Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH ARMADA PTA 3.0x80MM OTW

Facility

$925.00

Service Code	HCPCS C1725
Hospital Charge Code	270676590
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 ARMADA PTA 3.0x80MM OTW

Facility

$925.00

Hospital Charge Code	270675590
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 ARMADA PTA 4.0x100MM OTW

Facility

$925.00

Service Code	HCPCS C1725
Hospital Charge Code	270676591
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 ARMADA PTA 4.0x100MM OTW

Facility

$925.00

Service Code	HCPCS C1725
Hospital Charge Code	270676591
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 ARMADA PTA 4.0x120MM OTW

Facility

$1,175.00

Service Code	HCPCS C1725
Hospital Charge Code	270676598
Hospital Revenue Code	278
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) NJ Health	$235.00
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	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25
Rate for Payer: UnitedHealthcare Community & State	$37.13
Rate for Payer: Wellpoint Medicaid Managed Care	$33.37

CATH ARMADA PTA 4.0x120MM OTW

Facility

$1,175.00

Service Code	HCPCS C1725
Hospital Charge Code	270676598
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$284.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

CATH ARMADA PTA 4.0x150MM OTW

Facility

$1,175.00

Service Code	HCPCS C1725
Hospital Charge Code	270676592A
Hospital Revenue Code	278
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) NJ Health	$235.00
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	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25
Rate for Payer: UnitedHealthcare Community & State	$37.13
Rate for Payer: Wellpoint Medicaid Managed Care	$33.37

CATH ARMADA PTA 4.0x150MM OTW

Facility

$1,175.00

Service Code	HCPCS C1725
Hospital Charge Code	270676592A
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$284.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

CATH ARMADA PTA 4.0x150MM OTW

Facility

$1,175.00

Service Code	HCPCS C1725
Hospital Charge Code	270676592
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$284.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

CATH ARMADA PTA 4.0x150MM OTW

Facility

$1,175.00

Service Code	HCPCS C1725
Hospital Charge Code	270676592
Hospital Revenue Code	278
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) NJ Health	$235.00
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	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25
Rate for Payer: UnitedHealthcare Community & State	$37.13
Rate for Payer: Wellpoint Medicaid Managed Care	$33.37

CATH ARMADA PTA 4.0x200MM OTW

Facility

$1,175.00

Service Code	HCPCS C1725
Hospital Charge Code	270676593S
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$284.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

CATH ARMADA PTA 4.0x200MM OTW

Facility

$1,175.00

Service Code	HCPCS C1725
Hospital Charge Code	270676593A
Hospital Revenue Code	278
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) NJ Health	$235.00
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	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25
Rate for Payer: UnitedHealthcare Community & State	$37.13
Rate for Payer: Wellpoint Medicaid Managed Care	$33.37

CATH ARMADA PTA 4.0x200MM OTW

Facility

$1,175.00

Service Code	HCPCS C1725
Hospital Charge Code	270676593A
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$284.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

CATH ARMADA PTA 4.0x200MM OTW

Facility

$1,175.00

Service Code	HCPCS C1725
Hospital Charge Code	270676593
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$284.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

CATH ARMADA PTA 4.0x200MM OTW

Facility

$1,175.00

Service Code	HCPCS C1725
Hospital Charge Code	270676593S
Hospital Revenue Code	278
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) NJ Health	$235.00
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	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25
Rate for Payer: UnitedHealthcare Community & State	$37.13
Rate for Payer: Wellpoint Medicaid Managed Care	$33.37

CATH ARMADA PTA 4.0x200MM OTW

Facility

$1,175.00

Service Code	HCPCS C1725
Hospital Charge Code	270676593
Hospital Revenue Code	278
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) NJ Health	$235.00
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	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25
Rate for Payer: UnitedHealthcare Community & State	$37.13
Rate for Payer: Wellpoint Medicaid Managed Care	$33.37

CATH ARMADA PTA 4.0x40MM OTW

Facility

$925.00

Service Code	HCPCS C1725
Hospital Charge Code	270676594A
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 ARMADA PTA 4.0x40MM OTW

Facility

$925.00

Service Code	HCPCS C1725
Hospital Charge Code	270676594
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 ARMADA PTA 4.0x40MM OTW

Facility

$925.00

Service Code	HCPCS C1725
Hospital Charge Code	270676594
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 ARMADA PTA 4.0x40MM OTW

Facility

$925.00

Service Code	HCPCS C1725
Hospital Charge Code	270676594A
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 ARMADA PTA 4.0x40MM OTW

Facility

$925.00

Service Code	HCPCS C1725
Hospital Charge Code	270676594S
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 ARMADA PTA 4.0x40MM OTW

Facility

$925.00

Service Code	HCPCS C1725
Hospital Charge Code	270676594S
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 ARMADA PTA 4.0x60MM OTW

Facility

$925.00

Service Code	HCPCS C1725
Hospital Charge Code	270676595
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 ARMADA PTA 4.0x60MM OTW

Facility

$925.00

Service Code	HCPCS C1725
Hospital Charge Code	270676595A
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 ARMADA PTA 4.0x60MM OTW

Facility

$925.00

Service Code	HCPCS C1725
Hospital Charge Code	270676595A
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

Know your out-of-pocket cost for care.

All Charges