Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH TARGET TETRA 4.0MMX10.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700077S
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 4.0MMX10.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700077S
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 4.0MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700075S
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 4.0MMX6.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700075S
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 4.0MMX8.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700076S
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 4.0MMX8.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700076S
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 4.5MMX10.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700078S
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 4.5MMX10.0CM

Facility

$10,516.00

Service Code	HCPCS C1889
Hospital Charge Code	270700078S
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 TESIO LEFT SIDE 11FR 52CM

Facility

$1,505.00

Service Code	HCPCS C1750
Hospital Charge Code	270620402
Hospital Revenue Code	278
Min. Negotiated Rate	$225.75
Max. Negotiated Rate	$364.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$301.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.21
Rate for Payer: Qualcare PPO/HMO/WC	$225.75

CATH TESIO LEFT SIDE 11FR 52CM

Facility

$1,505.00

Service Code	HCPCS C1750
Hospital Charge Code	270620402
Hospital Revenue Code	278
Min. Negotiated Rate	$42.74
Max. Negotiated Rate	$752.50
Rate for Payer: Aetna Commercial	$571.90
Rate for Payer: Aetna Medicare Advantage	$451.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$383.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$383.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$301.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$383.77
Rate for Payer: Cigna Commercial	$752.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.21
Rate for Payer: Qualcare PPO/HMO/WC	$225.75
Rate for Payer: UnitedHealthcare Community & State	$47.56
Rate for Payer: Wellpoint Medicaid Managed Care	$42.74

CATH TESIO RT W/6F INTRO/TUNNE

Facility

$1,775.00

Service Code	HCPCS C1750
Hospital Charge Code	270658136
Hospital Revenue Code	278
Min. Negotiated Rate	$266.25
Max. Negotiated Rate	$429.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$355.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.55
Rate for Payer: Qualcare PPO/HMO/WC	$266.25

CATH TESIO RT W/6F INTRO/TUNNE

Facility

$1,775.00

Service Code	HCPCS C1750
Hospital Charge Code	270658136
Hospital Revenue Code	278
Min. Negotiated Rate	$50.41
Max. Negotiated Rate	$887.50
Rate for Payer: Aetna Commercial	$674.50
Rate for Payer: Aetna Medicare Advantage	$532.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$452.62
Rate for Payer: Cigna Commercial	$887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.55
Rate for Payer: Qualcare PPO/HMO/WC	$266.25
Rate for Payer: UnitedHealthcare Community & State	$56.09
Rate for Payer: Wellpoint Medicaid Managed Care	$50.41

CATH TEXAS EXTERNAL

Facility

$9.65

Hospital Charge Code	270300600
Hospital Revenue Code	272
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

CATH TEXAS EXTERNAL

Facility

$9.65

Hospital Charge Code	270300600
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$3.67
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.51
Rate for Payer: Oxford Commercial	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$1.93
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

CATH THAL DRAINAGE 28FR

Facility

$694.40

Hospital Charge Code	270638387
Hospital Revenue Code	272
Min. Negotiated Rate	$19.72
Max. Negotiated Rate	$347.20
Rate for Payer: Aetna Commercial	$263.87
Rate for Payer: Aetna Medicare Advantage	$208.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.07
Rate for Payer: Cigna Commercial	$347.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.54
Rate for Payer: Oxford Commercial	$138.88
Rate for Payer: Qualcare PPO/HMO/WC	$104.16
Rate for Payer: UnitedHealthcare Commercial	$138.88
Rate for Payer: UnitedHealthcare Community & State	$21.94
Rate for Payer: Wellpoint Medicaid Managed Care	$19.72

CATH THAL DRAINAGE 28FR

Facility

$694.40

Hospital Charge Code	270638387
Hospital Revenue Code	272
Min. Negotiated Rate	$104.16
Max. Negotiated Rate	$104.16
Rate for Payer: Qualcare PPO/HMO/WC	$104.16

CATH THORAC 28FR RT ANG

Facility

$85.00

Hospital Charge Code	270600388
Hospital Revenue Code	272
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$42.50
Rate for Payer: Aetna Commercial	$32.30
Rate for Payer: Aetna Medicare Advantage	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.68
Rate for Payer: Cigna Commercial	$42.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.10
Rate for Payer: Oxford Commercial	$17.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.75
Rate for Payer: UnitedHealthcare Commercial	$17.00
Rate for Payer: UnitedHealthcare Community & State	$2.69
Rate for Payer: Wellpoint Medicaid Managed Care	$2.41

CATH THORAC 28FR RT ANG

Facility

$85.00

Hospital Charge Code	270600388
Hospital Revenue Code	272
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$12.75
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

CATH THORAC 32FR RT ANG

Facility

$39.83

Hospital Charge Code	270600389
Hospital Revenue Code	272
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$19.91
Rate for Payer: Aetna Commercial	$15.14
Rate for Payer: Aetna Medicare Advantage	$11.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.16
Rate for Payer: Cigna Commercial	$19.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.36
Rate for Payer: Oxford Commercial	$7.97
Rate for Payer: Qualcare PPO/HMO/WC	$5.97
Rate for Payer: UnitedHealthcare Commercial	$7.97
Rate for Payer: UnitedHealthcare Community & State	$1.26
Rate for Payer: Wellpoint Medicaid Managed Care	$1.13

CATH THORAC 32FR RT ANG

Facility

$39.83

Hospital Charge Code	270600389
Hospital Revenue Code	272
Min. Negotiated Rate	$5.97
Max. Negotiated Rate	$5.97
Rate for Payer: Qualcare PPO/HMO/WC	$5.97

CATH THORAC 32FR STR

Facility

$62.96

Hospital Charge Code	270600390
Hospital Revenue Code	272
Min. Negotiated Rate	$9.44
Max. Negotiated Rate	$9.44
Rate for Payer: Qualcare PPO/HMO/WC	$9.44

CATH THORAC 32FR STR

Facility

$62.96

Hospital Charge Code	270600390
Hospital Revenue Code	272
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$31.48
Rate for Payer: Aetna Commercial	$23.92
Rate for Payer: Aetna Medicare Advantage	$18.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.05
Rate for Payer: Cigna Commercial	$31.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.37
Rate for Payer: Oxford Commercial	$12.59
Rate for Payer: Qualcare PPO/HMO/WC	$9.44
Rate for Payer: UnitedHealthcare Commercial	$12.59
Rate for Payer: UnitedHealthcare Community & State	$1.99
Rate for Payer: Wellpoint Medicaid Managed Care	$1.79

CATH THORAC 36FR STR

Facility

$31.90

Hospital Charge Code	270600391
Hospital Revenue Code	272
Min. Negotiated Rate	$4.79
Max. Negotiated Rate	$4.79
Rate for Payer: Qualcare PPO/HMO/WC	$4.79

CATH THORAC 36FR STR

Facility

$31.90

Hospital Charge Code	270600391
Hospital Revenue Code	272
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$15.95
Rate for Payer: Aetna Commercial	$12.12
Rate for Payer: Aetna Medicare Advantage	$9.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.13
Rate for Payer: Cigna Commercial	$15.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.29
Rate for Payer: Oxford Commercial	$6.38
Rate for Payer: Qualcare PPO/HMO/WC	$4.79
Rate for Payer: UnitedHealthcare Commercial	$6.38
Rate for Payer: UnitedHealthcare Community & State	$1.01
Rate for Payer: Wellpoint Medicaid Managed Care	$0.91

CATH THORACIC 32FR 8032

Facility

$20.28

Hospital Charge Code	270649070
Hospital Revenue Code	272
Min. Negotiated Rate	$3.04
Max. Negotiated Rate	$3.04
Rate for Payer: Qualcare PPO/HMO/WC	$3.04

Know your out-of-pocket cost for care.

All Charges