Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH POWERMIDLINE PICC KT 3FR

Facility

$735.00

Service Code	HCPCS C1751
Hospital Charge Code	270684374S
Hospital Revenue Code	278
Min. Negotiated Rate	$110.25
Max. Negotiated Rate	$177.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.87
Rate for Payer: Qualcare PPO/HMO/WC	$110.25

CATH POWERMIDLINE PICC KT 3FR

Facility

$735.00

Service Code	HCPCS C1751
Hospital Charge Code	270684374S
Hospital Revenue Code	278
Min. Negotiated Rate	$20.87
Max. Negotiated Rate	$367.50
Rate for Payer: Aetna Commercial	$279.30
Rate for Payer: Aetna Medicare Advantage	$220.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$187.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$187.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$187.43
Rate for Payer: Cigna Commercial	$367.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.87
Rate for Payer: Qualcare PPO/HMO/WC	$110.25
Rate for Payer: UnitedHealthcare Community & State	$23.23
Rate for Payer: Wellpoint Medicaid Managed Care	$20.87

CATH POWERMIDLINE PICC KT 4FR

Facility

$865.00

Service Code	HCPCS C1751
Hospital Charge Code	270684375N
Hospital Revenue Code	278
Min. Negotiated Rate	$24.57
Max. Negotiated Rate	$432.50
Rate for Payer: Aetna Commercial	$328.70
Rate for Payer: Aetna Medicare Advantage	$259.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$220.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$220.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$173.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$220.57
Rate for Payer: Cigna Commercial	$432.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.33
Rate for Payer: Qualcare PPO/HMO/WC	$129.75
Rate for Payer: UnitedHealthcare Community & State	$27.33
Rate for Payer: Wellpoint Medicaid Managed Care	$24.57

CATH POWERMIDLINE PICC KT 4FR

Facility

$865.00

Service Code	HCPCS C1751
Hospital Charge Code	270684375N
Hospital Revenue Code	278
Min. Negotiated Rate	$129.75
Max. Negotiated Rate	$209.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$173.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.33
Rate for Payer: Qualcare PPO/HMO/WC	$129.75

CATH POWER PICC 4FR SNGL 135CM

Facility

$518.50

Service Code	HCPCS C1751
Hospital Charge Code	270675028S
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 POWER PICC 4FR SNGL 135CM

Facility

$518.50

Service Code	HCPCS C1751
Hospital Charge Code	270675028S
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 POWER PICC 4FR SNGL 135CM

Facility

$518.50

Service Code	HCPCS C1751
Hospital Charge Code	270675028N
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 POWER PICC 4FR SNGL 135CM

Facility

$518.50

Service Code	HCPCS C1751
Hospital Charge Code	270675028N
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 POWER PICC 4FR SNGL 135CM

Facility

$518.50

Service Code	HCPCS C1751
Hospital Charge Code	270675028
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 POWER PICC 4FR SNGL 135CM

Facility

$518.50

Service Code	HCPCS C1751
Hospital Charge Code	270675028
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 POWER PICC 4FR SNGL 70CM

Facility

$518.50

Hospital Charge Code	270677809
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 POWER PICC 4FR SNGL 70CM

Facility

$518.50

Hospital Charge Code	270677809
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 POWER PICC 5FR DUAL 135CM

Facility

$520.00

Service Code	HCPCS C1751
Hospital Charge Code	270644329
Hospital Revenue Code	278
Min. Negotiated Rate	$14.77
Max. Negotiated Rate	$260.00
Rate for Payer: Aetna Commercial	$197.60
Rate for Payer: Aetna Medicare Advantage	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.60
Rate for Payer: Cigna Commercial	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$78.00
Rate for Payer: UnitedHealthcare Community & State	$16.43
Rate for Payer: Wellpoint Medicaid Managed Care	$14.77

CATH POWER PICC 5FR DUAL 135CM

Facility

$520.00

Service Code	HCPCS C1751
Hospital Charge Code	270644329N
Hospital Revenue Code	278
Min. Negotiated Rate	$14.77
Max. Negotiated Rate	$260.00
Rate for Payer: Aetna Commercial	$197.60
Rate for Payer: Aetna Medicare Advantage	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.60
Rate for Payer: Cigna Commercial	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$78.00
Rate for Payer: UnitedHealthcare Community & State	$16.43
Rate for Payer: Wellpoint Medicaid Managed Care	$14.77

CATH POWER PICC 5FR DUAL 135CM

Facility

$520.00

Service Code	HCPCS C1751
Hospital Charge Code	270644329N
Hospital Revenue Code	278
Min. Negotiated Rate	$78.00
Max. Negotiated Rate	$125.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$78.00

CATH POWER PICC 5FR DUAL 135CM

Facility

$520.00

Service Code	HCPCS C1751
Hospital Charge Code	270644329S
Hospital Revenue Code	278
Min. Negotiated Rate	$14.77
Max. Negotiated Rate	$260.00
Rate for Payer: Aetna Commercial	$197.60
Rate for Payer: Aetna Medicare Advantage	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.60
Rate for Payer: Cigna Commercial	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$78.00
Rate for Payer: UnitedHealthcare Community & State	$16.43
Rate for Payer: Wellpoint Medicaid Managed Care	$14.77

CATH POWER PICC 5FR DUAL 135CM

Facility

$520.00

Service Code	HCPCS C1751
Hospital Charge Code	270644329S
Hospital Revenue Code	278
Min. Negotiated Rate	$78.00
Max. Negotiated Rate	$125.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$78.00

CATH POWER PICC 5FR DUAL 135CM

Facility

$520.00

Service Code	HCPCS C1751
Hospital Charge Code	270644329
Hospital Revenue Code	278
Min. Negotiated Rate	$78.00
Max. Negotiated Rate	$125.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$78.00

CATH POWER PICC 5FR DUAL 70CM

Facility

$520.00

Hospital Charge Code	270662310
Hospital Revenue Code	278
Min. Negotiated Rate	$78.00
Max. Negotiated Rate	$125.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$78.00

CATH POWER PICC 5FR DUAL 70CM

Facility

$520.00

Hospital Charge Code	270662310
Hospital Revenue Code	278
Min. Negotiated Rate	$14.77
Max. Negotiated Rate	$260.00
Rate for Payer: Aetna Commercial	$197.60
Rate for Payer: Aetna Medicare Advantage	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.60
Rate for Payer: Cigna Commercial	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$78.00
Rate for Payer: UnitedHealthcare Community & State	$16.43
Rate for Payer: Wellpoint Medicaid Managed Care	$14.77

CATH POWER PICC SOLO D/LUM 5FR

Facility

$1,169.50

Service Code	HCPCS C1751
Hospital Charge Code	270649055N
Hospital Revenue Code	278
Min. Negotiated Rate	$33.21
Max. Negotiated Rate	$584.75
Rate for Payer: Aetna Commercial	$444.41
Rate for Payer: Aetna Medicare Advantage	$350.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$298.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$298.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$233.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$298.22
Rate for Payer: Cigna Commercial	$584.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$283.02
Rate for Payer: Qualcare PPO/HMO/WC	$175.43
Rate for Payer: UnitedHealthcare Community & State	$36.96
Rate for Payer: Wellpoint Medicaid Managed Care	$33.21

CATH POWER PICC SOLO D/LUM 5FR

Facility

$1,169.50

Service Code	HCPCS C1751
Hospital Charge Code	270649055N
Hospital Revenue Code	278
Min. Negotiated Rate	$175.43
Max. Negotiated Rate	$283.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$233.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$283.02
Rate for Payer: Qualcare PPO/HMO/WC	$175.43

CATH POWER PICC SOLO D/LUM 5FR

Facility

$1,169.50

Service Code	HCPCS C1751
Hospital Charge Code	270649055
Hospital Revenue Code	278
Min. Negotiated Rate	$175.43
Max. Negotiated Rate	$283.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$233.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$283.02
Rate for Payer: Qualcare PPO/HMO/WC	$175.43

CATH POWER PICC SOLO D/LUM 5FR

Facility

$1,169.50

Service Code	HCPCS C1751
Hospital Charge Code	270649055
Hospital Revenue Code	278
Min. Negotiated Rate	$33.21
Max. Negotiated Rate	$584.75
Rate for Payer: Aetna Commercial	$444.41
Rate for Payer: Aetna Medicare Advantage	$350.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$298.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$298.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$233.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$298.22
Rate for Payer: Cigna Commercial	$584.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$283.02
Rate for Payer: Qualcare PPO/HMO/WC	$175.43
Rate for Payer: UnitedHealthcare Community & State	$36.96
Rate for Payer: Wellpoint Medicaid Managed Care	$33.21

CATH POWER PICC SOLO S/LUM 4FR

Facility

$1,015.00

Service Code	HCPCS C1751
Hospital Charge Code	270649056N
Hospital Revenue Code	278
Min. Negotiated Rate	$152.25
Max. Negotiated Rate	$245.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.63
Rate for Payer: Qualcare PPO/HMO/WC	$152.25

Know your out-of-pocket cost for care.

All Charges