Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER 130CM 5F SIMMON

Facility

$625.00

Service Code	HCPCS C1725
Hospital Charge Code	270695066S
Hospital Revenue Code	278
Min. Negotiated Rate	$17.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

CATHETER 130CM 5F SIMMON

Facility

$625.00

Service Code	HCPCS C1725
Hospital Charge Code	270695066S
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

CATHETER 130 CM TO CAT 7

Facility

$38,600.00

Hospital Charge Code	270700669
Hospital Revenue Code	272
Min. Negotiated Rate	$5,790.00
Max. Negotiated Rate	$5,790.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,790.00

CATHETER 130 CM TO CAT 7

Facility

$38,600.00

Hospital Charge Code	270700669
Hospital Revenue Code	272
Min. Negotiated Rate	$1,096.24
Max. Negotiated Rate	$19,300.00
Rate for Payer: Aetna Commercial	$14,668.00
Rate for Payer: Aetna Medicare Advantage	$11,580.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,843.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,843.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,843.00
Rate for Payer: Cigna Commercial	$19,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,036.00
Rate for Payer: Oxford Commercial	$7,720.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,790.00
Rate for Payer: UnitedHealthcare Commercial	$7,720.00
Rate for Payer: UnitedHealthcare Community & State	$1,219.76
Rate for Payer: Wellpoint Medicaid Managed Care	$1,096.24

CATHETER 14FR CLOSED TRACH

Facility

$35.00

Hospital Charge Code	270689128
Hospital Revenue Code	272
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$17.50
Rate for Payer: Aetna Commercial	$13.30
Rate for Payer: Aetna Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.93
Rate for Payer: Cigna Commercial	$17.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.10
Rate for Payer: Oxford Commercial	$7.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.25
Rate for Payer: UnitedHealthcare Commercial	$7.00
Rate for Payer: UnitedHealthcare Community & State	$1.11
Rate for Payer: Wellpoint Medicaid Managed Care	$0.99

CATHETER 14FR CLOSED TRACH

Facility

$35.00

Hospital Charge Code	270689128
Hospital Revenue Code	272
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

CATHETER 16FR 20 IN 4 EYE

Facility

$33.60

Hospital Charge Code	270697328
Hospital Revenue Code	272
Min. Negotiated Rate	$5.04
Max. Negotiated Rate	$5.04
Rate for Payer: Qualcare PPO/HMO/WC	$5.04

CATHETER 16FR 20 IN 4 EYE

Facility

$33.60

Hospital Charge Code	270697328
Hospital Revenue Code	272
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$16.80
Rate for Payer: Aetna Commercial	$12.77
Rate for Payer: Aetna Medicare Advantage	$10.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.57
Rate for Payer: Cigna Commercial	$16.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.74
Rate for Payer: Oxford Commercial	$6.72
Rate for Payer: Qualcare PPO/HMO/WC	$5.04
Rate for Payer: UnitedHealthcare Commercial	$6.72
Rate for Payer: UnitedHealthcare Community & State	$1.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.95

CATHETER 20FR 5CC 3WAY FOLEY

Facility

$191.00

Hospital Charge Code	270331252
Hospital Revenue Code	272
Min. Negotiated Rate	$28.65
Max. Negotiated Rate	$28.65
Rate for Payer: Qualcare PPO/HMO/WC	$28.65

CATHETER 20FR 5CC 3WAY FOLEY

Facility

$191.00

Hospital Charge Code	270331252
Hospital Revenue Code	272
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$95.50
Rate for Payer: Aetna Commercial	$72.58
Rate for Payer: Aetna Medicare Advantage	$57.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.70
Rate for Payer: Cigna Commercial	$95.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.66
Rate for Payer: Oxford Commercial	$38.20
Rate for Payer: Qualcare PPO/HMO/WC	$28.65
Rate for Payer: UnitedHealthcare Commercial	$38.20
Rate for Payer: UnitedHealthcare Community & State	$6.04
Rate for Payer: Wellpoint Medicaid Managed Care	$5.42

CATHETER 26FR 30CC/ML RIBBED

Facility

$60.60

Hospital Charge Code	270664341
Hospital Revenue Code	272
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$30.30
Rate for Payer: Aetna Commercial	$23.03
Rate for Payer: Aetna Medicare Advantage	$18.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.45
Rate for Payer: Cigna Commercial	$30.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.76
Rate for Payer: Oxford Commercial	$12.12
Rate for Payer: Qualcare PPO/HMO/WC	$9.09
Rate for Payer: UnitedHealthcare Commercial	$12.12
Rate for Payer: UnitedHealthcare Community & State	$1.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1.72

CATHETER 26FR 30CC/ML RIBBED

Facility

$60.60

Hospital Charge Code	270664341
Hospital Revenue Code	272
Min. Negotiated Rate	$9.09
Max. Negotiated Rate	$9.09
Rate for Payer: Qualcare PPO/HMO/WC	$9.09

CATHETER 26FR 5CC/ML RIBBED

Facility

$55.95

Hospital Charge Code	270664342
Hospital Revenue Code	272
Min. Negotiated Rate	$8.39
Max. Negotiated Rate	$8.39
Rate for Payer: Qualcare PPO/HMO/WC	$8.39

CATHETER 26FR 5CC/ML RIBBED

Facility

$55.95

Hospital Charge Code	270664342
Hospital Revenue Code	272
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$27.98
Rate for Payer: Aetna Commercial	$21.26
Rate for Payer: Aetna Medicare Advantage	$16.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.27
Rate for Payer: Cigna Commercial	$27.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.55
Rate for Payer: Oxford Commercial	$11.19
Rate for Payer: Qualcare PPO/HMO/WC	$8.39
Rate for Payer: UnitedHealthcare Commercial	$11.19
Rate for Payer: UnitedHealthcare Community & State	$1.77
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

CATHETER 3 MAX W TUBE

Facility

$8,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270682967N
Hospital Revenue Code	278
Min. Negotiated Rate	$248.50
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$276.50
Rate for Payer: Wellpoint Medicaid Managed Care	$248.50

CATHETER 3 MAX W TUBE

Facility

$8,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270682967N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

CATHETER 3 MAX W TUBE

Facility

$8,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270682967
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

CATHETER 3 MAX W TUBE

Facility

$8,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270682967
Hospital Revenue Code	278
Min. Negotiated Rate	$248.50
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$276.50
Rate for Payer: Wellpoint Medicaid Managed Care	$248.50

CATHETER 3-WAY CONTINUOUS

Facility

$63.00

Hospital Charge Code	270331097
Hospital Revenue Code	272
Min. Negotiated Rate	$9.45
Max. Negotiated Rate	$9.45
Rate for Payer: Qualcare PPO/HMO/WC	$9.45

CATHETER 3-WAY CONTINUOUS

Facility

$63.00

Hospital Charge Code	270331097
Hospital Revenue Code	272
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna Commercial	$23.94
Rate for Payer: Aetna Medicare Advantage	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.07
Rate for Payer: Cigna Commercial	$31.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.38
Rate for Payer: Oxford Commercial	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.45
Rate for Payer: UnitedHealthcare Commercial	$12.60
Rate for Payer: UnitedHealthcare Community & State	$1.99
Rate for Payer: Wellpoint Medicaid Managed Care	$1.79

CATHETER 4 MAX W TUBE

Facility

$8,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270682966
Hospital Revenue Code	278
Min. Negotiated Rate	$248.50
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$276.50
Rate for Payer: Wellpoint Medicaid Managed Care	$248.50

CATHETER 4 MAX W TUBE

Facility

$8,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270682966
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

CATHETER 5F AL1

Facility

$40.00

Hospital Charge Code	270658170N
Hospital Revenue Code	270
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CATHETER 5F AL1

Facility

$37.35

Hospital Charge Code	270658170S
Hospital Revenue Code	270
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$18.68
Rate for Payer: Aetna Commercial	$14.19
Rate for Payer: Aetna Medicare Advantage	$11.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.52
Rate for Payer: Cigna Commercial	$18.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.71
Rate for Payer: Oxford Commercial	$7.47
Rate for Payer: Qualcare PPO/HMO/WC	$5.60
Rate for Payer: UnitedHealthcare Commercial	$7.47
Rate for Payer: UnitedHealthcare Community & State	$1.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

CATHETER 5F AL1

Facility

$40.00

Hospital Charge Code	270658170N
Hospital Revenue Code	270
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.40
Rate for Payer: Oxford Commercial	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$8.00
Rate for Payer: UnitedHealthcare Community & State	$1.26
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

Know your out-of-pocket cost for care.

All Charges