Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH AL 1.5 SH 7F 67004000

Facility

$277.70

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

Facility

$277.70

Service Code	HCPCS C1887
Hospital Charge Code	270636313N
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 6F

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636308
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 AL 1 6F

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636308
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 SH 6F 67003700

Facility

$277.70

Service Code	HCPCS C1887
Hospital Charge Code	270636309N
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 SH 6F 67003700

Facility

$277.70

Service Code	HCPCS C1887
Hospital Charge Code	270636309N
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 SH 6F 67003700

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636309
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 AL 1 SH 6F 67003700

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636309
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 .75 6F 67003400

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636306
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 AL .75 6F 67003400

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636306N
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 .75 6F 67003400

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636306
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 .75 6F 67003400

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636306N
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 AL II 7FR 77804000

Facility

$277.70

Service Code	HCPCS C1887
Hospital Charge Code	270636369N
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 II 7FR 77804000

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636369
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 AL II 7FR 77804000

Facility

$277.70

Service Code	HCPCS C1887
Hospital Charge Code	270636369N
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 II 7FR 77804000

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636369
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 I SH 7F 77803700

Facility

$220.00

Service Code	HCPCS C1887
Hospital Charge Code	270636365
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 AL I SH 7F 77803700

Facility

$220.00

Service Code	HCPCS C1887
Hospital Charge Code	270636365
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 AMPLATZ 1 MOD 5FR 100cm

Facility

$44.50

Service Code	HCPCS C1887
Hospital Charge Code	270644620C
Hospital Revenue Code	278
Min. Negotiated Rate	$1.26
Max. Negotiated Rate	$22.25
Rate for Payer: Aetna Commercial	$16.91
Rate for Payer: Aetna Medicare Advantage	$13.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.35
Rate for Payer: Cigna Commercial	$22.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.77
Rate for Payer: Qualcare PPO/HMO/WC	$6.67
Rate for Payer: UnitedHealthcare Community & State	$1.41
Rate for Payer: Wellpoint Medicaid Managed Care	$1.26

CATH AMPLATZ 1 MOD 5FR 100cm

Facility

$44.50

Service Code	HCPCS C1887
Hospital Charge Code	270644620C
Hospital Revenue Code	278
Min. Negotiated Rate	$6.67
Max. Negotiated Rate	$10.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.77
Rate for Payer: Qualcare PPO/HMO/WC	$6.67

CATH AMPLATZ 6FR 1.0 SAL W/SH

Facility

$225.00

Hospital Charge Code	270676567
Hospital Revenue Code	278
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Community & State	$7.11
Rate for Payer: Wellpoint Medicaid Managed Care	$6.39

CATH AMPLATZ 6FR 1.0 SAL W/SH

Facility

$225.00

Hospital Charge Code	270676567
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$54.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

CATH AMPLATZ SAL .75 W/SH

Facility

$225.00

Service Code	HCPCS C1887
Hospital Charge Code	270640495C
Hospital Revenue Code	278
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Community & State	$7.11
Rate for Payer: Wellpoint Medicaid Managed Care	$6.39

Know your out-of-pocket cost for care.

All Charges