Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER TREK CORONARY DILATAT

Facility

$850.00

Service Code	HCPCS C1725
Hospital Charge Code	270645272C
Hospital Revenue Code	278
Min. Negotiated Rate	$24.14
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Community & State	$26.86
Rate for Payer: Wellpoint Medicaid Managed Care	$24.14

CATHETER TREK CORONARY DILATAT

Facility

$500.00

Service Code	HCPCS C1725
Hospital Charge Code	270645241
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

CATHETER TRIPLE LUMEN 7FR 3L

Facility

$440.00

Hospital Charge Code	270660301
Hospital Revenue Code	278
Min. Negotiated Rate	$12.50
Max. Negotiated Rate	$220.00
Rate for Payer: Aetna Commercial	$167.20
Rate for Payer: Aetna Medicare Advantage	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.20
Rate for Payer: Cigna Commercial	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.48
Rate for Payer: Qualcare PPO/HMO/WC	$66.00
Rate for Payer: UnitedHealthcare Community & State	$13.90
Rate for Payer: Wellpoint Medicaid Managed Care	$12.50

CATHETER TRIPLE LUMEN 7FR 3L

Facility

$440.00

Hospital Charge Code	270660301
Hospital Revenue Code	278
Min. Negotiated Rate	$66.00
Max. Negotiated Rate	$106.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.48
Rate for Payer: Qualcare PPO/HMO/WC	$66.00

CATHETER TROCAR 28FR 561068

Facility

$78.82

Hospital Charge Code	270635998
Hospital Revenue Code	272
Min. Negotiated Rate	$11.82
Max. Negotiated Rate	$11.82
Rate for Payer: Qualcare PPO/HMO/WC	$11.82

CATHETER TROCAR 28FR 561068

Facility

$78.82

Hospital Charge Code	270635998
Hospital Revenue Code	272
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$39.41
Rate for Payer: Aetna Commercial	$29.95
Rate for Payer: Aetna Medicare Advantage	$23.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.10
Rate for Payer: Cigna Commercial	$39.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.49
Rate for Payer: Oxford Commercial	$15.76
Rate for Payer: Qualcare PPO/HMO/WC	$11.82
Rate for Payer: UnitedHealthcare Commercial	$15.76
Rate for Payer: UnitedHealthcare Community & State	$2.49
Rate for Payer: Wellpoint Medicaid Managed Care	$2.24

CATHETER TROCAR 32FR

Facility

$50.84

Hospital Charge Code	270649364
Hospital Revenue Code	272
Min. Negotiated Rate	$7.63
Max. Negotiated Rate	$7.63
Rate for Payer: Qualcare PPO/HMO/WC	$7.63

CATHETER TROCAR 32FR

Facility

$50.84

Hospital Charge Code	270649364
Hospital Revenue Code	272
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$25.42
Rate for Payer: Aetna Commercial	$19.32
Rate for Payer: Aetna Medicare Advantage	$15.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.96
Rate for Payer: Cigna Commercial	$25.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.22
Rate for Payer: Oxford Commercial	$10.17
Rate for Payer: Qualcare PPO/HMO/WC	$7.63
Rate for Payer: UnitedHealthcare Commercial	$10.17
Rate for Payer: UnitedHealthcare Community & State	$1.61
Rate for Payer: Wellpoint Medicaid Managed Care	$1.44

CATHETER TURBOHAWK THLSM

Facility

$17,500.00

Service Code	HCPCS C1885
Hospital Charge Code	270660344
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$4,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

CATHETER TURBOHAWK THLSM

Facility

$17,500.00

Service Code	HCPCS C1885
Hospital Charge Code	270660344
Hospital Revenue Code	278
Min. Negotiated Rate	$497.00
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$6,650.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00
Rate for Payer: UnitedHealthcare Community & State	$553.00
Rate for Payer: Wellpoint Medicaid Managed Care	$497.00

CATHETER UNIFUSE 5F 30X135CM

Facility

$800.00

Service Code	HCPCS C1751
Hospital Charge Code	270694142S
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

CATHETER UNIFUSE 5F 30X135CM

Facility

$800.00

Service Code	HCPCS C1751
Hospital Charge Code	270694142S
Hospital Revenue Code	278
Min. Negotiated Rate	$22.72
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Community & State	$25.28
Rate for Payer: Wellpoint Medicaid Managed Care	$22.72

CATHETER UNI-FUSE 5FX90X10CM

Facility

$1,250.00

Service Code	HCPCS C1757
Hospital Charge Code	270691928S
Hospital Revenue Code	278
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$39.50
Rate for Payer: Wellpoint Medicaid Managed Care	$35.50

CATHETER UNI-FUSE 5FX90X10CM

Facility

$1,250.00

Service Code	HCPCS C1757
Hospital Charge Code	270691928S
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

CATHETER URETERAL 5FR OLIVE TP

Facility

$497.25

Service Code	HCPCS C1758
Hospital Charge Code	270660056
Hospital Revenue Code	278
Min. Negotiated Rate	$74.59
Max. Negotiated Rate	$120.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.33
Rate for Payer: Qualcare PPO/HMO/WC	$74.59

CATHETER URETERAL 5FR OLIVE TP

Facility

$497.25

Service Code	HCPCS C1758
Hospital Charge Code	270660056
Hospital Revenue Code	278
Min. Negotiated Rate	$14.12
Max. Negotiated Rate	$248.62
Rate for Payer: Aetna Commercial	$188.96
Rate for Payer: Aetna Medicare Advantage	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.80
Rate for Payer: Cigna Commercial	$248.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.33
Rate for Payer: Qualcare PPO/HMO/WC	$74.59
Rate for Payer: UnitedHealthcare Community & State	$15.71
Rate for Payer: Wellpoint Medicaid Managed Care	$14.12

CATHETER URETERAL 5FR WHISTLE

Facility

$180.00

Hospital Charge Code	270331568
Hospital Revenue Code	278
Min. Negotiated Rate	$5.11
Max. Negotiated Rate	$90.00
Rate for Payer: Aetna Commercial	$68.40
Rate for Payer: Aetna Medicare Advantage	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.90
Rate for Payer: Cigna Commercial	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.56
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Community & State	$5.69
Rate for Payer: Wellpoint Medicaid Managed Care	$5.11

CATHETER URETERAL 5FR WHISTLE

Facility

$180.00

Hospital Charge Code	270331568
Hospital Revenue Code	278
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$43.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.56
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

CATHETER URETERAL CONE TIP

Facility

$614.25

Service Code	HCPCS C1758
Hospital Charge Code	270689505
Hospital Revenue Code	272
Min. Negotiated Rate	$17.44
Max. Negotiated Rate	$307.12
Rate for Payer: Aetna Commercial	$233.41
Rate for Payer: Aetna Medicare Advantage	$184.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.63
Rate for Payer: Cigna Commercial	$307.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.71
Rate for Payer: Oxford Commercial	$122.85
Rate for Payer: Qualcare PPO/HMO/WC	$92.14
Rate for Payer: UnitedHealthcare Commercial	$122.85
Rate for Payer: UnitedHealthcare Community & State	$19.41
Rate for Payer: Wellpoint Medicaid Managed Care	$17.44

CATHETER URETERAL CONE TIP

Facility

$614.25

Service Code	HCPCS C1758
Hospital Charge Code	270689505
Hospital Revenue Code	272
Min. Negotiated Rate	$92.14
Max. Negotiated Rate	$92.14
Rate for Payer: Qualcare PPO/HMO/WC	$92.14

CATHETER URETERAL OPEN END 5FR

Facility

$500.50

Hospital Charge Code	270684725
Hospital Revenue Code	272
Min. Negotiated Rate	$75.08
Max. Negotiated Rate	$75.08
Rate for Payer: Qualcare PPO/HMO/WC	$75.08

CATHETER URETERAL OPEN END 5FR

Facility

$500.50

Hospital Charge Code	270684725
Hospital Revenue Code	272
Min. Negotiated Rate	$14.21
Max. Negotiated Rate	$250.25
Rate for Payer: Aetna Commercial	$190.19
Rate for Payer: Aetna Medicare Advantage	$150.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.63
Rate for Payer: Cigna Commercial	$250.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.13
Rate for Payer: Oxford Commercial	$100.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.08
Rate for Payer: UnitedHealthcare Commercial	$100.10
Rate for Payer: UnitedHealthcare Community & State	$15.82
Rate for Payer: Wellpoint Medicaid Managed Care	$14.21

CATHETER URETERAL OPEN END 6FR

Facility

$80.56

Hospital Charge Code	270675130
Hospital Revenue Code	272
Min. Negotiated Rate	$12.08
Max. Negotiated Rate	$12.08
Rate for Payer: Qualcare PPO/HMO/WC	$12.08

CATHETER URETERAL OPEN END 6FR

Facility

$80.56

Hospital Charge Code	270675130
Hospital Revenue Code	272
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$40.28
Rate for Payer: Aetna Commercial	$30.61
Rate for Payer: Aetna Medicare Advantage	$24.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.54
Rate for Payer: Cigna Commercial	$40.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.95
Rate for Payer: Oxford Commercial	$16.11
Rate for Payer: Qualcare PPO/HMO/WC	$12.08
Rate for Payer: UnitedHealthcare Commercial	$16.11
Rate for Payer: UnitedHealthcare Community & State	$2.55
Rate for Payer: Wellpoint Medicaid Managed Care	$2.29

CATHETER URETERAL TIP 8 CONE

Facility

$262.15

Hospital Charge Code	270658469
Hospital Revenue Code	272
Min. Negotiated Rate	$39.32
Max. Negotiated Rate	$39.32
Rate for Payer: Qualcare PPO/HMO/WC	$39.32

Know your out-of-pocket cost for care.

All Charges