Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER SET 15FRX20CM CANNON

Facility

$3,306.00

Hospital Charge Code	270664095
Hospital Revenue Code	272
Min. Negotiated Rate	$495.90
Max. Negotiated Rate	$495.90
Rate for Payer: Qualcare PPO/HMO/WC	$495.90

CATHETER SET 15FRX20CM CANNON

Facility

$3,306.00

Hospital Charge Code	270664095
Hospital Revenue Code	272
Min. Negotiated Rate	$93.89
Max. Negotiated Rate	$1,653.00
Rate for Payer: Aetna Commercial	$1,256.28
Rate for Payer: Aetna Medicare Advantage	$991.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$843.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$843.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$843.03
Rate for Payer: Cigna Commercial	$1,653.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$859.56
Rate for Payer: Oxford Commercial	$661.20
Rate for Payer: Qualcare PPO/HMO/WC	$495.90
Rate for Payer: UnitedHealthcare Commercial	$661.20
Rate for Payer: UnitedHealthcare Community & State	$104.47
Rate for Payer: Wellpoint Medicaid Managed Care	$93.89

CATHETER SET EVD

Facility

$2,925.00

Hospital Charge Code	270667557
Hospital Revenue Code	278
Min. Negotiated Rate	$438.75
Max. Negotiated Rate	$707.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$707.85
Rate for Payer: Qualcare PPO/HMO/WC	$438.75

CATHETER SET EVD

Facility

$2,925.00

Hospital Charge Code	270667557
Hospital Revenue Code	278
Min. Negotiated Rate	$83.07
Max. Negotiated Rate	$1,462.50
Rate for Payer: Aetna Commercial	$1,111.50
Rate for Payer: Aetna Medicare Advantage	$877.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$745.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$745.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$745.88
Rate for Payer: Cigna Commercial	$1,462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$707.85
Rate for Payer: Qualcare PPO/HMO/WC	$438.75
Rate for Payer: UnitedHealthcare Community & State	$92.43
Rate for Payer: Wellpoint Medicaid Managed Care	$83.07

CATHETER SET SUPRAPUBIC

Facility

$2,287.80

Service Code	HCPCS C2627
Hospital Charge Code	270658452
Hospital Revenue Code	272
Min. Negotiated Rate	$343.17
Max. Negotiated Rate	$343.17
Rate for Payer: Qualcare PPO/HMO/WC	$343.17

CATHETER SET SUPRAPUBIC

Facility

$2,287.80

Service Code	HCPCS C2627
Hospital Charge Code	270658452
Hospital Revenue Code	272
Min. Negotiated Rate	$64.97
Max. Negotiated Rate	$1,143.90
Rate for Payer: Aetna Commercial	$869.36
Rate for Payer: Aetna Medicare Advantage	$686.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$583.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$583.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$583.39
Rate for Payer: Cigna Commercial	$1,143.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.83
Rate for Payer: Oxford Commercial	$457.56
Rate for Payer: Qualcare PPO/HMO/WC	$343.17
Rate for Payer: UnitedHealthcare Commercial	$457.56
Rate for Payer: UnitedHealthcare Community & State	$72.29
Rate for Payer: Wellpoint Medicaid Managed Care	$64.97

CATHETER SHOCKWAVE 3.5X60MM

Facility

$17,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270698156V
Hospital Revenue Code	278
Min. Negotiated Rate	$489.90
Max. Negotiated Rate	$8,625.00
Rate for Payer: Aetna Commercial	$6,555.00
Rate for Payer: Aetna Medicare Advantage	$5,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,398.75
Rate for Payer: Cigna Commercial	$8,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50
Rate for Payer: UnitedHealthcare Community & State	$545.10
Rate for Payer: Wellpoint Medicaid Managed Care	$489.90

CATHETER SHOCKWAVE 3.5X60MM

Facility

$17,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270698156V
Hospital Revenue Code	278
Min. Negotiated Rate	$2,587.50
Max. Negotiated Rate	$4,174.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50

CATHETER SILICONE 8.5 FR X 26

Facility

$630.70

Service Code	HCPCS C2617
Hospital Charge Code	270698594
Hospital Revenue Code	278
Min. Negotiated Rate	$94.61
Max. Negotiated Rate	$152.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.63
Rate for Payer: Qualcare PPO/HMO/WC	$94.61

CATHETER SILICONE 8.5 FR X 26

Facility

$630.70

Service Code	HCPCS C2617
Hospital Charge Code	270698594
Hospital Revenue Code	278
Min. Negotiated Rate	$17.91
Max. Negotiated Rate	$315.35
Rate for Payer: Aetna Commercial	$239.67
Rate for Payer: Aetna Medicare Advantage	$189.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.83
Rate for Payer: Cigna Commercial	$315.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.63
Rate for Payer: Qualcare PPO/HMO/WC	$94.61
Rate for Payer: UnitedHealthcare Community & State	$19.93
Rate for Payer: Wellpoint Medicaid Managed Care	$17.91

CATHETER SILVERHAWK L-SM LG VE

Facility

$15,625.00

Service Code	HCPCS C1714
Hospital Charge Code	270657512
Hospital Revenue Code	278
Min. Negotiated Rate	$2,343.75
Max. Negotiated Rate	$3,781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,781.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,343.75

CATHETER SILVERHAWK L-SM LG VE

Facility

$15,625.00

Service Code	HCPCS C1714
Hospital Charge Code	270657512
Hospital Revenue Code	278
Min. Negotiated Rate	$443.75
Max. Negotiated Rate	$7,812.50
Rate for Payer: Aetna Commercial	$5,937.50
Rate for Payer: Aetna Medicare Advantage	$4,687.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,984.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,984.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,984.38
Rate for Payer: Cigna Commercial	$7,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,781.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,343.75
Rate for Payer: UnitedHealthcare Community & State	$493.75
Rate for Payer: Wellpoint Medicaid Managed Care	$443.75

CATHETER SIM2 RIST 120CM

Facility

$600.00

Service Code	HCPCS C1887
Hospital Charge Code	270696077S
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

CATHETER SIM2 RIST 120CM

Facility

$600.00

Service Code	HCPCS C1887
Hospital Charge Code	270696077S
Hospital Revenue Code	278
Min. Negotiated Rate	$17.04
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$18.96
Rate for Payer: Wellpoint Medicaid Managed Care	$17.04

CATHETER SIM I 5FR

Facility

$27.91

Hospital Charge Code	270651799
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 SIM I 5FR

Facility

$27.91

Hospital Charge Code	270651799
Hospital Revenue Code	272
Min. Negotiated Rate	$4.19
Max. Negotiated Rate	$4.19
Rate for Payer: Qualcare PPO/HMO/WC	$4.19

CATHETER SOLIAIRE PLAT 4X40 MM

Facility

$37,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270685020S
Hospital Revenue Code	278
Min. Negotiated Rate	$5,621.25
Max. Negotiated Rate	$9,068.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,068.95
Rate for Payer: Qualcare PPO/HMO/WC	$5,621.25

CATHETER SOLIAIRE PLAT 4X40 MM

Facility

$37,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270685020S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,064.29
Max. Negotiated Rate	$18,737.50
Rate for Payer: Aetna Commercial	$14,240.50
Rate for Payer: Aetna Medicare Advantage	$11,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,556.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,556.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,556.12
Rate for Payer: Cigna Commercial	$18,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,068.95
Rate for Payer: Qualcare PPO/HMO/WC	$5,621.25
Rate for Payer: UnitedHealthcare Community & State	$1,184.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1,064.29

CATHETER SOLIAIRE PLAT 4X40 MM

Facility

$37,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270685020
Hospital Revenue Code	278
Min. Negotiated Rate	$1,064.29
Max. Negotiated Rate	$18,737.50
Rate for Payer: Aetna Commercial	$14,240.50
Rate for Payer: Aetna Medicare Advantage	$11,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,556.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,556.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,556.12
Rate for Payer: Cigna Commercial	$18,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,068.95
Rate for Payer: Qualcare PPO/HMO/WC	$5,621.25
Rate for Payer: UnitedHealthcare Community & State	$1,184.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1,064.29

CATHETER SOLIAIRE PLAT 4X40 MM

Facility

$37,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270685020
Hospital Revenue Code	278
Min. Negotiated Rate	$5,621.25
Max. Negotiated Rate	$9,068.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,068.95
Rate for Payer: Qualcare PPO/HMO/WC	$5,621.25

CATHETER SOLITAIRE 2 6x30 MM

Facility

$37,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270685021
Hospital Revenue Code	278
Min. Negotiated Rate	$1,064.29
Max. Negotiated Rate	$18,737.50
Rate for Payer: Aetna Commercial	$14,240.50
Rate for Payer: Aetna Medicare Advantage	$11,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,556.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,556.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,556.12
Rate for Payer: Cigna Commercial	$18,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,068.95
Rate for Payer: Qualcare PPO/HMO/WC	$5,621.25
Rate for Payer: UnitedHealthcare Community & State	$1,184.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1,064.29

CATHETER SOLITAIRE 2 6x30 MM

Facility

$37,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270685021
Hospital Revenue Code	278
Min. Negotiated Rate	$5,621.25
Max. Negotiated Rate	$9,068.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,068.95
Rate for Payer: Qualcare PPO/HMO/WC	$5,621.25

CATHETER SOLITAIRE 3 4MMX20CM

Facility

$40,775.00

Service Code	HCPCS C1757
Hospital Charge Code	270685144
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.01
Max. Negotiated Rate	$20,387.50
Rate for Payer: Aetna Commercial	$15,494.50
Rate for Payer: Aetna Medicare Advantage	$12,232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,397.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,397.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,155.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,397.62
Rate for Payer: Cigna Commercial	$20,387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,867.55
Rate for Payer: Qualcare PPO/HMO/WC	$6,116.25
Rate for Payer: UnitedHealthcare Community & State	$1,288.49
Rate for Payer: Wellpoint Medicaid Managed Care	$1,158.01

CATHETER SOLITAIRE 3 4MMX20CM

Facility

$40,775.00

Service Code	HCPCS C1757
Hospital Charge Code	270685144
Hospital Revenue Code	278
Min. Negotiated Rate	$6,116.25
Max. Negotiated Rate	$9,867.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,867.55
Rate for Payer: Qualcare PPO/HMO/WC	$6,116.25

CATHETER SOLITAIRE 3 6MMX40CM

Facility

$40,775.00

Service Code	HCPCS C1757
Hospital Charge Code	270685145
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.01
Max. Negotiated Rate	$20,387.50
Rate for Payer: Aetna Commercial	$15,494.50
Rate for Payer: Aetna Medicare Advantage	$12,232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,397.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,397.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,155.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,397.62
Rate for Payer: Cigna Commercial	$20,387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,867.55
Rate for Payer: Qualcare PPO/HMO/WC	$6,116.25
Rate for Payer: UnitedHealthcare Community & State	$1,288.49
Rate for Payer: Wellpoint Medicaid Managed Care	$1,158.01

Know your out-of-pocket cost for care.

All Charges