Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SHEATH STABILIZATION DEVICE

Facility

$89.50

Hospital Charge Code	270637975
Hospital Revenue Code	271
Min. Negotiated Rate	$2.54
Max. Negotiated Rate	$44.75
Rate for Payer: Aetna Commercial	$34.01
Rate for Payer: Aetna Medicare Advantage	$26.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.82
Rate for Payer: Cigna Commercial	$44.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.27
Rate for Payer: Oxford Commercial	$17.90
Rate for Payer: Qualcare PPO/HMO/WC	$13.43
Rate for Payer: UnitedHealthcare Commercial	$17.90
Rate for Payer: UnitedHealthcare Community & State	$2.83
Rate for Payer: Wellpoint Medicaid Managed Care	$2.54

SHEATH STABILIZATION DEVICE

Facility

$89.50

Hospital Charge Code	270637975
Hospital Revenue Code	271
Min. Negotiated Rate	$13.43
Max. Negotiated Rate	$13.43
Rate for Payer: Qualcare PPO/HMO/WC	$13.43

SHEATH STABILIZATION DEVICE

Facility

$89.50

Hospital Charge Code	270637975S
Hospital Revenue Code	271
Min. Negotiated Rate	$2.54
Max. Negotiated Rate	$44.75
Rate for Payer: Aetna Commercial	$34.01
Rate for Payer: Aetna Medicare Advantage	$26.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.82
Rate for Payer: Cigna Commercial	$44.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.27
Rate for Payer: Oxford Commercial	$17.90
Rate for Payer: Qualcare PPO/HMO/WC	$13.43
Rate for Payer: UnitedHealthcare Commercial	$17.90
Rate for Payer: UnitedHealthcare Community & State	$2.83
Rate for Payer: Wellpoint Medicaid Managed Care	$2.54

SHEATH STAPLER 45

Facility

$100.00

Hospital Charge Code	270666137
Hospital Revenue Code	272
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

SHEATH STAPLER 45

Facility

$100.00

Hospital Charge Code	270666137
Hospital Revenue Code	272
Min. Negotiated Rate	$2.84
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Commercial	$38.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.00
Rate for Payer: Oxford Commercial	$20.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$20.00
Rate for Payer: UnitedHealthcare Community & State	$3.16
Rate for Payer: Wellpoint Medicaid Managed Care	$2.84

SHEATH SUPER 12FR

Facility

$51.73

Hospital Charge Code	270660036
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 SUPER 12FR

Facility

$51.73

Hospital Charge Code	270660036
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 SUPER 5FR 11cm .035

Facility

$48.76

Service Code	HCPCS C1894
Hospital Charge Code	270623265
Hospital Revenue Code	278
Min. Negotiated Rate	$7.31
Max. Negotiated Rate	$11.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.31

SHEATH SUPER 5FR 11cm .035

Facility

$48.76

Service Code	HCPCS C1894
Hospital Charge Code	270623265
Hospital Revenue Code	278
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$24.38
Rate for Payer: Aetna Commercial	$18.53
Rate for Payer: Aetna Medicare Advantage	$14.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.43
Rate for Payer: Cigna Commercial	$24.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.31
Rate for Payer: UnitedHealthcare Community & State	$1.54
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

SHEATH SUPER PINNACLE 12FR

Facility

$51.73

Hospital Charge Code	270660039
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 SUPER PINNACLE 12FR

Facility

$51.73

Hospital Charge Code	270660039
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 SUPER W/O GW 10FR 25CM

Facility

$113.85

Hospital Charge Code	270677316
Hospital Revenue Code	272
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$56.92
Rate for Payer: Aetna Commercial	$43.26
Rate for Payer: Aetna Medicare Advantage	$34.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.03
Rate for Payer: Cigna Commercial	$56.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.60
Rate for Payer: Oxford Commercial	$22.77
Rate for Payer: Qualcare PPO/HMO/WC	$17.08
Rate for Payer: UnitedHealthcare Commercial	$22.77
Rate for Payer: UnitedHealthcare Community & State	$3.60
Rate for Payer: Wellpoint Medicaid Managed Care	$3.23

SHEATH SUPER W/O GW 10FR 25CM

Facility

$113.85

Hospital Charge Code	270677316
Hospital Revenue Code	272
Min. Negotiated Rate	$17.08
Max. Negotiated Rate	$17.08
Rate for Payer: Qualcare PPO/HMO/WC	$17.08

SHEATH SUPER W/O GW 10FR 25CM

Facility

$113.85

Hospital Charge Code	270677316O
Hospital Revenue Code	272
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$56.92
Rate for Payer: Aetna Commercial	$43.26
Rate for Payer: Aetna Medicare Advantage	$34.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.03
Rate for Payer: Cigna Commercial	$56.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.60
Rate for Payer: Oxford Commercial	$22.77
Rate for Payer: Qualcare PPO/HMO/WC	$17.08
Rate for Payer: UnitedHealthcare Commercial	$22.77
Rate for Payer: UnitedHealthcare Community & State	$3.60
Rate for Payer: Wellpoint Medicaid Managed Care	$3.23

SHEATH SUPER W/O GW 10FR 25CM

Facility

$113.85

Hospital Charge Code	270677316O
Hospital Revenue Code	272
Min. Negotiated Rate	$17.08
Max. Negotiated Rate	$17.08
Rate for Payer: Qualcare PPO/HMO/WC	$17.08

SHEATH SUPER W/O GW 4FR 11cm

Facility

$48.76

Service Code	HCPCS C1894
Hospital Charge Code	270637756
Hospital Revenue Code	278
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$24.38
Rate for Payer: Aetna Commercial	$18.53
Rate for Payer: Aetna Medicare Advantage	$14.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.43
Rate for Payer: Cigna Commercial	$24.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.31
Rate for Payer: UnitedHealthcare Community & State	$1.54
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

SHEATH SUPER W/O GW 4FR 11cm

Facility

$48.76

Service Code	HCPCS C1894
Hospital Charge Code	270637756
Hospital Revenue Code	278
Min. Negotiated Rate	$7.31
Max. Negotiated Rate	$11.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.31

SHEATH SUPER W/O GW 5FR 11cm

Facility

$48.76

Service Code	HCPCS C1894
Hospital Charge Code	270626580
Hospital Revenue Code	278
Min. Negotiated Rate	$7.31
Max. Negotiated Rate	$11.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.31

SHEATH SUPER W/O GW 5FR 11cm

Facility

$48.76

Service Code	HCPCS C1894
Hospital Charge Code	270626580
Hospital Revenue Code	278
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$24.38
Rate for Payer: Aetna Commercial	$18.53
Rate for Payer: Aetna Medicare Advantage	$14.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.43
Rate for Payer: Cigna Commercial	$24.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.31
Rate for Payer: UnitedHealthcare Community & State	$1.54
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

SHEATH SUPER W/O GW 5FR 25cm

Facility

$174.71

Hospital Charge Code	270637586
Hospital Revenue Code	278
Min. Negotiated Rate	$4.96
Max. Negotiated Rate	$87.36
Rate for Payer: Aetna Commercial	$66.39
Rate for Payer: Aetna Medicare Advantage	$52.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.55
Rate for Payer: Cigna Commercial	$87.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.28
Rate for Payer: Qualcare PPO/HMO/WC	$26.21
Rate for Payer: UnitedHealthcare Community & State	$5.52
Rate for Payer: Wellpoint Medicaid Managed Care	$4.96

SHEATH SUPER W/O GW 5FR 25cm

Facility

$174.71

Hospital Charge Code	270637586
Hospital Revenue Code	278
Min. Negotiated Rate	$26.21
Max. Negotiated Rate	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.28
Rate for Payer: Qualcare PPO/HMO/WC	$26.21

SHEATH SUPER W/O GW 6FR 11cm

Facility

$48.76

Service Code	HCPCS C1894
Hospital Charge Code	270638086
Hospital Revenue Code	278
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$24.38
Rate for Payer: Aetna Commercial	$18.53
Rate for Payer: Aetna Medicare Advantage	$14.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.43
Rate for Payer: Cigna Commercial	$24.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.31
Rate for Payer: UnitedHealthcare Community & State	$1.54
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

SHEATH SUPER W/O GW 6FR 11cm

Facility

$48.76

Service Code	HCPCS C1894
Hospital Charge Code	270638086
Hospital Revenue Code	278
Min. Negotiated Rate	$7.31
Max. Negotiated Rate	$11.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.31

SHEATH SUPER W/O GW 6FR 25cm

Facility

$174.71

Service Code	HCPCS C1894
Hospital Charge Code	270637678
Hospital Revenue Code	278
Min. Negotiated Rate	$26.21
Max. Negotiated Rate	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.28
Rate for Payer: Qualcare PPO/HMO/WC	$26.21

SHEATH SUPER W/O GW 6FR 25cm

Facility

$174.71

Service Code	HCPCS C1894
Hospital Charge Code	270637678
Hospital Revenue Code	278
Min. Negotiated Rate	$4.96
Max. Negotiated Rate	$87.36
Rate for Payer: Aetna Commercial	$66.39
Rate for Payer: Aetna Medicare Advantage	$52.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.55
Rate for Payer: Cigna Commercial	$87.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.28
Rate for Payer: Qualcare PPO/HMO/WC	$26.21
Rate for Payer: UnitedHealthcare Community & State	$5.52
Rate for Payer: Wellpoint Medicaid Managed Care	$4.96

Know your out-of-pocket cost for care.

All Charges