Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH FOX PTA SV 6x80x150cm

Facility

$1,175.00

Service Code	HCPCS C1725
Hospital Charge Code	270644404C
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$284.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

CATH FOX PTA SV 83976-02

Facility

$1,175.00

Service Code	HCPCS C1725
Hospital Charge Code	270644153C
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$284.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

CATH FOX PTA SV 83976-02

Facility

$1,175.00

Service Code	HCPCS C1725
Hospital Charge Code	270644153C
Hospital Revenue Code	278
Min. Negotiated Rate	$33.37
Max. Negotiated Rate	$587.50
Rate for Payer: Aetna Commercial	$446.50
Rate for Payer: Aetna Medicare Advantage	$352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.62
Rate for Payer: Cigna Commercial	$587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25
Rate for Payer: UnitedHealthcare Community & State	$37.13
Rate for Payer: Wellpoint Medicaid Managed Care	$33.37

CATH FOX PTA SV 83980-02

Facility

$925.00

Service Code	HCPCS C1725
Hospital Charge Code	270644152C
Hospital Revenue Code	278
Min. Negotiated Rate	$26.27
Max. Negotiated Rate	$462.50
Rate for Payer: Aetna Commercial	$351.50
Rate for Payer: Aetna Medicare Advantage	$277.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.88
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75
Rate for Payer: UnitedHealthcare Community & State	$29.23
Rate for Payer: Wellpoint Medicaid Managed Care	$26.27

CATH FOX PTA SV 83980-02

Facility

$925.00

Service Code	HCPCS C1725
Hospital Charge Code	270644152C
Hospital Revenue Code	278
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$223.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

CATH GLIDEPATH 31CM STR

Facility

$1,752.00

Hospital Charge Code	270677506
Hospital Revenue Code	278
Min. Negotiated Rate	$49.76
Max. Negotiated Rate	$876.00
Rate for Payer: Aetna Commercial	$665.76
Rate for Payer: Aetna Medicare Advantage	$525.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.76
Rate for Payer: Cigna Commercial	$876.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.98
Rate for Payer: Qualcare PPO/HMO/WC	$262.80
Rate for Payer: UnitedHealthcare Community & State	$55.36
Rate for Payer: Wellpoint Medicaid Managed Care	$49.76

CATH GLIDEPATH 31CM STR

Facility

$1,752.00

Hospital Charge Code	270677506
Hospital Revenue Code	278
Min. Negotiated Rate	$262.80
Max. Negotiated Rate	$423.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.98
Rate for Payer: Qualcare PPO/HMO/WC	$262.80

CATH GLIDEPATH 42CM STR

Facility

$1,752.00

Hospital Charge Code	270677507
Hospital Revenue Code	278
Min. Negotiated Rate	$49.76
Max. Negotiated Rate	$876.00
Rate for Payer: Aetna Commercial	$665.76
Rate for Payer: Aetna Medicare Advantage	$525.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.76
Rate for Payer: Cigna Commercial	$876.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.98
Rate for Payer: Qualcare PPO/HMO/WC	$262.80
Rate for Payer: UnitedHealthcare Community & State	$55.36
Rate for Payer: Wellpoint Medicaid Managed Care	$49.76

CATH GLIDEPATH 42CM STR

Facility

$1,752.00

Hospital Charge Code	270677507
Hospital Revenue Code	278
Min. Negotiated Rate	$262.80
Max. Negotiated Rate	$423.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.98
Rate for Payer: Qualcare PPO/HMO/WC	$262.80

CATH GUID 6F EBU 5.0 LA6EBU50

Facility

$225.00

Service Code	HCPCS C1887
Hospital Charge Code	270641795C
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$54.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

CATH GUID 6F EBU 5.0 LA6EBU50

Facility

$225.00

Service Code	HCPCS C1887
Hospital Charge Code	270641795C
Hospital Revenue Code	278
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Community & State	$7.11
Rate for Payer: Wellpoint Medicaid Managed Care	$6.39

CATH GUID 6F MACH 4.0 3435673

Facility

$255.00

Service Code	HCPCS C1887
Hospital Charge Code	270641796C
Hospital Revenue Code	278
Min. Negotiated Rate	$38.25
Max. Negotiated Rate	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.71
Rate for Payer: Qualcare PPO/HMO/WC	$38.25

CATH GUID 6F MACH 4.0 3435673

Facility

$255.00

Service Code	HCPCS C1887
Hospital Charge Code	270641796C
Hospital Revenue Code	278
Min. Negotiated Rate	$7.24
Max. Negotiated Rate	$127.50
Rate for Payer: Aetna Commercial	$96.90
Rate for Payer: Aetna Medicare Advantage	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.03
Rate for Payer: Cigna Commercial	$127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.71
Rate for Payer: Qualcare PPO/HMO/WC	$38.25
Rate for Payer: UnitedHealthcare Community & State	$8.06
Rate for Payer: Wellpoint Medicaid Managed Care	$7.24

CATH GUIDE 6F PTFE RENAL CRV

Facility

$280.00

Service Code	HCPCS C1887
Hospital Charge Code	270662342S
Hospital Revenue Code	278
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$67.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.76
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

CATH GUIDE 6F PTFE RENAL CRV

Facility

$280.00

Service Code	HCPCS C1887
Hospital Charge Code	270662342S
Hospital Revenue Code	278
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$106.40
Rate for Payer: Aetna Medicare Advantage	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.40
Rate for Payer: Cigna Commercial	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.76
Rate for Payer: Qualcare PPO/HMO/WC	$42.00
Rate for Payer: UnitedHealthcare Community & State	$8.85
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

CATH GUIDE 6F PTFE RENAL CRVD

Facility

$280.00

Service Code	HCPCS C1887
Hospital Charge Code	270662342
Hospital Revenue Code	278
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$67.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.76
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

CATH GUIDE 6F PTFE RENAL CRVD

Facility

$280.00

Service Code	HCPCS C1887
Hospital Charge Code	270662342
Hospital Revenue Code	278
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$106.40
Rate for Payer: Aetna Medicare Advantage	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.40
Rate for Payer: Cigna Commercial	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.76
Rate for Payer: Qualcare PPO/HMO/WC	$42.00
Rate for Payer: UnitedHealthcare Community & State	$8.85
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

CATH GUIDE AMPLATZ 6F AL .75

Facility

$225.00

Service Code	HCPCS C1887
Hospital Charge Code	270651090N
Hospital Revenue Code	278
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Community & State	$7.11
Rate for Payer: Wellpoint Medicaid Managed Care	$6.39

CATH GUIDE AMPLATZ 6F AL .75

Facility

$225.00

Service Code	HCPCS C1887
Hospital Charge Code	270651090
Hospital Revenue Code	278
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Community & State	$7.11
Rate for Payer: Wellpoint Medicaid Managed Care	$6.39

CATH GUIDE AMPLATZ 6F AL .75

Facility

$225.00

Service Code	HCPCS C1887
Hospital Charge Code	270651090
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$54.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

CATH GUIDE AMPLATZ 6F AL .75

Facility

$225.00

Service Code	HCPCS C1887
Hospital Charge Code	270651090N
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$54.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

CATH GUIDE CONCIERGE 6F ULT1

Facility

$225.00

Hospital Charge Code	270669767
Hospital Revenue Code	278
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Community & State	$7.11
Rate for Payer: Wellpoint Medicaid Managed Care	$6.39

CATH GUIDE CONCIERGE 6F ULT1

Facility

$225.00

Hospital Charge Code	270669767
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$54.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

CATH GUIDE CONCIERGE 6F ULT2

Facility

$225.00

Hospital Charge Code	270669768
Hospital Revenue Code	272
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.50
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$45.00
Rate for Payer: UnitedHealthcare Community & State	$7.11
Rate for Payer: Wellpoint Medicaid Managed Care	$6.39

CATH GUIDE CONCIERGE 6F ULT2

Facility

$225.00

Hospital Charge Code	270669768
Hospital Revenue Code	272
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

Know your out-of-pocket cost for care.

All Charges