Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH SWAN GANZ WEDGE 5F 110CM

Facility

$675.00

Service Code	HCPCS C1751
Hospital Charge Code	270696315C
Hospital Revenue Code	278
Min. Negotiated Rate	$19.17
Max. Negotiated Rate	$337.50
Rate for Payer: Aetna Commercial	$256.50
Rate for Payer: Aetna Medicare Advantage	$202.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.12
Rate for Payer: Cigna Commercial	$337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.35
Rate for Payer: Qualcare PPO/HMO/WC	$101.25
Rate for Payer: UnitedHealthcare Community & State	$21.33
Rate for Payer: Wellpoint Medicaid Managed Care	$19.17

CATH SYMMETRY 7FR 5x2 135cm

Facility

$1,493.50

Hospital Charge Code	270628772
Hospital Revenue Code	278
Min. Negotiated Rate	$42.42
Max. Negotiated Rate	$746.75
Rate for Payer: Aetna Commercial	$567.53
Rate for Payer: Aetna Medicare Advantage	$448.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$380.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$380.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$380.84
Rate for Payer: Cigna Commercial	$746.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.43
Rate for Payer: Qualcare PPO/HMO/WC	$224.03
Rate for Payer: UnitedHealthcare Community & State	$47.19
Rate for Payer: Wellpoint Medicaid Managed Care	$42.42

CATH SYMMETRY 7FR 5x2 135cm

Facility

$1,493.50

Hospital Charge Code	270628772
Hospital Revenue Code	278
Min. Negotiated Rate	$224.03
Max. Negotiated Rate	$361.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.43
Rate for Payer: Qualcare PPO/HMO/WC	$224.03

CATH SYNCHRO STR .014 215CM

Facility

$3,325.00

Service Code	HCPCS C1887
Hospital Charge Code	270693900S
Hospital Revenue Code	278
Min. Negotiated Rate	$94.43
Max. Negotiated Rate	$1,662.50
Rate for Payer: Aetna Commercial	$1,263.50
Rate for Payer: Aetna Medicare Advantage	$997.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$847.88
Rate for Payer: Cigna Commercial	$1,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: Qualcare PPO/HMO/WC	$498.75
Rate for Payer: UnitedHealthcare Community & State	$105.07
Rate for Payer: Wellpoint Medicaid Managed Care	$94.43

CATH SYNCHRO STR .014 215CM

Facility

$3,325.00

Service Code	HCPCS C1887
Hospital Charge Code	270693900S
Hospital Revenue Code	278
Min. Negotiated Rate	$498.75
Max. Negotiated Rate	$804.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: Qualcare PPO/HMO/WC	$498.75

CATH SYNCHRO STR 215CM

Facility

$3,231.75

Service Code	HCPCS C1769
Hospital Charge Code	270693900
Hospital Revenue Code	278
Min. Negotiated Rate	$484.76
Max. Negotiated Rate	$782.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$646.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$782.08
Rate for Payer: Qualcare PPO/HMO/WC	$484.76

CATH SYNCHRO STR 215CM

Facility

$3,231.75

Service Code	HCPCS C1769
Hospital Charge Code	270693900
Hospital Revenue Code	278
Min. Negotiated Rate	$91.78
Max. Negotiated Rate	$1,615.88
Rate for Payer: Aetna Commercial	$1,228.07
Rate for Payer: Aetna Medicare Advantage	$969.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$824.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$824.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$646.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$824.10
Rate for Payer: Cigna Commercial	$1,615.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$782.08
Rate for Payer: Qualcare PPO/HMO/WC	$484.76
Rate for Payer: UnitedHealthcare Community & State	$102.12
Rate for Payer: Wellpoint Medicaid Managed Care	$91.78

CATH SYNCHRO STRAND STR 215CM

Facility

$3,231.75

Service Code	HCPCS C1769
Hospital Charge Code	270693899
Hospital Revenue Code	278
Min. Negotiated Rate	$91.78
Max. Negotiated Rate	$1,615.88
Rate for Payer: Aetna Commercial	$1,228.07
Rate for Payer: Aetna Medicare Advantage	$969.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$824.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$824.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$646.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$824.10
Rate for Payer: Cigna Commercial	$1,615.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$782.08
Rate for Payer: Qualcare PPO/HMO/WC	$484.76
Rate for Payer: UnitedHealthcare Community & State	$102.12
Rate for Payer: Wellpoint Medicaid Managed Care	$91.78

CATH SYNCHRO STRAND STR 215CM

Facility

$3,231.75

Service Code	HCPCS C1769
Hospital Charge Code	270693899
Hospital Revenue Code	278
Min. Negotiated Rate	$484.76
Max. Negotiated Rate	$782.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$646.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$782.08
Rate for Payer: Qualcare PPO/HMO/WC	$484.76

CATH TARGET TETRA 2.0MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700071S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$2,544.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

CATH TARGET TETRA 2.0MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700071S
Hospital Revenue Code	278
Min. Negotiated Rate	$298.65
Max. Negotiated Rate	$5,258.00
Rate for Payer: Aetna Commercial	$3,996.08
Rate for Payer: Aetna Medicare Advantage	$3,154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,681.58
Rate for Payer: Cigna Commercial	$5,258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40
Rate for Payer: UnitedHealthcare Community & State	$332.31
Rate for Payer: Wellpoint Medicaid Managed Care	$298.65

CATH TARGET TETRA 2.5MMX3.5CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700072S
Hospital Revenue Code	278
Min. Negotiated Rate	$298.65
Max. Negotiated Rate	$5,258.00
Rate for Payer: Aetna Commercial	$3,996.08
Rate for Payer: Aetna Medicare Advantage	$3,154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,681.58
Rate for Payer: Cigna Commercial	$5,258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40
Rate for Payer: UnitedHealthcare Community & State	$332.31
Rate for Payer: Wellpoint Medicaid Managed Care	$298.65

CATH TARGET TETRA 2.5MMX3.5CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700072S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$2,544.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

CATH TARGET TETRA 2.5MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699379S
Hospital Revenue Code	278
Min. Negotiated Rate	$298.65
Max. Negotiated Rate	$5,258.00
Rate for Payer: Aetna Commercial	$3,996.08
Rate for Payer: Aetna Medicare Advantage	$3,154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,681.58
Rate for Payer: Cigna Commercial	$5,258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40
Rate for Payer: UnitedHealthcare Community & State	$332.31
Rate for Payer: Wellpoint Medicaid Managed Care	$298.65

CATH TARGET TETRA 2.5MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699379S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$2,544.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

CATH TARGET TETRA 3.0MMX10.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700073S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$2,544.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

CATH TARGET TETRA 3.0MMX10.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700073S
Hospital Revenue Code	278
Min. Negotiated Rate	$298.65
Max. Negotiated Rate	$5,258.00
Rate for Payer: Aetna Commercial	$3,996.08
Rate for Payer: Aetna Medicare Advantage	$3,154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,681.58
Rate for Payer: Cigna Commercial	$5,258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40
Rate for Payer: UnitedHealthcare Community & State	$332.31
Rate for Payer: Wellpoint Medicaid Managed Care	$298.65

CATH TARGET TETRA 3.0MMX4.5CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699381S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$2,544.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

CATH TARGET TETRA 3.0MMX4.5CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699381S
Hospital Revenue Code	278
Min. Negotiated Rate	$298.65
Max. Negotiated Rate	$5,258.00
Rate for Payer: Aetna Commercial	$3,996.08
Rate for Payer: Aetna Medicare Advantage	$3,154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,681.58
Rate for Payer: Cigna Commercial	$5,258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40
Rate for Payer: UnitedHealthcare Community & State	$332.31
Rate for Payer: Wellpoint Medicaid Managed Care	$298.65

CATH TARGET TETRA 3.0MMX6.0CM

Facility

$12,785.00

Service Code	HCPCS C1889
Hospital Charge Code	270699013S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,917.75
Max. Negotiated Rate	$3,093.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,557.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,093.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,917.75

CATH TARGET TETRA 3.0MMX6.0CM

Facility

$12,785.00

Service Code	HCPCS C1889
Hospital Charge Code	270699013S
Hospital Revenue Code	278
Min. Negotiated Rate	$363.09
Max. Negotiated Rate	$6,392.50
Rate for Payer: Aetna Commercial	$4,858.30
Rate for Payer: Aetna Medicare Advantage	$3,835.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,260.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,260.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,557.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,260.18
Rate for Payer: Cigna Commercial	$6,392.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,093.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,917.75
Rate for Payer: UnitedHealthcare Community & State	$404.01
Rate for Payer: Wellpoint Medicaid Managed Care	$363.09

CATH TARGET TETRA 3.0MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699380S
Hospital Revenue Code	278
Min. Negotiated Rate	$298.65
Max. Negotiated Rate	$5,258.00
Rate for Payer: Aetna Commercial	$3,996.08
Rate for Payer: Aetna Medicare Advantage	$3,154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,681.58
Rate for Payer: Cigna Commercial	$5,258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40
Rate for Payer: UnitedHealthcare Community & State	$332.31
Rate for Payer: Wellpoint Medicaid Managed Care	$298.65

CATH TARGET TETRA 3.0MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270699380S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$2,544.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

CATH TARGET TETRA 3.5MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700074S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.40
Max. Negotiated Rate	$2,544.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40

CATH TARGET TETRA 3.5MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700074S
Hospital Revenue Code	278
Min. Negotiated Rate	$298.65
Max. Negotiated Rate	$5,258.00
Rate for Payer: Aetna Commercial	$3,996.08
Rate for Payer: Aetna Medicare Advantage	$3,154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,681.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,681.58
Rate for Payer: Cigna Commercial	$5,258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.40
Rate for Payer: UnitedHealthcare Community & State	$332.31
Rate for Payer: Wellpoint Medicaid Managed Care	$298.65

Know your out-of-pocket cost for care.

All Charges