Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH 6FR 90CM THROMBECTOMY

Facility

$7,950.00

Service Code	HCPCS C1757
Hospital Charge Code	270648157A
Hospital Revenue Code	278
Min. Negotiated Rate	$1,192.50
Max. Negotiated Rate	$1,923.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,923.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.50

CATH 6FR 90CM THROMBECTOMY

Facility

$7,950.00

Service Code	HCPCS C1757
Hospital Charge Code	270648157
Hospital Revenue Code	278
Min. Negotiated Rate	$225.78
Max. Negotiated Rate	$3,975.00
Rate for Payer: Aetna Commercial	$3,021.00
Rate for Payer: Aetna Medicare Advantage	$2,385.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,027.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,027.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,590.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,027.25
Rate for Payer: Cigna Commercial	$3,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,923.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.50
Rate for Payer: UnitedHealthcare Community & State	$251.22
Rate for Payer: Wellpoint Medicaid Managed Care	$225.78

CATH 6FR 90CM THROMBECTOMY

Facility

$7,950.00

Service Code	HCPCS C1757
Hospital Charge Code	270648157A
Hospital Revenue Code	278
Min. Negotiated Rate	$225.78
Max. Negotiated Rate	$3,975.00
Rate for Payer: Aetna Commercial	$3,021.00
Rate for Payer: Aetna Medicare Advantage	$2,385.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,027.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,027.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,590.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,027.25
Rate for Payer: Cigna Commercial	$3,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,923.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.50
Rate for Payer: UnitedHealthcare Community & State	$251.22
Rate for Payer: Wellpoint Medicaid Managed Care	$225.78

CATH 6FR DRC 3 .07

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636344
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATH 6FR DRC 3 .07

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636344
Hospital Revenue Code	278
Min. Negotiated Rate	$6.82
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Community & State	$7.58
Rate for Payer: Wellpoint Medicaid Managed Care	$6.82

CATH 6FR DRC 3 .07

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636344S
Hospital Revenue Code	278
Min. Negotiated Rate	$6.82
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Community & State	$7.58
Rate for Payer: Wellpoint Medicaid Managed Care	$6.82

CATH 6FR DRC 3 .07

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636344S
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATH 6FR JL 6.0

Facility

$240.00

Hospital Charge Code	270637299N
Hospital Revenue Code	272
Min. Negotiated Rate	$6.82
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.40
Rate for Payer: Oxford Commercial	$48.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Commercial	$48.00
Rate for Payer: UnitedHealthcare Community & State	$7.58
Rate for Payer: Wellpoint Medicaid Managed Care	$6.82

CATH 6FR JL 6.0

Facility

$240.00

Hospital Charge Code	270637299
Hospital Revenue Code	272
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATH 6FR JL 6.0

Facility

$240.00

Hospital Charge Code	270637299N
Hospital Revenue Code	272
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATH 6FR JL 6.0

Facility

$240.00

Hospital Charge Code	270637299
Hospital Revenue Code	272
Min. Negotiated Rate	$6.82
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.40
Rate for Payer: Oxford Commercial	$48.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Commercial	$48.00
Rate for Payer: UnitedHealthcare Community & State	$7.58
Rate for Payer: Wellpoint Medicaid Managed Care	$6.82

CATH 6FR JL 6 0 533824

Facility

$41.20

Hospital Charge Code	270616021
Hospital Revenue Code	272
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$20.60
Rate for Payer: Aetna Commercial	$15.66
Rate for Payer: Aetna Medicare Advantage	$12.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.51
Rate for Payer: Cigna Commercial	$20.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.71
Rate for Payer: Oxford Commercial	$8.24
Rate for Payer: Qualcare PPO/HMO/WC	$6.18
Rate for Payer: UnitedHealthcare Commercial	$8.24
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.17

CATH 6FR JL 6 0 533824

Facility

$41.20

Hospital Charge Code	270616021
Hospital Revenue Code	272
Min. Negotiated Rate	$6.18
Max. Negotiated Rate	$6.18
Rate for Payer: Qualcare PPO/HMO/WC	$6.18

CATH 6FR JR 4.0

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636299
Hospital Revenue Code	278
Min. Negotiated Rate	$6.82
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Community & State	$7.58
Rate for Payer: Wellpoint Medicaid Managed Care	$6.82

CATH 6FR JR 4.0

Facility

$220.00

Service Code	HCPCS C1887
Hospital Charge Code	270636299N
Hospital Revenue Code	278
Min. Negotiated Rate	$6.25
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$83.60
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: Qualcare PPO/HMO/WC	$33.00
Rate for Payer: UnitedHealthcare Community & State	$6.95
Rate for Payer: Wellpoint Medicaid Managed Care	$6.25

CATH 6FR JR 4.0

Facility

$220.00

Service Code	HCPCS C1887
Hospital Charge Code	270636299N
Hospital Revenue Code	278
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$53.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

CATH 6FR JR 4.0

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636299S
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATH 6FR JR 4.0

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636299S
Hospital Revenue Code	278
Min. Negotiated Rate	$6.82
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Community & State	$7.58
Rate for Payer: Wellpoint Medicaid Managed Care	$6.82

CATH 6FR JR 4.0

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636299
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATH 6FR MPA1 SUPERTORQUE PLUS

Facility

$42.25

Hospital Charge Code	270662055
Hospital Revenue Code	272
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$21.12
Rate for Payer: Aetna Commercial	$16.05
Rate for Payer: Aetna Medicare Advantage	$12.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.77
Rate for Payer: Cigna Commercial	$21.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.98
Rate for Payer: Oxford Commercial	$8.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.34
Rate for Payer: UnitedHealthcare Commercial	$8.45
Rate for Payer: UnitedHealthcare Community & State	$1.34
Rate for Payer: Wellpoint Medicaid Managed Care	$1.20

CATH 6FR MPA1 SUPERTORQUE PLUS

Facility

$42.25

Hospital Charge Code	270662055
Hospital Revenue Code	272
Min. Negotiated Rate	$6.34
Max. Negotiated Rate	$6.34
Rate for Payer: Qualcare PPO/HMO/WC	$6.34

CATH 6FR SH JR 4.0

Facility

$217.50

Service Code	HCPCS C1887
Hospital Charge Code	270636300S
Hospital Revenue Code	278
Min. Negotiated Rate	$32.62
Max. Negotiated Rate	$52.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.63
Rate for Payer: Qualcare PPO/HMO/WC	$32.62

CATH 6FR SH JR 4.0

Facility

$217.50

Service Code	HCPCS C1887
Hospital Charge Code	270636300S
Hospital Revenue Code	278
Min. Negotiated Rate	$6.18
Max. Negotiated Rate	$108.75
Rate for Payer: Aetna Commercial	$82.65
Rate for Payer: Aetna Medicare Advantage	$65.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.46
Rate for Payer: Cigna Commercial	$108.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.63
Rate for Payer: Qualcare PPO/HMO/WC	$32.62
Rate for Payer: UnitedHealthcare Community & State	$6.87
Rate for Payer: Wellpoint Medicaid Managed Care	$6.18

CATH 6FR SH JR 4.0 67008300

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636300
Hospital Revenue Code	278
Min. Negotiated Rate	$6.82
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Community & State	$7.58
Rate for Payer: Wellpoint Medicaid Managed Care	$6.82

CATH 6FR SH JR 4.0 67008300

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636300
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

Know your out-of-pocket cost for care.

All Charges