Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SHEATH GUID PINN 7 F 45X35X2

Facility

$450.00

Service Code	HCPCS C1766
Hospital Charge Code	270658257N
Hospital Revenue Code	278
Min. Negotiated Rate	$12.78
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$171.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Community & State	$14.22
Rate for Payer: Wellpoint Medicaid Managed Care	$12.78

SHEATH GUID PINNAC 6 FR RSC05

Facility

$792.50

Hospital Charge Code	270658261
Hospital Revenue Code	278
Min. Negotiated Rate	$118.88
Max. Negotiated Rate	$191.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.78
Rate for Payer: Qualcare PPO/HMO/WC	$118.88

SHEATH GUID PINNAC 6 FR RSC05

Facility

$792.50

Hospital Charge Code	270658261
Hospital Revenue Code	278
Min. Negotiated Rate	$22.51
Max. Negotiated Rate	$396.25
Rate for Payer: Aetna Commercial	$301.15
Rate for Payer: Aetna Medicare Advantage	$237.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$202.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$202.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$202.09
Rate for Payer: Cigna Commercial	$396.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.78
Rate for Payer: Qualcare PPO/HMO/WC	$118.88
Rate for Payer: UnitedHealthcare Community & State	$25.04
Rate for Payer: Wellpoint Medicaid Managed Care	$22.51

SHEATH GUID PINNAC 6 FR RSC05

Facility

$550.00

Service Code	HCPCS C1766
Hospital Charge Code	270658261N
Hospital Revenue Code	278
Min. Negotiated Rate	$15.62
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$17.38
Rate for Payer: Wellpoint Medicaid Managed Care	$15.62

SHEATH GUID PINNAC 6 FR RSC05

Facility

$637.50

Service Code	HCPCS C1766
Hospital Charge Code	270658261S
Hospital Revenue Code	278
Min. Negotiated Rate	$95.62
Max. Negotiated Rate	$154.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.28
Rate for Payer: Qualcare PPO/HMO/WC	$95.62

SHEATH GUID PINNAC 6 FR RSC05

Facility

$550.00

Service Code	HCPCS C1766
Hospital Charge Code	270658261N
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

SHEATH GUID PINNAC 6 FR RSC05

Facility

$637.50

Service Code	HCPCS C1766
Hospital Charge Code	270658261S
Hospital Revenue Code	278
Min. Negotiated Rate	$18.11
Max. Negotiated Rate	$318.75
Rate for Payer: Aetna Commercial	$242.25
Rate for Payer: Aetna Medicare Advantage	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$162.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$162.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$162.56
Rate for Payer: Cigna Commercial	$318.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.28
Rate for Payer: Qualcare PPO/HMO/WC	$95.62
Rate for Payer: UnitedHealthcare Community & State	$20.14
Rate for Payer: Wellpoint Medicaid Managed Care	$18.11

SHEATH GUID PISHNN6 FR 45X35X2

Facility

$522.50

Hospital Charge Code	270658263A
Hospital Revenue Code	272
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$78.38
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

SHEATH GUID PISHNN6 FR 45X35X2

Facility

$522.50

Hospital Charge Code	270658263S
Hospital Revenue Code	272
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$78.38
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

SHEATH GUID PISHNN6 FR 45X35X2

Facility

$522.50

Hospital Charge Code	270658263A
Hospital Revenue Code	272
Min. Negotiated Rate	$14.84
Max. Negotiated Rate	$261.25
Rate for Payer: Aetna Commercial	$198.55
Rate for Payer: Aetna Medicare Advantage	$156.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.24
Rate for Payer: Cigna Commercial	$261.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.85
Rate for Payer: Oxford Commercial	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.38
Rate for Payer: UnitedHealthcare Commercial	$104.50
Rate for Payer: UnitedHealthcare Community & State	$16.51
Rate for Payer: Wellpoint Medicaid Managed Care	$14.84

SHEATH GUID PISHNN6 FR 45X35X2

Facility

$522.50

Hospital Charge Code	270658263
Hospital Revenue Code	272
Min. Negotiated Rate	$14.84
Max. Negotiated Rate	$261.25
Rate for Payer: Aetna Commercial	$198.55
Rate for Payer: Aetna Medicare Advantage	$156.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.24
Rate for Payer: Cigna Commercial	$261.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.85
Rate for Payer: Oxford Commercial	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.38
Rate for Payer: UnitedHealthcare Commercial	$104.50
Rate for Payer: UnitedHealthcare Community & State	$16.51
Rate for Payer: Wellpoint Medicaid Managed Care	$14.84

SHEATH GUID PISHNN6 FR 45X35X2

Facility

$522.50

Hospital Charge Code	270658263
Hospital Revenue Code	272
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$78.38
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

SHEATH GUID PISHNN6 FR 45X35X2

Facility

$522.50

Hospital Charge Code	270658263S
Hospital Revenue Code	272
Min. Negotiated Rate	$14.84
Max. Negotiated Rate	$261.25
Rate for Payer: Aetna Commercial	$198.55
Rate for Payer: Aetna Medicare Advantage	$156.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.24
Rate for Payer: Cigna Commercial	$261.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.85
Rate for Payer: Oxford Commercial	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.38
Rate for Payer: UnitedHealthcare Commercial	$104.50
Rate for Payer: UnitedHealthcare Community & State	$16.51
Rate for Payer: Wellpoint Medicaid Managed Care	$14.84

SHEATH GUID PISHNN6 FR 45X35X2

Facility

$450.00

Hospital Charge Code	270658263N
Hospital Revenue Code	272
Min. Negotiated Rate	$12.78
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$171.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Commercial	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.22
Rate for Payer: Wellpoint Medicaid Managed Care	$12.78

SHEATH GUID PISHNN6 FR 45X35X2

Facility

$450.00

Hospital Charge Code	270658263N
Hospital Revenue Code	272
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

SHEATH HEMOSTATIC 9FR BLK

Facility

$58.50

Hospital Charge Code	270672004
Hospital Revenue Code	272
Min. Negotiated Rate	$8.78
Max. Negotiated Rate	$8.78
Rate for Payer: Qualcare PPO/HMO/WC	$8.78

SHEATH HEMOSTATIC 9FR BLK

Facility

$58.50

Hospital Charge Code	270672004
Hospital Revenue Code	272
Min. Negotiated Rate	$1.66
Max. Negotiated Rate	$29.25
Rate for Payer: Aetna Commercial	$22.23
Rate for Payer: Aetna Medicare Advantage	$17.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.92
Rate for Payer: Cigna Commercial	$29.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.21
Rate for Payer: Oxford Commercial	$11.70
Rate for Payer: Qualcare PPO/HMO/WC	$8.78
Rate for Payer: UnitedHealthcare Commercial	$11.70
Rate for Payer: UnitedHealthcare Community & State	$1.85
Rate for Payer: Wellpoint Medicaid Managed Care	$1.66

SHEATH INTRODC 6F 11CM 504606X

Facility

$238.75

Service Code	HCPCS C2629
Hospital Charge Code	270600706
Hospital Revenue Code	279
Min. Negotiated Rate	$35.81
Max. Negotiated Rate	$35.81
Rate for Payer: Qualcare PPO/HMO/WC	$35.81

SHEATH INTRODC 6F 11CM 504606X

Facility

$238.75

Service Code	HCPCS C2629
Hospital Charge Code	270600706
Hospital Revenue Code	279
Min. Negotiated Rate	$6.78
Max. Negotiated Rate	$119.38
Rate for Payer: Aetna Commercial	$90.72
Rate for Payer: Aetna Medicare Advantage	$71.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.88
Rate for Payer: Cigna Commercial	$119.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.08
Rate for Payer: Oxford Commercial	$47.75
Rate for Payer: Qualcare PPO/HMO/WC	$35.81
Rate for Payer: UnitedHealthcare Commercial	$47.75
Rate for Payer: UnitedHealthcare Community & State	$7.54
Rate for Payer: Wellpoint Medicaid Managed Care	$6.78

SHEATH INTROD PIN 5X10 RSB502

Facility

$159.50

Service Code	HCPCS C1766
Hospital Charge Code	270654367
Hospital Revenue Code	278
Min. Negotiated Rate	$4.53
Max. Negotiated Rate	$79.75
Rate for Payer: Aetna Commercial	$60.61
Rate for Payer: Aetna Medicare Advantage	$47.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.67
Rate for Payer: Cigna Commercial	$79.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.60
Rate for Payer: Qualcare PPO/HMO/WC	$23.93
Rate for Payer: UnitedHealthcare Community & State	$5.04
Rate for Payer: Wellpoint Medicaid Managed Care	$4.53

SHEATH INTROD PIN 5X10 RSB502

Facility

$159.50

Service Code	HCPCS C1766
Hospital Charge Code	270654367N
Hospital Revenue Code	278
Min. Negotiated Rate	$23.93
Max. Negotiated Rate	$38.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.60
Rate for Payer: Qualcare PPO/HMO/WC	$23.93

SHEATH INTROD PIN 5X10 RSB502

Facility

$159.50

Service Code	HCPCS C1766
Hospital Charge Code	270654367S
Hospital Revenue Code	278
Min. Negotiated Rate	$4.53
Max. Negotiated Rate	$79.75
Rate for Payer: Aetna Commercial	$60.61
Rate for Payer: Aetna Medicare Advantage	$47.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.67
Rate for Payer: Cigna Commercial	$79.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.60
Rate for Payer: Qualcare PPO/HMO/WC	$23.93
Rate for Payer: UnitedHealthcare Community & State	$5.04
Rate for Payer: Wellpoint Medicaid Managed Care	$4.53

SHEATH INTROD PIN 5X10 RSB502

Facility

$159.50

Service Code	HCPCS C1766
Hospital Charge Code	270654367S
Hospital Revenue Code	278
Min. Negotiated Rate	$23.93
Max. Negotiated Rate	$38.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.60
Rate for Payer: Qualcare PPO/HMO/WC	$23.93

SHEATH INTROD PIN 5X10 RSB502

Facility

$159.50

Service Code	HCPCS C1766
Hospital Charge Code	270654367N
Hospital Revenue Code	278
Min. Negotiated Rate	$4.53
Max. Negotiated Rate	$79.75
Rate for Payer: Aetna Commercial	$60.61
Rate for Payer: Aetna Medicare Advantage	$47.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.67
Rate for Payer: Cigna Commercial	$79.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.60
Rate for Payer: Qualcare PPO/HMO/WC	$23.93
Rate for Payer: UnitedHealthcare Community & State	$5.04
Rate for Payer: Wellpoint Medicaid Managed Care	$4.53

SHEATH INTROD PIN 5X10 RSB502

Facility

$159.50

Service Code	HCPCS C1766
Hospital Charge Code	270654367
Hospital Revenue Code	278
Min. Negotiated Rate	$23.93
Max. Negotiated Rate	$38.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.60
Rate for Payer: Qualcare PPO/HMO/WC	$23.93

Know your out-of-pocket cost for care.

All Charges