Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

STENTP EVERFLX6FR BL 8X60X120

Facility

$6,624.80

Service Code	HCPCS C1876
Hospital Charge Code	270635763
Hospital Revenue Code	278
Min. Negotiated Rate	$993.72
Max. Negotiated Rate	$1,603.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,324.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,603.20
Rate for Payer: Qualcare PPO/HMO/WC	$993.72

STENTP EVERFLX6FR BL 8X60X120

Facility

$1,395.00

Service Code	HCPCS C1876
Hospital Charge Code	270635763N
Hospital Revenue Code	278
Min. Negotiated Rate	$209.25
Max. Negotiated Rate	$337.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$279.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.59
Rate for Payer: Qualcare PPO/HMO/WC	$209.25

STENTP EVERFLX6FR BL 8X60X120

Facility

$1,395.00

Service Code	HCPCS C1876
Hospital Charge Code	270635763N
Hospital Revenue Code	278
Min. Negotiated Rate	$39.62
Max. Negotiated Rate	$697.50
Rate for Payer: Aetna Commercial	$530.10
Rate for Payer: Aetna Medicare Advantage	$418.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$355.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$355.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$355.73
Rate for Payer: Cigna Commercial	$697.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.59
Rate for Payer: Qualcare PPO/HMO/WC	$209.25
Rate for Payer: UnitedHealthcare Community & State	$44.08
Rate for Payer: Wellpoint Medicaid Managed Care	$39.62

STENTP EVERFLX6FR BL 8X60X120

Facility

$1,395.00

Service Code	HCPCS C1876
Hospital Charge Code	270635763S
Hospital Revenue Code	278
Min. Negotiated Rate	$39.62
Max. Negotiated Rate	$697.50
Rate for Payer: Aetna Commercial	$530.10
Rate for Payer: Aetna Medicare Advantage	$418.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$355.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$355.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$355.73
Rate for Payer: Cigna Commercial	$697.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.59
Rate for Payer: Qualcare PPO/HMO/WC	$209.25
Rate for Payer: UnitedHealthcare Community & State	$44.08
Rate for Payer: Wellpoint Medicaid Managed Care	$39.62

STENTP EVERFLX6FR BL 8X60X120

Facility

$1,395.00

Service Code	HCPCS C1876
Hospital Charge Code	270635763S
Hospital Revenue Code	278
Min. Negotiated Rate	$209.25
Max. Negotiated Rate	$337.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$279.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.59
Rate for Payer: Qualcare PPO/HMO/WC	$209.25

STENT PIGTAIL 10FR 7cm

Facility

$275.00

Service Code	HCPCS C2617
Hospital Charge Code	270658551
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$66.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

STENT PIGTAIL 10FR 7cm

Facility

$275.00

Service Code	HCPCS C2617
Hospital Charge Code	270658551
Hospital Revenue Code	278
Min. Negotiated Rate	$7.81
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Community & State	$8.69
Rate for Payer: Wellpoint Medicaid Managed Care	$7.81

STENT PIGTAIL 7FR/10CM

Facility

$295.00

Hospital Charge Code	270655036
Hospital Revenue Code	278
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$147.50
Rate for Payer: Aetna Commercial	$112.10
Rate for Payer: Aetna Medicare Advantage	$88.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.22
Rate for Payer: Cigna Commercial	$147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: Qualcare PPO/HMO/WC	$44.25
Rate for Payer: UnitedHealthcare Community & State	$9.32
Rate for Payer: Wellpoint Medicaid Managed Care	$8.38

STENT PIGTAIL 7FR/10CM

Facility

$295.00

Hospital Charge Code	270655036
Hospital Revenue Code	278
Min. Negotiated Rate	$44.25
Max. Negotiated Rate	$71.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: Qualcare PPO/HMO/WC	$44.25

STENT PIPELINESHIELD 4.25X12MM

Facility

$89,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270699009S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,536.12
Max. Negotiated Rate	$44,650.00
Rate for Payer: Aetna Commercial	$33,934.00
Rate for Payer: Aetna Medicare Advantage	$26,790.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,771.50
Rate for Payer: Cigna Commercial	$44,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00
Rate for Payer: UnitedHealthcare Community & State	$2,821.88
Rate for Payer: Wellpoint Medicaid Managed Care	$2,536.12

STENT PIPELINESHIELD 4.25X12MM

Facility

$89,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270699009S
Hospital Revenue Code	278
Min. Negotiated Rate	$13,395.00
Max. Negotiated Rate	$21,610.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00

STENT PIPELINE SHIELD 4.5X12MM

Facility

$89,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270699274S
Hospital Revenue Code	278
Min. Negotiated Rate	$13,395.00
Max. Negotiated Rate	$21,610.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00

STENT PIPELINE SHIELD 4.5X12MM

Facility

$89,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270699274S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,536.12
Max. Negotiated Rate	$44,650.00
Rate for Payer: Aetna Commercial	$33,934.00
Rate for Payer: Aetna Medicare Advantage	$26,790.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,771.50
Rate for Payer: Cigna Commercial	$44,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00
Rate for Payer: UnitedHealthcare Community & State	$2,821.88
Rate for Payer: Wellpoint Medicaid Managed Care	$2,536.12

STENT PIPELINE SHIELD 4.5X14MM

Facility

$89,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270699630S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,536.12
Max. Negotiated Rate	$44,650.00
Rate for Payer: Aetna Commercial	$33,934.00
Rate for Payer: Aetna Medicare Advantage	$26,790.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,771.50
Rate for Payer: Cigna Commercial	$44,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00
Rate for Payer: UnitedHealthcare Community & State	$2,821.88
Rate for Payer: Wellpoint Medicaid Managed Care	$2,536.12

STENT PIPELINE SHIELD 4.5X14MM

Facility

$89,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270699630S
Hospital Revenue Code	278
Min. Negotiated Rate	$13,395.00
Max. Negotiated Rate	$21,610.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00

STENT PIPELINE SHIELD 4X10MM

Facility

$89,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270699005S
Hospital Revenue Code	278
Min. Negotiated Rate	$13,395.00
Max. Negotiated Rate	$21,610.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00

STENT PIPELINE SHIELD 4X10MM

Facility

$89,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270699005S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,536.12
Max. Negotiated Rate	$44,650.00
Rate for Payer: Aetna Commercial	$33,934.00
Rate for Payer: Aetna Medicare Advantage	$26,790.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,771.50
Rate for Payer: Cigna Commercial	$44,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00
Rate for Payer: UnitedHealthcare Community & State	$2,821.88
Rate for Payer: Wellpoint Medicaid Managed Care	$2,536.12

STENT PIPELINE SHIELD 4x14MM

Facility

$89,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270699008S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,536.12
Max. Negotiated Rate	$44,650.00
Rate for Payer: Aetna Commercial	$33,934.00
Rate for Payer: Aetna Medicare Advantage	$26,790.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,771.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,771.50
Rate for Payer: Cigna Commercial	$44,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00
Rate for Payer: UnitedHealthcare Community & State	$2,821.88
Rate for Payer: Wellpoint Medicaid Managed Care	$2,536.12

STENT PIPELINE SHIELD 4x14MM

Facility

$89,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270699008S
Hospital Revenue Code	278
Min. Negotiated Rate	$13,395.00
Max. Negotiated Rate	$21,610.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,610.60
Rate for Payer: Qualcare PPO/HMO/WC	$13,395.00

STENT PLACEMT ANTE CAROTID

Facility

$4,328.00

Service Code	HCPCS 37218
Hospital Charge Code	321037218
Hospital Revenue Code	361
Min. Negotiated Rate	$122.92
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$1,644.64
Rate for Payer: Aetna Medicare Advantage	$1,298.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,103.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,103.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,103.64
Rate for Payer: Cigna Commercial	$2,164.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,125.28
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$649.20
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$136.76
Rate for Payer: Wellpoint Medicaid Managed Care	$122.92

STENT PLACEMT ANTE CAROTID

Facility

$4,328.00

Service Code	HCPCS 37218
Hospital Charge Code	411037218
Hospital Revenue Code	361
Min. Negotiated Rate	$122.92
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$1,644.64
Rate for Payer: Aetna Medicare Advantage	$1,298.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,103.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,103.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,103.64
Rate for Payer: Cigna Commercial	$2,164.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,125.28
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$649.20
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$136.76
Rate for Payer: Wellpoint Medicaid Managed Care	$122.92

STENT PLACEMT ANTE CAROTID

Facility

$4,328.00

Service Code	HCPCS 37218
Hospital Charge Code	366837218
Hospital Revenue Code	361
Min. Negotiated Rate	$649.20
Max. Negotiated Rate	$649.20
Rate for Payer: Qualcare PPO/HMO/WC	$649.20

STENT PLACEMT ANTE CAROTID

Facility

$4,328.00

Service Code	HCPCS 37218
Hospital Charge Code	366837218
Hospital Revenue Code	361
Min. Negotiated Rate	$122.92
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$1,644.64
Rate for Payer: Aetna Medicare Advantage	$1,298.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,103.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,103.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,103.64
Rate for Payer: Cigna Commercial	$2,164.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,125.28
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$649.20
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$136.76
Rate for Payer: Wellpoint Medicaid Managed Care	$122.92

STENT PLACEMT ANTE CAROTID

Facility

$4,328.00

Service Code	HCPCS 37218
Hospital Charge Code	321037218
Hospital Revenue Code	361
Min. Negotiated Rate	$649.20
Max. Negotiated Rate	$649.20
Rate for Payer: Qualcare PPO/HMO/WC	$649.20

STENT PLACEMT ANTE CAROTID

Facility

$4,328.00

Service Code	HCPCS 37218
Hospital Charge Code	411037218
Hospital Revenue Code	361
Min. Negotiated Rate	$649.20
Max. Negotiated Rate	$649.20
Rate for Payer: Qualcare PPO/HMO/WC	$649.20

Know your out-of-pocket cost for care.

All Charges