Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH TRLBLZR .014 SC-014-150

Facility

$744.80

Service Code	HCPCS C1725
Hospital Charge Code	270643849C
Hospital Revenue Code	278
Min. Negotiated Rate	$111.72
Max. Negotiated Rate	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.24
Rate for Payer: Qualcare PPO/HMO/WC	$111.72

CATH TRLBLZR 035 135 SC035135

Facility

$744.80

Service Code	HCPCS C1725
Hospital Charge Code	270643851A
Hospital Revenue Code	278
Min. Negotiated Rate	$21.15
Max. Negotiated Rate	$372.40
Rate for Payer: Aetna Commercial	$283.02
Rate for Payer: Aetna Medicare Advantage	$223.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.92
Rate for Payer: Cigna Commercial	$372.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.24
Rate for Payer: Qualcare PPO/HMO/WC	$111.72
Rate for Payer: UnitedHealthcare Community & State	$23.54
Rate for Payer: Wellpoint Medicaid Managed Care	$21.15

CATH TRLBLZR 035 135 SC035135

Facility

$744.80

Service Code	HCPCS C1725
Hospital Charge Code	270643851C
Hospital Revenue Code	278
Min. Negotiated Rate	$111.72
Max. Negotiated Rate	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.24
Rate for Payer: Qualcare PPO/HMO/WC	$111.72

CATH TRLBLZR 035 135 SC035135

Facility

$744.80

Service Code	HCPCS C1725
Hospital Charge Code	270643851C
Hospital Revenue Code	278
Min. Negotiated Rate	$21.15
Max. Negotiated Rate	$372.40
Rate for Payer: Aetna Commercial	$283.02
Rate for Payer: Aetna Medicare Advantage	$223.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.92
Rate for Payer: Cigna Commercial	$372.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.24
Rate for Payer: Qualcare PPO/HMO/WC	$111.72
Rate for Payer: UnitedHealthcare Community & State	$23.54
Rate for Payer: Wellpoint Medicaid Managed Care	$21.15

CATH TRLBLZR 035 135 SC035135

Facility

$744.80

Service Code	HCPCS C1725
Hospital Charge Code	270643851A
Hospital Revenue Code	278
Min. Negotiated Rate	$111.72
Max. Negotiated Rate	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.24
Rate for Payer: Qualcare PPO/HMO/WC	$111.72

CATH TROCAR 28FR 8428

Facility

$80.71

Hospital Charge Code	270649078
Hospital Revenue Code	272
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$40.35
Rate for Payer: Aetna Commercial	$30.67
Rate for Payer: Aetna Medicare Advantage	$24.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.58
Rate for Payer: Cigna Commercial	$40.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.98
Rate for Payer: Oxford Commercial	$16.14
Rate for Payer: Qualcare PPO/HMO/WC	$12.11
Rate for Payer: UnitedHealthcare Commercial	$16.14
Rate for Payer: UnitedHealthcare Community & State	$2.55
Rate for Payer: Wellpoint Medicaid Managed Care	$2.29

CATH TROCAR 28FR 8428

Facility

$80.71

Hospital Charge Code	270649078
Hospital Revenue Code	272
Min. Negotiated Rate	$12.11
Max. Negotiated Rate	$12.11
Rate for Payer: Qualcare PPO/HMO/WC	$12.11

CATH TROCAR 8FR

Facility

$160.00

Hospital Charge Code	270678172
Hospital Revenue Code	272
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

CATH TROCAR 8FR

Facility

$160.00

Hospital Charge Code	270678172
Hospital Revenue Code	272
Min. Negotiated Rate	$4.54
Max. Negotiated Rate	$80.00
Rate for Payer: Aetna Commercial	$60.80
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.60
Rate for Payer: Oxford Commercial	$32.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$32.00
Rate for Payer: UnitedHealthcare Community & State	$5.06
Rate for Payer: Wellpoint Medicaid Managed Care	$4.54

CATH TRPL LUMEN BASIC SET 15CM

Facility

$700.00

Service Code	HCPCS C1752
Hospital Charge Code	270689086
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

CATH TRPL LUMEN BASIC SET 15CM

Facility

$700.00

Service Code	HCPCS C1752
Hospital Charge Code	270689086
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$22.12
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

CATH TUBE CHOLANGIOGRAM #14

Facility

$34.75

Hospital Charge Code	270655499
Hospital Revenue Code	270
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$17.38
Rate for Payer: Aetna Commercial	$13.21
Rate for Payer: Aetna Medicare Advantage	$10.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.86
Rate for Payer: Cigna Commercial	$17.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.04
Rate for Payer: Oxford Commercial	$6.95
Rate for Payer: Qualcare PPO/HMO/WC	$5.21
Rate for Payer: UnitedHealthcare Commercial	$6.95
Rate for Payer: UnitedHealthcare Community & State	$1.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.99

CATH TUBE CHOLANGIOGRAM #14

Facility

$34.75

Hospital Charge Code	270655499
Hospital Revenue Code	270
Min. Negotiated Rate	$5.21
Max. Negotiated Rate	$5.21
Rate for Payer: Qualcare PPO/HMO/WC	$5.21

CATH TURBO 6cm TIP

Facility

$16,975.00

Service Code	HCPCS C1885
Hospital Charge Code	270644411
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 TURBO 6cm TIP

Facility

$16,975.00

Service Code	HCPCS C1885
Hospital Charge Code	270644411
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 TURBOHAWK 6CM TIP

Facility

$16,975.00

Service Code	HCPCS C1885
Hospital Charge Code	270644411C
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 TURBOHAWK 6CM TIP

Facility

$16,975.00

Service Code	HCPCS C1885
Hospital Charge Code	270644411C
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 TURBOHAWK 6F 133x3.9x20cm

Facility

$16,975.00

Service Code	HCPCS C1885
Hospital Charge Code	270645549C
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 TURBOHAWK 6F 133x3.9x20cm

Facility

$16,975.00

Service Code	HCPCS C1885
Hospital Charge Code	270645549
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 TURBOHAWK 6F 133x3.9x20cm

Facility

$16,975.00

Service Code	HCPCS C1885
Hospital Charge Code	270645549
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 TURBOHAWK 6F 133x3.9x20cm

Facility

$16,975.00

Service Code	HCPCS C1885
Hospital Charge Code	270645549C
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 TURBOHAWK 6F 133x3.9x20cm

Facility

$16,000.00

Service Code	HCPCS C1885
Hospital Charge Code	270645549N
Hospital Revenue Code	278
Min. Negotiated Rate	$454.40
Max. Negotiated Rate	$8,000.00
Rate for Payer: Aetna Commercial	$6,080.00
Rate for Payer: Aetna Medicare Advantage	$4,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,080.00
Rate for Payer: Cigna Commercial	$8,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00
Rate for Payer: UnitedHealthcare Community & State	$505.60
Rate for Payer: Wellpoint Medicaid Managed Care	$454.40

CATH TURBOHAWK 6F 133x3.9x20cm

Facility

$16,000.00

Service Code	HCPCS C1885
Hospital Charge Code	270645549N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,400.00
Max. Negotiated Rate	$3,872.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00

CATH TURBOHAWK 8FR 110X6X50

Facility

$16,975.00

Service Code	HCPCS C1885
Hospital Charge Code	270642993
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 TURBOHAWK 8FR 110X6X50

Facility

$16,975.00

Service Code	HCPCS C1885
Hospital Charge Code	270642993
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

Know your out-of-pocket cost for care.

All Charges