Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SHEATH PEEL AWAY 5FR

Facility

$500.00

Hospital Charge Code	270669565
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SHEATH PEEL AWAY 7FR

Facility

$500.00

Hospital Charge Code	270669566
Hospital Revenue Code	278
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

SHEATH PEEL AWAY 7FR

Facility

$500.00

Hospital Charge Code	270669566
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SHEATH PEEL AWAY 8FR

Facility

$500.00

Hospital Charge Code	270669567
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SHEATH PEEL AWAY 8FR

Facility

$500.00

Hospital Charge Code	270669567
Hospital Revenue Code	278
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

SHEATH PINCLE 7FR 45CM RSR04

Facility

$522.50

Service Code	HCPCS C1887
Hospital Charge Code	270642216C
Hospital Revenue Code	278
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$126.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.44
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

SHEATH PINCLE 7FR 45CM RSR04

Facility

$522.50

Service Code	HCPCS C1887
Hospital Charge Code	270642216C
Hospital Revenue Code	278
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) NJ Health	$104.50
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	$126.44
Rate for Payer: Qualcare PPO/HMO/WC	$78.38
Rate for Payer: UnitedHealthcare Community & State	$16.51
Rate for Payer: Wellpoint Medicaid Managed Care	$14.84

SHEATH PINCLE 7FR 45CM RSR04

Facility

$522.50

Service Code	HCPCS C1887
Hospital Charge Code	270642216A
Hospital Revenue Code	278
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) NJ Health	$104.50
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	$126.44
Rate for Payer: Qualcare PPO/HMO/WC	$78.38
Rate for Payer: UnitedHealthcare Community & State	$16.51
Rate for Payer: Wellpoint Medicaid Managed Care	$14.84

SHEATH PINCLE 7FR 45CM RSR04

Facility

$522.50

Service Code	HCPCS C1887
Hospital Charge Code	270642216A
Hospital Revenue Code	278
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$126.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.44
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

SHEATH PINNACLE 10FR 10CM

Facility

$51.73

Service Code	HCPCS C2629
Hospital Charge Code	270625051
Hospital Revenue Code	278
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$25.86
Rate for Payer: Aetna Commercial	$19.66
Rate for Payer: Aetna Medicare Advantage	$15.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.19
Rate for Payer: Cigna Commercial	$25.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.52
Rate for Payer: Qualcare PPO/HMO/WC	$7.76
Rate for Payer: UnitedHealthcare Community & State	$1.63
Rate for Payer: Wellpoint Medicaid Managed Care	$1.47

SHEATH PINNACLE 10FR 10CM

Facility

$51.73

Service Code	HCPCS C2629
Hospital Charge Code	270625051
Hospital Revenue Code	278
Min. Negotiated Rate	$7.76
Max. Negotiated Rate	$12.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.52
Rate for Payer: Qualcare PPO/HMO/WC	$7.76

SHEATH PINNACLE 11FR 10cm .035

Facility

$51.73

Service Code	HCPCS C1894
Hospital Charge Code	270627343
Hospital Revenue Code	278
Min. Negotiated Rate	$7.76
Max. Negotiated Rate	$12.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.52
Rate for Payer: Qualcare PPO/HMO/WC	$7.76

SHEATH PINNACLE 11FR 10cm .035

Facility

$51.73

Service Code	HCPCS C1894
Hospital Charge Code	270627343
Hospital Revenue Code	278
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$25.86
Rate for Payer: Aetna Commercial	$19.66
Rate for Payer: Aetna Medicare Advantage	$15.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.19
Rate for Payer: Cigna Commercial	$25.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.52
Rate for Payer: Qualcare PPO/HMO/WC	$7.76
Rate for Payer: UnitedHealthcare Community & State	$1.63
Rate for Payer: Wellpoint Medicaid Managed Care	$1.47

SHEATH PINNACLE 5 FR

Facility

$522.50

Service Code	HCPCS C1894
Hospital Charge Code	270664722
Hospital Revenue Code	278
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) NJ Health	$104.50
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	$126.44
Rate for Payer: Qualcare PPO/HMO/WC	$78.38
Rate for Payer: UnitedHealthcare Community & State	$16.51
Rate for Payer: Wellpoint Medicaid Managed Care	$14.84

SHEATH PINNACLE 5 FR

Facility

$522.50

Service Code	HCPCS C1894
Hospital Charge Code	270664722
Hospital Revenue Code	278
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$126.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.44
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

SHEATH PINNACLE 5FR 10CM .035

Facility

$700.00

Hospital Charge Code	270689904
Hospital Revenue Code	272
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.00
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Commercial	$140.00
Rate for Payer: UnitedHealthcare Community & State	$22.12
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

SHEATH PINNACLE 5FR 10CM .035

Facility

$700.00

Hospital Charge Code	270689904
Hospital Revenue Code	272
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SHEATH PINNACLE 6FR 10CM .035

Facility

$700.00

Hospital Charge Code	270689905
Hospital Revenue Code	272
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.00
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Commercial	$140.00
Rate for Payer: UnitedHealthcare Community & State	$22.12
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

SHEATH PINNACLE 6FR 10CM .035

Facility

$700.00

Hospital Charge Code	270689905
Hospital Revenue Code	272
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SHEATH PINNACLE 6FR 10CM .038

Facility

$650.00

Service Code	HCPCS C1893
Hospital Charge Code	270642942
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

SHEATH PINNACLE 6FR 10CM .038

Facility

$650.00

Service Code	HCPCS C1893
Hospital Charge Code	270642942
Hospital Revenue Code	278
Min. Negotiated Rate	$18.46
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Community & State	$20.54
Rate for Payer: Wellpoint Medicaid Managed Care	$18.46

SHEATH PINNACLE 6FR 25CM

Facility

$1,525.00

Service Code	HCPCS C1894
Hospital Charge Code	270643051
Hospital Revenue Code	278
Min. Negotiated Rate	$228.75
Max. Negotiated Rate	$369.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.05
Rate for Payer: Qualcare PPO/HMO/WC	$228.75

SHEATH PINNACLE 6FR 25CM

Facility

$1,525.00

Service Code	HCPCS C1894
Hospital Charge Code	270643051
Hospital Revenue Code	278
Min. Negotiated Rate	$43.31
Max. Negotiated Rate	$762.50
Rate for Payer: Aetna Commercial	$579.50
Rate for Payer: Aetna Medicare Advantage	$457.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$388.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$388.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$388.88
Rate for Payer: Cigna Commercial	$762.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.05
Rate for Payer: Qualcare PPO/HMO/WC	$228.75
Rate for Payer: UnitedHealthcare Community & State	$48.19
Rate for Payer: Wellpoint Medicaid Managed Care	$43.31

SHEATH PINNACLE 6FR 45cm RXR01

Facility

$155.00

Service Code	HCPCS C1887
Hospital Charge Code	270642214A
Hospital Revenue Code	278
Min. Negotiated Rate	$23.25
Max. Negotiated Rate	$37.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.51
Rate for Payer: Qualcare PPO/HMO/WC	$23.25

SHEATH PINNACLE 6FR 45cm RXR01

Facility

$155.00

Service Code	HCPCS C1887
Hospital Charge Code	270642214C
Hospital Revenue Code	278
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$77.50
Rate for Payer: Aetna Commercial	$58.90
Rate for Payer: Aetna Medicare Advantage	$46.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.52
Rate for Payer: Cigna Commercial	$77.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.51
Rate for Payer: Qualcare PPO/HMO/WC	$23.25
Rate for Payer: UnitedHealthcare Community & State	$4.90
Rate for Payer: Wellpoint Medicaid Managed Care	$4.40

Know your out-of-pocket cost for care.

All Charges