Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH BIOFLOW DURAMAX 23CM

Facility

$1,250.00

Hospital Charge Code	270676456
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 23CM

Facility

$1,250.00

Hospital Charge Code	270676456
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

CATH BIOFLOW DURAMAX 27CM

Facility

$1,250.00

Hospital Charge Code	270676457
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

CATH BIOFLOW DURAMAX 27CM

Facility

$1,250.00

Hospital Charge Code	270676457
Hospital Revenue Code	272
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

CATH CANATA 2.5FR 135cm

Facility

$1,700.00

Service Code	HCPCS C1887
Hospital Charge Code	270645715C
Hospital Revenue Code	278
Min. Negotiated Rate	$255.00
Max. Negotiated Rate	$411.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.40
Rate for Payer: Qualcare PPO/HMO/WC	$255.00

CATH CANATA 2.5FR 135cm

Facility

$1,700.00

Service Code	HCPCS C1887
Hospital Charge Code	270645715C
Hospital Revenue Code	278
Min. Negotiated Rate	$48.28
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$646.00
Rate for Payer: Aetna Medicare Advantage	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$433.50
Rate for Payer: Cigna Commercial	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.40
Rate for Payer: Qualcare PPO/HMO/WC	$255.00
Rate for Payer: UnitedHealthcare Community & State	$53.72
Rate for Payer: Wellpoint Medicaid Managed Care	$48.28

CATH CANNONII 15FR50 CS15552SP

Facility

$1,504.35

Service Code	HCPCS C1752
Hospital Charge Code	270632406
Hospital Revenue Code	278
Min. Negotiated Rate	$42.72
Max. Negotiated Rate	$752.17
Rate for Payer: Aetna Commercial	$571.65
Rate for Payer: Aetna Medicare Advantage	$451.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$383.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$383.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$383.61
Rate for Payer: Cigna Commercial	$752.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.05
Rate for Payer: Qualcare PPO/HMO/WC	$225.65
Rate for Payer: UnitedHealthcare Community & State	$47.54
Rate for Payer: Wellpoint Medicaid Managed Care	$42.72

CATH CANNONII 15FR50 CS15552SP

Facility

$1,504.35

Service Code	HCPCS C1752
Hospital Charge Code	270632406
Hospital Revenue Code	278
Min. Negotiated Rate	$225.65
Max. Negotiated Rate	$364.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.05
Rate for Payer: Qualcare PPO/HMO/WC	$225.65

CATH CANNON II 15x36 CS15362

Facility

$1,504.35

Service Code	HCPCS C1752
Hospital Charge Code	270632405
Hospital Revenue Code	278
Min. Negotiated Rate	$225.65
Max. Negotiated Rate	$364.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.05
Rate for Payer: Qualcare PPO/HMO/WC	$225.65

CATH CANNON II 15x36 CS15362

Facility

$1,504.35

Service Code	HCPCS C1752
Hospital Charge Code	270632405
Hospital Revenue Code	278
Min. Negotiated Rate	$42.72
Max. Negotiated Rate	$752.17
Rate for Payer: Aetna Commercial	$571.65
Rate for Payer: Aetna Medicare Advantage	$451.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$383.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$383.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$383.61
Rate for Payer: Cigna Commercial	$752.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.05
Rate for Payer: Qualcare PPO/HMO/WC	$225.65
Rate for Payer: UnitedHealthcare Community & State	$47.54
Rate for Payer: Wellpoint Medicaid Managed Care	$42.72

CATH CANO II 15F 24 CS15242VSP

Facility

$1,504.35

Service Code	HCPCS C1752
Hospital Charge Code	270640063
Hospital Revenue Code	278
Min. Negotiated Rate	$225.65
Max. Negotiated Rate	$364.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.05
Rate for Payer: Qualcare PPO/HMO/WC	$225.65

CATH CANO II 15F 24 CS15242VSP

Facility

$1,504.35

Service Code	HCPCS C1752
Hospital Charge Code	270640063
Hospital Revenue Code	278
Min. Negotiated Rate	$42.72
Max. Negotiated Rate	$752.17
Rate for Payer: Aetna Commercial	$571.65
Rate for Payer: Aetna Medicare Advantage	$451.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$383.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$383.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$383.61
Rate for Payer: Cigna Commercial	$752.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.05
Rate for Payer: Qualcare PPO/HMO/WC	$225.65
Rate for Payer: UnitedHealthcare Community & State	$47.54
Rate for Payer: Wellpoint Medicaid Managed Care	$42.72

CATH CANON II 15FR 28c CS15282

Facility

$1,504.35

Service Code	HCPCS C1750
Hospital Charge Code	270632034
Hospital Revenue Code	278
Min. Negotiated Rate	$225.65
Max. Negotiated Rate	$364.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.05
Rate for Payer: Qualcare PPO/HMO/WC	$225.65

CATH CANON II 15FR 28c CS15282

Facility

$1,504.35

Service Code	HCPCS C1750
Hospital Charge Code	270632034
Hospital Revenue Code	278
Min. Negotiated Rate	$42.72
Max. Negotiated Rate	$752.17
Rate for Payer: Aetna Commercial	$571.65
Rate for Payer: Aetna Medicare Advantage	$451.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$383.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$383.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$383.61
Rate for Payer: Cigna Commercial	$752.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.05
Rate for Payer: Qualcare PPO/HMO/WC	$225.65
Rate for Payer: UnitedHealthcare Community & State	$47.54
Rate for Payer: Wellpoint Medicaid Managed Care	$42.72

CATH CANON II 15FR 32c CS15322

Facility

$1,587.10

Service Code	HCPCS C1752
Hospital Charge Code	270631856
Hospital Revenue Code	278
Min. Negotiated Rate	$238.06
Max. Negotiated Rate	$384.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$317.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$384.08
Rate for Payer: Qualcare PPO/HMO/WC	$238.06

CATH CANON II 15FR 32c CS15322

Facility

$1,587.10

Service Code	HCPCS C1752
Hospital Charge Code	270631856
Hospital Revenue Code	278
Min. Negotiated Rate	$45.07
Max. Negotiated Rate	$793.55
Rate for Payer: Aetna Commercial	$603.10
Rate for Payer: Aetna Medicare Advantage	$476.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$404.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$404.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$317.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$404.71
Rate for Payer: Cigna Commercial	$793.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$384.08
Rate for Payer: Qualcare PPO/HMO/WC	$238.06
Rate for Payer: UnitedHealthcare Community & State	$50.15
Rate for Payer: Wellpoint Medicaid Managed Care	$45.07

CATH CENTERCROSS ANCHOR DEVIC

Facility

$7,475.00

Hospital Charge Code	270683237
Hospital Revenue Code	272
Min. Negotiated Rate	$212.29
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,943.50
Rate for Payer: Oxford Commercial	$1,495.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Commercial	$1,495.00
Rate for Payer: UnitedHealthcare Community & State	$236.21
Rate for Payer: Wellpoint Medicaid Managed Care	$212.29

CATH CENTERCROSS ANCHOR DEVIC

Facility

$7,475.00

Hospital Charge Code	270683237
Hospital Revenue Code	272
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,121.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

CATH CENTERCROSS ANCHOR DEVIC

Facility

$7,475.00

Hospital Charge Code	270683237N
Hospital Revenue Code	272
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,121.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

CATH CENTERCROSS ANCHOR DEVIC

Facility

$7,475.00

Hospital Charge Code	270683237N
Hospital Revenue Code	272
Min. Negotiated Rate	$212.29
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,943.50
Rate for Payer: Oxford Commercial	$1,495.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Commercial	$1,495.00
Rate for Payer: UnitedHealthcare Community & State	$236.21
Rate for Payer: Wellpoint Medicaid Managed Care	$212.29

CATH CENTRAL VENOUS OXIMETRY

Facility

$2,750.00

Service Code	HCPCS C1751
Hospital Charge Code	270689001
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$665.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

CATH CENTRAL VENOUS OXIMETRY

Facility

$2,750.00

Service Code	HCPCS C1751
Hospital Charge Code	270689001
Hospital Revenue Code	278
Min. Negotiated Rate	$78.10
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Community & State	$86.90
Rate for Payer: Wellpoint Medicaid Managed Care	$78.10

CATH CHOCOLATE 4.0X40CM

Facility

$5,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270684604
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

CATH CHOCOLATE 4.0X40CM

Facility

$5,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270684604
Hospital Revenue Code	278
Min. Negotiated Rate	$149.10
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,995.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Community & State	$165.90
Rate for Payer: Wellpoint Medicaid Managed Care	$149.10

CATH CHOLANGIOGRAPH 4FR

Facility

$300.00

Hospital Charge Code	270600380
Hospital Revenue Code	272
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) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.00
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$60.00
Rate for Payer: UnitedHealthcare Community & State	$9.48
Rate for Payer: Wellpoint Medicaid Managed Care	$8.52

Know your out-of-pocket cost for care.

All Charges