Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER JL6.0 6FR/100CM/.035

Facility

$37.35

Service Code	HCPCS C1887
Hospital Charge Code	270658052
Hospital Revenue Code	278
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$9.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.04
Rate for Payer: Qualcare PPO/HMO/WC	$5.60

CATHETER JR6.0FR.100CM/.038

Facility

$47.25

Service Code	HCPCS C1887
Hospital Charge Code	270658031
Hospital Revenue Code	278
Min. Negotiated Rate	$1.34
Max. Negotiated Rate	$23.62
Rate for Payer: Aetna Commercial	$17.95
Rate for Payer: Aetna Medicare Advantage	$14.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.05
Rate for Payer: Cigna Commercial	$23.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.43
Rate for Payer: Qualcare PPO/HMO/WC	$7.09
Rate for Payer: UnitedHealthcare Community & State	$1.49
Rate for Payer: Wellpoint Medicaid Managed Care	$1.34

CATHETER JR6.0FR.100CM/.038

Facility

$8.00

Service Code	HCPCS C1887
Hospital Charge Code	270658031N
Hospital Revenue Code	278
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.94
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

CATHETER JR6.0FR.100CM/.038

Facility

$45.25

Service Code	HCPCS C1887
Hospital Charge Code	270658031S
Hospital Revenue Code	278
Min. Negotiated Rate	$6.79
Max. Negotiated Rate	$10.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.95
Rate for Payer: Qualcare PPO/HMO/WC	$6.79

CATHETER JR6.0FR.100CM/.038

Facility

$45.25

Service Code	HCPCS C1887
Hospital Charge Code	270658031S
Hospital Revenue Code	278
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$22.62
Rate for Payer: Aetna Commercial	$17.20
Rate for Payer: Aetna Medicare Advantage	$13.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.54
Rate for Payer: Cigna Commercial	$22.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.95
Rate for Payer: Qualcare PPO/HMO/WC	$6.79
Rate for Payer: UnitedHealthcare Community & State	$1.43
Rate for Payer: Wellpoint Medicaid Managed Care	$1.29

CATHETER JR6.0FR.100CM/.038

Facility

$8.00

Service Code	HCPCS C1887
Hospital Charge Code	270658031N
Hospital Revenue Code	278
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$3.04
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.94
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

CATHETER JR6.0FR.100CM/.038

Facility

$47.25

Service Code	HCPCS C1887
Hospital Charge Code	270658031
Hospital Revenue Code	278
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$11.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.43
Rate for Payer: Qualcare PPO/HMO/WC	$7.09

CATHETER KIT INFANT 5FR

Facility

$8.67

Service Code	HCPCS A4338
Hospital Charge Code	270650094
Hospital Revenue Code	272
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$1.30
Rate for Payer: Qualcare PPO/HMO/WC	$1.30

CATHETER KIT INFANT 5FR

Facility

$8.67

Service Code	HCPCS A4338
Hospital Charge Code	270650094
Hospital Revenue Code	272
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$4.33
Rate for Payer: Aetna Commercial	$3.29
Rate for Payer: Aetna Medicare Advantage	$2.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.21
Rate for Payer: Cigna Commercial	$4.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.25
Rate for Payer: Oxford Commercial	$1.73
Rate for Payer: Qualcare PPO/HMO/WC	$1.30
Rate for Payer: UnitedHealthcare Commercial	$1.73
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.25

CATHETER KIT TENCKHOFF 42CM

Facility

$438.95

Hospital Charge Code	270660019
Hospital Revenue Code	272
Min. Negotiated Rate	$65.84
Max. Negotiated Rate	$65.84
Rate for Payer: Qualcare PPO/HMO/WC	$65.84

CATHETER KIT TENCKHOFF 42CM

Facility

$438.95

Hospital Charge Code	270660019
Hospital Revenue Code	272
Min. Negotiated Rate	$12.47
Max. Negotiated Rate	$219.47
Rate for Payer: Aetna Commercial	$166.80
Rate for Payer: Aetna Medicare Advantage	$131.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.93
Rate for Payer: Cigna Commercial	$219.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.13
Rate for Payer: Oxford Commercial	$87.79
Rate for Payer: Qualcare PPO/HMO/WC	$65.84
Rate for Payer: UnitedHealthcare Commercial	$87.79
Rate for Payer: UnitedHealthcare Community & State	$13.87
Rate for Payer: Wellpoint Medicaid Managed Care	$12.47

CATHETER KIT TESIO

Facility

$1,839.00

Hospital Charge Code	270335306
Hospital Revenue Code	278
Min. Negotiated Rate	$52.23
Max. Negotiated Rate	$919.50
Rate for Payer: Aetna Commercial	$698.82
Rate for Payer: Aetna Medicare Advantage	$551.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$468.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$468.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$367.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$468.94
Rate for Payer: Cigna Commercial	$919.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$445.04
Rate for Payer: Qualcare PPO/HMO/WC	$275.85
Rate for Payer: UnitedHealthcare Community & State	$58.11
Rate for Payer: Wellpoint Medicaid Managed Care	$52.23

CATHETER KIT TESIO

Facility

$1,839.00

Hospital Charge Code	270335306
Hospital Revenue Code	278
Min. Negotiated Rate	$275.85
Max. Negotiated Rate	$445.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$367.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$445.04
Rate for Payer: Qualcare PPO/HMO/WC	$275.85

CATHETER KIT UROFORCE 4MMx6CM

Facility

$813.40

Hospital Charge Code	270682632
Hospital Revenue Code	272
Min. Negotiated Rate	$122.01
Max. Negotiated Rate	$122.01
Rate for Payer: Qualcare PPO/HMO/WC	$122.01

CATHETER KIT UROFORCE 4MMx6CM

Facility

$813.40

Hospital Charge Code	270682632
Hospital Revenue Code	272
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$406.70
Rate for Payer: Aetna Commercial	$309.09
Rate for Payer: Aetna Medicare Advantage	$244.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.42
Rate for Payer: Cigna Commercial	$406.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.48
Rate for Payer: Oxford Commercial	$162.68
Rate for Payer: Qualcare PPO/HMO/WC	$122.01
Rate for Payer: UnitedHealthcare Commercial	$162.68
Rate for Payer: UnitedHealthcare Community & State	$25.70
Rate for Payer: Wellpoint Medicaid Managed Care	$23.10

CATHETER L 160 CM X 2.5 ML PRO

Facility

$2,800.00

Hospital Charge Code	270688445
Hospital Revenue Code	272
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

CATHETER L 160 CM X 2.5 ML PRO

Facility

$2,800.00

Hospital Charge Code	270688445
Hospital Revenue Code	272
Min. Negotiated Rate	$79.52
Max. Negotiated Rate	$1,400.00
Rate for Payer: Aetna Commercial	$1,064.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$728.00
Rate for Payer: Oxford Commercial	$560.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$560.00
Rate for Payer: UnitedHealthcare Community & State	$88.48
Rate for Payer: Wellpoint Medicaid Managed Care	$79.52

CATHETER LEAD PACE 4FR 38MM

Facility

$3,300.00

Service Code	HCPCS C1898
Hospital Charge Code	270699655S
Hospital Revenue Code	278
Min. Negotiated Rate	$93.72
Max. Negotiated Rate	$1,650.00
Rate for Payer: Aetna Commercial	$1,254.00
Rate for Payer: Aetna Medicare Advantage	$990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$841.50
Rate for Payer: Cigna Commercial	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.60
Rate for Payer: Qualcare PPO/HMO/WC	$495.00
Rate for Payer: UnitedHealthcare Community & State	$104.28
Rate for Payer: Wellpoint Medicaid Managed Care	$93.72

CATHETER LEAD PACE 4FR 38MM

Facility

$3,300.00

Service Code	HCPCS C1898
Hospital Charge Code	270699655S
Hospital Revenue Code	278
Min. Negotiated Rate	$495.00
Max. Negotiated Rate	$798.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.60
Rate for Payer: Qualcare PPO/HMO/WC	$495.00

CATHETER LOCKING DRAINAGE 12FR

Facility

$328.00

Hospital Charge Code	270655075R
Hospital Revenue Code	272
Min. Negotiated Rate	$49.20
Max. Negotiated Rate	$49.20
Rate for Payer: Qualcare PPO/HMO/WC	$49.20

CATHETER LOCKING DRAINAGE 12FR

Facility

$346.75

Hospital Charge Code	270655075N
Hospital Revenue Code	272
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$173.38
Rate for Payer: Aetna Commercial	$131.76
Rate for Payer: Aetna Medicare Advantage	$104.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.42
Rate for Payer: Cigna Commercial	$173.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.16
Rate for Payer: Oxford Commercial	$69.35
Rate for Payer: Qualcare PPO/HMO/WC	$52.01
Rate for Payer: UnitedHealthcare Commercial	$69.35
Rate for Payer: UnitedHealthcare Community & State	$10.96
Rate for Payer: Wellpoint Medicaid Managed Care	$9.85

CATHETER LOCKING DRAINAGE 12FR

Facility

$328.00

Hospital Charge Code	270655075S
Hospital Revenue Code	272
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$164.00
Rate for Payer: Aetna Commercial	$124.64
Rate for Payer: Aetna Medicare Advantage	$98.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.64
Rate for Payer: Cigna Commercial	$164.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.28
Rate for Payer: Oxford Commercial	$65.60
Rate for Payer: Qualcare PPO/HMO/WC	$49.20
Rate for Payer: UnitedHealthcare Commercial	$65.60
Rate for Payer: UnitedHealthcare Community & State	$10.36
Rate for Payer: Wellpoint Medicaid Managed Care	$9.32

CATHETER LOCKING DRAINAGE 12FR

Facility

$328.00

Hospital Charge Code	270655075
Hospital Revenue Code	272
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$164.00
Rate for Payer: Aetna Commercial	$124.64
Rate for Payer: Aetna Medicare Advantage	$98.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.64
Rate for Payer: Cigna Commercial	$164.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.28
Rate for Payer: Oxford Commercial	$65.60
Rate for Payer: Qualcare PPO/HMO/WC	$49.20
Rate for Payer: UnitedHealthcare Commercial	$65.60
Rate for Payer: UnitedHealthcare Community & State	$10.36
Rate for Payer: Wellpoint Medicaid Managed Care	$9.32

CATHETER LOCKING DRAINAGE 12FR

Facility

$328.00

Hospital Charge Code	270655075S
Hospital Revenue Code	272
Min. Negotiated Rate	$49.20
Max. Negotiated Rate	$49.20
Rate for Payer: Qualcare PPO/HMO/WC	$49.20

CATHETER LOCKING DRAINAGE 12FR

Facility

$328.00

Hospital Charge Code	270655075
Hospital Revenue Code	272
Min. Negotiated Rate	$49.20
Max. Negotiated Rate	$49.20
Rate for Payer: Qualcare PPO/HMO/WC	$49.20

Know your out-of-pocket cost for care.

All Charges