Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH MPA2 5FR 100cm 534542T

Facility

$44.50

Service Code	HCPCS C1887
Hospital Charge Code	270644598C
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 MPA2 5FR 100cm 534542T

Facility

$44.50

Service Code	HCPCS C1887
Hospital Charge Code	270644598C
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 MP DRAINAGE 10FR

Facility

$512.70

Hospital Charge Code	270637553
Hospital Revenue Code	272
Min. Negotiated Rate	$76.91
Max. Negotiated Rate	$76.91
Rate for Payer: Qualcare PPO/HMO/WC	$76.91

CATH MP DRAINAGE 10FR

Facility

$512.70

Hospital Charge Code	270637553
Hospital Revenue Code	272
Min. Negotiated Rate	$14.56
Max. Negotiated Rate	$256.35
Rate for Payer: Aetna Commercial	$194.83
Rate for Payer: Aetna Medicare Advantage	$153.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.74
Rate for Payer: Cigna Commercial	$256.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.30
Rate for Payer: Oxford Commercial	$102.54
Rate for Payer: Qualcare PPO/HMO/WC	$76.91
Rate for Payer: UnitedHealthcare Commercial	$102.54
Rate for Payer: UnitedHealthcare Community & State	$16.20
Rate for Payer: Wellpoint Medicaid Managed Care	$14.56

CATH MP DRAINAGE 12FR

Facility

$512.70

Hospital Charge Code	270642067
Hospital Revenue Code	272
Min. Negotiated Rate	$14.56
Max. Negotiated Rate	$256.35
Rate for Payer: Aetna Commercial	$194.83
Rate for Payer: Aetna Medicare Advantage	$153.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.74
Rate for Payer: Cigna Commercial	$256.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.30
Rate for Payer: Oxford Commercial	$102.54
Rate for Payer: Qualcare PPO/HMO/WC	$76.91
Rate for Payer: UnitedHealthcare Commercial	$102.54
Rate for Payer: UnitedHealthcare Community & State	$16.20
Rate for Payer: Wellpoint Medicaid Managed Care	$14.56

CATH MP DRAINAGE 12FR

Facility

$512.70

Hospital Charge Code	270642067
Hospital Revenue Code	272
Min. Negotiated Rate	$76.91
Max. Negotiated Rate	$76.91
Rate for Payer: Qualcare PPO/HMO/WC	$76.91

CATH MP DRAINAGE 14FR

Facility

$512.70

Hospital Charge Code	270637554
Hospital Revenue Code	272
Min. Negotiated Rate	$76.91
Max. Negotiated Rate	$76.91
Rate for Payer: Qualcare PPO/HMO/WC	$76.91

CATH MP DRAINAGE 14FR

Facility

$512.70

Hospital Charge Code	270637554
Hospital Revenue Code	272
Min. Negotiated Rate	$14.56
Max. Negotiated Rate	$256.35
Rate for Payer: Aetna Commercial	$194.83
Rate for Payer: Aetna Medicare Advantage	$153.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.74
Rate for Payer: Cigna Commercial	$256.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.30
Rate for Payer: Oxford Commercial	$102.54
Rate for Payer: Qualcare PPO/HMO/WC	$76.91
Rate for Payer: UnitedHealthcare Commercial	$102.54
Rate for Payer: UnitedHealthcare Community & State	$16.20
Rate for Payer: Wellpoint Medicaid Managed Care	$14.56

CATH MP DRAINAGE 8FR

Facility

$512.70

Hospital Charge Code	270642068
Hospital Revenue Code	272
Min. Negotiated Rate	$76.91
Max. Negotiated Rate	$76.91
Rate for Payer: Qualcare PPO/HMO/WC	$76.91

CATH MP DRAINAGE 8FR

Facility

$512.70

Hospital Charge Code	270642068
Hospital Revenue Code	272
Min. Negotiated Rate	$14.56
Max. Negotiated Rate	$256.35
Rate for Payer: Aetna Commercial	$194.83
Rate for Payer: Aetna Medicare Advantage	$153.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.74
Rate for Payer: Cigna Commercial	$256.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.30
Rate for Payer: Oxford Commercial	$102.54
Rate for Payer: Qualcare PPO/HMO/WC	$76.91
Rate for Payer: UnitedHealthcare Commercial	$102.54
Rate for Payer: UnitedHealthcare Community & State	$16.20
Rate for Payer: Wellpoint Medicaid Managed Care	$14.56

CATH MRI POWER PORT 8F 1LUMEN

Facility

$3,050.00

Service Code	HCPCS C1788
Hospital Charge Code	270644422
Hospital Revenue Code	278
Min. Negotiated Rate	$86.62
Max. Negotiated Rate	$1,525.00
Rate for Payer: Aetna Commercial	$1,159.00
Rate for Payer: Aetna Medicare Advantage	$915.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$777.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$777.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$610.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$777.75
Rate for Payer: Cigna Commercial	$1,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$738.10
Rate for Payer: Qualcare PPO/HMO/WC	$457.50
Rate for Payer: UnitedHealthcare Community & State	$96.38
Rate for Payer: Wellpoint Medicaid Managed Care	$86.62

CATH MRI POWER PORT 8F 1LUMEN

Facility

$3,050.00

Service Code	HCPCS C1788
Hospital Charge Code	270644422
Hospital Revenue Code	278
Min. Negotiated Rate	$457.50
Max. Negotiated Rate	$738.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$610.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$738.10
Rate for Payer: Qualcare PPO/HMO/WC	$457.50

CATH MT BALLN USQ/5-4 225121

Facility

$1,287.25

Service Code	HCPCS C1725
Hospital Charge Code	270624347
Hospital Revenue Code	278
Min. Negotiated Rate	$36.56
Max. Negotiated Rate	$643.62
Rate for Payer: Aetna Commercial	$489.15
Rate for Payer: Aetna Medicare Advantage	$386.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.25
Rate for Payer: Cigna Commercial	$643.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.51
Rate for Payer: Qualcare PPO/HMO/WC	$193.09
Rate for Payer: UnitedHealthcare Community & State	$40.68
Rate for Payer: Wellpoint Medicaid Managed Care	$36.56

CATH MT BALLN USQ/5-4 225121

Facility

$1,287.25

Service Code	HCPCS C1725
Hospital Charge Code	270624347
Hospital Revenue Code	278
Min. Negotiated Rate	$193.09
Max. Negotiated Rate	$311.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.51
Rate for Payer: Qualcare PPO/HMO/WC	$193.09

CATH MT GLIDE 5 100 32-139

Facility

$253.25

Service Code	HCPCS C1887
Hospital Charge Code	270623514S
Hospital Revenue Code	278
Min. Negotiated Rate	$37.99
Max. Negotiated Rate	$61.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.29
Rate for Payer: Qualcare PPO/HMO/WC	$37.99

CATH MT GLIDE 5 100 32-139

Facility

$253.25

Service Code	HCPCS C1887
Hospital Charge Code	270623514S
Hospital Revenue Code	278
Min. Negotiated Rate	$7.19
Max. Negotiated Rate	$126.62
Rate for Payer: Aetna Commercial	$96.23
Rate for Payer: Aetna Medicare Advantage	$75.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.58
Rate for Payer: Cigna Commercial	$126.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.29
Rate for Payer: Qualcare PPO/HMO/WC	$37.99
Rate for Payer: UnitedHealthcare Community & State	$8.00
Rate for Payer: Wellpoint Medicaid Managed Care	$7.19

CATH MT GLIDE 5 100 32-139

Facility

$253.25

Service Code	HCPCS C1887
Hospital Charge Code	270623514O
Hospital Revenue Code	278
Min. Negotiated Rate	$7.19
Max. Negotiated Rate	$126.62
Rate for Payer: Aetna Commercial	$96.23
Rate for Payer: Aetna Medicare Advantage	$75.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.58
Rate for Payer: Cigna Commercial	$126.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.29
Rate for Payer: Qualcare PPO/HMO/WC	$37.99
Rate for Payer: UnitedHealthcare Community & State	$8.00
Rate for Payer: Wellpoint Medicaid Managed Care	$7.19

CATH MT GLIDE 5 100 32-139

Facility

$253.25

Service Code	HCPCS C1887
Hospital Charge Code	270623514
Hospital Revenue Code	278
Min. Negotiated Rate	$7.19
Max. Negotiated Rate	$126.62
Rate for Payer: Aetna Commercial	$96.23
Rate for Payer: Aetna Medicare Advantage	$75.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.58
Rate for Payer: Cigna Commercial	$126.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.29
Rate for Payer: Qualcare PPO/HMO/WC	$37.99
Rate for Payer: UnitedHealthcare Community & State	$8.00
Rate for Payer: Wellpoint Medicaid Managed Care	$7.19

CATH MT GLIDE 5 100 32-139

Facility

$253.25

Service Code	HCPCS C1887
Hospital Charge Code	270623514
Hospital Revenue Code	278
Min. Negotiated Rate	$37.99
Max. Negotiated Rate	$61.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.29
Rate for Payer: Qualcare PPO/HMO/WC	$37.99

CATH MT GLIDE 5 100 32-139

Facility

$71.50

Service Code	HCPCS C1887
Hospital Charge Code	270623514N
Hospital Revenue Code	278
Min. Negotiated Rate	$2.03
Max. Negotiated Rate	$35.75
Rate for Payer: Aetna Commercial	$27.17
Rate for Payer: Aetna Medicare Advantage	$21.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.23
Rate for Payer: Cigna Commercial	$35.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.30
Rate for Payer: Qualcare PPO/HMO/WC	$10.72
Rate for Payer: UnitedHealthcare Community & State	$2.26
Rate for Payer: Wellpoint Medicaid Managed Care	$2.03

CATH MT GLIDE 5 100 32-139

Facility

$71.50

Service Code	HCPCS C1887
Hospital Charge Code	270623514N
Hospital Revenue Code	278
Min. Negotiated Rate	$10.72
Max. Negotiated Rate	$17.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.30
Rate for Payer: Qualcare PPO/HMO/WC	$10.72

CATH MT GLIDE 5 100 32-139

Facility

$253.25

Service Code	HCPCS C1887
Hospital Charge Code	270623514O
Hospital Revenue Code	278
Min. Negotiated Rate	$37.99
Max. Negotiated Rate	$61.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.29
Rate for Payer: Qualcare PPO/HMO/WC	$37.99

CATH MUSTANG BALLOON 6MMx200CM

Facility

$1,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270673900
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

CATH MUSTANG BALLOON 6MMx200CM

Facility

$1,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270673900
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

CATH NAVIEN DSC ST LP 5F 105CM

Facility

$6,750.00

Service Code	HCPCS C1887
Hospital Charge Code	270695993S
Hospital Revenue Code	278
Min. Negotiated Rate	$191.70
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$213.30
Rate for Payer: Wellpoint Medicaid Managed Care	$191.70

Know your out-of-pocket cost for care.

All Charges