Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER BALLOON UT/SDS OTW 10

Facility

$857.50

Service Code	HCPCS C1725
Hospital Charge Code	270655037
Hospital Revenue Code	278
Min. Negotiated Rate	$24.35
Max. Negotiated Rate	$428.75
Rate for Payer: Aetna Commercial	$325.85
Rate for Payer: Aetna Medicare Advantage	$257.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.66
Rate for Payer: Cigna Commercial	$428.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.51
Rate for Payer: Qualcare PPO/HMO/WC	$128.62
Rate for Payer: UnitedHealthcare Community & State	$27.10
Rate for Payer: Wellpoint Medicaid Managed Care	$24.35

CATHETER BENCHMARK 105 CM

Facility

$4,975.00

Hospital Charge Code	270685065
Hospital Revenue Code	272
Min. Negotiated Rate	$141.29
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,890.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,293.50
Rate for Payer: Oxford Commercial	$995.00
Rate for Payer: Qualcare PPO/HMO/WC	$746.25
Rate for Payer: UnitedHealthcare Commercial	$995.00
Rate for Payer: UnitedHealthcare Community & State	$157.21
Rate for Payer: Wellpoint Medicaid Managed Care	$141.29

CATHETER BENCHMARK 105 CM

Facility

$4,975.00

Hospital Charge Code	270685065
Hospital Revenue Code	272
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$746.25
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

CATHETER BENCHMARK 6 FRX 95 CM

Facility

$4,775.00

Hospital Charge Code	270685064
Hospital Revenue Code	272
Min. Negotiated Rate	$135.61
Max. Negotiated Rate	$2,387.50
Rate for Payer: Aetna Commercial	$1,814.50
Rate for Payer: Aetna Medicare Advantage	$1,432.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,217.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,217.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,217.62
Rate for Payer: Cigna Commercial	$2,387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,241.50
Rate for Payer: Oxford Commercial	$955.00
Rate for Payer: Qualcare PPO/HMO/WC	$716.25
Rate for Payer: UnitedHealthcare Commercial	$955.00
Rate for Payer: UnitedHealthcare Community & State	$150.89
Rate for Payer: Wellpoint Medicaid Managed Care	$135.61

CATHETER BENCHMARK 6 FRX 95 CM

Facility

$4,775.00

Hospital Charge Code	270685064
Hospital Revenue Code	272
Min. Negotiated Rate	$716.25
Max. Negotiated Rate	$716.25
Rate for Payer: Qualcare PPO/HMO/WC	$716.25

CATHETER BENCHMARK 90X125

Facility

$4,475.00

Hospital Charge Code	270691254
Hospital Revenue Code	272
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$671.25
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

CATHETER BENCHMARK 90X125

Facility

$4,475.00

Hospital Charge Code	270691254
Hospital Revenue Code	272
Min. Negotiated Rate	$127.09
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,700.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,163.50
Rate for Payer: Oxford Commercial	$895.00
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Commercial	$895.00
Rate for Payer: UnitedHealthcare Community & State	$141.41
Rate for Payer: Wellpoint Medicaid Managed Care	$127.09

CATHETER BENCHMARK 95CM

Facility

$4,475.00

Service Code	HCPCS C1887
Hospital Charge Code	270698235S
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

CATHETER BENCHMARK 95CM

Facility

$4,475.00

Service Code	HCPCS C1887
Hospital Charge Code	270698235S
Hospital Revenue Code	278
Min. Negotiated Rate	$127.09
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,700.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Community & State	$141.41
Rate for Payer: Wellpoint Medicaid Managed Care	$127.09

CATHETER BERENSTEIN 5FR 100cm

Facility

$55.82

Service Code	HCPCS C1725
Hospital Charge Code	270651770
Hospital Revenue Code	278
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$27.91
Rate for Payer: Aetna Commercial	$21.21
Rate for Payer: Aetna Medicare Advantage	$16.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.23
Rate for Payer: Cigna Commercial	$27.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.51
Rate for Payer: Qualcare PPO/HMO/WC	$8.37
Rate for Payer: UnitedHealthcare Community & State	$1.76
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

CATHETER BERENSTEIN 5FR 100cm

Facility

$55.82

Service Code	HCPCS C1725
Hospital Charge Code	270651770
Hospital Revenue Code	278
Min. Negotiated Rate	$8.37
Max. Negotiated Rate	$13.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.51
Rate for Payer: Qualcare PPO/HMO/WC	$8.37

CATHETER BERENSTEIN 5Fx40CM

Facility

$90.00

Service Code	HCPCS C1887
Hospital Charge Code	270678517S
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

CATHETER BERENSTEIN 5Fx40CM

Facility

$90.00

Service Code	HCPCS C1887
Hospital Charge Code	270678517
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

CATHETER BERENSTEIN 5Fx40CM

Facility

$90.00

Service Code	HCPCS C1887
Hospital Charge Code	270678517S
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

CATHETER BERENSTEIN 5Fx40CM

Facility

$90.00

Service Code	HCPCS C1887
Hospital Charge Code	270678517
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

CATHETER BERN 5FR 125CM

Facility

$300.00

Service Code	HCPCS C1887
Hospital Charge Code	270700328
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

CATHETER BERN 5FR 125CM

Facility

$300.00

Service Code	HCPCS C1887
Hospital Charge Code	270700328
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

CATHETER BILLARY 10FR

Facility

$399.95

Hospital Charge Code	270651773
Hospital Revenue Code	272
Min. Negotiated Rate	$59.99
Max. Negotiated Rate	$59.99
Rate for Payer: Qualcare PPO/HMO/WC	$59.99

CATHETER BILLARY 10FR

Facility

$399.95

Hospital Charge Code	270651773
Hospital Revenue Code	272
Min. Negotiated Rate	$11.36
Max. Negotiated Rate	$199.97
Rate for Payer: Aetna Commercial	$151.98
Rate for Payer: Aetna Medicare Advantage	$119.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.99
Rate for Payer: Cigna Commercial	$199.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.99
Rate for Payer: Oxford Commercial	$79.99
Rate for Payer: Qualcare PPO/HMO/WC	$59.99
Rate for Payer: UnitedHealthcare Commercial	$79.99
Rate for Payer: UnitedHealthcare Community & State	$12.64
Rate for Payer: Wellpoint Medicaid Managed Care	$11.36

CATHETER BILLARY 8FR

Facility

$399.95

Hospital Charge Code	270654389
Hospital Revenue Code	272
Min. Negotiated Rate	$11.36
Max. Negotiated Rate	$199.97
Rate for Payer: Aetna Commercial	$151.98
Rate for Payer: Aetna Medicare Advantage	$119.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.99
Rate for Payer: Cigna Commercial	$199.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.99
Rate for Payer: Oxford Commercial	$79.99
Rate for Payer: Qualcare PPO/HMO/WC	$59.99
Rate for Payer: UnitedHealthcare Commercial	$79.99
Rate for Payer: UnitedHealthcare Community & State	$12.64
Rate for Payer: Wellpoint Medicaid Managed Care	$11.36

CATHETER BILLARY 8FR

Facility

$399.95

Hospital Charge Code	270654389
Hospital Revenue Code	272
Min. Negotiated Rate	$59.99
Max. Negotiated Rate	$59.99
Rate for Payer: Qualcare PPO/HMO/WC	$59.99

CATHETER BLACKHAWK 14X12X6D-8H

Facility

$20,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704750
Hospital Revenue Code	278
Min. Negotiated Rate	$568.00
Max. Negotiated Rate	$10,000.00
Rate for Payer: Aetna Commercial	$7,600.00
Rate for Payer: Aetna Medicare Advantage	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,100.00
Rate for Payer: Cigna Commercial	$10,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00
Rate for Payer: UnitedHealthcare Community & State	$632.00
Rate for Payer: Wellpoint Medicaid Managed Care	$568.00

CATHETER BLACKHAWK 14X12X6D-8H

Facility

$20,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704750
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

CATHETER BMK70MP 120BER 95CM

Facility

$4,475.00

Service Code	HCPCS C1887
Hospital Charge Code	270690321S
Hospital Revenue Code	272
Min. Negotiated Rate	$127.09
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,700.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,163.50
Rate for Payer: Oxford Commercial	$895.00
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Commercial	$895.00
Rate for Payer: UnitedHealthcare Community & State	$141.41
Rate for Payer: Wellpoint Medicaid Managed Care	$127.09

CATHETER BMK70MP 120BER 95CM

Facility

$4,475.00

Service Code	HCPCS C1887
Hospital Charge Code	270690321S
Hospital Revenue Code	272
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$671.25
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

Know your out-of-pocket cost for care.

All Charges