Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH SIM2 RADIAL DX 105FSIM130

Facility

$0.01

Service Code	HCPCS C1887
Hospital Charge Code	270696078S
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

CATH SIZING 5FR 100CM 13709703

Facility

$750.00

Hospital Charge Code	270639810C
Hospital Revenue Code	272
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

CATH SIZING 5FR 100CM 13709703

Facility

$750.00

Hospital Charge Code	270639810C
Hospital Revenue Code	272
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$150.00
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

CATH SLIP BEACON TIP 6FR 125cm

Facility

$463.75

Hospital Charge Code	270644912
Hospital Revenue Code	272
Min. Negotiated Rate	$69.56
Max. Negotiated Rate	$69.56
Rate for Payer: Qualcare PPO/HMO/WC	$69.56

CATH SLIP BEACON TIP 6FR 125cm

Facility

$463.75

Hospital Charge Code	270644912
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 SLIP VERT 5FR 125cm

Facility

$1,657.50

Hospital Charge Code	270635004
Hospital Revenue Code	272
Min. Negotiated Rate	$248.62
Max. Negotiated Rate	$248.62
Rate for Payer: Qualcare PPO/HMO/WC	$248.62

CATH SLIP VERT 5FR 125cm

Facility

$1,657.50

Hospital Charge Code	270635004
Hospital Revenue Code	272
Min. Negotiated Rate	$47.07
Max. Negotiated Rate	$828.75
Rate for Payer: Aetna Commercial	$629.85
Rate for Payer: Aetna Medicare Advantage	$497.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$422.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$422.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$422.66
Rate for Payer: Cigna Commercial	$828.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$430.95
Rate for Payer: Oxford Commercial	$331.50
Rate for Payer: Qualcare PPO/HMO/WC	$248.62
Rate for Payer: UnitedHealthcare Commercial	$331.50
Rate for Payer: UnitedHealthcare Community & State	$52.38
Rate for Payer: Wellpoint Medicaid Managed Care	$47.07

CATH SOFTOUCH 5FR 100CM

Facility

$37.35

Hospital Charge Code	270658020
Hospital Revenue Code	270
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 SOFTOUCH 5FR 100CM

Facility

$37.35

Hospital Charge Code	270658020
Hospital Revenue Code	270
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$5.60

CATH SOFT-VU N/BRD 5FR 90CM

Facility

$90.00

Hospital Charge Code	270678626
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

CATH SOFT-VU N/BRD 5FR 90CM

Facility

$90.00

Hospital Charge Code	270678626
Hospital Revenue Code	272
Min. Negotiated Rate	$2.56
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.40
Rate for Payer: Oxford Commercial	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$18.00
Rate for Payer: UnitedHealthcare Community & State	$2.84
Rate for Payer: Wellpoint Medicaid Managed Care	$2.56

CATH SOLID CROWN 1.5MM

Facility

$16,975.00

Hospital Charge Code	270676795
Hospital Revenue Code	278
Min. Negotiated Rate	$482.09
Max. Negotiated Rate	$8,487.50
Rate for Payer: Aetna Commercial	$6,450.50
Rate for Payer: Aetna Medicare Advantage	$5,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,328.62
Rate for Payer: Cigna Commercial	$8,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25
Rate for Payer: UnitedHealthcare Community & State	$536.41
Rate for Payer: Wellpoint Medicaid Managed Care	$482.09

CATH SOLID CROWN 1.5MM

Facility

$16,975.00

Hospital Charge Code	270676795
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$4,107.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATH SOLID CROWN 1.5MMX145CM

Facility

$16,975.00

Service Code	HCPCS C1724
Hospital Charge Code	270681083
Hospital Revenue Code	278
Min. Negotiated Rate	$482.09
Max. Negotiated Rate	$8,487.50
Rate for Payer: Aetna Commercial	$6,450.50
Rate for Payer: Aetna Medicare Advantage	$5,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,328.62
Rate for Payer: Cigna Commercial	$8,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25
Rate for Payer: UnitedHealthcare Community & State	$536.41
Rate for Payer: Wellpoint Medicaid Managed Care	$482.09

CATH SOLID CROWN 1.5MMX145CM

Facility

$16,975.00

Service Code	HCPCS C1724
Hospital Charge Code	270681083
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$4,107.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATH SOLID CROWN 2.0MM

Facility

$16,975.00

Hospital Charge Code	270676796
Hospital Revenue Code	278
Min. Negotiated Rate	$482.09
Max. Negotiated Rate	$8,487.50
Rate for Payer: Aetna Commercial	$6,450.50
Rate for Payer: Aetna Medicare Advantage	$5,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,328.62
Rate for Payer: Cigna Commercial	$8,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25
Rate for Payer: UnitedHealthcare Community & State	$536.41
Rate for Payer: Wellpoint Medicaid Managed Care	$482.09

CATH SOLID CROWN 2.0MM

Facility

$16,975.00

Hospital Charge Code	270676796
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$4,107.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATH SOLID CROWN 2.0MM 145CM

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270681112S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$4,107.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATH SOLID CROWN 2.0MM 145CM

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270681112S
Hospital Revenue Code	278
Min. Negotiated Rate	$482.09
Max. Negotiated Rate	$8,487.50
Rate for Payer: Aetna Commercial	$6,450.50
Rate for Payer: Aetna Medicare Advantage	$5,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,328.62
Rate for Payer: Cigna Commercial	$8,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25
Rate for Payer: UnitedHealthcare Community & State	$536.41
Rate for Payer: Wellpoint Medicaid Managed Care	$482.09

CATH SOLID CROWN 2.0MM 145CM

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270681112
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$4,107.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATH SOLID CROWN 2.0MM 145CM

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270681112
Hospital Revenue Code	278
Min. Negotiated Rate	$482.09
Max. Negotiated Rate	$8,487.50
Rate for Payer: Aetna Commercial	$6,450.50
Rate for Payer: Aetna Medicare Advantage	$5,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,328.62
Rate for Payer: Cigna Commercial	$8,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25
Rate for Payer: UnitedHealthcare Community & State	$536.41
Rate for Payer: Wellpoint Medicaid Managed Care	$482.09

CATH SOLID CROWN 2.0MM 145CM

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270681112A
Hospital Revenue Code	278
Min. Negotiated Rate	$2,546.25
Max. Negotiated Rate	$4,107.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25

CATH SOLID CROWN 2.0MM 145CM

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270681112A
Hospital Revenue Code	278
Min. Negotiated Rate	$482.09
Max. Negotiated Rate	$8,487.50
Rate for Payer: Aetna Commercial	$6,450.50
Rate for Payer: Aetna Medicare Advantage	$5,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,328.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,328.62
Rate for Payer: Cigna Commercial	$8,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,107.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,546.25
Rate for Payer: UnitedHealthcare Community & State	$536.41
Rate for Payer: Wellpoint Medicaid Managed Care	$482.09

CATH SOLID EXCHAN 1.25 360 145

Facility

$12,500.00

Service Code	HCPCS C1724
Hospital Charge Code	270689192
Hospital Revenue Code	272
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$1,875.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

CATH SOLID EXCHAN 1.25 360 145

Facility

$12,500.00

Service Code	HCPCS C1724
Hospital Charge Code	270689192
Hospital Revenue Code	272
Min. Negotiated Rate	$355.00
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$4,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,250.00
Rate for Payer: Oxford Commercial	$2,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00
Rate for Payer: UnitedHealthcare Commercial	$2,500.00
Rate for Payer: UnitedHealthcare Community & State	$395.00
Rate for Payer: Wellpoint Medicaid Managed Care	$355.00

Know your out-of-pocket cost for care.

All Charges