Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PUMP INTRATHECAL AP03000H

Facility

$69,750.00

Service Code	HCPCS C1772
Hospital Charge Code	270699219
Hospital Revenue Code	278
Min. Negotiated Rate	$10,462.50
Max. Negotiated Rate	$16,879.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,879.50
Rate for Payer: Qualcare PPO/HMO/WC	$10,462.50

PUMP IZ 700CX

Facility

$51,525.00

Service Code	HCPCS C1813
Hospital Charge Code	270688017
Hospital Revenue Code	278
Min. Negotiated Rate	$1,463.31
Max. Negotiated Rate	$25,762.50
Rate for Payer: Aetna Commercial	$19,579.50
Rate for Payer: Aetna Medicare Advantage	$15,457.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,138.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,138.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,305.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,138.88
Rate for Payer: Cigna Commercial	$25,762.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,469.05
Rate for Payer: Qualcare PPO/HMO/WC	$7,728.75
Rate for Payer: UnitedHealthcare Community & State	$1,628.19
Rate for Payer: Wellpoint Medicaid Managed Care	$1,463.31

PUMP IZ 700CX

Facility

$51,525.00

Service Code	HCPCS C1813
Hospital Charge Code	270688017
Hospital Revenue Code	278
Min. Negotiated Rate	$7,728.75
Max. Negotiated Rate	$12,469.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,469.05
Rate for Payer: Qualcare PPO/HMO/WC	$7,728.75

PUMP ON-Q 100MLX2ML/HR W/2.5

Facility

$525.00

Service Code	HCPCS C1772
Hospital Charge Code	270650396
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

PUMP ON-Q 100MLX2ML/HR W/2.5

Facility

$525.00

Service Code	HCPCS C1772
Hospital Charge Code	270650396
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

PUMP ON-Q DUAL 600ML 1-7ML/HR

Facility

$2,850.00

Hospital Charge Code	270676702
Hospital Revenue Code	272
Min. Negotiated Rate	$80.94
Max. Negotiated Rate	$1,425.00
Rate for Payer: Aetna Commercial	$1,083.00
Rate for Payer: Aetna Medicare Advantage	$855.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$726.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$726.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$726.75
Rate for Payer: Cigna Commercial	$1,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$741.00
Rate for Payer: Oxford Commercial	$570.00
Rate for Payer: Qualcare PPO/HMO/WC	$427.50
Rate for Payer: UnitedHealthcare Commercial	$570.00
Rate for Payer: UnitedHealthcare Community & State	$90.06
Rate for Payer: Wellpoint Medicaid Managed Care	$80.94

PUMP ON-Q DUAL 600ML 1-7ML/HR

Facility

$2,850.00

Hospital Charge Code	270676702
Hospital Revenue Code	272
Min. Negotiated Rate	$427.50
Max. Negotiated Rate	$427.50
Rate for Payer: Qualcare PPO/HMO/WC	$427.50

PUMP ON-Q DUAL 600ML 2-14ML/HR

Facility

$2,350.00

Hospital Charge Code	270678112
Hospital Revenue Code	272
Min. Negotiated Rate	$352.50
Max. Negotiated Rate	$352.50
Rate for Payer: Qualcare PPO/HMO/WC	$352.50

PUMP ON-Q DUAL 600ML 2-14ML/HR

Facility

$2,350.00

Hospital Charge Code	270678112
Hospital Revenue Code	272
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) PPO	$599.25
Rate for Payer: Cigna Commercial	$1,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$611.00
Rate for Payer: Oxford Commercial	$470.00
Rate for Payer: Qualcare PPO/HMO/WC	$352.50
Rate for Payer: UnitedHealthcare Commercial	$470.00
Rate for Payer: UnitedHealthcare Community & State	$74.26
Rate for Payer: Wellpoint Medicaid Managed Care	$66.74

PUMP ON-Q W/DUAL SAF 400ML

Facility

$1,658.00

Hospital Charge Code	270650397
Hospital Revenue Code	272
Min. Negotiated Rate	$248.70
Max. Negotiated Rate	$248.70
Rate for Payer: Qualcare PPO/HMO/WC	$248.70

PUMP ON-Q W/DUAL SAF 400ML

Facility

$1,658.00

Hospital Charge Code	270650397
Hospital Revenue Code	272
Min. Negotiated Rate	$47.09
Max. Negotiated Rate	$829.00
Rate for Payer: Aetna Commercial	$630.04
Rate for Payer: Aetna Medicare Advantage	$497.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$422.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$422.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$422.79
Rate for Payer: Cigna Commercial	$829.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$431.08
Rate for Payer: Oxford Commercial	$331.60
Rate for Payer: Qualcare PPO/HMO/WC	$248.70
Rate for Payer: UnitedHealthcare Commercial	$331.60
Rate for Payer: UnitedHealthcare Community & State	$52.39
Rate for Payer: Wellpoint Medicaid Managed Care	$47.09

PUMP SET IMPELLA 2.5 AIC

Facility

$125,000.00

Hospital Charge Code	270681567
Hospital Revenue Code	278
Min. Negotiated Rate	$3,550.00
Max. Negotiated Rate	$62,500.00
Rate for Payer: Aetna Commercial	$47,500.00
Rate for Payer: Aetna Medicare Advantage	$37,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,875.00
Rate for Payer: Cigna Commercial	$62,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$18,750.00
Rate for Payer: UnitedHealthcare Community & State	$3,950.00
Rate for Payer: Wellpoint Medicaid Managed Care	$3,550.00

PUMP SET IMPELLA 2.5 AIC

Facility

$125,000.00

Hospital Charge Code	270681567
Hospital Revenue Code	278
Min. Negotiated Rate	$18,750.00
Max. Negotiated Rate	$30,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$18,750.00

PUMP SET IMPELLA CP

Facility

$125,000.00

Hospital Charge Code	270681568
Hospital Revenue Code	278
Min. Negotiated Rate	$3,550.00
Max. Negotiated Rate	$62,500.00
Rate for Payer: Aetna Commercial	$47,500.00
Rate for Payer: Aetna Medicare Advantage	$37,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,875.00
Rate for Payer: Cigna Commercial	$62,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$18,750.00
Rate for Payer: UnitedHealthcare Community & State	$3,950.00
Rate for Payer: Wellpoint Medicaid Managed Care	$3,550.00

PUMP SET IMPELLA CP

Facility

$125,000.00

Hospital Charge Code	270681568S
Hospital Revenue Code	278
Min. Negotiated Rate	$18,750.00
Max. Negotiated Rate	$30,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$18,750.00

PUMP SET IMPELLA CP

Facility

$125,000.00

Hospital Charge Code	270681568
Hospital Revenue Code	278
Min. Negotiated Rate	$18,750.00
Max. Negotiated Rate	$30,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$18,750.00

PUMP SET IMPELLA CP

Facility

$125,000.00

Hospital Charge Code	270681568S
Hospital Revenue Code	278
Min. Negotiated Rate	$3,550.00
Max. Negotiated Rate	$62,500.00
Rate for Payer: Aetna Commercial	$47,500.00
Rate for Payer: Aetna Medicare Advantage	$37,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,875.00
Rate for Payer: Cigna Commercial	$62,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$18,750.00
Rate for Payer: UnitedHealthcare Community & State	$3,950.00
Rate for Payer: Wellpoint Medicaid Managed Care	$3,550.00

PUMP SOLUSET CLAVE

Facility

$40.91

Hospital Charge Code	270650216
Hospital Revenue Code	270
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$20.45
Rate for Payer: Aetna Commercial	$15.55
Rate for Payer: Aetna Medicare Advantage	$12.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.43
Rate for Payer: Cigna Commercial	$20.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.64
Rate for Payer: Oxford Commercial	$8.18
Rate for Payer: Qualcare PPO/HMO/WC	$6.14
Rate for Payer: UnitedHealthcare Commercial	$8.18
Rate for Payer: UnitedHealthcare Community & State	$1.29
Rate for Payer: Wellpoint Medicaid Managed Care	$1.16

PUMP SOLUSET CLAVE

Facility

$40.91

Hospital Charge Code	270650216
Hospital Revenue Code	270
Min. Negotiated Rate	$6.14
Max. Negotiated Rate	$6.14
Rate for Payer: Qualcare PPO/HMO/WC	$6.14

PUMP SYNCHROMED II

Facility

$56,000.00

Service Code	HCPCS C1772
Hospital Charge Code	270660619
Hospital Revenue Code	278
Min. Negotiated Rate	$8,400.00
Max. Negotiated Rate	$13,552.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,552.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,400.00

PUMP SYNCHROMED II

Facility

$56,000.00

Service Code	HCPCS C1772
Hospital Charge Code	270660619
Hospital Revenue Code	278
Min. Negotiated Rate	$1,590.40
Max. Negotiated Rate	$28,000.00
Rate for Payer: Aetna Commercial	$21,280.00
Rate for Payer: Aetna Medicare Advantage	$16,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,280.00
Rate for Payer: Cigna Commercial	$28,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,552.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,400.00
Rate for Payer: UnitedHealthcare Community & State	$1,769.60
Rate for Payer: Wellpoint Medicaid Managed Care	$1,590.40

PUMP SYSTM CLLCTION HYGIENIKIT

Facility

$578.45

Hospital Charge Code	270662660
Hospital Revenue Code	270
Min. Negotiated Rate	$16.43
Max. Negotiated Rate	$289.23
Rate for Payer: Aetna Commercial	$219.81
Rate for Payer: Aetna Medicare Advantage	$173.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.50
Rate for Payer: Cigna Commercial	$289.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.40
Rate for Payer: Oxford Commercial	$115.69
Rate for Payer: Qualcare PPO/HMO/WC	$86.77
Rate for Payer: UnitedHealthcare Commercial	$115.69
Rate for Payer: UnitedHealthcare Community & State	$18.28
Rate for Payer: Wellpoint Medicaid Managed Care	$16.43

PUMP SYSTM CLLCTION HYGIENIKIT

Facility

$578.45

Hospital Charge Code	270662660
Hospital Revenue Code	270
Min. Negotiated Rate	$86.77
Max. Negotiated Rate	$86.77
Rate for Payer: Qualcare PPO/HMO/WC	$86.77

PUMP TUBE SET ARTHROSCOPY

Facility

$287.70

Hospital Charge Code	270657504
Hospital Revenue Code	270
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$143.85
Rate for Payer: Aetna Commercial	$109.33
Rate for Payer: Aetna Medicare Advantage	$86.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.36
Rate for Payer: Cigna Commercial	$143.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.80
Rate for Payer: Oxford Commercial	$57.54
Rate for Payer: Qualcare PPO/HMO/WC	$43.16
Rate for Payer: UnitedHealthcare Commercial	$57.54
Rate for Payer: UnitedHealthcare Community & State	$9.09
Rate for Payer: Wellpoint Medicaid Managed Care	$8.17

PUMP TUBE SET ARTHROSCOPY

Facility

$287.70

Hospital Charge Code	270657504
Hospital Revenue Code	270
Min. Negotiated Rate	$43.16
Max. Negotiated Rate	$43.16
Rate for Payer: Qualcare PPO/HMO/WC	$43.16

Know your out-of-pocket cost for care.

All Charges