Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH EKOSONIC MACH 4 50x106CM

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270637511
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 50X106CM

Facility

$13,475.00

Service Code	HCPCS C1751
Hospital Charge Code	270637511S
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 50X106CM

Facility

$14,225.00

Service Code	HCPCS C1887
Hospital Charge Code	270637511C
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 50X106CM

Facility

$13,475.00

Service Code	HCPCS C1751
Hospital Charge Code	270637511S
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 50X106CM

Facility

$11,975.00

Service Code	HCPCS C1887
Hospital Charge Code	270637511N
Hospital Revenue Code	278
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$5,987.50
Rate for Payer: Aetna Commercial	$4,550.50
Rate for Payer: Aetna Medicare Advantage	$3,592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,053.62
Rate for Payer: Cigna Commercial	$5,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,897.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25
Rate for Payer: UnitedHealthcare Community & State	$378.41
Rate for Payer: Wellpoint Medicaid Managed Care	$340.09

CATH EKOSONIC MACH 4 50X106CM

Facility

$14,225.00

Service Code	HCPCS C1887
Hospital Charge Code	270637511C
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 50X106CM

Facility

$11,975.00

Service Code	HCPCS C1887
Hospital Charge Code	270637511N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,796.25
Max. Negotiated Rate	$2,897.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,897.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25

CATH EKOSONIC MACH 4 50x135CM

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270649756
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 50x135CM

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270649756
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 50x135CM

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270649756S
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 50x135CM

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270649756S
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 50x135CM

Facility

$13,475.00

Service Code	HCPCS C1751
Hospital Charge Code	270649756N
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 50x135CM

Facility

$13,475.00

Service Code	HCPCS C1751
Hospital Charge Code	270649756N
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 6x106cm

Facility

$14,225.00

Service Code	HCPCS C1887
Hospital Charge Code	270642114C
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 6x106cm

Facility

$14,225.00

Service Code	HCPCS C1887
Hospital Charge Code	270642114C
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 6x106cm

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270642114
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 6x106cm

Facility

$14,225.00

Service Code	HCPCS C1751
Hospital Charge Code	270642114
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 500-55124

Facility

$14,225.00

Service Code	HCPCS C1887
Hospital Charge Code	270639437A
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 500-55124

Facility

$14,225.00

Service Code	HCPCS C1887
Hospital Charge Code	270639437A
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 500-55124

Facility

$14,225.00

Service Code	HCPCS C1887
Hospital Charge Code	270639437C
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 500-55124

Facility

$14,225.00

Service Code	HCPCS C1887
Hospital Charge Code	270639437C
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 EMBOLECT 2FR 120602F

Facility

$440.00

Service Code	HCPCS C1757
Hospital Charge Code	270600382
Hospital Revenue Code	278
Min. Negotiated Rate	$66.00
Max. Negotiated Rate	$106.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.48
Rate for Payer: Qualcare PPO/HMO/WC	$66.00

CATH EMBOLECT 2FR 120602F

Facility

$440.00

Service Code	HCPCS C1757
Hospital Charge Code	270600382
Hospital Revenue Code	278
Min. Negotiated Rate	$12.50
Max. Negotiated Rate	$220.00
Rate for Payer: Aetna Commercial	$167.20
Rate for Payer: Aetna Medicare Advantage	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.20
Rate for Payer: Cigna Commercial	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.48
Rate for Payer: Qualcare PPO/HMO/WC	$66.00
Rate for Payer: UnitedHealthcare Community & State	$13.90
Rate for Payer: Wellpoint Medicaid Managed Care	$12.50

CATH EMBOLECT 3FR 120803F

Facility

$250.00

Service Code	HCPCS C1757
Hospital Charge Code	270600372S
Hospital Revenue Code	278
Min. Negotiated Rate	$7.10
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Community & State	$7.90
Rate for Payer: Wellpoint Medicaid Managed Care	$7.10

CATH EMBOLECT 3FR 120803F

Facility

$250.00

Service Code	HCPCS C1757
Hospital Charge Code	270600372
Hospital Revenue Code	278
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

Know your out-of-pocket cost for care.

All Charges