Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH ARMADA PTA 6.0x80MM OTW

Facility

$1,175.00

Service Code	HCPCS C1725
Hospital Charge Code	270676617C
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 6.0x80MM OTW

Facility

$253.93

Service Code	HCPCS C1725
Hospital Charge Code	270676618
Hospital Revenue Code	278
Min. Negotiated Rate	$7.21
Max. Negotiated Rate	$126.97
Rate for Payer: Aetna Commercial	$96.49
Rate for Payer: Aetna Medicare Advantage	$76.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.75
Rate for Payer: Cigna Commercial	$126.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.45
Rate for Payer: Qualcare PPO/HMO/WC	$38.09
Rate for Payer: UnitedHealthcare Community & State	$8.02
Rate for Payer: Wellpoint Medicaid Managed Care	$7.21

CATH ARMADA PTA 6.0x80MM OTW

Facility

$1,175.00

Service Code	HCPCS C1725
Hospital Charge Code	270676617C
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 6.0x80MM OTW

Facility

$1,175.00

Service Code	HCPCS C1725
Hospital Charge Code	270676617
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 6.0x80MM OTW

Facility

$253.93

Service Code	HCPCS C1725
Hospital Charge Code	270676618
Hospital Revenue Code	278
Min. Negotiated Rate	$38.09
Max. Negotiated Rate	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.45
Rate for Payer: Qualcare PPO/HMO/WC	$38.09

CATH ARMADA PTA 6.0x80MM OTW

Facility

$1,175.00

Service Code	HCPCS C1725
Hospital Charge Code	270676617
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 ASH SPLIT 14FR 28cm

Facility

$1,540.00

Service Code	HCPCS C1750
Hospital Charge Code	270617195
Hospital Revenue Code	278
Min. Negotiated Rate	$231.00
Max. Negotiated Rate	$372.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$308.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.68
Rate for Payer: Qualcare PPO/HMO/WC	$231.00

CATH ASH SPLIT 14FR 28cm

Facility

$1,540.00

Service Code	HCPCS C1750
Hospital Charge Code	270617195
Hospital Revenue Code	278
Min. Negotiated Rate	$43.74
Max. Negotiated Rate	$770.00
Rate for Payer: Aetna Commercial	$585.20
Rate for Payer: Aetna Medicare Advantage	$462.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$392.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$392.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$308.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$392.70
Rate for Payer: Cigna Commercial	$770.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.68
Rate for Payer: Qualcare PPO/HMO/WC	$231.00
Rate for Payer: UnitedHealthcare Community & State	$48.66
Rate for Payer: Wellpoint Medicaid Managed Care	$43.74

CATH ASPIRATION NASOTRACH

Facility

$235.00

Service Code	HCPCS 31720
Hospital Charge Code	9500425
Hospital Revenue Code	410
Min. Negotiated Rate	$6.67
Max. Negotiated Rate	$1,440.00
Rate for Payer: Aetna Commercial	$707.61
Rate for Payer: Aetna Medicare Advantage	$842.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$943.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$943.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$943.69
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: Cigna Medicare Advantage	$260.15
Rate for Payer: Clover Medicare Advantage	$247.14
Rate for Payer: EmblemHealth Commercial	$780.45
Rate for Payer: Humana Medicare Advantage	$267.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$260.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.10
Rate for Payer: Oxford Commercial	$1,367.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.25
Rate for Payer: UnitedHealthcare Commercial	$1,440.00
Rate for Payer: UnitedHealthcare Community & State	$7.43
Rate for Payer: UnitedHealthcare Medicare Advantage	$260.15
Rate for Payer: Wellcare Medicare Advantage	$260.15
Rate for Payer: Wellpoint Medicaid Managed Care	$6.67

CATH ASPIRATION NASOTRACH

Facility

$235.00

Service Code	HCPCS 31720
Hospital Charge Code	9500425
Hospital Revenue Code	410
Min. Negotiated Rate	$35.25
Max. Negotiated Rate	$35.25
Rate for Payer: Qualcare PPO/HMO/WC	$35.25

CATH ASPIRAT ZOOM 088 LDP 110C

Facility

$12,425.00

Service Code	HCPCS C1887
Hospital Charge Code	270694790S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,863.75
Max. Negotiated Rate	$3,006.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,006.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.75

CATH ASPIRAT ZOOM 088 LDP 110C

Facility

$12,425.00

Service Code	HCPCS C1887
Hospital Charge Code	270694790S
Hospital Revenue Code	278
Min. Negotiated Rate	$352.87
Max. Negotiated Rate	$6,212.50
Rate for Payer: Aetna Commercial	$4,721.50
Rate for Payer: Aetna Medicare Advantage	$3,727.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,168.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,168.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,485.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,168.38
Rate for Payer: Cigna Commercial	$6,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,006.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.75
Rate for Payer: UnitedHealthcare Community & State	$392.63
Rate for Payer: Wellpoint Medicaid Managed Care	$352.87

CATH ATTAIN COMMAND 50S

Facility

$1,175.00

Service Code	HCPCS C1887
Hospital Charge Code	270675266
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 ATTAIN COMMAND 50S

Facility

$1,175.00

Service Code	HCPCS C1887
Hospital Charge Code	270675266
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 ATTAIN COMMAND MP

Facility

$1,175.00

Service Code	HCPCS C1887
Hospital Charge Code	270675267
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 ATTAIN COMMAND MP

Facility

$1,175.00

Service Code	HCPCS C1887
Hospital Charge Code	270675267
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 AVIATOR PLUS 4X30MM 142CM

Facility

$1,710.00

Service Code	HCPCS C1725
Hospital Charge Code	270700672S
Hospital Revenue Code	278
Min. Negotiated Rate	$256.50
Max. Negotiated Rate	$413.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$342.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.82
Rate for Payer: Qualcare PPO/HMO/WC	$256.50

CATH AVIATOR PLUS 4X30MM 142CM

Facility

$1,710.00

Service Code	HCPCS C1725
Hospital Charge Code	270700672S
Hospital Revenue Code	278
Min. Negotiated Rate	$48.56
Max. Negotiated Rate	$855.00
Rate for Payer: Aetna Commercial	$649.80
Rate for Payer: Aetna Medicare Advantage	$513.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$436.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$436.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$342.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$436.05
Rate for Payer: Cigna Commercial	$855.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.82
Rate for Payer: Qualcare PPO/HMO/WC	$256.50
Rate for Payer: UnitedHealthcare Community & State	$54.04
Rate for Payer: Wellpoint Medicaid Managed Care	$48.56

CATH AVIATOR PLUS 6x20mm 142cm

Facility

$1,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270631631
Hospital Revenue Code	278
Min. Negotiated Rate	$29.82
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$399.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$157.50
Rate for Payer: UnitedHealthcare Community & State	$33.18
Rate for Payer: Wellpoint Medicaid Managed Care	$29.82

CATH AVIATOR PLUS 6x20mm 142cm

Facility

$1,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270631631
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

CATH AVIATOR PLUS 7x20mm 142cm

Facility

$2,300.00

Service Code	HCPCS C1725
Hospital Charge Code	270639316S
Hospital Revenue Code	278
Min. Negotiated Rate	$65.32
Max. Negotiated Rate	$1,150.00
Rate for Payer: Aetna Commercial	$874.00
Rate for Payer: Aetna Medicare Advantage	$690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$586.50
Rate for Payer: Cigna Commercial	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: Qualcare PPO/HMO/WC	$345.00
Rate for Payer: UnitedHealthcare Community & State	$72.68
Rate for Payer: Wellpoint Medicaid Managed Care	$65.32

CATH AVIATOR PLUS 7x20mm 142cm

Facility

$2,300.00

Service Code	HCPCS C1725
Hospital Charge Code	270639316S
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$556.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

CATH BAKER JEJUNOSTOMY 16FR

Facility

$694.45

Hospital Charge Code	270679142
Hospital Revenue Code	272
Min. Negotiated Rate	$19.72
Max. Negotiated Rate	$347.23
Rate for Payer: Aetna Commercial	$263.89
Rate for Payer: Aetna Medicare Advantage	$208.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.08
Rate for Payer: Cigna Commercial	$347.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.56
Rate for Payer: Oxford Commercial	$138.89
Rate for Payer: Qualcare PPO/HMO/WC	$104.17
Rate for Payer: UnitedHealthcare Commercial	$138.89
Rate for Payer: UnitedHealthcare Community & State	$21.94
Rate for Payer: Wellpoint Medicaid Managed Care	$19.72

CATH BAKER JEJUNOSTOMY 16FR

Facility

$694.45

Hospital Charge Code	270679142
Hospital Revenue Code	272
Min. Negotiated Rate	$104.17
Max. Negotiated Rate	$104.17
Rate for Payer: Qualcare PPO/HMO/WC	$104.17

CATH BALLN 5/40/80 050040080

Facility

$700.00

Hospital Charge Code	270661866
Hospital Revenue Code	272
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

Know your out-of-pocket cost for care.

All Charges