Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER CRAGG-MCNAMARA

Facility

$500.00

Service Code	HCPCS C1887
Hospital Charge Code	270657463N
Hospital Revenue Code	278
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

CATHETER CRAGG-MCNAMARA

Facility

$800.00

Service Code	HCPCS C1887
Hospital Charge Code	270657466N
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

CATHETER CRAGG-MCNAMARA

Facility

$490.00

Service Code	HCPCS C1887
Hospital Charge Code	270657463
Hospital Revenue Code	278
Min. Negotiated Rate	$13.92
Max. Negotiated Rate	$245.00
Rate for Payer: Aetna Commercial	$186.20
Rate for Payer: Aetna Medicare Advantage	$147.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.95
Rate for Payer: Cigna Commercial	$245.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.58
Rate for Payer: Qualcare PPO/HMO/WC	$73.50
Rate for Payer: UnitedHealthcare Community & State	$15.48
Rate for Payer: Wellpoint Medicaid Managed Care	$13.92

CATHETER CRAGG-MCNAMARA

Facility

$490.00

Service Code	HCPCS C1887
Hospital Charge Code	270657463
Hospital Revenue Code	278
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$118.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.58
Rate for Payer: Qualcare PPO/HMO/WC	$73.50

CATHETER CRAGG-MCNAMARA

Facility

$500.00

Service Code	HCPCS C1887
Hospital Charge Code	270657463N
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

CATHETER CRAGG-MCNAMARA 5FR/13

Facility

$490.00

Service Code	HCPCS C1887
Hospital Charge Code	270657469
Hospital Revenue Code	278
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$118.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.58
Rate for Payer: Qualcare PPO/HMO/WC	$73.50

CATHETER CRAGG-MCNAMARA 5FR/13

Facility

$490.00

Service Code	HCPCS C1887
Hospital Charge Code	270657469
Hospital Revenue Code	278
Min. Negotiated Rate	$13.92
Max. Negotiated Rate	$245.00
Rate for Payer: Aetna Commercial	$186.20
Rate for Payer: Aetna Medicare Advantage	$147.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.95
Rate for Payer: Cigna Commercial	$245.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.58
Rate for Payer: Qualcare PPO/HMO/WC	$73.50
Rate for Payer: UnitedHealthcare Community & State	$15.48
Rate for Payer: Wellpoint Medicaid Managed Care	$13.92

CATHETER CRYO FOCAL ABLATION

Facility

$5,500.00

Service Code	HCPCS C1886
Hospital Charge Code	270679445
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

CATHETER CRYO FOCAL ABLATION

Facility

$5,500.00

Hospital Charge Code	270679455
Hospital Revenue Code	272
Min. Negotiated Rate	$156.20
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,430.00
Rate for Payer: Oxford Commercial	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Commercial	$1,100.00
Rate for Payer: UnitedHealthcare Community & State	$173.80
Rate for Payer: Wellpoint Medicaid Managed Care	$156.20

CATHETER CRYO FOCAL ABLATION

Facility

$5,500.00

Service Code	HCPCS C1886
Hospital Charge Code	270679445
Hospital Revenue Code	278
Min. Negotiated Rate	$156.20
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$173.80
Rate for Payer: Wellpoint Medicaid Managed Care	$156.20

CATHETER CRYO FOCAL ABLATION

Facility

$5,500.00

Hospital Charge Code	270679455
Hospital Revenue Code	272
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

CATHETER CXI SUPPORT 2 6F

Facility

$994.50

Service Code	HCPCS C1887
Hospital Charge Code	270679800
Hospital Revenue Code	278
Min. Negotiated Rate	$28.24
Max. Negotiated Rate	$497.25
Rate for Payer: Aetna Commercial	$377.91
Rate for Payer: Aetna Medicare Advantage	$298.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.60
Rate for Payer: Cigna Commercial	$497.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.67
Rate for Payer: Qualcare PPO/HMO/WC	$149.18
Rate for Payer: UnitedHealthcare Community & State	$31.43
Rate for Payer: Wellpoint Medicaid Managed Care	$28.24

CATHETER CXI SUPPORT 2 6F

Facility

$994.50

Service Code	HCPCS C1887
Hospital Charge Code	270679800
Hospital Revenue Code	278
Min. Negotiated Rate	$149.18
Max. Negotiated Rate	$240.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.67
Rate for Payer: Qualcare PPO/HMO/WC	$149.18

CATHETER CXI SUPPORT 2 6F

Facility

$994.50

Service Code	HCPCS C1887
Hospital Charge Code	270679800S
Hospital Revenue Code	278
Min. Negotiated Rate	$28.24
Max. Negotiated Rate	$497.25
Rate for Payer: Aetna Commercial	$377.91
Rate for Payer: Aetna Medicare Advantage	$298.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.60
Rate for Payer: Cigna Commercial	$497.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.67
Rate for Payer: Qualcare PPO/HMO/WC	$149.18
Rate for Payer: UnitedHealthcare Community & State	$31.43
Rate for Payer: Wellpoint Medicaid Managed Care	$28.24

CATHETER CXI SUPPORT 2 6F

Facility

$994.50

Service Code	HCPCS C1887
Hospital Charge Code	270679800N
Hospital Revenue Code	278
Min. Negotiated Rate	$149.18
Max. Negotiated Rate	$240.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.67
Rate for Payer: Qualcare PPO/HMO/WC	$149.18

CATHETER CXI SUPPORT 2 6F

Facility

$994.50

Service Code	HCPCS C1887
Hospital Charge Code	270679800S
Hospital Revenue Code	278
Min. Negotiated Rate	$149.18
Max. Negotiated Rate	$240.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.67
Rate for Payer: Qualcare PPO/HMO/WC	$149.18

CATHETER CXI SUPPORT 2 6F

Facility

$994.50

Service Code	HCPCS C1887
Hospital Charge Code	270679800N
Hospital Revenue Code	278
Min. Negotiated Rate	$28.24
Max. Negotiated Rate	$497.25
Rate for Payer: Aetna Commercial	$377.91
Rate for Payer: Aetna Medicare Advantage	$298.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.60
Rate for Payer: Cigna Commercial	$497.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.67
Rate for Payer: Qualcare PPO/HMO/WC	$149.18
Rate for Payer: UnitedHealthcare Community & State	$31.43
Rate for Payer: Wellpoint Medicaid Managed Care	$28.24

CATHETER DAV 125 CM

Facility

$625.00

Service Code	HCPCS C1887
Hospital Charge Code	270690858
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 DAV 125 CM

Facility

$625.00

Service Code	HCPCS C1887
Hospital Charge Code	270690858
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 (DAVIS MODEL) 14FR

Facility

$339.00

Hospital Charge Code	270332134
Hospital Revenue Code	272
Min. Negotiated Rate	$50.85
Max. Negotiated Rate	$50.85
Rate for Payer: Qualcare PPO/HMO/WC	$50.85

CATHETER (DAVIS MODEL) 14FR

Facility

$339.00

Hospital Charge Code	270332134
Hospital Revenue Code	272
Min. Negotiated Rate	$9.63
Max. Negotiated Rate	$169.50
Rate for Payer: Aetna Commercial	$128.82
Rate for Payer: Aetna Medicare Advantage	$101.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.44
Rate for Payer: Cigna Commercial	$169.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.14
Rate for Payer: Oxford Commercial	$67.80
Rate for Payer: Qualcare PPO/HMO/WC	$50.85
Rate for Payer: UnitedHealthcare Commercial	$67.80
Rate for Payer: UnitedHealthcare Community & State	$10.71
Rate for Payer: Wellpoint Medicaid Managed Care	$9.63

CATHETER DILUMEN 130 CM EA

Facility

$10,000.00

Hospital Charge Code	270695193
Hospital Revenue Code	272
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

CATHETER DILUMEN 130 CM EA

Facility

$10,000.00

Hospital Charge Code	270695193
Hospital Revenue Code	272
Min. Negotiated Rate	$284.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,600.00
Rate for Payer: Oxford Commercial	$2,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Commercial	$2,000.00
Rate for Payer: UnitedHealthcare Community & State	$316.00
Rate for Payer: Wellpoint Medicaid Managed Care	$284.00

CATHETER DOVERTER FRED X 21

Facility

$86,600.00

Service Code	HCPCS C1876
Hospital Charge Code	270700000S
Hospital Revenue Code	278
Min. Negotiated Rate	$12,990.00
Max. Negotiated Rate	$20,957.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20,957.20
Rate for Payer: Qualcare PPO/HMO/WC	$12,990.00

CATHETER DOVERTER FRED X 21

Facility

$86,600.00

Service Code	HCPCS C1876
Hospital Charge Code	270700000S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,459.44
Max. Negotiated Rate	$43,300.00
Rate for Payer: Aetna Commercial	$32,908.00
Rate for Payer: Aetna Medicare Advantage	$25,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,083.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,083.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,083.00
Rate for Payer: Cigna Commercial	$43,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20,957.20
Rate for Payer: Qualcare PPO/HMO/WC	$12,990.00
Rate for Payer: UnitedHealthcare Community & State	$2,736.56
Rate for Payer: Wellpoint Medicaid Managed Care	$2,459.44

Know your out-of-pocket cost for care.

All Charges