facility

$2,350.00

Service Code	HCPCS C1788
Hospital Charge Code	270637943
Hospital Revenue Code	278
Min. Negotiated Rate	$352.50
Max. Negotiated Rate	$568.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$568.70
Rate for Payer: Qualcare PPO/HMO/WC	$352.50

PORT POWER IMPLANTABLE 1708000

Facility

$2,350.00

Service Code	HCPCS C1788
Hospital Charge Code	270637943
Hospital Revenue Code	278
Min. Negotiated Rate	$66.74
Max. Negotiated Rate	$1,175.00
Rate for Payer: Aetna Commercial	$893.00
Rate for Payer: Aetna Medicare Advantage	$705.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$599.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$599.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$470.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$599.25
Rate for Payer: Cigna Commercial	$1,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$568.70
Rate for Payer: Qualcare PPO/HMO/WC	$352.50
Rate for Payer: UnitedHealthcare Community & State	$74.26
Rate for Payer: Wellpoint Medicaid Managed Care	$66.74

PORT POWER VUE 1708062

Facility

$2,350.00

Service Code	HCPCS C1751
Hospital Charge Code	270660816N
Hospital Revenue Code	278
Min. Negotiated Rate	$352.50
Max. Negotiated Rate	$568.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$568.70
Rate for Payer: Qualcare PPO/HMO/WC	$352.50

PORT POWER VUE 1708062

Facility

$3,290.00

Service Code	HCPCS C1751
Hospital Charge Code	270660816
Hospital Revenue Code	278
Min. Negotiated Rate	$93.44
Max. Negotiated Rate	$1,645.00
Rate for Payer: Aetna Commercial	$1,250.20
Rate for Payer: Aetna Medicare Advantage	$987.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$838.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$838.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$658.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$838.95
Rate for Payer: Cigna Commercial	$1,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$796.18
Rate for Payer: Qualcare PPO/HMO/WC	$493.50
Rate for Payer: UnitedHealthcare Community & State	$103.96
Rate for Payer: Wellpoint Medicaid Managed Care	$93.44

PORT POWER VUE 1708062

Facility

$3,290.00

Service Code	HCPCS C1751
Hospital Charge Code	270660816S
Hospital Revenue Code	278
Min. Negotiated Rate	$93.44
Max. Negotiated Rate	$1,645.00
Rate for Payer: Aetna Commercial	$1,250.20
Rate for Payer: Aetna Medicare Advantage	$987.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$838.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$838.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$658.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$838.95
Rate for Payer: Cigna Commercial	$1,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$796.18
Rate for Payer: Qualcare PPO/HMO/WC	$493.50
Rate for Payer: UnitedHealthcare Community & State	$103.96
Rate for Payer: Wellpoint Medicaid Managed Care	$93.44

PORT POWER VUE 1708062

Facility

$2,350.00

Service Code	HCPCS C1751
Hospital Charge Code	270660816N
Hospital Revenue Code	278
Min. Negotiated Rate	$66.74
Max. Negotiated Rate	$1,175.00
Rate for Payer: Aetna Commercial	$893.00
Rate for Payer: Aetna Medicare Advantage	$705.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$599.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$599.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$470.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$599.25
Rate for Payer: Cigna Commercial	$1,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$568.70
Rate for Payer: Qualcare PPO/HMO/WC	$352.50
Rate for Payer: UnitedHealthcare Community & State	$74.26
Rate for Payer: Wellpoint Medicaid Managed Care	$66.74

PORT POWER VUE 1708062

Facility

$3,290.00

Service Code	HCPCS C1751
Hospital Charge Code	270660816S
Hospital Revenue Code	278
Min. Negotiated Rate	$493.50
Max. Negotiated Rate	$796.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$658.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$796.18
Rate for Payer: Qualcare PPO/HMO/WC	$493.50

PORT POWER VUE 1708062

Facility

$3,290.00

Service Code	HCPCS C1751
Hospital Charge Code	270660816
Hospital Revenue Code	278
Min. Negotiated Rate	$493.50
Max. Negotiated Rate	$796.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$658.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$796.18
Rate for Payer: Qualcare PPO/HMO/WC	$493.50

PORT PROTECTOR CUROS LUER LOCK

Facility

$15.22

Hospital Charge Code	270684765
Hospital Revenue Code	272
Min. Negotiated Rate	$2.28
Max. Negotiated Rate	$2.28
Rate for Payer: Qualcare PPO/HMO/WC	$2.28

PORT PROTECTOR CUROS LUER LOCK

Facility

$15.22

Hospital Charge Code	270684765
Hospital Revenue Code	272
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$7.61
Rate for Payer: Aetna Commercial	$5.78
Rate for Payer: Aetna Medicare Advantage	$4.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.88
Rate for Payer: Cigna Commercial	$7.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.96
Rate for Payer: Oxford Commercial	$3.04
Rate for Payer: Qualcare PPO/HMO/WC	$2.28
Rate for Payer: UnitedHealthcare Commercial	$3.04
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.43

PORT SINGLE PROFUSE CT 8F

Facility

$950.00

Service Code	HCPCS C1788
Hospital Charge Code	270690294
Hospital Revenue Code	278
Min. Negotiated Rate	$26.98
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$361.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50
Rate for Payer: UnitedHealthcare Community & State	$30.02
Rate for Payer: Wellpoint Medicaid Managed Care	$26.98

PORT SINGLE PROFUSE CT 8F

Facility

$950.00

Service Code	HCPCS C1788
Hospital Charge Code	270690294
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$229.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

PORT SINGLE SITE

Facility

$750.00

Hospital Charge Code	270677930
Hospital Revenue Code	272
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) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$150.00
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

PORT SINGLE SITE

Facility

$750.00

Hospital Charge Code	270677930
Hospital Revenue Code	272
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

PORT SINGLE SITE 8.5

Facility

$750.00

Hospital Charge Code	270664270
Hospital Revenue Code	272
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) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$150.00
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

PORT SINGLE SITE 8.5

Facility

$750.00

Hospital Charge Code	270664270
Hospital Revenue Code	272
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

POSITIONER HEAD ADULT

Facility

$10.14

Hospital Charge Code	270665497
Hospital Revenue Code	270
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$5.07
Rate for Payer: Aetna Commercial	$3.85
Rate for Payer: Aetna Medicare Advantage	$3.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.59
Rate for Payer: Cigna Commercial	$5.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.64
Rate for Payer: Oxford Commercial	$2.03
Rate for Payer: Qualcare PPO/HMO/WC	$1.52
Rate for Payer: UnitedHealthcare Commercial	$2.03
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

Know your out-of-pocket cost for care.

All Charges