Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER SOLITAIRE 3 6MMX40CM

Facility

$40,775.00

Service Code	HCPCS C1757
Hospital Charge Code	270685145S
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

CATHETER SOLITAIRE 3 6MMX40CM

Facility

$40,775.00

Service Code	HCPCS C1757
Hospital Charge Code	270685145
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 sos omni (3)5fr80 cm

Facility

$90.00

Service Code	HCPCS C1887
Hospital Charge Code	270623892
Hospital Revenue Code	278
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$21.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.78
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

Catheter sos omni (3)5fr80 cm

Facility

$90.00

Service Code	HCPCS C1887
Hospital Charge Code	270623892
Hospital Revenue Code	278
Min. Negotiated Rate	$2.56
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.78
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Community & State	$2.84
Rate for Payer: Wellpoint Medicaid Managed Care	$2.56

CATHETER SPRINTER 3.25x12MM

Facility

$625.00

Service Code	HCPCS C1725
Hospital Charge Code	270684712
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

CATHETER SPRINTER 3.25x12MM

Facility

$625.00

Service Code	HCPCS C1725
Hospital Charge Code	270684712
Hospital Revenue Code	272
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) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$125.00
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

CATHETER SPRINTER 3.25x15MM

Facility

$625.00

Service Code	HCPCS C1725
Hospital Charge Code	270684711
Hospital Revenue Code	272
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) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$125.00
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

CATHETER SPRINTER 3.25x15MM

Facility

$625.00

Service Code	HCPCS C1725
Hospital Charge Code	270684711
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

CATHETER SPRINTER 3.75x12MM

Facility

$625.00

Service Code	HCPCS C1725
Hospital Charge Code	270684713
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

CATHETER SPRINTER 3.75x12MM

Facility

$625.00

Service Code	HCPCS C1725
Hospital Charge Code	270684713
Hospital Revenue Code	272
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) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$125.00
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

CATHETER SPYSCOPES DS II

Facility

$13,250.00

Hospital Charge Code	270686107
Hospital Revenue Code	272
Min. Negotiated Rate	$376.30
Max. Negotiated Rate	$6,625.00
Rate for Payer: Aetna Commercial	$5,035.00
Rate for Payer: Aetna Medicare Advantage	$3,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,378.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,378.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,378.75
Rate for Payer: Cigna Commercial	$6,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,445.00
Rate for Payer: Oxford Commercial	$2,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,987.50
Rate for Payer: UnitedHealthcare Commercial	$2,650.00
Rate for Payer: UnitedHealthcare Community & State	$418.70
Rate for Payer: Wellpoint Medicaid Managed Care	$376.30

CATHETER SPYSCOPES DS II

Facility

$13,250.00

Hospital Charge Code	270686107
Hospital Revenue Code	272
Min. Negotiated Rate	$1,987.50
Max. Negotiated Rate	$1,987.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,987.50

CATHETER STAY FIX 5F -14F

Facility

$45.00

Service Code	HCPCS C1729
Hospital Charge Code	270658019
Hospital Revenue Code	278
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$10.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

CATHETER STAY FIX 5F -14F

Facility

$45.00

Hospital Charge Code	270658019R
Hospital Revenue Code	272
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

CATHETER STAY FIX 5F -14F

Facility

$45.00

Hospital Charge Code	270658019R
Hospital Revenue Code	272
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.70
Rate for Payer: Oxford Commercial	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Commercial	$9.00
Rate for Payer: UnitedHealthcare Community & State	$1.42
Rate for Payer: Wellpoint Medicaid Managed Care	$1.28

CATHETER STAY FIX 5F -14F

Facility

$45.00

Service Code	HCPCS C1729
Hospital Charge Code	270658019S
Hospital Revenue Code	278
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Community & State	$1.42
Rate for Payer: Wellpoint Medicaid Managed Care	$1.28

CATHETER STAY FIX 5F -14F

Facility

$45.00

Service Code	HCPCS C1729
Hospital Charge Code	270658019S
Hospital Revenue Code	278
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$10.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

CATHETER STAY FIX 5F -14F

Facility

$10.50

Service Code	HCPCS C1729
Hospital Charge Code	270658019N
Hospital Revenue Code	278
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.54
Rate for Payer: Qualcare PPO/HMO/WC	$1.57

CATHETER STAY FIX 5F -14F

Facility

$10.50

Service Code	HCPCS C1729
Hospital Charge Code	270658019N
Hospital Revenue Code	278
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$5.25
Rate for Payer: Aetna Commercial	$3.99
Rate for Payer: Aetna Medicare Advantage	$3.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.68
Rate for Payer: Cigna Commercial	$5.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.54
Rate for Payer: Qualcare PPO/HMO/WC	$1.57
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

CATHETER STAY FIX 5F -14F

Facility

$45.00

Service Code	HCPCS C1729
Hospital Charge Code	270658019
Hospital Revenue Code	278
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Community & State	$1.42
Rate for Payer: Wellpoint Medicaid Managed Care	$1.28

CATHETER STEALTH 1.24 MICRO 14

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270669752N
Hospital Revenue Code	278
Min. Negotiated Rate	$482.09
Max. Negotiated Rate	$8,487.50
Rate for Payer: Aetna Commercial	$6,450.50
Rate for Payer: Aetna Medicare Advantage	$5,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,328.62
Rate for Payer: Cigna Commercial	$8,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25
Rate for Payer: UnitedHealthcare Community & State	$536.41
Rate for Payer: Wellpoint Medicaid Managed Care	$482.09

CATHETER STEALTH 1.24 MICRO 14

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270669752S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$4,107.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATHETER STEALTH 1.24 MICRO 14

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270669752
Hospital Revenue Code	278
Min. Negotiated Rate	$482.09
Max. Negotiated Rate	$8,487.50
Rate for Payer: Aetna Commercial	$6,450.50
Rate for Payer: Aetna Medicare Advantage	$5,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,328.62
Rate for Payer: Cigna Commercial	$8,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25
Rate for Payer: UnitedHealthcare Community & State	$536.41
Rate for Payer: Wellpoint Medicaid Managed Care	$482.09

CATHETER STEALTH 1.24 MICRO 14

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270669752N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$4,107.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

Know your out-of-pocket cost for care.

All Charges