Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SHEATH ANSEL 7FR 45CM

Facility

$375.00

Service Code	HCPCS C1894
Hospital Charge Code	270677225N
Hospital Revenue Code	278
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) NJ Health	$75.00
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	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

SHEATH ANSEL HI FLX 6FR 55CM

Facility

$320.00

Service Code	HCPCS C1894
Hospital Charge Code	270675906S
Hospital Revenue Code	278
Min. Negotiated Rate	$9.09
Max. Negotiated Rate	$160.00
Rate for Payer: Aetna Commercial	$121.60
Rate for Payer: Aetna Medicare Advantage	$96.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.60
Rate for Payer: Cigna Commercial	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: Qualcare PPO/HMO/WC	$48.00
Rate for Payer: UnitedHealthcare Community & State	$10.11
Rate for Payer: Wellpoint Medicaid Managed Care	$9.09

SHEATH ANSEL HI FLX 6FR 55CM

Facility

$320.00

Service Code	HCPCS C1894
Hospital Charge Code	270675906S
Hospital Revenue Code	278
Min. Negotiated Rate	$48.00
Max. Negotiated Rate	$77.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: Qualcare PPO/HMO/WC	$48.00

SHEATH ANSEL HI FLX 6FR 55CM

Facility

$320.00

Service Code	HCPCS C1894
Hospital Charge Code	270675906
Hospital Revenue Code	278
Min. Negotiated Rate	$48.00
Max. Negotiated Rate	$77.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: Qualcare PPO/HMO/WC	$48.00

SHEATH ANSEL HI FLX 6FR 55CM

Facility

$320.00

Service Code	HCPCS C1894
Hospital Charge Code	270675906
Hospital Revenue Code	278
Min. Negotiated Rate	$9.09
Max. Negotiated Rate	$160.00
Rate for Payer: Aetna Commercial	$121.60
Rate for Payer: Aetna Medicare Advantage	$96.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.60
Rate for Payer: Cigna Commercial	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: Qualcare PPO/HMO/WC	$48.00
Rate for Payer: UnitedHealthcare Community & State	$10.11
Rate for Payer: Wellpoint Medicaid Managed Care	$9.09

SHEATH ANSEL HI FLX 7FR 55CM

Facility

$320.00

Service Code	HCPCS C1894
Hospital Charge Code	270675907S
Hospital Revenue Code	278
Min. Negotiated Rate	$48.00
Max. Negotiated Rate	$77.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: Qualcare PPO/HMO/WC	$48.00

SHEATH ANSEL HI FLX 7FR 55CM

Facility

$320.00

Service Code	HCPCS C1894
Hospital Charge Code	270675907
Hospital Revenue Code	278
Min. Negotiated Rate	$9.09
Max. Negotiated Rate	$160.00
Rate for Payer: Aetna Commercial	$121.60
Rate for Payer: Aetna Medicare Advantage	$96.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.60
Rate for Payer: Cigna Commercial	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: Qualcare PPO/HMO/WC	$48.00
Rate for Payer: UnitedHealthcare Community & State	$10.11
Rate for Payer: Wellpoint Medicaid Managed Care	$9.09

SHEATH ANSEL HI FLX 7FR 55CM

Facility

$320.00

Service Code	HCPCS C1894
Hospital Charge Code	270675907
Hospital Revenue Code	278
Min. Negotiated Rate	$48.00
Max. Negotiated Rate	$77.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: Qualcare PPO/HMO/WC	$48.00

SHEATH ANSEL HI FLX 7FR 55CM

Facility

$320.00

Service Code	HCPCS C1894
Hospital Charge Code	270675907S
Hospital Revenue Code	278
Min. Negotiated Rate	$9.09
Max. Negotiated Rate	$160.00
Rate for Payer: Aetna Commercial	$121.60
Rate for Payer: Aetna Medicare Advantage	$96.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.60
Rate for Payer: Cigna Commercial	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: Qualcare PPO/HMO/WC	$48.00
Rate for Payer: UnitedHealthcare Community & State	$10.11
Rate for Payer: Wellpoint Medicaid Managed Care	$9.09

SHEATH ANSEL HI FLX 7FR 70CM

Facility

$370.00

Service Code	HCPCS C1894
Hospital Charge Code	270675908
Hospital Revenue Code	278
Min. Negotiated Rate	$10.51
Max. Negotiated Rate	$185.00
Rate for Payer: Aetna Commercial	$140.60
Rate for Payer: Aetna Medicare Advantage	$111.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.35
Rate for Payer: Cigna Commercial	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.54
Rate for Payer: Qualcare PPO/HMO/WC	$55.50
Rate for Payer: UnitedHealthcare Community & State	$11.69
Rate for Payer: Wellpoint Medicaid Managed Care	$10.51

SHEATH ANSEL HI FLX 7FR 70CM

Facility

$370.00

Service Code	HCPCS C1894
Hospital Charge Code	270675908
Hospital Revenue Code	278
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$89.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.54
Rate for Payer: Qualcare PPO/HMO/WC	$55.50

SHEATH ANSEL HI FLX 7FR 70CM

Facility

$370.00

Service Code	HCPCS C1894
Hospital Charge Code	270675908S
Hospital Revenue Code	278
Min. Negotiated Rate	$10.51
Max. Negotiated Rate	$185.00
Rate for Payer: Aetna Commercial	$140.60
Rate for Payer: Aetna Medicare Advantage	$111.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.35
Rate for Payer: Cigna Commercial	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.54
Rate for Payer: Qualcare PPO/HMO/WC	$55.50
Rate for Payer: UnitedHealthcare Community & State	$11.69
Rate for Payer: Wellpoint Medicaid Managed Care	$10.51

SHEATH ANSEL HI FLX 7FR 70CM

Facility

$370.00

Service Code	HCPCS C1894
Hospital Charge Code	270675908S
Hospital Revenue Code	278
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$89.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.54
Rate for Payer: Qualcare PPO/HMO/WC	$55.50

SHEATH CARD INTRODC 8F 501-598

Facility

$136.85

Service Code	HCPCS C2629
Hospital Charge Code	270606061
Hospital Revenue Code	278
Min. Negotiated Rate	$20.53
Max. Negotiated Rate	$33.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.12
Rate for Payer: Qualcare PPO/HMO/WC	$20.53

SHEATH CARD INTRODC 8F 501-598

Facility

$136.85

Service Code	HCPCS C2629
Hospital Charge Code	270606061
Hospital Revenue Code	278
Min. Negotiated Rate	$3.89
Max. Negotiated Rate	$68.42
Rate for Payer: Aetna Commercial	$52.00
Rate for Payer: Aetna Medicare Advantage	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.90
Rate for Payer: Cigna Commercial	$68.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.12
Rate for Payer: Qualcare PPO/HMO/WC	$20.53
Rate for Payer: UnitedHealthcare Community & State	$4.32
Rate for Payer: Wellpoint Medicaid Managed Care	$3.89

SHEATH CATH 16F DRYSEAL FLEX

Facility

$3,020.00

Service Code	HCPCS C1894
Hospital Charge Code	270698776S
Hospital Revenue Code	278
Min. Negotiated Rate	$453.00
Max. Negotiated Rate	$730.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$604.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$730.84
Rate for Payer: Qualcare PPO/HMO/WC	$453.00

SHEATH CATH 16F DRYSEAL FLEX

Facility

$3,020.00

Service Code	HCPCS C1894
Hospital Charge Code	270698776S
Hospital Revenue Code	278
Min. Negotiated Rate	$85.77
Max. Negotiated Rate	$1,510.00
Rate for Payer: Aetna Commercial	$1,147.60
Rate for Payer: Aetna Medicare Advantage	$906.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$770.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$770.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$604.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$770.10
Rate for Payer: Cigna Commercial	$1,510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$730.84
Rate for Payer: Qualcare PPO/HMO/WC	$453.00
Rate for Payer: UnitedHealthcare Community & State	$95.43
Rate for Payer: Wellpoint Medicaid Managed Care	$85.77

SHEATH DESILETS-HOFFMAN SET

Facility

$324.45

Service Code	HCPCS C1894
Hospital Charge Code	270659157
Hospital Revenue Code	272
Min. Negotiated Rate	$48.67
Max. Negotiated Rate	$48.67
Rate for Payer: Qualcare PPO/HMO/WC	$48.67

SHEATH DESILETS-HOFFMAN SET

Facility

$324.45

Service Code	HCPCS C1894
Hospital Charge Code	270659157
Hospital Revenue Code	272
Min. Negotiated Rate	$9.21
Max. Negotiated Rate	$162.22
Rate for Payer: Aetna Commercial	$123.29
Rate for Payer: Aetna Medicare Advantage	$97.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.73
Rate for Payer: Cigna Commercial	$162.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.36
Rate for Payer: Oxford Commercial	$64.89
Rate for Payer: Qualcare PPO/HMO/WC	$48.67
Rate for Payer: UnitedHealthcare Commercial	$64.89
Rate for Payer: UnitedHealthcare Community & State	$10.25
Rate for Payer: Wellpoint Medicaid Managed Care	$9.21

SHEATH FLEXOR ACCESS 12FR 35cm

Facility

$649.00

Hospital Charge Code	270647885
Hospital Revenue Code	272
Min. Negotiated Rate	$97.35
Max. Negotiated Rate	$97.35
Rate for Payer: Qualcare PPO/HMO/WC	$97.35

SHEATH FLEXOR ACCESS 12FR 35cm

Facility

$649.00

Hospital Charge Code	270647885
Hospital Revenue Code	272
Min. Negotiated Rate	$18.43
Max. Negotiated Rate	$324.50
Rate for Payer: Aetna Commercial	$246.62
Rate for Payer: Aetna Medicare Advantage	$194.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.50
Rate for Payer: Cigna Commercial	$324.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.74
Rate for Payer: Oxford Commercial	$129.80
Rate for Payer: Qualcare PPO/HMO/WC	$97.35
Rate for Payer: UnitedHealthcare Commercial	$129.80
Rate for Payer: UnitedHealthcare Community & State	$20.51
Rate for Payer: Wellpoint Medicaid Managed Care	$18.43

SHEATH FLEXOR ANSEL GUIDING

Facility

$375.00

Hospital Charge Code	270660259
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

SHEATH FLEXOR ANSEL GUIDING

Facility

$375.00

Hospital Charge Code	270660259
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

SHEATH FLEXOR HIGH-FLEX ANSEL

Facility

$370.00

Hospital Charge Code	270662215S
Hospital Revenue Code	272
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$55.50
Rate for Payer: Qualcare PPO/HMO/WC	$55.50

SHEATH FLEXOR HIGH-FLEX ANSEL

Facility

$370.00

Service Code	HCPCS C1894
Hospital Charge Code	270662215
Hospital Revenue Code	272
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$55.50
Rate for Payer: Qualcare PPO/HMO/WC	$55.50

Know your out-of-pocket cost for care.

All Charges