Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH STEALTH 1.25 MICRO 60

Facility

$18,975.00

Hospital Charge Code	270671186
Hospital Revenue Code	278
Min. Negotiated Rate	$538.89
Max. Negotiated Rate	$9,487.50
Rate for Payer: Aetna Commercial	$7,210.50
Rate for Payer: Aetna Medicare Advantage	$5,692.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,838.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,838.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,838.62
Rate for Payer: Cigna Commercial	$9,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,591.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,846.25
Rate for Payer: UnitedHealthcare Community & State	$599.61
Rate for Payer: Wellpoint Medicaid Managed Care	$538.89

CATH STEALTH 1.25 SOLID 60

Facility

$18,970.00

Service Code	HCPCS C1724
Hospital Charge Code	270671187
Hospital Revenue Code	278
Min. Negotiated Rate	$2,845.50
Max. Negotiated Rate	$4,590.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,794.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,590.74
Rate for Payer: Qualcare PPO/HMO/WC	$2,845.50

CATH STEALTH 1.25 SOLID 60

Facility

$18,970.00

Service Code	HCPCS C1724
Hospital Charge Code	270671187N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,845.50
Max. Negotiated Rate	$4,590.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,794.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,590.74
Rate for Payer: Qualcare PPO/HMO/WC	$2,845.50

CATH STEALTH 1.25 SOLID 60

Facility

$18,970.00

Service Code	HCPCS C1724
Hospital Charge Code	270671187N
Hospital Revenue Code	278
Min. Negotiated Rate	$538.75
Max. Negotiated Rate	$9,485.00
Rate for Payer: Aetna Commercial	$7,208.60
Rate for Payer: Aetna Medicare Advantage	$5,691.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,837.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,837.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,794.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,837.35
Rate for Payer: Cigna Commercial	$9,485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,590.74
Rate for Payer: Qualcare PPO/HMO/WC	$2,845.50
Rate for Payer: UnitedHealthcare Community & State	$599.45
Rate for Payer: Wellpoint Medicaid Managed Care	$538.75

CATH STEALTH 1.25 SOLID 60

Facility

$18,970.00

Service Code	HCPCS C1724
Hospital Charge Code	270671187
Hospital Revenue Code	278
Min. Negotiated Rate	$538.75
Max. Negotiated Rate	$9,485.00
Rate for Payer: Aetna Commercial	$7,208.60
Rate for Payer: Aetna Medicare Advantage	$5,691.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,837.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,837.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,794.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,837.35
Rate for Payer: Cigna Commercial	$9,485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,590.74
Rate for Payer: Qualcare PPO/HMO/WC	$2,845.50
Rate for Payer: UnitedHealthcare Community & State	$599.45
Rate for Payer: Wellpoint Medicaid Managed Care	$538.75

CATH STEALTH DMNDBK DBE-150

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270647202N
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 STEALTH DMNDBK DBE-150

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270647202N
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 STEALTH DMNDBK DBE-150

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270647202C
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 STEALTH DMNDBK DBE-150

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270647202C
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 STEALTH PRDR PRD-SC30-125

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270647205N
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 STEALTH PRDR PRD-SC30-125

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270647205N
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 STEALTH PRDR PRD-SC30-125

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270647205C
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 STEALTH PRDR PRD-SC30-125

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270647205C
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 STEALTH PRDR PRD-SC30-200

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270647207N
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 STEALTH PRDR PRD-SC30-200

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270647207C
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 STEALTH PRDR PRD-SC30-200

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270647207N
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 STEALTH PRDR PRD-SC30-200

Facility

$16,975.00

Service Code	HCPCS C1714
Hospital Charge Code	270647207C
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 STEALTH PRDR-SC30-150

Facility

$16,975.00

Service Code	HCPCS C1874
Hospital Charge Code	270647206C
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 STEALTH PRDR-SC30-150

Facility

$16,975.00

Service Code	HCPCS C1874
Hospital Charge Code	270647206C
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 STR RED RUBBER 14F

Facility

$11.25

Hospital Charge Code	270300525
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

CATH STR RED RUBBER 14F

Facility

$11.25

Hospital Charge Code	270300525
Hospital Revenue Code	272
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$4.28
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$2.25
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

CATH STR RED RUBBER 8F

Facility

$4.43

Service Code	HCPCS C1758
Hospital Charge Code	270300510
Hospital Revenue Code	278
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.21
Rate for Payer: Aetna Commercial	$1.68
Rate for Payer: Aetna Medicare Advantage	$1.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.13
Rate for Payer: Cigna Commercial	$2.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.07
Rate for Payer: Qualcare PPO/HMO/WC	$0.66
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

CATH STR RED RUBBER 8F

Facility

$4.43

Service Code	HCPCS C1758
Hospital Charge Code	270300510
Hospital Revenue Code	278
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$1.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.07
Rate for Payer: Qualcare PPO/HMO/WC	$0.66

CATH SUB 2x60x130 SUV020060130

Facility

$4,856.00

Hospital Charge Code	270636609
Hospital Revenue Code	278
Min. Negotiated Rate	$728.40
Max. Negotiated Rate	$1,175.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$971.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,175.15
Rate for Payer: Qualcare PPO/HMO/WC	$728.40

CATH SUB 2x60x130 SUV020060130

Facility

$4,856.00

Hospital Charge Code	270636609
Hospital Revenue Code	278
Min. Negotiated Rate	$137.91
Max. Negotiated Rate	$2,428.00
Rate for Payer: Aetna Commercial	$1,845.28
Rate for Payer: Aetna Medicare Advantage	$1,456.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,238.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,238.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$971.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,238.28
Rate for Payer: Cigna Commercial	$2,428.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,175.15
Rate for Payer: Qualcare PPO/HMO/WC	$728.40
Rate for Payer: UnitedHealthcare Community & State	$153.45
Rate for Payer: Wellpoint Medicaid Managed Care	$137.91

Know your out-of-pocket cost for care.

All Charges