Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH SHOCKWAVE PERIP 7.0X60MM

Facility

$16,500.00

Service Code	HCPCS C1725
Hospital Charge Code	270690506S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,475.00
Max. Negotiated Rate	$3,993.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,993.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,475.00

CATH SHOCKWAVE PERIP 7.0X60MM

Facility

$16,500.00

Service Code	HCPCS C1725
Hospital Charge Code	270690506S
Hospital Revenue Code	278
Min. Negotiated Rate	$468.60
Max. Negotiated Rate	$8,250.00
Rate for Payer: Aetna Commercial	$6,270.00
Rate for Payer: Aetna Medicare Advantage	$4,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,207.50
Rate for Payer: Cigna Commercial	$8,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,993.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,475.00
Rate for Payer: UnitedHealthcare Community & State	$521.40
Rate for Payer: Wellpoint Medicaid Managed Care	$468.60

CATH SHOCKWAVE PERIPH 6X60MM

Facility

$17,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270696636S
Hospital Revenue Code	278
Min. Negotiated Rate	$489.90
Max. Negotiated Rate	$8,625.00
Rate for Payer: Aetna Commercial	$6,555.00
Rate for Payer: Aetna Medicare Advantage	$5,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,398.75
Rate for Payer: Cigna Commercial	$8,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50
Rate for Payer: UnitedHealthcare Community & State	$545.10
Rate for Payer: Wellpoint Medicaid Managed Care	$489.90

CATH SHOCKWAVE PERIPH 6X60MM

Facility

$17,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270696636S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,587.50
Max. Negotiated Rate	$4,174.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50

CATH SHOCKWAVE S4 IVL 3.5X40MM

Facility

$13,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270698155S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$3,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

CATH SHOCKWAVE S4 IVL 3.5X40MM

Facility

$13,750.00

Service Code	HCPCS C1725
Hospital Charge Code	270698155S
Hospital Revenue Code	278
Min. Negotiated Rate	$390.50
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$5,225.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50
Rate for Payer: UnitedHealthcare Community & State	$434.50
Rate for Payer: Wellpoint Medicaid Managed Care	$390.50

CATH SHUTTLE JB1 6FR 125cm

Facility

$463.75

Hospital Charge Code	270636223
Hospital Revenue Code	272
Min. Negotiated Rate	$69.56
Max. Negotiated Rate	$69.56
Rate for Payer: Qualcare PPO/HMO/WC	$69.56

CATH SHUTTLE JB1 6FR 125cm

Facility

$463.75

Hospital Charge Code	270636223
Hospital Revenue Code	272
Min. Negotiated Rate	$13.17
Max. Negotiated Rate	$231.88
Rate for Payer: Aetna Commercial	$176.22
Rate for Payer: Aetna Medicare Advantage	$139.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.26
Rate for Payer: Cigna Commercial	$231.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.58
Rate for Payer: Oxford Commercial	$92.75
Rate for Payer: Qualcare PPO/HMO/WC	$69.56
Rate for Payer: UnitedHealthcare Commercial	$92.75
Rate for Payer: UnitedHealthcare Community & State	$14.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.17

CATH SILICONE 8.5FX22

Facility

$630.70

Service Code	HCPCS C2617
Hospital Charge Code	270697412
Hospital Revenue Code	278
Min. Negotiated Rate	$94.61
Max. Negotiated Rate	$152.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.63
Rate for Payer: Qualcare PPO/HMO/WC	$94.61

CATH SILICONE 8.5FX22

Facility

$630.70

Service Code	HCPCS C2617
Hospital Charge Code	270697412
Hospital Revenue Code	278
Min. Negotiated Rate	$17.91
Max. Negotiated Rate	$315.35
Rate for Payer: Aetna Commercial	$239.67
Rate for Payer: Aetna Medicare Advantage	$189.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.83
Rate for Payer: Cigna Commercial	$315.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.63
Rate for Payer: Qualcare PPO/HMO/WC	$94.61
Rate for Payer: UnitedHealthcare Community & State	$19.93
Rate for Payer: Wellpoint Medicaid Managed Care	$17.91

CATH SILVERHAWK LS 110x6 P4012

Facility

$14,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270634056
Hospital Revenue Code	278
Min. Negotiated Rate	$2,246.25
Max. Negotiated Rate	$3,623.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,623.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,246.25

CATH SILVERHAWK LS 110x6 P4012

Facility

$14,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270634056
Hospital Revenue Code	278
Min. Negotiated Rate	$425.29
Max. Negotiated Rate	$7,487.50
Rate for Payer: Aetna Commercial	$5,690.50
Rate for Payer: Aetna Medicare Advantage	$4,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,818.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,818.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,818.62
Rate for Payer: Cigna Commercial	$7,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,623.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,246.25
Rate for Payer: UnitedHealthcare Community & State	$473.21
Rate for Payer: Wellpoint Medicaid Managed Care	$425.29

CATH SILVERHAWK MS-M 6.0cm

Facility

$15,325.00

Service Code	HCPCS C1714
Hospital Charge Code	270643309
Hospital Revenue Code	278
Min. Negotiated Rate	$435.23
Max. Negotiated Rate	$7,662.50
Rate for Payer: Aetna Commercial	$5,823.50
Rate for Payer: Aetna Medicare Advantage	$4,597.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,907.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,907.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,065.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,907.88
Rate for Payer: Cigna Commercial	$7,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,708.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,298.75
Rate for Payer: UnitedHealthcare Community & State	$484.27
Rate for Payer: Wellpoint Medicaid Managed Care	$435.23

CATH SILVERHAWK MS-M 6.0cm

Facility

$15,325.00

Service Code	HCPCS C1714
Hospital Charge Code	270643309
Hospital Revenue Code	278
Min. Negotiated Rate	$2,298.75
Max. Negotiated Rate	$3,708.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,065.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,708.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,298.75

CATH SILVERHAWK SS+ P4030

Facility

$14,750.00

Service Code	HCPCS C1714
Hospital Charge Code	270643355
Hospital Revenue Code	278
Min. Negotiated Rate	$418.90
Max. Negotiated Rate	$7,375.00
Rate for Payer: Aetna Commercial	$5,605.00
Rate for Payer: Aetna Medicare Advantage	$4,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,761.25
Rate for Payer: Cigna Commercial	$7,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,569.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,212.50
Rate for Payer: UnitedHealthcare Community & State	$466.10
Rate for Payer: Wellpoint Medicaid Managed Care	$418.90

CATH SILVERHAWK SS+ P4030

Facility

$14,750.00

Service Code	HCPCS C1714
Hospital Charge Code	270643355
Hospital Revenue Code	278
Min. Negotiated Rate	$2,212.50
Max. Negotiated Rate	$3,569.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,569.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,212.50

CATH SILVERSOAKER ON-Q 7.5in

Facility

$615.00

Hospital Charge Code	270650398
Hospital Revenue Code	272
Min. Negotiated Rate	$92.25
Max. Negotiated Rate	$92.25
Rate for Payer: Qualcare PPO/HMO/WC	$92.25

CATH SILVERSOAKER ON-Q 7.5in

Facility

$615.00

Hospital Charge Code	270650398
Hospital Revenue Code	272
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$307.50
Rate for Payer: Aetna Commercial	$233.70
Rate for Payer: Aetna Medicare Advantage	$184.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.82
Rate for Payer: Cigna Commercial	$307.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.90
Rate for Payer: Oxford Commercial	$123.00
Rate for Payer: Qualcare PPO/HMO/WC	$92.25
Rate for Payer: UnitedHealthcare Commercial	$123.00
Rate for Payer: UnitedHealthcare Community & State	$19.43
Rate for Payer: Wellpoint Medicaid Managed Care	$17.47

CATH SIM 2 5FR X 100CM

Facility

$74.30

Hospital Charge Code	270681565
Hospital Revenue Code	272
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$37.15
Rate for Payer: Aetna Commercial	$28.23
Rate for Payer: Aetna Medicare Advantage	$22.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.95
Rate for Payer: Cigna Commercial	$37.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.32
Rate for Payer: Oxford Commercial	$14.86
Rate for Payer: Qualcare PPO/HMO/WC	$11.14
Rate for Payer: UnitedHealthcare Commercial	$14.86
Rate for Payer: UnitedHealthcare Community & State	$2.35
Rate for Payer: Wellpoint Medicaid Managed Care	$2.11

CATH SIM 2 5FR X 100CM

Facility

$74.30

Hospital Charge Code	270681565S
Hospital Revenue Code	272
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$37.15
Rate for Payer: Aetna Commercial	$28.23
Rate for Payer: Aetna Medicare Advantage	$22.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.95
Rate for Payer: Cigna Commercial	$37.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.32
Rate for Payer: Oxford Commercial	$14.86
Rate for Payer: Qualcare PPO/HMO/WC	$11.14
Rate for Payer: UnitedHealthcare Commercial	$14.86
Rate for Payer: UnitedHealthcare Community & State	$2.35
Rate for Payer: Wellpoint Medicaid Managed Care	$2.11

CATH SIM 2 5FR X 100CM

Facility

$74.30

Hospital Charge Code	270681565S
Hospital Revenue Code	272
Min. Negotiated Rate	$11.14
Max. Negotiated Rate	$11.14
Rate for Payer: Qualcare PPO/HMO/WC	$11.14

CATH SIM 2 5FR X 100CM

Facility

$74.30

Hospital Charge Code	270681565N
Hospital Revenue Code	272
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$37.15
Rate for Payer: Aetna Commercial	$28.23
Rate for Payer: Aetna Medicare Advantage	$22.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.95
Rate for Payer: Cigna Commercial	$37.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.32
Rate for Payer: Oxford Commercial	$14.86
Rate for Payer: Qualcare PPO/HMO/WC	$11.14
Rate for Payer: UnitedHealthcare Commercial	$14.86
Rate for Payer: UnitedHealthcare Community & State	$2.35
Rate for Payer: Wellpoint Medicaid Managed Care	$2.11

CATH SIM 2 5FR X 100CM

Facility

$74.30

Hospital Charge Code	270681565N
Hospital Revenue Code	272
Min. Negotiated Rate	$11.14
Max. Negotiated Rate	$11.14
Rate for Payer: Qualcare PPO/HMO/WC	$11.14

CATH SIM 2 5FR X 100CM

Facility

$74.30

Hospital Charge Code	270681565
Hospital Revenue Code	272
Min. Negotiated Rate	$11.14
Max. Negotiated Rate	$11.14
Rate for Payer: Qualcare PPO/HMO/WC	$11.14

CATH SIM2 RADIAL DX 105FSIM130

Facility

$0.01

Service Code	HCPCS C1887
Hospital Charge Code	270696078S
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

Know your out-of-pocket cost for care.

All Charges