Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH OUTBACK

Facility

$10,500.00

Service Code	HCPCS C2628
Hospital Charge Code	270637755S
Hospital Revenue Code	278
Min. Negotiated Rate	$298.20
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,990.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00
Rate for Payer: UnitedHealthcare Community & State	$331.80
Rate for Payer: Wellpoint Medicaid Managed Care	$298.20

CATH OUTBACK

Facility

$10,685.70

Service Code	HCPCS C2628
Hospital Charge Code	270637755O
Hospital Revenue Code	278
Min. Negotiated Rate	$1,602.86
Max. Negotiated Rate	$2,585.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,137.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,585.94
Rate for Payer: Qualcare PPO/HMO/WC	$1,602.86

CATH OUTBACK

Facility

$8,750.00

Service Code	HCPCS C2628
Hospital Charge Code	270637755C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

CATH OUTBACK 120 CM RE-ENTRY

Facility

$8,775.00

Hospital Charge Code	270637755
Hospital Revenue Code	279
Min. Negotiated Rate	$249.21
Max. Negotiated Rate	$4,387.50
Rate for Payer: Aetna Commercial	$3,334.50
Rate for Payer: Aetna Medicare Advantage	$2,632.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,237.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,237.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,237.62
Rate for Payer: Cigna Commercial	$4,387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,281.50
Rate for Payer: Oxford Commercial	$1,755.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,316.25
Rate for Payer: UnitedHealthcare Commercial	$1,755.00
Rate for Payer: UnitedHealthcare Community & State	$277.29
Rate for Payer: Wellpoint Medicaid Managed Care	$249.21

CATH OUTBACK 120 CM RE-ENTRY

Facility

$8,775.00

Hospital Charge Code	270637755
Hospital Revenue Code	279
Min. Negotiated Rate	$1,316.25
Max. Negotiated Rate	$1,316.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,316.25

CATH PACING GD RIGHTSITE 43CM

Facility

$2,200.00

Service Code	HCPCS C1887
Hospital Charge Code	270699656C
Hospital Revenue Code	278
Min. Negotiated Rate	$62.48
Max. Negotiated Rate	$1,100.00
Rate for Payer: Aetna Commercial	$836.00
Rate for Payer: Aetna Medicare Advantage	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$561.00
Rate for Payer: Cigna Commercial	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: Qualcare PPO/HMO/WC	$330.00
Rate for Payer: UnitedHealthcare Community & State	$69.52
Rate for Payer: Wellpoint Medicaid Managed Care	$62.48

CATH PACING GD RIGHTSITE 43CM

Facility

$2,200.00

Service Code	HCPCS C1887
Hospital Charge Code	270699656C
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$532.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: Qualcare PPO/HMO/WC	$330.00

CATH PACING SSPC2 .035 8FX40CM

Facility

$2,475.00

Service Code	HCPCS C1887
Hospital Charge Code	270695977S
Hospital Revenue Code	272
Min. Negotiated Rate	$70.29
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$643.50
Rate for Payer: Oxford Commercial	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$495.00
Rate for Payer: UnitedHealthcare Community & State	$78.21
Rate for Payer: Wellpoint Medicaid Managed Care	$70.29

CATH PACING SSPC2 .035 8FX40CM

Facility

$2,475.00

Service Code	HCPCS C1887
Hospital Charge Code	270695977S
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

CATH PACING SSPC3 .035 8FX40CM

Facility

$2,475.00

Service Code	HCPCS C1887
Hospital Charge Code	270695975S
Hospital Revenue Code	272
Min. Negotiated Rate	$70.29
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$643.50
Rate for Payer: Oxford Commercial	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$495.00
Rate for Payer: UnitedHealthcare Community & State	$78.21
Rate for Payer: Wellpoint Medicaid Managed Care	$70.29

CATH PACING SSPC3 .035 8FX40CM

Facility

$2,475.00

Service Code	HCPCS C1887
Hospital Charge Code	270695975S
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

CATH PANTHERIS 7FR ARTHERECTMY

Facility

$16,475.00

Service Code	HCPCS C1724
Hospital Charge Code	270676627
Hospital Revenue Code	278
Min. Negotiated Rate	$467.89
Max. Negotiated Rate	$8,237.50
Rate for Payer: Aetna Commercial	$6,260.50
Rate for Payer: Aetna Medicare Advantage	$4,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,201.12
Rate for Payer: Cigna Commercial	$8,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25
Rate for Payer: UnitedHealthcare Community & State	$520.61
Rate for Payer: Wellpoint Medicaid Managed Care	$467.89

CATH PANTHERIS 7FR ARTHERECTMY

Facility

$16,475.00

Service Code	HCPCS C1724
Hospital Charge Code	270676627N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,471.25
Max. Negotiated Rate	$3,986.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25

CATH PANTHERIS 7FR ARTHERECTMY

Facility

$16,475.00

Service Code	HCPCS C1724
Hospital Charge Code	270676627
Hospital Revenue Code	278
Min. Negotiated Rate	$2,471.25
Max. Negotiated Rate	$3,986.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25

CATH PANTHERIS 7FR ARTHERECTMY

Facility

$16,475.00

Service Code	HCPCS C1724
Hospital Charge Code	270676627N
Hospital Revenue Code	278
Min. Negotiated Rate	$467.89
Max. Negotiated Rate	$8,237.50
Rate for Payer: Aetna Commercial	$6,260.50
Rate for Payer: Aetna Medicare Advantage	$4,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,201.12
Rate for Payer: Cigna Commercial	$8,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25
Rate for Payer: UnitedHealthcare Community & State	$520.61
Rate for Payer: Wellpoint Medicaid Managed Care	$467.89

CATH PANTHERIS 8FR ARTHERECTMY

Facility

$105.00

Hospital Charge Code	270676332
Hospital Revenue Code	278
Min. Negotiated Rate	$2.98
Max. Negotiated Rate	$52.50
Rate for Payer: Aetna Commercial	$39.90
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.41
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Community & State	$3.32
Rate for Payer: Wellpoint Medicaid Managed Care	$2.98

CATH PANTHERIS 8FR ARTHERECTMY

Facility

$105.00

Hospital Charge Code	270676332
Hospital Revenue Code	278
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$25.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.41
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

CATH PANTHERIS 8FR ARTHERECTMY

Facility

$16,475.00

Hospital Charge Code	270676331
Hospital Revenue Code	278
Min. Negotiated Rate	$467.89
Max. Negotiated Rate	$8,237.50
Rate for Payer: Aetna Commercial	$6,260.50
Rate for Payer: Aetna Medicare Advantage	$4,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,201.12
Rate for Payer: Cigna Commercial	$8,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25
Rate for Payer: UnitedHealthcare Community & State	$520.61
Rate for Payer: Wellpoint Medicaid Managed Care	$467.89

CATH PANTHERIS 8FR ARTHERECTMY

Facility

$16,475.00

Hospital Charge Code	270676331
Hospital Revenue Code	278
Min. Negotiated Rate	$2,471.25
Max. Negotiated Rate	$3,986.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25

CATH PENUMBRA 6F 80CM 105CM

Facility

$4,475.00

Service Code	HCPCS C1887
Hospital Charge Code	270691882S
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

CATH PENUMBRA 6F 80CM 105CM

Facility

$4,475.00

Service Code	HCPCS C1887
Hospital Charge Code	270691882S
Hospital Revenue Code	278
Min. Negotiated Rate	$127.09
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,700.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Community & State	$141.41
Rate for Payer: Wellpoint Medicaid Managed Care	$127.09

CATH PENUMBRA THROMBECT 138CM

Facility

$13,975.00

Service Code	HCPCS C1757
Hospital Charge Code	270693921S
Hospital Revenue Code	278
Min. Negotiated Rate	$396.89
Max. Negotiated Rate	$6,987.50
Rate for Payer: Aetna Commercial	$5,310.50
Rate for Payer: Aetna Medicare Advantage	$4,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,563.62
Rate for Payer: Cigna Commercial	$6,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,381.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25
Rate for Payer: UnitedHealthcare Community & State	$441.61
Rate for Payer: Wellpoint Medicaid Managed Care	$396.89

CATH PENUMBRA THROMBECT 138CM

Facility

$13,975.00

Service Code	HCPCS C1757
Hospital Charge Code	270693921S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,096.25
Max. Negotiated Rate	$3,381.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,381.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25

CATH PERC. HARD OPEN 9.6FR

Facility

$2,400.00

Hospital Charge Code	270685029
Hospital Revenue Code	272
Min. Negotiated Rate	$360.00
Max. Negotiated Rate	$360.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00

CATH PERC. HARD OPEN 9.6FR

Facility

$2,400.00

Hospital Charge Code	270685029
Hospital Revenue Code	272
Min. Negotiated Rate	$68.16
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$912.00
Rate for Payer: Aetna Medicare Advantage	$720.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$612.00
Rate for Payer: Cigna Commercial	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.00
Rate for Payer: Oxford Commercial	$480.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00
Rate for Payer: UnitedHealthcare Commercial	$480.00
Rate for Payer: UnitedHealthcare Community & State	$75.84
Rate for Payer: Wellpoint Medicaid Managed Care	$68.16

Know your out-of-pocket cost for care.

All Charges