Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

WALL STENT 16X 90X 75 MM

Facility

$10,398.10

Service Code	HCPCS C1876
Hospital Charge Code	270684832N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,559.71
Max. Negotiated Rate	$2,516.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,079.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,516.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,559.71

WALL STENT 16X 90X 75 MM

Facility

$10,398.10

Service Code	HCPCS C1876
Hospital Charge Code	270684832
Hospital Revenue Code	278
Min. Negotiated Rate	$295.31
Max. Negotiated Rate	$5,199.05
Rate for Payer: Aetna Commercial	$3,951.28
Rate for Payer: Aetna Medicare Advantage	$3,119.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,651.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,651.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,079.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,651.52
Rate for Payer: Cigna Commercial	$5,199.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,516.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,559.71
Rate for Payer: UnitedHealthcare Community & State	$328.58
Rate for Payer: Wellpoint Medicaid Managed Care	$295.31

WALLSTENT 20X 80X 75

Facility

$10,383.10

Service Code	HCPCS C1876
Hospital Charge Code	270684833
Hospital Revenue Code	278
Min. Negotiated Rate	$294.88
Max. Negotiated Rate	$5,191.55
Rate for Payer: Aetna Commercial	$3,945.58
Rate for Payer: Aetna Medicare Advantage	$3,114.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,647.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,647.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,076.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,647.69
Rate for Payer: Cigna Commercial	$5,191.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,512.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,557.46
Rate for Payer: UnitedHealthcare Community & State	$328.11
Rate for Payer: Wellpoint Medicaid Managed Care	$294.88

WALLSTENT 20X 80X 75

Facility

$10,383.10

Service Code	HCPCS C1876
Hospital Charge Code	270684833N
Hospital Revenue Code	278
Min. Negotiated Rate	$294.88
Max. Negotiated Rate	$5,191.55
Rate for Payer: Aetna Commercial	$3,945.58
Rate for Payer: Aetna Medicare Advantage	$3,114.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,647.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,647.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,076.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,647.69
Rate for Payer: Cigna Commercial	$5,191.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,512.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,557.46
Rate for Payer: UnitedHealthcare Community & State	$328.11
Rate for Payer: Wellpoint Medicaid Managed Care	$294.88

WALLSTENT 20X 80X 75

Facility

$10,383.10

Service Code	HCPCS C1876
Hospital Charge Code	270684833N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,557.46
Max. Negotiated Rate	$2,512.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,076.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,512.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,557.46

WALLSTENT 20X 80X 75

Facility

$10,383.10

Service Code	HCPCS C1876
Hospital Charge Code	270684833
Hospital Revenue Code	278
Min. Negotiated Rate	$1,557.46
Max. Negotiated Rate	$2,512.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,076.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,512.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,557.46

WALLSTENT 9FR 16x60 75CM

Facility

$5,250.00

Service Code	HCPCS C1876
Hospital Charge Code	270676562
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

WALLSTENT 9FR 16x60 75CM

Facility

$5,250.00

Service Code	HCPCS C1876
Hospital Charge Code	270676562
Hospital Revenue Code	278
Min. Negotiated Rate	$149.10
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,995.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Community & State	$165.90
Rate for Payer: Wellpoint Medicaid Managed Care	$149.10

WALLSTENT 9FR 16x60 75CM

Facility

$5,250.00

Service Code	HCPCS C1876
Hospital Charge Code	270676562A
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

WALLSTENT 9FR 16x60 75CM

Facility

$5,250.00

Service Code	HCPCS C1876
Hospital Charge Code	270676562A
Hospital Revenue Code	278
Min. Negotiated Rate	$149.10
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,995.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Community & State	$165.90
Rate for Payer: Wellpoint Medicaid Managed Care	$149.10

WALNUT (F256) IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	39900354
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

WALNUT (F256) IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	39900354
Hospital Revenue Code	305
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.94
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

WAND 50-S

Facility

$800.00

Hospital Charge Code	270676343
Hospital Revenue Code	272
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

WAND 50-S

Facility

$800.00

Hospital Charge Code	270676343
Hospital Revenue Code	272
Min. Negotiated Rate	$22.72
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.00
Rate for Payer: Oxford Commercial	$160.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Commercial	$160.00
Rate for Payer: UnitedHealthcare Community & State	$25.28
Rate for Payer: Wellpoint Medicaid Managed Care	$22.72

WAND 90-S ACCELERATOR

Facility

$750.00

Hospital Charge Code	270676342
Hospital Revenue Code	272
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$150.00
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

WAND 90-S ACCELERATOR

Facility

$750.00

Hospital Charge Code	270676342
Hospital Revenue Code	272
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

WAND APOLLO ABLATOR 50 DEG MUT

Facility

$995.00

Hospital Charge Code	270687552
Hospital Revenue Code	272
Min. Negotiated Rate	$28.26
Max. Negotiated Rate	$497.50
Rate for Payer: Aetna Commercial	$378.10
Rate for Payer: Aetna Medicare Advantage	$298.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.72
Rate for Payer: Cigna Commercial	$497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.70
Rate for Payer: Oxford Commercial	$199.00
Rate for Payer: Qualcare PPO/HMO/WC	$149.25
Rate for Payer: UnitedHealthcare Commercial	$199.00
Rate for Payer: UnitedHealthcare Community & State	$31.44
Rate for Payer: Wellpoint Medicaid Managed Care	$28.26

WAND APOLLO ABLATOR 50 DEG MUT

Facility

$995.00

Hospital Charge Code	270687552
Hospital Revenue Code	272
Min. Negotiated Rate	$149.25
Max. Negotiated Rate	$149.25
Rate for Payer: Qualcare PPO/HMO/WC	$149.25

WAND EVAC 70 COBLATOR

Facility

$1,335.00

Hospital Charge Code	270630595
Hospital Revenue Code	272
Min. Negotiated Rate	$200.25
Max. Negotiated Rate	$200.25
Rate for Payer: Qualcare PPO/HMO/WC	$200.25

WAND EVAC 70 COBLATOR

Facility

$1,335.00

Hospital Charge Code	270630595
Hospital Revenue Code	272
Min. Negotiated Rate	$37.91
Max. Negotiated Rate	$667.50
Rate for Payer: Aetna Commercial	$507.30
Rate for Payer: Aetna Medicare Advantage	$400.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$340.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$340.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$340.43
Rate for Payer: Cigna Commercial	$667.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$347.10
Rate for Payer: Oxford Commercial	$267.00
Rate for Payer: Qualcare PPO/HMO/WC	$200.25
Rate for Payer: UnitedHealthcare Commercial	$267.00
Rate for Payer: UnitedHealthcare Community & State	$42.19
Rate for Payer: Wellpoint Medicaid Managed Care	$37.91

WAND PORT APOLLO RF 90 DEG

Facility

$950.00

Hospital Charge Code	270681362
Hospital Revenue Code	272
Min. Negotiated Rate	$26.98
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$361.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.00
Rate for Payer: Oxford Commercial	$190.00
Rate for Payer: Qualcare PPO/HMO/WC	$142.50
Rate for Payer: UnitedHealthcare Commercial	$190.00
Rate for Payer: UnitedHealthcare Community & State	$30.02
Rate for Payer: Wellpoint Medicaid Managed Care	$26.98

WAND PORT APOLLO RF 90 DEG

Facility

$950.00

Hospital Charge Code	270681362
Hospital Revenue Code	272
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$142.50
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

WAND PROCISE XP

Facility

$1,175.00

Hospital Charge Code	270683545
Hospital Revenue Code	272
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$176.25
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

WAND PROCISE XP

Facility

$1,175.00

Hospital Charge Code	270683545
Hospital Revenue Code	272
Min. Negotiated Rate	$33.37
Max. Negotiated Rate	$587.50
Rate for Payer: Aetna Commercial	$446.50
Rate for Payer: Aetna Medicare Advantage	$352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.62
Rate for Payer: Cigna Commercial	$587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$305.50
Rate for Payer: Oxford Commercial	$235.00
Rate for Payer: Qualcare PPO/HMO/WC	$176.25
Rate for Payer: UnitedHealthcare Commercial	$235.00
Rate for Payer: UnitedHealthcare Community & State	$37.13
Rate for Payer: Wellpoint Medicaid Managed Care	$33.37

WAND REFLEX ULTRA PTR

Facility

$1,335.00

Hospital Charge Code	270663823
Hospital Revenue Code	272
Min. Negotiated Rate	$37.91
Max. Negotiated Rate	$667.50
Rate for Payer: Aetna Commercial	$507.30
Rate for Payer: Aetna Medicare Advantage	$400.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$340.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$340.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$340.43
Rate for Payer: Cigna Commercial	$667.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$347.10
Rate for Payer: Oxford Commercial	$267.00
Rate for Payer: Qualcare PPO/HMO/WC	$200.25
Rate for Payer: UnitedHealthcare Commercial	$267.00
Rate for Payer: UnitedHealthcare Community & State	$42.19
Rate for Payer: Wellpoint Medicaid Managed Care	$37.91

Know your out-of-pocket cost for care.

All Charges