Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH 8 INDIGO ASPIRATION 85CM

Facility

$14,450.00

Service Code	HCPCS C1757
Hospital Charge Code	270685329
Hospital Revenue Code	278
Min. Negotiated Rate	$410.38
Max. Negotiated Rate	$7,225.00
Rate for Payer: Aetna Commercial	$5,491.00
Rate for Payer: Aetna Medicare Advantage	$4,335.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,684.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,684.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,890.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,684.75
Rate for Payer: Cigna Commercial	$7,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,496.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,167.50
Rate for Payer: UnitedHealthcare Community & State	$456.62
Rate for Payer: Wellpoint Medicaid Managed Care	$410.38

CATH 8MMX39MM 7FR 80CM

Facility

$17,520.00

Service Code	HCPCS C1874
Hospital Charge Code	270692153
Hospital Revenue Code	278
Min. Negotiated Rate	$497.57
Max. Negotiated Rate	$8,760.00
Rate for Payer: Aetna Commercial	$6,657.60
Rate for Payer: Aetna Medicare Advantage	$5,256.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,467.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,467.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,504.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,467.60
Rate for Payer: Cigna Commercial	$8,760.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,239.84
Rate for Payer: Qualcare PPO/HMO/WC	$2,628.00
Rate for Payer: UnitedHealthcare Community & State	$553.63
Rate for Payer: Wellpoint Medicaid Managed Care	$497.57

CATH 8MMX39MM 7FR 80CM

Facility

$17,520.00

Service Code	HCPCS C1874
Hospital Charge Code	270692153
Hospital Revenue Code	278
Min. Negotiated Rate	$2,628.00
Max. Negotiated Rate	$4,239.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,504.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,239.84
Rate for Payer: Qualcare PPO/HMO/WC	$2,628.00

CATH 9F LUMEN DUAL 008273-902

Facility

$925.00

Service Code	HCPCS C1887
Hospital Charge Code	270658556
Hospital Revenue Code	278
Min. Negotiated Rate	$26.27
Max. Negotiated Rate	$462.50
Rate for Payer: Aetna Commercial	$351.50
Rate for Payer: Aetna Medicare Advantage	$277.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.88
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75
Rate for Payer: UnitedHealthcare Community & State	$29.23
Rate for Payer: Wellpoint Medicaid Managed Care	$26.27

CATH 9F LUMEN DUAL 008273-902

Facility

$925.00

Service Code	HCPCS C1887
Hospital Charge Code	270658556
Hospital Revenue Code	278
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$223.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

CATH ACCU KIT INTERM 18GX2.25

Facility

$580.00

Service Code	HCPCS C1751
Hospital Charge Code	270699051C
Hospital Revenue Code	278
Min. Negotiated Rate	$16.47
Max. Negotiated Rate	$290.00
Rate for Payer: Aetna Commercial	$220.40
Rate for Payer: Aetna Medicare Advantage	$174.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.90
Rate for Payer: Cigna Commercial	$290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.36
Rate for Payer: Qualcare PPO/HMO/WC	$87.00
Rate for Payer: UnitedHealthcare Community & State	$18.33
Rate for Payer: Wellpoint Medicaid Managed Care	$16.47

CATH ACCU KIT INTERM 18GX2.25

Facility

$580.00

Service Code	HCPCS C1751
Hospital Charge Code	270699051C
Hospital Revenue Code	278
Min. Negotiated Rate	$87.00
Max. Negotiated Rate	$140.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.36
Rate for Payer: Qualcare PPO/HMO/WC	$87.00

CATH ACCU KIT INTERM 18GX2.25

Facility

$580.00

Service Code	HCPCS C1751
Hospital Charge Code	270699051
Hospital Revenue Code	278
Min. Negotiated Rate	$16.47
Max. Negotiated Rate	$290.00
Rate for Payer: Aetna Commercial	$220.40
Rate for Payer: Aetna Medicare Advantage	$174.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.90
Rate for Payer: Cigna Commercial	$290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.36
Rate for Payer: Qualcare PPO/HMO/WC	$87.00
Rate for Payer: UnitedHealthcare Community & State	$18.33
Rate for Payer: Wellpoint Medicaid Managed Care	$16.47

CATH ACCU KIT INTERM 18GX2.25

Facility

$580.00

Service Code	HCPCS C1751
Hospital Charge Code	270699051
Hospital Revenue Code	278
Min. Negotiated Rate	$87.00
Max. Negotiated Rate	$140.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.36
Rate for Payer: Qualcare PPO/HMO/WC	$87.00

CATH ACCU KIT INTERM 20GX2.25

Facility

$580.00

Service Code	HCPCS C1751
Hospital Charge Code	270699196C
Hospital Revenue Code	278
Min. Negotiated Rate	$16.47
Max. Negotiated Rate	$290.00
Rate for Payer: Aetna Commercial	$220.40
Rate for Payer: Aetna Medicare Advantage	$174.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.90
Rate for Payer: Cigna Commercial	$290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.36
Rate for Payer: Qualcare PPO/HMO/WC	$87.00
Rate for Payer: UnitedHealthcare Community & State	$18.33
Rate for Payer: Wellpoint Medicaid Managed Care	$16.47

CATH ACCU KIT INTERM 20GX2.25

Facility

$580.00

Service Code	HCPCS C1751
Hospital Charge Code	270699196C
Hospital Revenue Code	278
Min. Negotiated Rate	$87.00
Max. Negotiated Rate	$140.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.36
Rate for Payer: Qualcare PPO/HMO/WC	$87.00

CATH ACCU KIT INTERM 20GX2.25

Facility

$580.00

Service Code	HCPCS C1751
Hospital Charge Code	270699196
Hospital Revenue Code	278
Min. Negotiated Rate	$87.00
Max. Negotiated Rate	$140.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.36
Rate for Payer: Qualcare PPO/HMO/WC	$87.00

CATH ACCU KIT INTERM 20GX2.25

Facility

$580.00

Service Code	HCPCS C1751
Hospital Charge Code	270699196
Hospital Revenue Code	278
Min. Negotiated Rate	$16.47
Max. Negotiated Rate	$290.00
Rate for Payer: Aetna Commercial	$220.40
Rate for Payer: Aetna Medicare Advantage	$174.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.90
Rate for Payer: Cigna Commercial	$290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.36
Rate for Payer: Qualcare PPO/HMO/WC	$87.00
Rate for Payer: UnitedHealthcare Community & State	$18.33
Rate for Payer: Wellpoint Medicaid Managed Care	$16.47

CATH AD BEREN 5F .038 10722105

Facility

$90.00

Service Code	HCPCS C1887
Hospital Charge Code	270623924
Hospital Revenue Code	278
Min. Negotiated Rate	$2.56
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.78
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Community & State	$2.84
Rate for Payer: Wellpoint Medicaid Managed Care	$2.56

CATH AD BEREN 5F .038 10722105

Facility

$90.00

Service Code	HCPCS C1887
Hospital Charge Code	270623924
Hospital Revenue Code	278
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$21.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.78
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

CATH AD CARD 5F .035 10732201

Facility

$90.00

Service Code	HCPCS C1887
Hospital Charge Code	270623313
Hospital Revenue Code	278
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$21.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.78
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

CATH AD CARD 5F .035 10732201

Facility

$90.00

Service Code	HCPCS C1887
Hospital Charge Code	270623313
Hospital Revenue Code	278
Min. Negotiated Rate	$2.56
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.78
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Community & State	$2.84
Rate for Payer: Wellpoint Medicaid Managed Care	$2.56

CATH AD CARD BERENS 10722104

Facility

$94.45

Hospital Charge Code	270623315
Hospital Revenue Code	272
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$47.23
Rate for Payer: Aetna Commercial	$35.89
Rate for Payer: Aetna Medicare Advantage	$28.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.08
Rate for Payer: Cigna Commercial	$47.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.56
Rate for Payer: Oxford Commercial	$18.89
Rate for Payer: Qualcare PPO/HMO/WC	$14.17
Rate for Payer: UnitedHealthcare Commercial	$18.89
Rate for Payer: UnitedHealthcare Community & State	$2.98
Rate for Payer: Wellpoint Medicaid Managed Care	$2.68

CATH AD CARD BERENS 10722104

Facility

$94.45

Hospital Charge Code	270623315
Hospital Revenue Code	272
Min. Negotiated Rate	$14.17
Max. Negotiated Rate	$14.17
Rate for Payer: Qualcare PPO/HMO/WC	$14.17

CATH ADMIRAL XTREME 9x60x80

Facility

$700.00

Service Code	HCPCS C1725
Hospital Charge Code	270642305
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

CATH ADMIRAL XTREME 9x60x80

Facility

$700.00

Service Code	HCPCS C1725
Hospital Charge Code	270642305
Hospital Revenue Code	278
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) NJ Health	$140.00
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	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$22.12
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

CATH AL 1.5 6F 67003800

Facility

$277.70

Service Code	HCPCS C1887
Hospital Charge Code	270636312
Hospital Revenue Code	278
Min. Negotiated Rate	$7.89
Max. Negotiated Rate	$138.85
Rate for Payer: Aetna Commercial	$105.53
Rate for Payer: Aetna Medicare Advantage	$83.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.81
Rate for Payer: Cigna Commercial	$138.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.20
Rate for Payer: Qualcare PPO/HMO/WC	$41.66
Rate for Payer: UnitedHealthcare Community & State	$8.78
Rate for Payer: Wellpoint Medicaid Managed Care	$7.89

CATH AL 1.5 6F 67003800

Facility

$277.70

Service Code	HCPCS C1887
Hospital Charge Code	270636312
Hospital Revenue Code	278
Min. Negotiated Rate	$41.66
Max. Negotiated Rate	$67.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.20
Rate for Payer: Qualcare PPO/HMO/WC	$41.66

CATH AL 1.5 SH 7F 67004000

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636313S
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 AL 1.5 SH 7F 67004000

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636313S
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