Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH PRONTO V4 6FR .014x138CM

Facility

$2,475.00

Hospital Charge Code	270678227
Hospital Revenue Code	278
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) NJ Health	$495.00
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	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Community & State	$78.21
Rate for Payer: Wellpoint Medicaid Managed Care	$70.29

CATH PRONTO V4 6FR .014x138CM

Facility

$2,475.00

Hospital Charge Code	270678227
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

CATH PROWLER PL 20CM TIP 450

Facility

$5,587.55

Service Code	HCPCS C1887
Hospital Charge Code	270700023S
Hospital Revenue Code	278
Min. Negotiated Rate	$158.69
Max. Negotiated Rate	$2,793.78
Rate for Payer: Aetna Commercial	$2,123.27
Rate for Payer: Aetna Medicare Advantage	$1,676.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,424.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,424.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,424.83
Rate for Payer: Cigna Commercial	$2,793.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,352.19
Rate for Payer: Qualcare PPO/HMO/WC	$838.13
Rate for Payer: UnitedHealthcare Community & State	$176.57
Rate for Payer: Wellpoint Medicaid Managed Care	$158.69

CATH PROWLER PL 20CM TIP 450

Facility

$5,587.55

Service Code	HCPCS C1887
Hospital Charge Code	270700023S
Hospital Revenue Code	278
Min. Negotiated Rate	$838.13
Max. Negotiated Rate	$1,352.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,352.19
Rate for Payer: Qualcare PPO/HMO/WC	$838.13

CATH PROWLER PL 20CM TIP 900

Facility

$5,587.55

Service Code	HCPCS C1887
Hospital Charge Code	270700024S
Hospital Revenue Code	278
Min. Negotiated Rate	$158.69
Max. Negotiated Rate	$2,793.78
Rate for Payer: Aetna Commercial	$2,123.27
Rate for Payer: Aetna Medicare Advantage	$1,676.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,424.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,424.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,424.83
Rate for Payer: Cigna Commercial	$2,793.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,352.19
Rate for Payer: Qualcare PPO/HMO/WC	$838.13
Rate for Payer: UnitedHealthcare Community & State	$176.57
Rate for Payer: Wellpoint Medicaid Managed Care	$158.69

CATH PROWLER PL 20CM TIP 900

Facility

$5,587.55

Service Code	HCPCS C1887
Hospital Charge Code	270700024S
Hospital Revenue Code	278
Min. Negotiated Rate	$838.13
Max. Negotiated Rate	$1,352.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,352.19
Rate for Payer: Qualcare PPO/HMO/WC	$838.13

CATH PROWLER SEL PL 45 150CM

Facility

$5,585.75

Service Code	HCPCS C1887
Hospital Charge Code	270700025S
Hospital Revenue Code	278
Min. Negotiated Rate	$158.64
Max. Negotiated Rate	$2,792.88
Rate for Payer: Aetna Commercial	$2,122.59
Rate for Payer: Aetna Medicare Advantage	$1,675.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,424.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,424.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,424.37
Rate for Payer: Cigna Commercial	$2,792.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,351.75
Rate for Payer: Qualcare PPO/HMO/WC	$837.86
Rate for Payer: UnitedHealthcare Community & State	$176.51
Rate for Payer: Wellpoint Medicaid Managed Care	$158.64

CATH PROWLER SEL PL 45 150CM

Facility

$5,585.75

Service Code	HCPCS C1887
Hospital Charge Code	270700025S
Hospital Revenue Code	278
Min. Negotiated Rate	$837.86
Max. Negotiated Rate	$1,351.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,351.75
Rate for Payer: Qualcare PPO/HMO/WC	$837.86

CATH PROWLER SEL PL 90 150CM

Facility

$5,587.55

Service Code	HCPCS C1887
Hospital Charge Code	270700026S
Hospital Revenue Code	278
Min. Negotiated Rate	$158.69
Max. Negotiated Rate	$2,793.78
Rate for Payer: Aetna Commercial	$2,123.27
Rate for Payer: Aetna Medicare Advantage	$1,676.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,424.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,424.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,424.83
Rate for Payer: Cigna Commercial	$2,793.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,352.19
Rate for Payer: Qualcare PPO/HMO/WC	$838.13
Rate for Payer: UnitedHealthcare Community & State	$176.57
Rate for Payer: Wellpoint Medicaid Managed Care	$158.69

CATH PROWLER SEL PL 90 150CM

Facility

$5,587.55

Service Code	HCPCS C1887
Hospital Charge Code	270700026S
Hospital Revenue Code	278
Min. Negotiated Rate	$838.13
Max. Negotiated Rate	$1,352.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,352.19
Rate for Payer: Qualcare PPO/HMO/WC	$838.13

CATH PTA CHOCOLATE 3.0X40MM

Facility

$3,825.00

Service Code	HCPCS C1725
Hospital Charge Code	270687515
Hospital Revenue Code	278
Min. Negotiated Rate	$108.63
Max. Negotiated Rate	$1,912.50
Rate for Payer: Aetna Commercial	$1,453.50
Rate for Payer: Aetna Medicare Advantage	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$975.38
Rate for Payer: Cigna Commercial	$1,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$925.65
Rate for Payer: Qualcare PPO/HMO/WC	$573.75
Rate for Payer: UnitedHealthcare Community & State	$120.87
Rate for Payer: Wellpoint Medicaid Managed Care	$108.63

CATH PTA CHOCOLATE 3.0X40MM

Facility

$3,825.00

Service Code	HCPCS C1725
Hospital Charge Code	270687515
Hospital Revenue Code	278
Min. Negotiated Rate	$573.75
Max. Negotiated Rate	$925.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$925.65
Rate for Payer: Qualcare PPO/HMO/WC	$573.75

CATH PTA CONQUEST 10x4 CQ75104

Facility

$1,325.00

Service Code	HCPCS C1725
Hospital Charge Code	270634922
Hospital Revenue Code	278
Min. Negotiated Rate	$37.63
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$41.87
Rate for Payer: Wellpoint Medicaid Managed Care	$37.63

CATH PTA CONQUEST 10x4 CQ75104

Facility

$1,325.00

Service Code	HCPCS C1725
Hospital Charge Code	270634922
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

CATH PTA CONQUEST 6x2 CQ7562

Facility

$1,325.00

Service Code	HCPCS C1725
Hospital Charge Code	270634926
Hospital Revenue Code	278
Min. Negotiated Rate	$37.63
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$41.87
Rate for Payer: Wellpoint Medicaid Managed Care	$37.63

CATH PTA CONQUEST 6x2 CQ7562

Facility

$1,325.00

Service Code	HCPCS C1725
Hospital Charge Code	270634926
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

CATH PTA CONQUEST 7x2 CQ7572

Facility

$1,325.00

Service Code	HCPCS C1725
Hospital Charge Code	270634927
Hospital Revenue Code	278
Min. Negotiated Rate	$37.63
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$41.87
Rate for Payer: Wellpoint Medicaid Managed Care	$37.63

CATH PTA CONQUEST 7x2 CQ7572

Facility

$1,325.00

Service Code	HCPCS C1725
Hospital Charge Code	270634927
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

CATH PTA CONQUEST 7x4

Facility

$1,325.00

Service Code	HCPCS C1725
Hospital Charge Code	270636042A
Hospital Revenue Code	278
Min. Negotiated Rate	$37.63
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$41.87
Rate for Payer: Wellpoint Medicaid Managed Care	$37.63

CATH PTA CONQUEST 7x4

Facility

$1,325.00

Service Code	HCPCS C1725
Hospital Charge Code	270636042
Hospital Revenue Code	278
Min. Negotiated Rate	$37.63
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$41.87
Rate for Payer: Wellpoint Medicaid Managed Care	$37.63

CATH PTA CONQUEST 7x4

Facility

$1,325.00

Service Code	HCPCS C1725
Hospital Charge Code	270636042
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

CATH PTA CONQUEST 7x4

Facility

$1,325.00

Service Code	HCPCS C1725
Hospital Charge Code	270636042A
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

CATH PTA CONQUEST 8x4 CQ7584

Facility

$1,325.00

Service Code	HCPCS C1725
Hospital Charge Code	270634921
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

CATH PTA CONQUEST 8x4 CQ7584

Facility

$1,325.00

Service Code	HCPCS C1725
Hospital Charge Code	270634921
Hospital Revenue Code	278
Min. Negotiated Rate	$37.63
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$41.87
Rate for Payer: Wellpoint Medicaid Managed Care	$37.63

CATH PTA LUTONIX .035 4X100MM

Facility

$8,250.00

Service Code	HCPCS C2623
Hospital Charge Code	270670877
Hospital Revenue Code	278
Min. Negotiated Rate	$1,237.50
Max. Negotiated Rate	$1,996.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50

Know your out-of-pocket cost for care.

All Charges