Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH JR 3.5 7FR 778-080-00

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636354
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATH JR 3.5SH 6FR 670-081-00

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636298
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATH JR 3.5SH 6FR 670-081-00

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636298
Hospital Revenue Code	278
Min. Negotiated Rate	$6.82
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Community & State	$7.58
Rate for Payer: Wellpoint Medicaid Managed Care	$6.82

CATH JR 4.0 7FR 77808200

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636356
Hospital Revenue Code	278
Min. Negotiated Rate	$6.82
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Community & State	$7.58
Rate for Payer: Wellpoint Medicaid Managed Care	$6.82

CATH JR 4.0 7FR 77808200

Facility

$240.00

Service Code	HCPCS C1887
Hospital Charge Code	270636356
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CATH JR4 5FR 100cm

Facility

$44.50

Service Code	HCPCS C1887
Hospital Charge Code	270644602C
Hospital Revenue Code	278
Min. Negotiated Rate	$1.26
Max. Negotiated Rate	$22.25
Rate for Payer: Aetna Commercial	$16.91
Rate for Payer: Aetna Medicare Advantage	$13.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.35
Rate for Payer: Cigna Commercial	$22.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.77
Rate for Payer: Qualcare PPO/HMO/WC	$6.67
Rate for Payer: UnitedHealthcare Community & State	$1.41
Rate for Payer: Wellpoint Medicaid Managed Care	$1.26

CATH JR4 5FR 100cm

Facility

$44.50

Service Code	HCPCS C1887
Hospital Charge Code	270644602C
Hospital Revenue Code	278
Min. Negotiated Rate	$6.67
Max. Negotiated Rate	$10.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.77
Rate for Payer: Qualcare PPO/HMO/WC	$6.67

CATH JUDKINS 6FR JR 4.0 100cm

Facility

$37.90

Service Code	HCPCS C1887
Hospital Charge Code	270648005N
Hospital Revenue Code	278
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$9.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.17
Rate for Payer: Qualcare PPO/HMO/WC	$5.68

CATH JUDKINS 6FR JR 4.0 100cm

Facility

$470.50

Service Code	HCPCS C1887
Hospital Charge Code	270648005
Hospital Revenue Code	279
Min. Negotiated Rate	$70.58
Max. Negotiated Rate	$70.58
Rate for Payer: Qualcare PPO/HMO/WC	$70.58

CATH JUDKINS 6FR JR 4.0 100cm

Facility

$37.90

Service Code	HCPCS C1887
Hospital Charge Code	270648005N
Hospital Revenue Code	278
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$18.95
Rate for Payer: Aetna Commercial	$14.40
Rate for Payer: Aetna Medicare Advantage	$11.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.66
Rate for Payer: Cigna Commercial	$18.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.17
Rate for Payer: Qualcare PPO/HMO/WC	$5.68
Rate for Payer: UnitedHealthcare Community & State	$1.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1.08

CATH JUDKINS 6FR JR 4.0 100cm

Facility

$37.90

Service Code	HCPCS C1887
Hospital Charge Code	270648005S
Hospital Revenue Code	278
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$9.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.17
Rate for Payer: Qualcare PPO/HMO/WC	$5.68

CATH JUDKINS 6FR JR 4.0 100cm

Facility

$37.90

Service Code	HCPCS C1887
Hospital Charge Code	270648005S
Hospital Revenue Code	278
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$18.95
Rate for Payer: Aetna Commercial	$14.40
Rate for Payer: Aetna Medicare Advantage	$11.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.66
Rate for Payer: Cigna Commercial	$18.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.17
Rate for Payer: Qualcare PPO/HMO/WC	$5.68
Rate for Payer: UnitedHealthcare Community & State	$1.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1.08

CATH JUDKINS 6FR JR 4.0 100cm

Facility

$470.50

Service Code	HCPCS C1887
Hospital Charge Code	270648005
Hospital Revenue Code	279
Min. Negotiated Rate	$13.36
Max. Negotiated Rate	$235.25
Rate for Payer: Aetna Commercial	$178.79
Rate for Payer: Aetna Medicare Advantage	$141.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.98
Rate for Payer: Cigna Commercial	$235.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.33
Rate for Payer: Oxford Commercial	$94.10
Rate for Payer: Qualcare PPO/HMO/WC	$70.58
Rate for Payer: UnitedHealthcare Commercial	$94.10
Rate for Payer: UnitedHealthcare Community & State	$14.87
Rate for Payer: Wellpoint Medicaid Managed Care	$13.36

CATH KIT COMMON DUCT EXPLOR

Facility

$4,350.00

Hospital Charge Code	270630273
Hospital Revenue Code	272
Min. Negotiated Rate	$652.50
Max. Negotiated Rate	$652.50
Rate for Payer: Qualcare PPO/HMO/WC	$652.50

CATH KIT COMMON DUCT EXPLOR

Facility

$4,350.00

Hospital Charge Code	270630273
Hospital Revenue Code	272
Min. Negotiated Rate	$123.54
Max. Negotiated Rate	$2,175.00
Rate for Payer: Aetna Commercial	$1,653.00
Rate for Payer: Aetna Medicare Advantage	$1,305.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,109.25
Rate for Payer: Cigna Commercial	$2,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,131.00
Rate for Payer: Oxford Commercial	$870.00
Rate for Payer: Qualcare PPO/HMO/WC	$652.50
Rate for Payer: UnitedHealthcare Commercial	$870.00
Rate for Payer: UnitedHealthcare Community & State	$137.46
Rate for Payer: Wellpoint Medicaid Managed Care	$123.54

CATH KIT MULTI LUMEN MAX 7FR

Facility

$609.24

Service Code	HCPCS C1751
Hospital Charge Code	270665276S
Hospital Revenue Code	278
Min. Negotiated Rate	$91.39
Max. Negotiated Rate	$147.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.44
Rate for Payer: Qualcare PPO/HMO/WC	$91.39

CATH KIT MULTI LUMEN MAX 7FR

Facility

$609.24

Service Code	HCPCS C1751
Hospital Charge Code	270665276S
Hospital Revenue Code	278
Min. Negotiated Rate	$17.30
Max. Negotiated Rate	$304.62
Rate for Payer: Aetna Commercial	$231.51
Rate for Payer: Aetna Medicare Advantage	$182.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.36
Rate for Payer: Cigna Commercial	$304.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.44
Rate for Payer: Qualcare PPO/HMO/WC	$91.39
Rate for Payer: UnitedHealthcare Community & State	$19.25
Rate for Payer: Wellpoint Medicaid Managed Care	$17.30

CATH KIT TRIPLE LUMEN 7FR

Facility

$235.15

Hospital Charge Code	270649052
Hospital Revenue Code	272
Min. Negotiated Rate	$6.68
Max. Negotiated Rate	$117.58
Rate for Payer: Aetna Commercial	$89.36
Rate for Payer: Aetna Medicare Advantage	$70.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.96
Rate for Payer: Cigna Commercial	$117.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.14
Rate for Payer: Oxford Commercial	$47.03
Rate for Payer: Qualcare PPO/HMO/WC	$35.27
Rate for Payer: UnitedHealthcare Commercial	$47.03
Rate for Payer: UnitedHealthcare Community & State	$7.43
Rate for Payer: Wellpoint Medicaid Managed Care	$6.68

CATH KIT TRIPLE LUMEN 7FR

Facility

$235.15

Hospital Charge Code	270649052
Hospital Revenue Code	272
Min. Negotiated Rate	$35.27
Max. Negotiated Rate	$35.27
Rate for Payer: Qualcare PPO/HMO/WC	$35.27

CATH KIT TRIPLE LUMEN 7FRX8

Facility

$163.65

Service Code	HCPCS C1751
Hospital Charge Code	270649053
Hospital Revenue Code	272
Min. Negotiated Rate	$24.55
Max. Negotiated Rate	$24.55
Rate for Payer: Qualcare PPO/HMO/WC	$24.55

CATH KIT TRIPLE LUMEN 7FRX8

Facility

$163.65

Service Code	HCPCS C1751
Hospital Charge Code	270649053
Hospital Revenue Code	272
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$81.83
Rate for Payer: Aetna Commercial	$62.19
Rate for Payer: Aetna Medicare Advantage	$49.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.73
Rate for Payer: Cigna Commercial	$81.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.55
Rate for Payer: Oxford Commercial	$32.73
Rate for Payer: Qualcare PPO/HMO/WC	$24.55
Rate for Payer: UnitedHealthcare Commercial	$32.73
Rate for Payer: UnitedHealthcare Community & State	$5.17
Rate for Payer: Wellpoint Medicaid Managed Care	$4.65

CATH KIT TROCAR 20F

Facility

$132.90

Hospital Charge Code	270300555
Hospital Revenue Code	272
Min. Negotiated Rate	$19.93
Max. Negotiated Rate	$19.93
Rate for Payer: Qualcare PPO/HMO/WC	$19.93

CATH KIT TROCAR 20F

Facility

$132.90

Hospital Charge Code	270300555
Hospital Revenue Code	272
Min. Negotiated Rate	$3.77
Max. Negotiated Rate	$66.45
Rate for Payer: Aetna Commercial	$50.50
Rate for Payer: Aetna Medicare Advantage	$39.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.89
Rate for Payer: Cigna Commercial	$66.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.55
Rate for Payer: Oxford Commercial	$26.58
Rate for Payer: Qualcare PPO/HMO/WC	$19.93
Rate for Payer: UnitedHealthcare Commercial	$26.58
Rate for Payer: UnitedHealthcare Community & State	$4.20
Rate for Payer: Wellpoint Medicaid Managed Care	$3.77

CATH KIT TROCAR 28F

Facility

$132.90

Hospital Charge Code	270300565
Hospital Revenue Code	272
Min. Negotiated Rate	$3.77
Max. Negotiated Rate	$66.45
Rate for Payer: Aetna Commercial	$50.50
Rate for Payer: Aetna Medicare Advantage	$39.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.89
Rate for Payer: Cigna Commercial	$66.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.55
Rate for Payer: Oxford Commercial	$26.58
Rate for Payer: Qualcare PPO/HMO/WC	$19.93
Rate for Payer: UnitedHealthcare Commercial	$26.58
Rate for Payer: UnitedHealthcare Community & State	$4.20
Rate for Payer: Wellpoint Medicaid Managed Care	$3.77

CATH KIT TROCAR 28F

Facility

$132.90

Hospital Charge Code	270300565
Hospital Revenue Code	272
Min. Negotiated Rate	$19.93
Max. Negotiated Rate	$19.93
Rate for Payer: Qualcare PPO/HMO/WC	$19.93

Know your out-of-pocket cost for care.

All Charges