Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH EKOSONIC MACH 4 12x106cm

Facility

$14,225.00

Service Code	HCPCS C1887
Hospital Charge Code	270642113A
Hospital Revenue Code	278
Min. Negotiated Rate	$2,133.75
Max. Negotiated Rate	$3,442.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75

CATH EKOSONIC MACH 4 12x106cm

Facility

$14,225.00

Service Code	HCPCS C1887
Hospital Charge Code	270642113C
Hospital Revenue Code	278
Min. Negotiated Rate	$403.99
Max. Negotiated Rate	$7,112.50
Rate for Payer: Aetna Commercial	$5,405.50
Rate for Payer: Aetna Medicare Advantage	$4,267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,627.38
Rate for Payer: Cigna Commercial	$7,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75
Rate for Payer: UnitedHealthcare Community & State	$449.51
Rate for Payer: Wellpoint Medicaid Managed Care	$403.99

CATH EKOSONIC MACH 4 12x106cm

Facility

$14,225.00

Service Code	HCPCS C1887
Hospital Charge Code	270642113A
Hospital Revenue Code	278
Min. Negotiated Rate	$403.99
Max. Negotiated Rate	$7,112.50
Rate for Payer: Aetna Commercial	$5,405.50
Rate for Payer: Aetna Medicare Advantage	$4,267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,627.38
Rate for Payer: Cigna Commercial	$7,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75
Rate for Payer: UnitedHealthcare Community & State	$449.51
Rate for Payer: Wellpoint Medicaid Managed Care	$403.99

CATH EKOSONIC MACH 4 12x106CM

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270642113
Hospital Revenue Code	278
Min. Negotiated Rate	$2,133.75
Max. Negotiated Rate	$3,442.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75

CATH EKOSONIC MACH 4 12x106CM

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270642113
Hospital Revenue Code	278
Min. Negotiated Rate	$403.99
Max. Negotiated Rate	$7,112.50
Rate for Payer: Aetna Commercial	$5,405.50
Rate for Payer: Aetna Medicare Advantage	$4,267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,627.38
Rate for Payer: Cigna Commercial	$7,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75
Rate for Payer: UnitedHealthcare Community & State	$449.51
Rate for Payer: Wellpoint Medicaid Managed Care	$403.99

CATH EKOSONIC MACH 4 12x135CM

Facility

$13,475.00

Service Code	HCPCS C1751
Hospital Charge Code	270658687N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,021.25
Max. Negotiated Rate	$3,260.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,260.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,021.25

CATH EKOSONIC MACH 4 12x135CM

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270658687S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,133.75
Max. Negotiated Rate	$3,442.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75

CATH EKOSONIC MACH 4 12x135CM

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270658687
Hospital Revenue Code	278
Min. Negotiated Rate	$403.99
Max. Negotiated Rate	$7,112.50
Rate for Payer: Aetna Commercial	$5,405.50
Rate for Payer: Aetna Medicare Advantage	$4,267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,627.38
Rate for Payer: Cigna Commercial	$7,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75
Rate for Payer: UnitedHealthcare Community & State	$449.51
Rate for Payer: Wellpoint Medicaid Managed Care	$403.99

CATH EKOSONIC MACH 4 12x135CM

Facility

$13,475.00

Service Code	HCPCS C1751
Hospital Charge Code	270658687N
Hospital Revenue Code	278
Min. Negotiated Rate	$382.69
Max. Negotiated Rate	$6,737.50
Rate for Payer: Aetna Commercial	$5,120.50
Rate for Payer: Aetna Medicare Advantage	$4,042.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,436.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,436.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,436.12
Rate for Payer: Cigna Commercial	$6,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,260.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,021.25
Rate for Payer: UnitedHealthcare Community & State	$425.81
Rate for Payer: Wellpoint Medicaid Managed Care	$382.69

CATH EKOSONIC MACH 4 12x135CM

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270658687
Hospital Revenue Code	278
Min. Negotiated Rate	$2,133.75
Max. Negotiated Rate	$3,442.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75

CATH EKOSONIC MACH 4 12x135CM

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270658687S
Hospital Revenue Code	278
Min. Negotiated Rate	$403.99
Max. Negotiated Rate	$7,112.50
Rate for Payer: Aetna Commercial	$5,405.50
Rate for Payer: Aetna Medicare Advantage	$4,267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,627.38
Rate for Payer: Cigna Commercial	$7,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75
Rate for Payer: UnitedHealthcare Community & State	$449.51
Rate for Payer: Wellpoint Medicaid Managed Care	$403.99

CATH EKOSONIC MACH 4 18x106cm

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270642291C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,133.75
Max. Negotiated Rate	$3,442.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75

CATH EKOSONIC MACH 4 18x106cm

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270642291A
Hospital Revenue Code	278
Min. Negotiated Rate	$403.99
Max. Negotiated Rate	$7,112.50
Rate for Payer: Aetna Commercial	$5,405.50
Rate for Payer: Aetna Medicare Advantage	$4,267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,627.38
Rate for Payer: Cigna Commercial	$7,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75
Rate for Payer: UnitedHealthcare Community & State	$449.51
Rate for Payer: Wellpoint Medicaid Managed Care	$403.99

CATH EKOSONIC MACH 4 18x106cm

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270642291C
Hospital Revenue Code	278
Min. Negotiated Rate	$403.99
Max. Negotiated Rate	$7,112.50
Rate for Payer: Aetna Commercial	$5,405.50
Rate for Payer: Aetna Medicare Advantage	$4,267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,627.38
Rate for Payer: Cigna Commercial	$7,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75
Rate for Payer: UnitedHealthcare Community & State	$449.51
Rate for Payer: Wellpoint Medicaid Managed Care	$403.99

CATH EKOSONIC MACH 4 18x106cm

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270642291A
Hospital Revenue Code	278
Min. Negotiated Rate	$2,133.75
Max. Negotiated Rate	$3,442.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75

CATH EKOSONIC MACH 4 18x106CM

Facility

$13,475.00

Service Code	HCPCS C1751
Hospital Charge Code	270642291N
Hospital Revenue Code	278
Min. Negotiated Rate	$382.69
Max. Negotiated Rate	$6,737.50
Rate for Payer: Aetna Commercial	$5,120.50
Rate for Payer: Aetna Medicare Advantage	$4,042.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,436.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,436.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,436.12
Rate for Payer: Cigna Commercial	$6,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,260.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,021.25
Rate for Payer: UnitedHealthcare Community & State	$425.81
Rate for Payer: Wellpoint Medicaid Managed Care	$382.69

CATH EKOSONIC MACH 4 18x106CM

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270642291S
Hospital Revenue Code	278
Min. Negotiated Rate	$403.99
Max. Negotiated Rate	$7,112.50
Rate for Payer: Aetna Commercial	$5,405.50
Rate for Payer: Aetna Medicare Advantage	$4,267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,627.38
Rate for Payer: Cigna Commercial	$7,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75
Rate for Payer: UnitedHealthcare Community & State	$449.51
Rate for Payer: Wellpoint Medicaid Managed Care	$403.99

CATH EKOSONIC MACH 4 18x106CM

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270642291
Hospital Revenue Code	278
Min. Negotiated Rate	$403.99
Max. Negotiated Rate	$7,112.50
Rate for Payer: Aetna Commercial	$5,405.50
Rate for Payer: Aetna Medicare Advantage	$4,267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,627.38
Rate for Payer: Cigna Commercial	$7,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75
Rate for Payer: UnitedHealthcare Community & State	$449.51
Rate for Payer: Wellpoint Medicaid Managed Care	$403.99

CATH EKOSONIC MACH 4 18x106CM

Facility

$13,475.00

Service Code	HCPCS C1751
Hospital Charge Code	270642291N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,021.25
Max. Negotiated Rate	$3,260.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,260.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,021.25

CATH EKOSONIC MACH 4 18x106CM

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270642291
Hospital Revenue Code	278
Min. Negotiated Rate	$2,133.75
Max. Negotiated Rate	$3,442.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75

CATH EKOSONIC MACH 4 18x106CM

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270642291S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,133.75
Max. Negotiated Rate	$3,442.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75

CATH EKOSONIC MACH 4 24x106CM

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270639437
Hospital Revenue Code	272
Min. Negotiated Rate	$403.99
Max. Negotiated Rate	$7,112.50
Rate for Payer: Aetna Commercial	$5,405.50
Rate for Payer: Aetna Medicare Advantage	$4,267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,627.38
Rate for Payer: Cigna Commercial	$7,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,698.50
Rate for Payer: Oxford Commercial	$2,845.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75
Rate for Payer: UnitedHealthcare Commercial	$2,845.00
Rate for Payer: UnitedHealthcare Community & State	$449.51
Rate for Payer: Wellpoint Medicaid Managed Care	$403.99

CATH EKOSONIC MACH 4 24x106CM

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270639437
Hospital Revenue Code	272
Min. Negotiated Rate	$2,133.75
Max. Negotiated Rate	$2,133.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75

CATH EKOSONIC MACH 4 30x106CM

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270637509
Hospital Revenue Code	278
Min. Negotiated Rate	$2,133.75
Max. Negotiated Rate	$3,442.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75

CATH EKOSONIC MACH 4 30x106CM

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270637509
Hospital Revenue Code	278
Min. Negotiated Rate	$403.99
Max. Negotiated Rate	$7,112.50
Rate for Payer: Aetna Commercial	$5,405.50
Rate for Payer: Aetna Medicare Advantage	$4,267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,627.38
Rate for Payer: Cigna Commercial	$7,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75
Rate for Payer: UnitedHealthcare Community & State	$449.51
Rate for Payer: Wellpoint Medicaid Managed Care	$403.99

Know your out-of-pocket cost for care.

All Charges