Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATHETER XCEL

Facility

$1,025.00

Hospital Charge Code	270697249S
Hospital Revenue Code	272
Min. Negotiated Rate	$29.11
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$389.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.50
Rate for Payer: Oxford Commercial	$205.00
Rate for Payer: Qualcare PPO/HMO/WC	$153.75
Rate for Payer: UnitedHealthcare Commercial	$205.00
Rate for Payer: UnitedHealthcare Community & State	$32.39
Rate for Payer: Wellpoint Medicaid Managed Care	$29.11

CATHETER XCEL

Facility

$1,025.00

Hospital Charge Code	270697249S
Hospital Revenue Code	272
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$153.75
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

CATHETER ZILVER PTX 6MM X 140M

Facility

$11,975.00

Service Code	HCPCS C1874
Hospital Charge Code	270682885
Hospital Revenue Code	278
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$5,987.50
Rate for Payer: Aetna Commercial	$4,550.50
Rate for Payer: Aetna Medicare Advantage	$3,592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,053.62
Rate for Payer: Cigna Commercial	$5,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,897.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25
Rate for Payer: UnitedHealthcare Community & State	$378.41
Rate for Payer: Wellpoint Medicaid Managed Care	$340.09

CATHETER ZILVER PTX 6MM X 140M

Facility

$11,975.00

Service Code	HCPCS C1874
Hospital Charge Code	270682885
Hospital Revenue Code	278
Min. Negotiated Rate	$1,796.25
Max. Negotiated Rate	$2,897.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,897.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25

CATHETER ZILVER PTX 7MMX140MM

Facility

$11,975.00

Service Code	HCPCS C1874
Hospital Charge Code	270682884
Hospital Revenue Code	278
Min. Negotiated Rate	$1,796.25
Max. Negotiated Rate	$2,897.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,897.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25

CATHETER ZILVER PTX 7MMX140MM

Facility

$11,975.00

Service Code	HCPCS C1874
Hospital Charge Code	270682884N
Hospital Revenue Code	278
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$5,987.50
Rate for Payer: Aetna Commercial	$4,550.50
Rate for Payer: Aetna Medicare Advantage	$3,592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,053.62
Rate for Payer: Cigna Commercial	$5,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,897.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25
Rate for Payer: UnitedHealthcare Community & State	$378.41
Rate for Payer: Wellpoint Medicaid Managed Care	$340.09

CATHETER ZILVER PTX 7MMX140MM

Facility

$11,975.00

Service Code	HCPCS C1874
Hospital Charge Code	270682884N
Hospital Revenue Code	278
Min. Negotiated Rate	$1,796.25
Max. Negotiated Rate	$2,897.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,897.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25

CATHETER ZILVER PTX 7MMX140MM

Facility

$11,975.00

Service Code	HCPCS C1874
Hospital Charge Code	270682884
Hospital Revenue Code	278
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$5,987.50
Rate for Payer: Aetna Commercial	$4,550.50
Rate for Payer: Aetna Medicare Advantage	$3,592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,053.62
Rate for Payer: Cigna Commercial	$5,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,897.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25
Rate for Payer: UnitedHealthcare Community & State	$378.41
Rate for Payer: Wellpoint Medicaid Managed Care	$340.09

CATHETR BALLN ADMRLXTRME 6/40

Facility

$700.00

Service Code	HCPCS C1725
Hospital Charge Code	270657948
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$22.12
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

CATHETR BALLN ADMRLXTRME 6/40

Facility

$700.00

Service Code	HCPCS C1725
Hospital Charge Code	270657948
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

CATHETR BALLN ADMRLXTRME 8/20

Facility

$700.00

Service Code	HCPCS C1725
Hospital Charge Code	270657951
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$22.12
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

CATHETR BALLN ADMRLXTRME 8/20

Facility

$700.00

Service Code	HCPCS C1725
Hospital Charge Code	270657951
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

CATH EVD BACTISEAL 3MMX35CM

Facility

$4,080.00

Service Code	HCPCS C1729
Hospital Charge Code	270695431
Hospital Revenue Code	278
Min. Negotiated Rate	$115.87
Max. Negotiated Rate	$2,040.00
Rate for Payer: Aetna Commercial	$1,550.40
Rate for Payer: Aetna Medicare Advantage	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,040.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,040.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$816.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,040.40
Rate for Payer: Cigna Commercial	$2,040.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$987.36
Rate for Payer: Qualcare PPO/HMO/WC	$612.00
Rate for Payer: UnitedHealthcare Community & State	$128.93
Rate for Payer: Wellpoint Medicaid Managed Care	$115.87

CATH EVD BACTISEAL 3MMX35CM

Facility

$4,080.00

Service Code	HCPCS C1729
Hospital Charge Code	270695431
Hospital Revenue Code	278
Min. Negotiated Rate	$612.00
Max. Negotiated Rate	$987.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$816.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$987.36
Rate for Payer: Qualcare PPO/HMO/WC	$612.00

CATH EXCELSIOR SL 10PS 90

Facility

$5,463.75

Service Code	HCPCS C1887
Hospital Charge Code	270695281S
Hospital Revenue Code	278
Min. Negotiated Rate	$819.56
Max. Negotiated Rate	$1,322.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,092.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,322.23
Rate for Payer: Qualcare PPO/HMO/WC	$819.56

CATH EXCELSIOR SL 10PS 90

Facility

$5,463.75

Service Code	HCPCS C1887
Hospital Charge Code	270695281S
Hospital Revenue Code	278
Min. Negotiated Rate	$155.17
Max. Negotiated Rate	$2,731.88
Rate for Payer: Aetna Commercial	$2,076.22
Rate for Payer: Aetna Medicare Advantage	$1,639.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,393.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,393.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,092.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,393.26
Rate for Payer: Cigna Commercial	$2,731.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,322.23
Rate for Payer: Qualcare PPO/HMO/WC	$819.56
Rate for Payer: UnitedHealthcare Community & State	$172.65
Rate for Payer: Wellpoint Medicaid Managed Care	$155.17

CATH EXCELSIOR SL 2TIP 6X150CM

Facility

$5,027.25

Service Code	HCPCS C1887
Hospital Charge Code	270695280S
Hospital Revenue Code	272
Min. Negotiated Rate	$142.77
Max. Negotiated Rate	$2,513.62
Rate for Payer: Aetna Commercial	$1,910.36
Rate for Payer: Aetna Medicare Advantage	$1,508.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,281.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,281.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,281.95
Rate for Payer: Cigna Commercial	$2,513.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,307.09
Rate for Payer: Oxford Commercial	$1,005.45
Rate for Payer: Qualcare PPO/HMO/WC	$754.09
Rate for Payer: UnitedHealthcare Commercial	$1,005.45
Rate for Payer: UnitedHealthcare Community & State	$158.86
Rate for Payer: Wellpoint Medicaid Managed Care	$142.77

CATH EXCELSIOR SL 2TIP 6X150CM

Facility

$5,027.25

Service Code	HCPCS C1887
Hospital Charge Code	270695280S
Hospital Revenue Code	272
Min. Negotiated Rate	$754.09
Max. Negotiated Rate	$754.09
Rate for Payer: Qualcare PPO/HMO/WC	$754.09

CATH EXCELSIOR SL2TIP PSC6X150

Facility

$5,027.25

Service Code	HCPCS C1887
Hospital Charge Code	270695285S
Hospital Revenue Code	272
Min. Negotiated Rate	$142.77
Max. Negotiated Rate	$2,513.62
Rate for Payer: Aetna Commercial	$1,910.36
Rate for Payer: Aetna Medicare Advantage	$1,508.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,281.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,281.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,281.95
Rate for Payer: Cigna Commercial	$2,513.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,307.09
Rate for Payer: Oxford Commercial	$1,005.45
Rate for Payer: Qualcare PPO/HMO/WC	$754.09
Rate for Payer: UnitedHealthcare Commercial	$1,005.45
Rate for Payer: UnitedHealthcare Community & State	$158.86
Rate for Payer: Wellpoint Medicaid Managed Care	$142.77

CATH EXCELSIOR SL2TIP PSC6X150

Facility

$5,027.25

Service Code	HCPCS C1887
Hospital Charge Code	270695285S
Hospital Revenue Code	272
Min. Negotiated Rate	$754.09
Max. Negotiated Rate	$754.09
Rate for Payer: Qualcare PPO/HMO/WC	$754.09

CATH EXCELSIOR XT17PS457.5X150

Facility

$4,982.00

Service Code	HCPCS C1887
Hospital Charge Code	270695288S
Hospital Revenue Code	272
Min. Negotiated Rate	$141.49
Max. Negotiated Rate	$2,491.00
Rate for Payer: Aetna Commercial	$1,893.16
Rate for Payer: Aetna Medicare Advantage	$1,494.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,270.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,270.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,270.41
Rate for Payer: Cigna Commercial	$2,491.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,295.32
Rate for Payer: Oxford Commercial	$996.40
Rate for Payer: Qualcare PPO/HMO/WC	$747.30
Rate for Payer: UnitedHealthcare Commercial	$996.40
Rate for Payer: UnitedHealthcare Community & State	$157.43
Rate for Payer: Wellpoint Medicaid Managed Care	$141.49

CATH EXCELSIOR XT17PS457.5X150

Facility

$4,982.00

Service Code	HCPCS C1887
Hospital Charge Code	270695288S
Hospital Revenue Code	272
Min. Negotiated Rate	$747.30
Max. Negotiated Rate	$747.30
Rate for Payer: Qualcare PPO/HMO/WC	$747.30

CATH FC PTA 9x40x80 10330-40

Facility

$625.00

Service Code	HCPCS C1725
Hospital Charge Code	270644440A
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

CATH FC PTA 9x40x80 10330-40

Facility

$625.00

Service Code	HCPCS C1725
Hospital Charge Code	270644440A
Hospital Revenue Code	278
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) NJ Health	$125.00
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	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

CATH FC PTA 9x40x80 10330-40

Facility

$625.00

Service Code	HCPCS C1725
Hospital Charge Code	270644440C
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

Know your out-of-pocket cost for care.

All Charges