Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH BALN ADMIRAL 6/60/80 XTRM

Facility

$700.00

Service Code	HCPCS C1725
Hospital Charge Code	270660312
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 BALN ADML 7X60X80

Facility

$700.00

Service Code	HCPCS C1725
Hospital Charge Code	270659677
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 BALN ADML 7X60X80

Facility

$700.00

Service Code	HCPCS C1725
Hospital Charge Code	270659677
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 BALN AMP 025150152

Facility

$1,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270657941
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 BALN AMP 025150152

Facility

$1,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270657941
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 BALON HIGH PRESS 6X40X80

Facility

$950.00

Service Code	HCPCS C1725
Hospital Charge Code	270658398
Hospital Revenue Code	278
Min. Negotiated Rate	$26.98
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$361.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50
Rate for Payer: UnitedHealthcare Community & State	$30.02
Rate for Payer: Wellpoint Medicaid Managed Care	$26.98

CATH BALON HIGH PRESS 6X40X80

Facility

$950.00

Service Code	HCPCS C1725
Hospital Charge Code	270658398
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$229.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

CATH BD COUNCIL 2W 18F 0196L18

Facility

$62.05

Hospital Charge Code	270626856
Hospital Revenue Code	272
Min. Negotiated Rate	$9.31
Max. Negotiated Rate	$9.31
Rate for Payer: Qualcare PPO/HMO/WC	$9.31

CATH BD COUNCIL 2W 18F 0196L18

Facility

$62.05

Hospital Charge Code	270626856
Hospital Revenue Code	272
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$31.02
Rate for Payer: Aetna Commercial	$23.58
Rate for Payer: Aetna Medicare Advantage	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.82
Rate for Payer: Cigna Commercial	$31.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.13
Rate for Payer: Oxford Commercial	$12.41
Rate for Payer: Qualcare PPO/HMO/WC	$9.31
Rate for Payer: UnitedHealthcare Commercial	$12.41
Rate for Payer: UnitedHealthcare Community & State	$1.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.76

CATH BERENSTEIN 4FR .035 100CM

Facility

$90.00

Service Code	HCPCS C1887
Hospital Charge Code	270647405
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 BERENSTEIN 4FR .035 100CM

Facility

$90.00

Service Code	HCPCS C1887
Hospital Charge Code	270647405
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 BERENSTEIN TEMPO 5FR100CM

Facility

$74.75

Service Code	HCPCS C1887
Hospital Charge Code	270623709
Hospital Revenue Code	278
Min. Negotiated Rate	$11.21
Max. Negotiated Rate	$18.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.09
Rate for Payer: Qualcare PPO/HMO/WC	$11.21

CATH BERENSTEIN TEMPO 5FR100CM

Facility

$74.75

Service Code	HCPCS C1887
Hospital Charge Code	270623709
Hospital Revenue Code	278
Min. Negotiated Rate	$2.12
Max. Negotiated Rate	$37.38
Rate for Payer: Aetna Commercial	$28.41
Rate for Payer: Aetna Medicare Advantage	$22.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.06
Rate for Payer: Cigna Commercial	$37.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.09
Rate for Payer: Qualcare PPO/HMO/WC	$11.21
Rate for Payer: UnitedHealthcare Community & State	$2.36
Rate for Payer: Wellpoint Medicaid Managed Care	$2.12

CATH BERN IMPRESS 5FX100CM

Facility

$300.00

Service Code	HCPCS C1887
Hospital Charge Code	270700330S
Hospital Revenue Code	278
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Community & State	$9.48
Rate for Payer: Wellpoint Medicaid Managed Care	$8.52

CATH BERN IMPRESS 5FX100CM

Facility

$300.00

Service Code	HCPCS C1887
Hospital Charge Code	270700330S
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

CATH BIOFLO 15FR 55CM SNGL VLV

Facility

$2,050.00

Hospital Charge Code	270677954
Hospital Revenue Code	272
Min. Negotiated Rate	$58.22
Max. Negotiated Rate	$1,025.00
Rate for Payer: Aetna Commercial	$779.00
Rate for Payer: Aetna Medicare Advantage	$615.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$522.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$522.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$522.75
Rate for Payer: Cigna Commercial	$1,025.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$533.00
Rate for Payer: Oxford Commercial	$410.00
Rate for Payer: Qualcare PPO/HMO/WC	$307.50
Rate for Payer: UnitedHealthcare Commercial	$410.00
Rate for Payer: UnitedHealthcare Community & State	$64.78
Rate for Payer: Wellpoint Medicaid Managed Care	$58.22

CATH BIOFLO 15FR 55CM SNGL VLV

Facility

$2,050.00

Hospital Charge Code	270677954
Hospital Revenue Code	272
Min. Negotiated Rate	$307.50
Max. Negotiated Rate	$307.50
Rate for Payer: Qualcare PPO/HMO/WC	$307.50

CATH BIOFLO PICC 5FR DUAL 70CM

Facility

$450.00

Service Code	HCPCS C1769
Hospital Charge Code	270676708
Hospital Revenue Code	272
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

CATH BIOFLO PICC 5FR DUAL 70CM

Facility

$450.00

Service Code	HCPCS C1769
Hospital Charge Code	270676708
Hospital Revenue Code	272
Min. Negotiated Rate	$12.78
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$171.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Commercial	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.22
Rate for Payer: Wellpoint Medicaid Managed Care	$12.78

CATH BIOFLO PICC DUAL 145cm

Facility

$600.00

Service Code	HCPCS C1751
Hospital Charge Code	270673435
Hospital Revenue Code	278
Min. Negotiated Rate	$17.04
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$18.96
Rate for Payer: Wellpoint Medicaid Managed Care	$17.04

CATH BIOFLO PICC DUAL 145cm

Facility

$600.00

Service Code	HCPCS C1751
Hospital Charge Code	270673435
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

CATH BIOFLO PICC SNGL 145cm

Facility

$575.00

Service Code	HCPCS C1751
Hospital Charge Code	270673434
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$139.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

CATH BIOFLO PICC SNGL 145cm

Facility

$575.00

Service Code	HCPCS C1751
Hospital Charge Code	270673434
Hospital Revenue Code	278
Min. Negotiated Rate	$16.33
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$218.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25
Rate for Payer: UnitedHealthcare Community & State	$18.17
Rate for Payer: Wellpoint Medicaid Managed Care	$16.33

CATH BIOFLOW DURAMAX 19CM

Facility

$1,250.00

Hospital Charge Code	270676455
Hospital Revenue Code	272
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

CATH BIOFLOW DURAMAX 19CM

Facility

$1,250.00

Hospital Charge Code	270676455
Hospital Revenue Code	272
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$250.00
Rate for Payer: UnitedHealthcare Community & State	$39.50
Rate for Payer: Wellpoint Medicaid Managed Care	$35.50

Know your out-of-pocket cost for care.

All Charges