Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER PEAR SHAPED

Facility

$8,250.00

Service Code	HCPCS C1886
Hospital Charge Code	270682728
Hospital Revenue Code	278
Min. Negotiated Rate	$234.30
Max. Negotiated Rate	$4,125.00
Rate for Payer: Aetna Commercial	$3,135.00
Rate for Payer: Aetna Medicare Advantage	$2,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,103.75
Rate for Payer: Cigna Commercial	$4,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50
Rate for Payer: UnitedHealthcare Community & State	$260.70
Rate for Payer: Wellpoint Medicaid Managed Care	$234.30

CATHETER PERF 6F 610038ULT1

Facility

$113.75

Service Code	HCPCS C1725
Hospital Charge Code	270667499
Hospital Revenue Code	278
Min. Negotiated Rate	$17.06
Max. Negotiated Rate	$27.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.53
Rate for Payer: Qualcare PPO/HMO/WC	$17.06

CATHETER PERF 6F 610038ULT1

Facility

$113.75

Service Code	HCPCS C1725
Hospital Charge Code	270667499
Hospital Revenue Code	278
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$56.88
Rate for Payer: Aetna Commercial	$43.23
Rate for Payer: Aetna Medicare Advantage	$34.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.01
Rate for Payer: Cigna Commercial	$56.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.53
Rate for Payer: Qualcare PPO/HMO/WC	$17.06
Rate for Payer: UnitedHealthcare Community & State	$3.59
Rate for Payer: Wellpoint Medicaid Managed Care	$3.23

CATHETER PERFORMA 145 DEGREE C

Facility

$40.00

Service Code	HCPCS C1729
Hospital Charge Code	270658203
Hospital Revenue Code	278
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$9.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.68
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CATHETER PERFORMA 145 DEGREE C

Facility

$40.00

Service Code	HCPCS C1729
Hospital Charge Code	270658203
Hospital Revenue Code	278
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) NJ Health	$8.00
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	$9.68
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Community & State	$1.26
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

CATHETER PERFORMA 5 F 65 CM

Facility

$135.60

Hospital Charge Code	270690529
Hospital Revenue Code	272
Min. Negotiated Rate	$3.85
Max. Negotiated Rate	$67.80
Rate for Payer: Aetna Commercial	$51.53
Rate for Payer: Aetna Medicare Advantage	$40.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.58
Rate for Payer: Cigna Commercial	$67.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.26
Rate for Payer: Oxford Commercial	$27.12
Rate for Payer: Qualcare PPO/HMO/WC	$20.34
Rate for Payer: UnitedHealthcare Commercial	$27.12
Rate for Payer: UnitedHealthcare Community & State	$4.28
Rate for Payer: Wellpoint Medicaid Managed Care	$3.85

CATHETER PERFORMA 5 F 65 CM

Facility

$135.60

Hospital Charge Code	270690529
Hospital Revenue Code	272
Min. Negotiated Rate	$20.34
Max. Negotiated Rate	$20.34
Rate for Payer: Qualcare PPO/HMO/WC	$20.34

CATHETER PERFORMA JUDKINS LEFT

Facility

$37.35

Service Code	HCPCS C1887
Hospital Charge Code	270658176
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 PERFORMA JUDKINS LEFT

Facility

$37.35

Service Code	HCPCS C1887
Hospital Charge Code	270658176
Hospital Revenue Code	278
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) NJ Health	$7.47
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	$9.04
Rate for Payer: Qualcare PPO/HMO/WC	$5.60
Rate for Payer: UnitedHealthcare Community & State	$1.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

CATHETER PERFORMA JUDKINS RIGH

Facility

$40.00

Service Code	HCPCS C1887
Hospital Charge Code	270658179
Hospital Revenue Code	278
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$9.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.68
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CATHETER PERFORMA JUDKINS RIGH

Facility

$40.00

Service Code	HCPCS C1887
Hospital Charge Code	270658179
Hospital Revenue Code	278
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) NJ Health	$8.00
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	$9.68
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Community & State	$1.26
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

CATHETER PERFORMA ULTIMATE

Facility

$77.25

Service Code	HCPCS C1887
Hospital Charge Code	270657625
Hospital Revenue Code	278
Min. Negotiated Rate	$11.59
Max. Negotiated Rate	$18.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.69
Rate for Payer: Qualcare PPO/HMO/WC	$11.59

CATHETER PERFORMA ULTIMATE

Facility

$77.25

Service Code	HCPCS C1887
Hospital Charge Code	270657626
Hospital Revenue Code	278
Min. Negotiated Rate	$11.59
Max. Negotiated Rate	$18.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.69
Rate for Payer: Qualcare PPO/HMO/WC	$11.59

CATHETER PERFORMA ULTIMATE

Facility

$77.25

Service Code	HCPCS C1887
Hospital Charge Code	270657626
Hospital Revenue Code	278
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$38.62
Rate for Payer: Aetna Commercial	$29.36
Rate for Payer: Aetna Medicare Advantage	$23.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.70
Rate for Payer: Cigna Commercial	$38.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.69
Rate for Payer: Qualcare PPO/HMO/WC	$11.59
Rate for Payer: UnitedHealthcare Community & State	$2.44
Rate for Payer: Wellpoint Medicaid Managed Care	$2.19

CATHETER PERFORMA ULTIMATE

Facility

$77.25

Service Code	HCPCS C1887
Hospital Charge Code	270657625
Hospital Revenue Code	278
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$38.62
Rate for Payer: Aetna Commercial	$29.36
Rate for Payer: Aetna Medicare Advantage	$23.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.70
Rate for Payer: Cigna Commercial	$38.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.69
Rate for Payer: Qualcare PPO/HMO/WC	$11.59
Rate for Payer: UnitedHealthcare Community & State	$2.44
Rate for Payer: Wellpoint Medicaid Managed Care	$2.19

CATHETER PERITONEAL BARDPORT

Facility

$4,115.00

Service Code	HCPCS C1752
Hospital Charge Code	270660589
Hospital Revenue Code	278
Min. Negotiated Rate	$116.87
Max. Negotiated Rate	$2,057.50
Rate for Payer: Aetna Commercial	$1,563.70
Rate for Payer: Aetna Medicare Advantage	$1,234.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,049.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,049.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$823.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,049.33
Rate for Payer: Cigna Commercial	$2,057.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$995.83
Rate for Payer: Qualcare PPO/HMO/WC	$617.25
Rate for Payer: UnitedHealthcare Community & State	$130.03
Rate for Payer: Wellpoint Medicaid Managed Care	$116.87

CATHETER PERITONEAL BARDPORT

Facility

$4,115.00

Service Code	HCPCS C1752
Hospital Charge Code	270660589
Hospital Revenue Code	278
Min. Negotiated Rate	$617.25
Max. Negotiated Rate	$995.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$823.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$995.83
Rate for Payer: Qualcare PPO/HMO/WC	$617.25

CATHETER PERITONEAL W/SLITS

Facility

$880.00

Service Code	HCPCS C1752
Hospital Charge Code	270628769
Hospital Revenue Code	278
Min. Negotiated Rate	$132.00
Max. Negotiated Rate	$212.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.96
Rate for Payer: Qualcare PPO/HMO/WC	$132.00

CATHETER PERITONEAL W/SLITS

Facility

$880.00

Service Code	HCPCS C1752
Hospital Charge Code	270628769
Hospital Revenue Code	278
Min. Negotiated Rate	$24.99
Max. Negotiated Rate	$440.00
Rate for Payer: Aetna Commercial	$334.40
Rate for Payer: Aetna Medicare Advantage	$264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.40
Rate for Payer: Cigna Commercial	$440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.96
Rate for Payer: Qualcare PPO/HMO/WC	$132.00
Rate for Payer: UnitedHealthcare Community & State	$27.81
Rate for Payer: Wellpoint Medicaid Managed Care	$24.99

CATHETER PERITONEL IMPLANT

Facility

$880.00

Service Code	HCPCS C1729
Hospital Charge Code	270659526
Hospital Revenue Code	278
Min. Negotiated Rate	$132.00
Max. Negotiated Rate	$212.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.96
Rate for Payer: Qualcare PPO/HMO/WC	$132.00

CATHETER PERITONEL IMPLANT

Facility

$880.00

Service Code	HCPCS C1729
Hospital Charge Code	270659526
Hospital Revenue Code	278
Min. Negotiated Rate	$24.99
Max. Negotiated Rate	$440.00
Rate for Payer: Aetna Commercial	$334.40
Rate for Payer: Aetna Medicare Advantage	$264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.40
Rate for Payer: Cigna Commercial	$440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.96
Rate for Payer: Qualcare PPO/HMO/WC	$132.00
Rate for Payer: UnitedHealthcare Community & State	$27.81
Rate for Payer: Wellpoint Medicaid Managed Care	$24.99

CATHETER PHEMON 27 150 CM

Facility

$6,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685148
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$1,573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

CATHETER PHEMON 27 150 CM

Facility

$6,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685148S
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$1,573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

CATHETER PHEMON 27 150 CM

Facility

$6,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685148
Hospital Revenue Code	278
Min. Negotiated Rate	$184.60
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$2,470.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00
Rate for Payer: UnitedHealthcare Community & State	$205.40
Rate for Payer: Wellpoint Medicaid Managed Care	$184.60

CATHETER PHEMON 27 150 CM

Facility

$6,500.00

Service Code	HCPCS C1887
Hospital Charge Code	270685148S
Hospital Revenue Code	278
Min. Negotiated Rate	$184.60
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$2,470.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00
Rate for Payer: UnitedHealthcare Community & State	$205.40
Rate for Payer: Wellpoint Medicaid Managed Care	$184.60

Know your out-of-pocket cost for care.

All Charges