Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH FLEXIMA NEPHROS REG 8FR

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270601342N
Hospital Revenue Code	278
Min. Negotiated Rate	$60.19
Max. Negotiated Rate	$97.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.10
Rate for Payer: Qualcare PPO/HMO/WC	$60.19

CATH FLEXIMA NEPHROS REG 8FR

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270601342N
Hospital Revenue Code	278
Min. Negotiated Rate	$11.40
Max. Negotiated Rate	$200.62
Rate for Payer: Aetna Commercial	$152.47
Rate for Payer: Aetna Medicare Advantage	$120.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.32
Rate for Payer: Cigna Commercial	$200.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.10
Rate for Payer: Qualcare PPO/HMO/WC	$60.19
Rate for Payer: UnitedHealthcare Community & State	$12.68
Rate for Payer: Wellpoint Medicaid Managed Care	$11.40

CATH FLEXIMA NEPHROS REG 8FR

Facility

$399.95

Service Code	HCPCS C1729
Hospital Charge Code	270601342S
Hospital Revenue Code	278
Min. Negotiated Rate	$11.36
Max. Negotiated Rate	$199.97
Rate for Payer: Aetna Commercial	$151.98
Rate for Payer: Aetna Medicare Advantage	$119.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.99
Rate for Payer: Cigna Commercial	$199.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.79
Rate for Payer: Qualcare PPO/HMO/WC	$59.99
Rate for Payer: UnitedHealthcare Community & State	$12.64
Rate for Payer: Wellpoint Medicaid Managed Care	$11.36

CATH FOGARTY EMBOLECTOMY 4FR

Facility

$382.50

Service Code	HCPCS C1757
Hospital Charge Code	270655969
Hospital Revenue Code	278
Min. Negotiated Rate	$10.86
Max. Negotiated Rate	$191.25
Rate for Payer: Aetna Commercial	$145.35
Rate for Payer: Aetna Medicare Advantage	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.54
Rate for Payer: Cigna Commercial	$191.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.56
Rate for Payer: Qualcare PPO/HMO/WC	$57.38
Rate for Payer: UnitedHealthcare Community & State	$12.09
Rate for Payer: Wellpoint Medicaid Managed Care	$10.86

CATH FOGARTY EMBOLECTOMY 4FR

Facility

$382.50

Service Code	HCPCS C1757
Hospital Charge Code	270655969
Hospital Revenue Code	278
Min. Negotiated Rate	$57.38
Max. Negotiated Rate	$92.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.56
Rate for Payer: Qualcare PPO/HMO/WC	$57.38

CATH FOGARTY IRRIG 4FR 220804F

Facility

$131.45

Hospital Charge Code	270600385
Hospital Revenue Code	272
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$65.72
Rate for Payer: Aetna Commercial	$49.95
Rate for Payer: Aetna Medicare Advantage	$39.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.52
Rate for Payer: Cigna Commercial	$65.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.18
Rate for Payer: Oxford Commercial	$26.29
Rate for Payer: Qualcare PPO/HMO/WC	$19.72
Rate for Payer: UnitedHealthcare Commercial	$26.29
Rate for Payer: UnitedHealthcare Community & State	$4.15
Rate for Payer: Wellpoint Medicaid Managed Care	$3.73

CATH FOGARTY IRRIG 4FR 220804F

Facility

$131.45

Hospital Charge Code	270600385
Hospital Revenue Code	272
Min. Negotiated Rate	$19.72
Max. Negotiated Rate	$19.72
Rate for Payer: Qualcare PPO/HMO/WC	$19.72

CATH FOGY LUMN 5F 0364lW405F35

Facility

$442.55

Service Code	HCPCS C1887
Hospital Charge Code	270636106
Hospital Revenue Code	278
Min. Negotiated Rate	$66.38
Max. Negotiated Rate	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.10
Rate for Payer: Qualcare PPO/HMO/WC	$66.38

CATH FOGY LUMN 5F 0364lW405F35

Facility

$442.55

Service Code	HCPCS C1887
Hospital Charge Code	270636106
Hospital Revenue Code	278
Min. Negotiated Rate	$12.57
Max. Negotiated Rate	$221.28
Rate for Payer: Aetna Commercial	$168.17
Rate for Payer: Aetna Medicare Advantage	$132.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.85
Rate for Payer: Cigna Commercial	$221.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.10
Rate for Payer: Qualcare PPO/HMO/WC	$66.38
Rate for Payer: UnitedHealthcare Community & State	$13.98
Rate for Payer: Wellpoint Medicaid Managed Care	$12.57

CATH FOLEY 16FR 3WAY 30cc

Facility

$63.18

Hospital Charge Code	270649432
Hospital Revenue Code	272
Min. Negotiated Rate	$9.48
Max. Negotiated Rate	$9.48
Rate for Payer: Qualcare PPO/HMO/WC	$9.48

CATH FOLEY 16FR 3WAY 30cc

Facility

$63.18

Hospital Charge Code	270649432
Hospital Revenue Code	272
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$31.59
Rate for Payer: Aetna Commercial	$24.01
Rate for Payer: Aetna Medicare Advantage	$18.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.11
Rate for Payer: Cigna Commercial	$31.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.43
Rate for Payer: Oxford Commercial	$12.64
Rate for Payer: Qualcare PPO/HMO/WC	$9.48
Rate for Payer: UnitedHealthcare Commercial	$12.64
Rate for Payer: UnitedHealthcare Community & State	$2.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1.79

CATH FOLEY 18FR 3WAY 30cc

Facility

$64.74

Hospital Charge Code	270649433
Hospital Revenue Code	272
Min. Negotiated Rate	$9.71
Max. Negotiated Rate	$9.71
Rate for Payer: Qualcare PPO/HMO/WC	$9.71

CATH FOLEY 18FR 3WAY 30cc

Facility

$64.74

Hospital Charge Code	270649433
Hospital Revenue Code	272
Min. Negotiated Rate	$1.84
Max. Negotiated Rate	$32.37
Rate for Payer: Aetna Commercial	$24.60
Rate for Payer: Aetna Medicare Advantage	$19.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.51
Rate for Payer: Cigna Commercial	$32.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.83
Rate for Payer: Oxford Commercial	$12.95
Rate for Payer: Qualcare PPO/HMO/WC	$9.71
Rate for Payer: UnitedHealthcare Commercial	$12.95
Rate for Payer: UnitedHealthcare Community & State	$2.05
Rate for Payer: Wellpoint Medicaid Managed Care	$1.84

CATH FOLEY 20FR 3WAY 30cc

Facility

$64.74

Hospital Charge Code	270649434
Hospital Revenue Code	272
Min. Negotiated Rate	$9.71
Max. Negotiated Rate	$9.71
Rate for Payer: Qualcare PPO/HMO/WC	$9.71

CATH FOLEY 20FR 3WAY 30cc

Facility

$64.74

Hospital Charge Code	270649434
Hospital Revenue Code	272
Min. Negotiated Rate	$1.84
Max. Negotiated Rate	$32.37
Rate for Payer: Aetna Commercial	$24.60
Rate for Payer: Aetna Medicare Advantage	$19.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.51
Rate for Payer: Cigna Commercial	$32.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.83
Rate for Payer: Oxford Commercial	$12.95
Rate for Payer: Qualcare PPO/HMO/WC	$9.71
Rate for Payer: UnitedHealthcare Commercial	$12.95
Rate for Payer: UnitedHealthcare Community & State	$2.05
Rate for Payer: Wellpoint Medicaid Managed Care	$1.84

CATH FOLEY 20FR 3WAY 5cc

Facility

$65.83

Hospital Charge Code	270649440
Hospital Revenue Code	272
Min. Negotiated Rate	$9.87
Max. Negotiated Rate	$9.87
Rate for Payer: Qualcare PPO/HMO/WC	$9.87

CATH FOLEY 20FR 3WAY 5cc

Facility

$65.83

Hospital Charge Code	270649440
Hospital Revenue Code	272
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$32.91
Rate for Payer: Aetna Commercial	$25.02
Rate for Payer: Aetna Medicare Advantage	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.79
Rate for Payer: Cigna Commercial	$32.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.12
Rate for Payer: Oxford Commercial	$13.17
Rate for Payer: Qualcare PPO/HMO/WC	$9.87
Rate for Payer: UnitedHealthcare Commercial	$13.17
Rate for Payer: UnitedHealthcare Community & State	$2.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.87

CATH FOLEY 20FR LATEX 2 WAY

Facility

$40.25

Service Code	HCPCS C2627
Hospital Charge Code	270649040
Hospital Revenue Code	278
Min. Negotiated Rate	$6.04
Max. Negotiated Rate	$9.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.74
Rate for Payer: Qualcare PPO/HMO/WC	$6.04

CATH FOLEY 20FR LATEX 2 WAY

Facility

$40.25

Service Code	HCPCS C2627
Hospital Charge Code	270649040
Hospital Revenue Code	278
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$20.12
Rate for Payer: Aetna Commercial	$15.29
Rate for Payer: Aetna Medicare Advantage	$12.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.26
Rate for Payer: Cigna Commercial	$20.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.74
Rate for Payer: Qualcare PPO/HMO/WC	$6.04
Rate for Payer: UnitedHealthcare Community & State	$1.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

CATH FOLEY 22FR 3WAY 30cc

Facility

$65.36

Hospital Charge Code	270649435
Hospital Revenue Code	272
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$32.68
Rate for Payer: Aetna Commercial	$24.84
Rate for Payer: Aetna Medicare Advantage	$19.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.67
Rate for Payer: Cigna Commercial	$32.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.99
Rate for Payer: Oxford Commercial	$13.07
Rate for Payer: Qualcare PPO/HMO/WC	$9.80
Rate for Payer: UnitedHealthcare Commercial	$13.07
Rate for Payer: UnitedHealthcare Community & State	$2.07
Rate for Payer: Wellpoint Medicaid Managed Care	$1.86

CATH FOLEY 22FR 3WAY 30cc

Facility

$65.36

Hospital Charge Code	270649435
Hospital Revenue Code	272
Min. Negotiated Rate	$9.80
Max. Negotiated Rate	$9.80
Rate for Payer: Qualcare PPO/HMO/WC	$9.80

CATH FOLEY 22FR 3WAY 5cc

Facility

$65.83

Hospital Charge Code	270649441
Hospital Revenue Code	272
Min. Negotiated Rate	$9.87
Max. Negotiated Rate	$9.87
Rate for Payer: Qualcare PPO/HMO/WC	$9.87

CATH FOLEY 22FR 3WAY 5cc

Facility

$65.83

Hospital Charge Code	270649441
Hospital Revenue Code	272
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$32.91
Rate for Payer: Aetna Commercial	$25.02
Rate for Payer: Aetna Medicare Advantage	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.79
Rate for Payer: Cigna Commercial	$32.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.12
Rate for Payer: Oxford Commercial	$13.17
Rate for Payer: Qualcare PPO/HMO/WC	$9.87
Rate for Payer: UnitedHealthcare Commercial	$13.17
Rate for Payer: UnitedHealthcare Community & State	$2.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.87

CATH FOLEY 24FR 3WAY 30cc

Facility

$64.74

Hospital Charge Code	270649436
Hospital Revenue Code	272
Min. Negotiated Rate	$9.71
Max. Negotiated Rate	$9.71
Rate for Payer: Qualcare PPO/HMO/WC	$9.71

CATH FOLEY 24FR 3WAY 30cc

Facility

$64.74

Hospital Charge Code	270649436
Hospital Revenue Code	272
Min. Negotiated Rate	$1.84
Max. Negotiated Rate	$32.37
Rate for Payer: Aetna Commercial	$24.60
Rate for Payer: Aetna Medicare Advantage	$19.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.51
Rate for Payer: Cigna Commercial	$32.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.83
Rate for Payer: Oxford Commercial	$12.95
Rate for Payer: Qualcare PPO/HMO/WC	$9.71
Rate for Payer: UnitedHealthcare Commercial	$12.95
Rate for Payer: UnitedHealthcare Community & State	$2.05
Rate for Payer: Wellpoint Medicaid Managed Care	$1.84

Know your out-of-pocket cost for care.

All Charges