Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH PERCUT SUPRPUB 14F 143112

Facility

$388.95

Service Code	HCPCS C2627
Hospital Charge Code	270600273
Hospital Revenue Code	278
Min. Negotiated Rate	$11.05
Max. Negotiated Rate	$194.47
Rate for Payer: Aetna Commercial	$147.80
Rate for Payer: Aetna Medicare Advantage	$116.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.18
Rate for Payer: Cigna Commercial	$194.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.13
Rate for Payer: Qualcare PPO/HMO/WC	$58.34
Rate for Payer: UnitedHealthcare Community & State	$12.29
Rate for Payer: Wellpoint Medicaid Managed Care	$11.05

CATH PERCUT SUPRPUB 14F 143112

Facility

$388.95

Service Code	HCPCS C2627
Hospital Charge Code	270600273
Hospital Revenue Code	278
Min. Negotiated Rate	$58.34
Max. Negotiated Rate	$94.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.13
Rate for Payer: Qualcare PPO/HMO/WC	$58.34

CATH PERF 6F 610038ULT2

Facility

$113.75

Hospital Charge Code	270667500
Hospital Revenue Code	272
Min. Negotiated Rate	$17.06
Max. Negotiated Rate	$17.06
Rate for Payer: Qualcare PPO/HMO/WC	$17.06

CATH PERF 6F 610038ULT2

Facility

$113.75

Hospital Charge Code	270667500
Hospital Revenue Code	272
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$56.88
Rate for Payer: Aetna Commercial	$43.23
Rate for Payer: Aetna Medicare Advantage	$34.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.01
Rate for Payer: Cigna Commercial	$56.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.57
Rate for Payer: Oxford Commercial	$22.75
Rate for Payer: Qualcare PPO/HMO/WC	$17.06
Rate for Payer: UnitedHealthcare Commercial	$22.75
Rate for Payer: UnitedHealthcare Community & State	$3.59
Rate for Payer: Wellpoint Medicaid Managed Care	$3.23

CATH PERF 6FR JL4 750120

Facility

$37.90

Hospital Charge Code	270655490S
Hospital Revenue Code	272
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) PPO	$9.66
Rate for Payer: Cigna Commercial	$18.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.85
Rate for Payer: Oxford Commercial	$7.58
Rate for Payer: Qualcare PPO/HMO/WC	$5.68
Rate for Payer: UnitedHealthcare Commercial	$7.58
Rate for Payer: UnitedHealthcare Community & State	$1.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1.08

CATH PERF 6FR JL4 750120

Facility

$37.90

Hospital Charge Code	270655490
Hospital Revenue Code	272
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) PPO	$9.66
Rate for Payer: Cigna Commercial	$18.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.85
Rate for Payer: Oxford Commercial	$7.58
Rate for Payer: Qualcare PPO/HMO/WC	$5.68
Rate for Payer: UnitedHealthcare Commercial	$7.58
Rate for Payer: UnitedHealthcare Community & State	$1.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1.08

CATH PERF 6FR JL4 750120

Facility

$37.90

Hospital Charge Code	270655490S
Hospital Revenue Code	272
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$5.68
Rate for Payer: Qualcare PPO/HMO/WC	$5.68

CATH PERF 6FR JL4 750120

Facility

$37.90

Hospital Charge Code	270655490
Hospital Revenue Code	272
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$5.68
Rate for Payer: Qualcare PPO/HMO/WC	$5.68

CATH PERF 6FR JL4 750120

Facility

$37.90

Hospital Charge Code	270655490N
Hospital Revenue Code	272
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) PPO	$9.66
Rate for Payer: Cigna Commercial	$18.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.85
Rate for Payer: Oxford Commercial	$7.58
Rate for Payer: Qualcare PPO/HMO/WC	$5.68
Rate for Payer: UnitedHealthcare Commercial	$7.58
Rate for Payer: UnitedHealthcare Community & State	$1.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1.08

CATH PERF 6FR JL4 750120

Facility

$37.90

Hospital Charge Code	270655490N
Hospital Revenue Code	272
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$5.68
Rate for Payer: Qualcare PPO/HMO/WC	$5.68

CATH PERFORMA 4F 7706 10

Facility

$37.35

Hospital Charge Code	270658256
Hospital Revenue Code	272
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$5.60

CATH PERFORMA 4F 7706 10

Facility

$37.35

Hospital Charge Code	270658256
Hospital Revenue Code	272
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$18.68
Rate for Payer: Aetna Commercial	$14.19
Rate for Payer: Aetna Medicare Advantage	$11.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.52
Rate for Payer: Cigna Commercial	$18.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.71
Rate for Payer: Oxford Commercial	$7.47
Rate for Payer: Qualcare PPO/HMO/WC	$5.60
Rate for Payer: UnitedHealthcare Commercial	$7.47
Rate for Payer: UnitedHealthcare Community & State	$1.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

CATH PERFUSION W/ASP TB RED43

Facility

$11,950.00

Service Code	HCPCS C1887
Hospital Charge Code	270700022S
Hospital Revenue Code	278
Min. Negotiated Rate	$339.38
Max. Negotiated Rate	$5,975.00
Rate for Payer: Aetna Commercial	$4,541.00
Rate for Payer: Aetna Medicare Advantage	$3,585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,047.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,047.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,047.25
Rate for Payer: Cigna Commercial	$5,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,891.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,792.50
Rate for Payer: UnitedHealthcare Community & State	$377.62
Rate for Payer: Wellpoint Medicaid Managed Care	$339.38

CATH PERFUSION W/ASP TB RED43

Facility

$11,950.00

Service Code	HCPCS C1887
Hospital Charge Code	270700022S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,792.50
Max. Negotiated Rate	$2,891.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,891.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,792.50

CATH PERITONEAL CURL KIT 60CM

Facility

$589.50

Service Code	HCPCS C1750
Hospital Charge Code	270693168
Hospital Revenue Code	278
Min. Negotiated Rate	$16.74
Max. Negotiated Rate	$294.75
Rate for Payer: Aetna Commercial	$224.01
Rate for Payer: Aetna Medicare Advantage	$176.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$150.32
Rate for Payer: Cigna Commercial	$294.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.66
Rate for Payer: Qualcare PPO/HMO/WC	$88.42
Rate for Payer: UnitedHealthcare Community & State	$18.63
Rate for Payer: Wellpoint Medicaid Managed Care	$16.74

CATH PERITONEAL CURL KIT 60CM

Facility

$589.50

Service Code	HCPCS C1750
Hospital Charge Code	270693168
Hospital Revenue Code	278
Min. Negotiated Rate	$88.42
Max. Negotiated Rate	$142.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.66
Rate for Payer: Qualcare PPO/HMO/WC	$88.42

CATH PICC 4FR DUAL LUMEN

Facility

$518.50

Service Code	HCPCS C1751
Hospital Charge Code	675028
Hospital Revenue Code	278
Min. Negotiated Rate	$14.73
Max. Negotiated Rate	$259.25
Rate for Payer: Aetna Commercial	$197.03
Rate for Payer: Aetna Medicare Advantage	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.22
Rate for Payer: Cigna Commercial	$259.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.48
Rate for Payer: Qualcare PPO/HMO/WC	$77.78
Rate for Payer: UnitedHealthcare Community & State	$16.38
Rate for Payer: Wellpoint Medicaid Managed Care	$14.73

CATH PICC 4FR DUAL LUMEN

Facility

$518.50

Service Code	HCPCS C1751
Hospital Charge Code	675028
Hospital Revenue Code	278
Min. Negotiated Rate	$77.78
Max. Negotiated Rate	$125.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.48
Rate for Payer: Qualcare PPO/HMO/WC	$77.78

CATH PICC 5FR SNGL LUMEN

Facility

$472.00

Service Code	HCPCS C1751
Hospital Charge Code	270664312
Hospital Revenue Code	278
Min. Negotiated Rate	$70.80
Max. Negotiated Rate	$114.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.22
Rate for Payer: Qualcare PPO/HMO/WC	$70.80

CATH PICC 5FR SNGL LUMEN

Facility

$472.00

Service Code	HCPCS C1751
Hospital Charge Code	270664312S
Hospital Revenue Code	278
Min. Negotiated Rate	$70.80
Max. Negotiated Rate	$114.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.22
Rate for Payer: Qualcare PPO/HMO/WC	$70.80

CATH PICC 5FR SNGL LUMEN

Facility

$472.00

Service Code	HCPCS C1751
Hospital Charge Code	270664312S
Hospital Revenue Code	278
Min. Negotiated Rate	$13.40
Max. Negotiated Rate	$236.00
Rate for Payer: Aetna Commercial	$179.36
Rate for Payer: Aetna Medicare Advantage	$141.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.36
Rate for Payer: Cigna Commercial	$236.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.22
Rate for Payer: Qualcare PPO/HMO/WC	$70.80
Rate for Payer: UnitedHealthcare Community & State	$14.92
Rate for Payer: Wellpoint Medicaid Managed Care	$13.40

CATH PICC 5FR SNGL LUMEN

Facility

$475.00

Service Code	HCPCS C1751
Hospital Charge Code	270664312N
Hospital Revenue Code	278
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$180.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Community & State	$15.01
Rate for Payer: Wellpoint Medicaid Managed Care	$13.49

CATH PICC 5FR SNGL LUMEN

Facility

$472.00

Service Code	HCPCS C1751
Hospital Charge Code	270664312
Hospital Revenue Code	278
Min. Negotiated Rate	$13.40
Max. Negotiated Rate	$236.00
Rate for Payer: Aetna Commercial	$179.36
Rate for Payer: Aetna Medicare Advantage	$141.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.36
Rate for Payer: Cigna Commercial	$236.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.22
Rate for Payer: Qualcare PPO/HMO/WC	$70.80
Rate for Payer: UnitedHealthcare Community & State	$14.92
Rate for Payer: Wellpoint Medicaid Managed Care	$13.40

CATH PICC 5FR SNGL LUMEN

Facility

$475.00

Service Code	HCPCS C1751
Hospital Charge Code	270664312N
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

CATH PIGTAIL 145 5FR 110cm

Facility

$44.50

Hospital Charge Code	270644615C
Hospital Revenue Code	272
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) PPO	$11.35
Rate for Payer: Cigna Commercial	$22.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.57
Rate for Payer: Oxford Commercial	$8.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.67
Rate for Payer: UnitedHealthcare Commercial	$8.90
Rate for Payer: UnitedHealthcare Community & State	$1.41
Rate for Payer: Wellpoint Medicaid Managed Care	$1.26

Know your out-of-pocket cost for care.

All Charges