Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH APEX MONORAIL 15X2 5

Facility

$1,225.00

Hospital Charge Code	270653670
Hospital Revenue Code	278
Min. Negotiated Rate	$183.75
Max. Negotiated Rate	$296.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$245.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.45
Rate for Payer: Qualcare PPO/HMO/WC	$183.75

CATH APEX MONORAIL 15X2 5

Facility

$1,225.00

Hospital Charge Code	270653670
Hospital Revenue Code	278
Min. Negotiated Rate	$34.79
Max. Negotiated Rate	$612.50
Rate for Payer: Aetna Commercial	$465.50
Rate for Payer: Aetna Medicare Advantage	$367.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$312.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$312.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$245.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$312.38
Rate for Payer: Cigna Commercial	$612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.45
Rate for Payer: Qualcare PPO/HMO/WC	$183.75
Rate for Payer: UnitedHealthcare Community & State	$38.71
Rate for Payer: Wellpoint Medicaid Managed Care	$34.79

CATH AR I 6F

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636302
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 AR I 6F

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636302
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 AR I 7FR 77811000

Facility

$277.70

Service Code	HCPCS C1887
Hospital Charge Code	270636360N
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 AR I 7FR 77811000

Facility

$220.00

Service Code	HCPCS C1887
Hospital Charge Code	270636360
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 AR I 7FR 77811000

Facility

$220.00

Service Code	HCPCS C1887
Hospital Charge Code	270636360
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 AR I 7FR 77811000

Facility

$277.70

Service Code	HCPCS C1887
Hospital Charge Code	270636360N
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 AR II 533643

Facility

$42.25

Service Code	HCPCS C1887
Hospital Charge Code	270622011
Hospital Revenue Code	278
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) NJ Health	$8.45
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	$10.22
Rate for Payer: Qualcare PPO/HMO/WC	$6.34
Rate for Payer: UnitedHealthcare Community & State	$1.34
Rate for Payer: Wellpoint Medicaid Managed Care	$1.20

CATH AR II 533643

Facility

$42.25

Service Code	HCPCS C1887
Hospital Charge Code	270622011
Hospital Revenue Code	278
Min. Negotiated Rate	$6.34
Max. Negotiated Rate	$10.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.22
Rate for Payer: Qualcare PPO/HMO/WC	$6.34

CATH AR I SH 6F 637011100

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636303
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 AR I SH 6F 637011100

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636303
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 ARMADA 14 PTA 1.5x120x150

Facility

$1,320.00

Service Code	HCPCS C1725
Hospital Charge Code	270645975
Hospital Revenue Code	278
Min. Negotiated Rate	$198.00
Max. Negotiated Rate	$319.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.44
Rate for Payer: Qualcare PPO/HMO/WC	$198.00

CATH ARMADA 14 PTA 1.5x120x150

Facility

$1,320.00

Service Code	HCPCS C1725
Hospital Charge Code	270645975
Hospital Revenue Code	278
Min. Negotiated Rate	$37.49
Max. Negotiated Rate	$660.00
Rate for Payer: Aetna Commercial	$501.60
Rate for Payer: Aetna Medicare Advantage	$396.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$336.60
Rate for Payer: Cigna Commercial	$660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.44
Rate for Payer: Qualcare PPO/HMO/WC	$198.00
Rate for Payer: UnitedHealthcare Community & State	$41.71
Rate for Payer: Wellpoint Medicaid Managed Care	$37.49

CATH ARMADA 14 PTA 1.5x80x150

Facility

$1,200.00

Service Code	HCPCS C1725
Hospital Charge Code	270645974C
Hospital Revenue Code	278
Min. Negotiated Rate	$180.00
Max. Negotiated Rate	$290.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.40
Rate for Payer: Qualcare PPO/HMO/WC	$180.00

CATH ARMADA 14 PTA 1.5x80x150

Facility

$1,200.00

Service Code	HCPCS C1725
Hospital Charge Code	270645974C
Hospital Revenue Code	278
Min. Negotiated Rate	$34.08
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$456.00
Rate for Payer: Aetna Medicare Advantage	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$306.00
Rate for Payer: Cigna Commercial	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.40
Rate for Payer: Qualcare PPO/HMO/WC	$180.00
Rate for Payer: UnitedHealthcare Community & State	$37.92
Rate for Payer: Wellpoint Medicaid Managed Care	$34.08

CATH ARMADA 14 PTA 1.5X80X150

Facility

$1,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270645974S
Hospital Revenue Code	278
Min. Negotiated Rate	$49.70
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Community & State	$55.30
Rate for Payer: Wellpoint Medicaid Managed Care	$49.70

CATH ARMADA 14 PTA 1.5X80X150

Facility

$1,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270645974S
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

CATH ARMADA 14 PTA 2 0x120x150

Facility

$1,325.00

Service Code	HCPCS C1725
Hospital Charge Code	270645956S
Hospital Revenue Code	278
Min. Negotiated Rate	$37.63
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$41.87
Rate for Payer: Wellpoint Medicaid Managed Care	$37.63

CATH ARMADA 14 PTA 2 0x120x150

Facility

$1,325.00

Service Code	HCPCS C1725
Hospital Charge Code	270645956
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

CATH ARMADA 14 PTA 2 0x120x150

Facility

$1,325.00

Service Code	HCPCS C1725
Hospital Charge Code	270645956
Hospital Revenue Code	278
Min. Negotiated Rate	$37.63
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$41.87
Rate for Payer: Wellpoint Medicaid Managed Care	$37.63

CATH ARMADA 14 PTA 2 0x120x150

Facility

$1,325.00

Service Code	HCPCS C1725
Hospital Charge Code	270645956S
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

CATH ARMADA 14 PTA 2.0x120x150

Facility

$1,325.00

Service Code	HCPCS C1725
Hospital Charge Code	270645956C
Hospital Revenue Code	278
Min. Negotiated Rate	$37.63
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$41.87
Rate for Payer: Wellpoint Medicaid Managed Care	$37.63

CATH ARMADA 14 PTA 2.0x120x150

Facility

$1,325.00

Service Code	HCPCS C1725
Hospital Charge Code	270645956C
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

CATH ARMADA 14 PTA 2.0x200x150

Facility

$1,325.00

Service Code	HCPCS C1725
Hospital Charge Code	270645976C
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

Know your out-of-pocket cost for care.

All Charges