Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER PHENOM PLUS 120 CM

Facility

$9,250.00

Service Code	HCPCS C1887
Hospital Charge Code	270685196
Hospital Revenue Code	278
Min. Negotiated Rate	$1,387.50
Max. Negotiated Rate	$2,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50

CATHETER PHENOM PLUS 120 CM

Facility

$9,250.00

Service Code	HCPCS C1887
Hospital Charge Code	270685196
Hospital Revenue Code	278
Min. Negotiated Rate	$262.70
Max. Negotiated Rate	$4,625.00
Rate for Payer: Aetna Commercial	$3,515.00
Rate for Payer: Aetna Medicare Advantage	$2,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,358.75
Rate for Payer: Cigna Commercial	$4,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50
Rate for Payer: UnitedHealthcare Community & State	$292.30
Rate for Payer: Wellpoint Medicaid Managed Care	$262.70

CATHETER PHENOM PLUS 120 CM

Facility

$9,250.00

Service Code	HCPCS C1887
Hospital Charge Code	270685196S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,387.50
Max. Negotiated Rate	$2,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50

CATHETER PHENOM PLUS 120 CM

Facility

$9,250.00

Service Code	HCPCS C1887
Hospital Charge Code	270685196S
Hospital Revenue Code	278
Min. Negotiated Rate	$262.70
Max. Negotiated Rate	$4,625.00
Rate for Payer: Aetna Commercial	$3,515.00
Rate for Payer: Aetna Medicare Advantage	$2,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,358.75
Rate for Payer: Cigna Commercial	$4,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50
Rate for Payer: UnitedHealthcare Community & State	$292.30
Rate for Payer: Wellpoint Medicaid Managed Care	$262.70

CATHETER PIGTAIL 10FR NEPHRO

Facility

$830.00

Service Code	HCPCS C1729
Hospital Charge Code	270680007
Hospital Revenue Code	278
Min. Negotiated Rate	$23.57
Max. Negotiated Rate	$415.00
Rate for Payer: Aetna Commercial	$315.40
Rate for Payer: Aetna Medicare Advantage	$249.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.65
Rate for Payer: Cigna Commercial	$415.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.86
Rate for Payer: Qualcare PPO/HMO/WC	$124.50
Rate for Payer: UnitedHealthcare Community & State	$26.23
Rate for Payer: Wellpoint Medicaid Managed Care	$23.57

CATHETER PIGTAIL 10FR NEPHRO

Facility

$830.00

Service Code	HCPCS C1729
Hospital Charge Code	270680007
Hospital Revenue Code	278
Min. Negotiated Rate	$124.50
Max. Negotiated Rate	$200.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.86
Rate for Payer: Qualcare PPO/HMO/WC	$124.50

CATHETER PIG TAIL 5FR 65CM

Facility

$27.91

Hospital Charge Code	270669872
Hospital Revenue Code	272
Min. Negotiated Rate	$4.19
Max. Negotiated Rate	$4.19
Rate for Payer: Qualcare PPO/HMO/WC	$4.19

CATHETER PIG TAIL 5FR 65CM

Facility

$27.91

Hospital Charge Code	270669872
Hospital Revenue Code	272
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$13.96
Rate for Payer: Aetna Commercial	$10.61
Rate for Payer: Aetna Medicare Advantage	$8.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.12
Rate for Payer: Cigna Commercial	$13.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.26
Rate for Payer: Oxford Commercial	$5.58
Rate for Payer: Qualcare PPO/HMO/WC	$4.19
Rate for Payer: UnitedHealthcare Commercial	$5.58
Rate for Payer: UnitedHealthcare Community & State	$0.88
Rate for Payer: Wellpoint Medicaid Managed Care	$0.79

CATHETER PIGTAIL 8FR NEPHRO

Facility

$830.00

Service Code	HCPCS C1729
Hospital Charge Code	270680006
Hospital Revenue Code	278
Min. Negotiated Rate	$124.50
Max. Negotiated Rate	$200.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.86
Rate for Payer: Qualcare PPO/HMO/WC	$124.50

CATHETER PIGTAIL 8FR NEPHRO

Facility

$830.00

Service Code	HCPCS C1729
Hospital Charge Code	270680006
Hospital Revenue Code	278
Min. Negotiated Rate	$23.57
Max. Negotiated Rate	$415.00
Rate for Payer: Aetna Commercial	$315.40
Rate for Payer: Aetna Medicare Advantage	$249.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.65
Rate for Payer: Cigna Commercial	$415.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.86
Rate for Payer: Qualcare PPO/HMO/WC	$124.50
Rate for Payer: UnitedHealthcare Community & State	$26.23
Rate for Payer: Wellpoint Medicaid Managed Care	$23.57

CATHETER POWER PICC 135CM 5FR

Facility

$635.00

Hospital Charge Code	270671561
Hospital Revenue Code	278
Min. Negotiated Rate	$18.03
Max. Negotiated Rate	$317.50
Rate for Payer: Aetna Commercial	$241.30
Rate for Payer: Aetna Medicare Advantage	$190.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$127.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.93
Rate for Payer: Cigna Commercial	$317.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.67
Rate for Payer: Qualcare PPO/HMO/WC	$95.25
Rate for Payer: UnitedHealthcare Community & State	$20.07
Rate for Payer: Wellpoint Medicaid Managed Care	$18.03

CATHETER POWER PICC 135CM 5FR

Facility

$635.00

Hospital Charge Code	270671561
Hospital Revenue Code	278
Min. Negotiated Rate	$95.25
Max. Negotiated Rate	$153.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$127.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.67
Rate for Payer: Qualcare PPO/HMO/WC	$95.25

CATHETER POWER PICC SOLO 5FR

Facility

$1,391.00

Service Code	HCPCS C1751
Hospital Charge Code	270682901
Hospital Revenue Code	278
Min. Negotiated Rate	$39.50
Max. Negotiated Rate	$695.50
Rate for Payer: Aetna Commercial	$528.58
Rate for Payer: Aetna Medicare Advantage	$417.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$354.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$354.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$278.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$354.70
Rate for Payer: Cigna Commercial	$695.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$336.62
Rate for Payer: Qualcare PPO/HMO/WC	$208.65
Rate for Payer: UnitedHealthcare Community & State	$43.96
Rate for Payer: Wellpoint Medicaid Managed Care	$39.50

CATHETER POWER PICC SOLO 5FR

Facility

$4,173.00

Service Code	HCPCS C1751
Hospital Charge Code	270682901N
Hospital Revenue Code	278
Min. Negotiated Rate	$625.95
Max. Negotiated Rate	$1,009.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$834.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,009.87
Rate for Payer: Qualcare PPO/HMO/WC	$625.95

CATHETER POWER PICC SOLO 5FR

Facility

$4,173.00

Service Code	HCPCS C1751
Hospital Charge Code	270682901N
Hospital Revenue Code	278
Min. Negotiated Rate	$118.51
Max. Negotiated Rate	$2,086.50
Rate for Payer: Aetna Commercial	$1,585.74
Rate for Payer: Aetna Medicare Advantage	$1,251.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,064.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,064.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$834.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,064.12
Rate for Payer: Cigna Commercial	$2,086.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,009.87
Rate for Payer: Qualcare PPO/HMO/WC	$625.95
Rate for Payer: UnitedHealthcare Community & State	$131.87
Rate for Payer: Wellpoint Medicaid Managed Care	$118.51

CATHETER POWER PICC SOLO 5FR

Facility

$1,391.00

Service Code	HCPCS C1751
Hospital Charge Code	270682901
Hospital Revenue Code	278
Min. Negotiated Rate	$208.65
Max. Negotiated Rate	$336.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$278.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$336.62
Rate for Payer: Qualcare PPO/HMO/WC	$208.65

CATHETER PRECISE 5X30MM

Facility

$10,565.00

Service Code	HCPCS C1876
Hospital Charge Code	270696950S
Hospital Revenue Code	278
Min. Negotiated Rate	$300.05
Max. Negotiated Rate	$5,282.50
Rate for Payer: Aetna Commercial	$4,014.70
Rate for Payer: Aetna Medicare Advantage	$3,169.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,694.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,694.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,113.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,694.07
Rate for Payer: Cigna Commercial	$5,282.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,556.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,584.75
Rate for Payer: UnitedHealthcare Community & State	$333.85
Rate for Payer: Wellpoint Medicaid Managed Care	$300.05

CATHETER PRECISE 5X30MM

Facility

$10,565.00

Service Code	HCPCS C1876
Hospital Charge Code	270696950S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,584.75
Max. Negotiated Rate	$2,556.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,113.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,556.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,584.75

CATHETER PRECISE PRO 5X40MM

Facility

$10,565.00

Service Code	HCPCS C1876
Hospital Charge Code	270696951S
Hospital Revenue Code	278
Min. Negotiated Rate	$300.05
Max. Negotiated Rate	$5,282.50
Rate for Payer: Aetna Commercial	$4,014.70
Rate for Payer: Aetna Medicare Advantage	$3,169.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,694.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,694.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,113.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,694.07
Rate for Payer: Cigna Commercial	$5,282.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,556.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,584.75
Rate for Payer: UnitedHealthcare Community & State	$333.85
Rate for Payer: Wellpoint Medicaid Managed Care	$300.05

CATHETER PRECISE PRO 5X40MM

Facility

$10,565.00

Service Code	HCPCS C1876
Hospital Charge Code	270696951S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,584.75
Max. Negotiated Rate	$2,556.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,113.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,556.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,584.75

CATHETER PROGREAT COAXIAL

Facility

$2,800.00

Hospital Charge Code	270658289S
Hospital Revenue Code	272
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

CATHETER PROGREAT COAXIAL

Facility

$2,968.00

Hospital Charge Code	270658289N
Hospital Revenue Code	272
Min. Negotiated Rate	$84.29
Max. Negotiated Rate	$1,484.00
Rate for Payer: Aetna Commercial	$1,127.84
Rate for Payer: Aetna Medicare Advantage	$890.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$756.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$756.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$756.84
Rate for Payer: Cigna Commercial	$1,484.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$771.68
Rate for Payer: Oxford Commercial	$593.60
Rate for Payer: Qualcare PPO/HMO/WC	$445.20
Rate for Payer: UnitedHealthcare Commercial	$593.60
Rate for Payer: UnitedHealthcare Community & State	$93.79
Rate for Payer: Wellpoint Medicaid Managed Care	$84.29

CATHETER PROGREAT COAXIAL

Facility

$2,968.00

Hospital Charge Code	270658289O
Hospital Revenue Code	272
Min. Negotiated Rate	$84.29
Max. Negotiated Rate	$1,484.00
Rate for Payer: Aetna Commercial	$1,127.84
Rate for Payer: Aetna Medicare Advantage	$890.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$756.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$756.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$756.84
Rate for Payer: Cigna Commercial	$1,484.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$771.68
Rate for Payer: Oxford Commercial	$593.60
Rate for Payer: Qualcare PPO/HMO/WC	$445.20
Rate for Payer: UnitedHealthcare Commercial	$593.60
Rate for Payer: UnitedHealthcare Community & State	$93.79
Rate for Payer: Wellpoint Medicaid Managed Care	$84.29

CATHETER PROGREAT COAXIAL

Facility

$2,968.00

Hospital Charge Code	270658289N
Hospital Revenue Code	272
Min. Negotiated Rate	$445.20
Max. Negotiated Rate	$445.20
Rate for Payer: Qualcare PPO/HMO/WC	$445.20

CATHETER PROGREAT COAXIAL

Facility

$2,968.00

Hospital Charge Code	270658289O
Hospital Revenue Code	272
Min. Negotiated Rate	$445.20
Max. Negotiated Rate	$445.20
Rate for Payer: Qualcare PPO/HMO/WC	$445.20

Know your out-of-pocket cost for care.

All Charges