Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH POWER PICC SOLO S/LUM 4FR

Facility

$1,111.00

Service Code	HCPCS C1751
Hospital Charge Code	270649056
Hospital Revenue Code	278
Min. Negotiated Rate	$31.55
Max. Negotiated Rate	$555.50
Rate for Payer: Aetna Commercial	$422.18
Rate for Payer: Aetna Medicare Advantage	$333.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$283.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$283.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$283.31
Rate for Payer: Cigna Commercial	$555.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.86
Rate for Payer: Qualcare PPO/HMO/WC	$166.65
Rate for Payer: UnitedHealthcare Community & State	$35.11
Rate for Payer: Wellpoint Medicaid Managed Care	$31.55

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	$28.83
Max. Negotiated Rate	$507.50
Rate for Payer: Aetna Commercial	$385.70
Rate for Payer: Aetna Medicare Advantage	$304.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$258.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$258.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$258.82
Rate for Payer: Cigna Commercial	$507.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.63
Rate for Payer: Qualcare PPO/HMO/WC	$152.25
Rate for Payer: UnitedHealthcare Community & State	$32.07
Rate for Payer: Wellpoint Medicaid Managed Care	$28.83

CATH POWER PICC SOLO S/LUM 4FR

Facility

$1,111.00

Service Code	HCPCS C1751
Hospital Charge Code	270649056S
Hospital Revenue Code	278
Min. Negotiated Rate	$166.65
Max. Negotiated Rate	$268.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.86
Rate for Payer: Qualcare PPO/HMO/WC	$166.65

CATH POWER PICC SOLO S/LUM 4FR

Facility

$1,111.00

Service Code	HCPCS C1751
Hospital Charge Code	270649056
Hospital Revenue Code	278
Min. Negotiated Rate	$166.65
Max. Negotiated Rate	$268.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.86
Rate for Payer: Qualcare PPO/HMO/WC	$166.65

CATH POWER PICC SOLO S/LUM 4FR

Facility

$1,111.00

Service Code	HCPCS C1751
Hospital Charge Code	270649056S
Hospital Revenue Code	278
Min. Negotiated Rate	$31.55
Max. Negotiated Rate	$555.50
Rate for Payer: Aetna Commercial	$422.18
Rate for Payer: Aetna Medicare Advantage	$333.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$283.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$283.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$283.31
Rate for Payer: Cigna Commercial	$555.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.86
Rate for Payer: Qualcare PPO/HMO/WC	$166.65
Rate for Payer: UnitedHealthcare Community & State	$35.11
Rate for Payer: Wellpoint Medicaid Managed Care	$31.55

CATH PRESEP OXIM 8.5F 20CM

Facility

$2,137.50

Hospital Charge Code	270660557
Hospital Revenue Code	278
Min. Negotiated Rate	$320.62
Max. Negotiated Rate	$517.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$427.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$517.27
Rate for Payer: Qualcare PPO/HMO/WC	$320.62

CATH PRESEP OXIM 8.5F 20CM

Facility

$2,137.50

Hospital Charge Code	270660557
Hospital Revenue Code	278
Min. Negotiated Rate	$60.70
Max. Negotiated Rate	$1,068.75
Rate for Payer: Aetna Commercial	$812.25
Rate for Payer: Aetna Medicare Advantage	$641.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$545.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$545.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$427.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$545.06
Rate for Payer: Cigna Commercial	$1,068.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$517.27
Rate for Payer: Qualcare PPO/HMO/WC	$320.62
Rate for Payer: UnitedHealthcare Community & State	$67.55
Rate for Payer: Wellpoint Medicaid Managed Care	$60.70

CATH PRO-LINE 6FR 60CM D/LUMEN

Facility

$1,125.00

Hospital Charge Code	270678223
Hospital Revenue Code	278
Min. Negotiated Rate	$31.95
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$31.95

CATH PRO-LINE 6FR 60CM D/LUMEN

Facility

$1,125.00

Hospital Charge Code	270678223
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

CATH PRONTO EXTRACTION

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270636440
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

CATH PRONTO EXTRACTION

Facility

$2,455.25

Service Code	HCPCS C1757
Hospital Charge Code	270636440N
Hospital Revenue Code	278
Min. Negotiated Rate	$368.29
Max. Negotiated Rate	$594.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.17
Rate for Payer: Qualcare PPO/HMO/WC	$368.29

CATH PRONTO EXTRACTION

Facility

$2,455.25

Service Code	HCPCS C1757
Hospital Charge Code	270636440N
Hospital Revenue Code	278
Min. Negotiated Rate	$69.73
Max. Negotiated Rate	$1,227.62
Rate for Payer: Aetna Commercial	$933.00
Rate for Payer: Aetna Medicare Advantage	$736.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$626.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$626.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$626.09
Rate for Payer: Cigna Commercial	$1,227.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.17
Rate for Payer: Qualcare PPO/HMO/WC	$368.29
Rate for Payer: UnitedHealthcare Community & State	$77.59
Rate for Payer: Wellpoint Medicaid Managed Care	$69.73

CATH PRONTO EXTRACTION

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270636440S
Hospital Revenue Code	278
Min. Negotiated Rate	$41.89
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$46.61
Rate for Payer: Wellpoint Medicaid Managed Care	$41.89

CATH PRONTO EXTRACTION

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270636440
Hospital Revenue Code	278
Min. Negotiated Rate	$41.89
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$46.61
Rate for Payer: Wellpoint Medicaid Managed Care	$41.89

CATH PRONTO EXTRACTION

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270636440S
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

CATH PRONTO LP 5FR .014x138CM

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270676760
Hospital Revenue Code	278
Min. Negotiated Rate	$41.89
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$46.61
Rate for Payer: Wellpoint Medicaid Managed Care	$41.89

CATH PRONTO LP 5FR .014x138CM

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270676760S
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

CATH PRONTO LP 5FR .014x138CM

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270676760N
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

CATH PRONTO LP 5FR .014x138CM

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270676760N
Hospital Revenue Code	278
Min. Negotiated Rate	$41.89
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$46.61
Rate for Payer: Wellpoint Medicaid Managed Care	$41.89

CATH PRONTO LP 5FR .014x138CM

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270676760S
Hospital Revenue Code	278
Min. Negotiated Rate	$41.89
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$46.61
Rate for Payer: Wellpoint Medicaid Managed Care	$41.89

CATH PRONTO LP 5FR .014x138CM

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270676760
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

CATH PRONTO LP 6FR .014x140CM

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270676762
Hospital Revenue Code	272
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$221.25
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

CATH PRONTO LP 6FR .014x140CM

Facility

$1,475.00

Hospital Charge Code	270676761
Hospital Revenue Code	278
Min. Negotiated Rate	$41.89
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$46.61
Rate for Payer: Wellpoint Medicaid Managed Care	$41.89

CATH PRONTO LP 6FR .014x140CM

Facility

$1,475.00

Hospital Charge Code	270676761
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

CATH PRONTO LP 6FR .014x140CM

Facility

$1,475.00

Service Code	HCPCS C1757
Hospital Charge Code	270676762
Hospital Revenue Code	272
Min. Negotiated Rate	$41.89
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.50
Rate for Payer: Oxford Commercial	$295.00
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Commercial	$295.00
Rate for Payer: UnitedHealthcare Community & State	$46.61
Rate for Payer: Wellpoint Medicaid Managed Care	$41.89

Know your out-of-pocket cost for care.

All Charges