Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH URETERAL TIGERTAIL 5FR

Facility

$49.75

Service Code	HCPCS C1758
Hospital Charge Code	270660500
Hospital Revenue Code	278
Min. Negotiated Rate	$7.46
Max. Negotiated Rate	$12.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.04
Rate for Payer: Qualcare PPO/HMO/WC	$7.46

CATH URETH 2WAY 6 EYE 20FR

Facility

$53.81

Hospital Charge Code	270684822
Hospital Revenue Code	272
Min. Negotiated Rate	$1.53
Max. Negotiated Rate	$26.91
Rate for Payer: Aetna Commercial	$20.45
Rate for Payer: Aetna Medicare Advantage	$16.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.72
Rate for Payer: Cigna Commercial	$26.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.99
Rate for Payer: Oxford Commercial	$10.76
Rate for Payer: Qualcare PPO/HMO/WC	$8.07
Rate for Payer: UnitedHealthcare Commercial	$10.76
Rate for Payer: UnitedHealthcare Community & State	$1.70
Rate for Payer: Wellpoint Medicaid Managed Care	$1.53

CATH URETH 2WAY 6 EYE 20FR

Facility

$53.81

Hospital Charge Code	270684822
Hospital Revenue Code	272
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.07

CATH URETH 2WAY 6 EYE 22FR

Facility

$53.81

Hospital Charge Code	270684823
Hospital Revenue Code	272
Min. Negotiated Rate	$1.53
Max. Negotiated Rate	$26.91
Rate for Payer: Aetna Commercial	$20.45
Rate for Payer: Aetna Medicare Advantage	$16.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.72
Rate for Payer: Cigna Commercial	$26.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.99
Rate for Payer: Oxford Commercial	$10.76
Rate for Payer: Qualcare PPO/HMO/WC	$8.07
Rate for Payer: UnitedHealthcare Commercial	$10.76
Rate for Payer: UnitedHealthcare Community & State	$1.70
Rate for Payer: Wellpoint Medicaid Managed Care	$1.53

CATH URETH 2WAY 6 EYE 22FR

Facility

$53.81

Hospital Charge Code	270684823
Hospital Revenue Code	272
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.07

CATH URETH 2WAY 6 EYE 24FR

Facility

$53.81

Hospital Charge Code	270684824
Hospital Revenue Code	272
Min. Negotiated Rate	$1.53
Max. Negotiated Rate	$26.91
Rate for Payer: Aetna Commercial	$20.45
Rate for Payer: Aetna Medicare Advantage	$16.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.72
Rate for Payer: Cigna Commercial	$26.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.99
Rate for Payer: Oxford Commercial	$10.76
Rate for Payer: Qualcare PPO/HMO/WC	$8.07
Rate for Payer: UnitedHealthcare Commercial	$10.76
Rate for Payer: UnitedHealthcare Community & State	$1.70
Rate for Payer: Wellpoint Medicaid Managed Care	$1.53

CATH URETH 2WAY 6 EYE 24FR

Facility

$53.81

Hospital Charge Code	270684824
Hospital Revenue Code	272
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.07

CATH URETH COUDE 3 WAY 22FR 30

Facility

$146.58

Hospital Charge Code	270633022
Hospital Revenue Code	272
Min. Negotiated Rate	$21.99
Max. Negotiated Rate	$21.99
Rate for Payer: Qualcare PPO/HMO/WC	$21.99

CATH URETH COUDE 3 WAY 22FR 30

Facility

$146.58

Hospital Charge Code	270633022
Hospital Revenue Code	272
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$73.29
Rate for Payer: Aetna Commercial	$55.70
Rate for Payer: Aetna Medicare Advantage	$43.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.38
Rate for Payer: Cigna Commercial	$73.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.11
Rate for Payer: Oxford Commercial	$29.32
Rate for Payer: Qualcare PPO/HMO/WC	$21.99
Rate for Payer: UnitedHealthcare Commercial	$29.32
Rate for Payer: UnitedHealthcare Community & State	$4.63
Rate for Payer: Wellpoint Medicaid Managed Care	$4.16

CATH URETH COUDE 3 WAY 24FR 30

Facility

$146.58

Hospital Charge Code	270684838
Hospital Revenue Code	272
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$73.29
Rate for Payer: Aetna Commercial	$55.70
Rate for Payer: Aetna Medicare Advantage	$43.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.38
Rate for Payer: Cigna Commercial	$73.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.11
Rate for Payer: Oxford Commercial	$29.32
Rate for Payer: Qualcare PPO/HMO/WC	$21.99
Rate for Payer: UnitedHealthcare Commercial	$29.32
Rate for Payer: UnitedHealthcare Community & State	$4.63
Rate for Payer: Wellpoint Medicaid Managed Care	$4.16

CATH URETH COUDE 3 WAY 24FR 30

Facility

$146.58

Hospital Charge Code	270684838
Hospital Revenue Code	272
Min. Negotiated Rate	$21.99
Max. Negotiated Rate	$21.99
Rate for Payer: Qualcare PPO/HMO/WC	$21.99

CATH URET OLIVE TP 5FR

Facility

$36.77

Service Code	HCPCS C1758
Hospital Charge Code	270605598
Hospital Revenue Code	278
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$18.39
Rate for Payer: Aetna Commercial	$13.97
Rate for Payer: Aetna Medicare Advantage	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.38
Rate for Payer: Cigna Commercial	$18.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.90
Rate for Payer: Qualcare PPO/HMO/WC	$5.52
Rate for Payer: UnitedHealthcare Community & State	$1.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

CATH URET OLIVE TP 5FR

Facility

$36.77

Service Code	HCPCS C1758
Hospital Charge Code	270605598
Hospital Revenue Code	278
Min. Negotiated Rate	$5.52
Max. Negotiated Rate	$8.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.90
Rate for Payer: Qualcare PPO/HMO/WC	$5.52

CATH URET POLLACK 5F 70 021305

Facility

$59.25

Service Code	HCPCS C1758
Hospital Charge Code	270643424
Hospital Revenue Code	278
Min. Negotiated Rate	$8.89
Max. Negotiated Rate	$14.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.34
Rate for Payer: Qualcare PPO/HMO/WC	$8.89

CATH URET POLLACK 5F 70 021305

Facility

$59.25

Service Code	HCPCS C1758
Hospital Charge Code	270643424
Hospital Revenue Code	278
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$29.62
Rate for Payer: Aetna Commercial	$22.52
Rate for Payer: Aetna Medicare Advantage	$17.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.11
Rate for Payer: Cigna Commercial	$29.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.34
Rate for Payer: Qualcare PPO/HMO/WC	$8.89
Rate for Payer: UnitedHealthcare Community & State	$1.87
Rate for Payer: Wellpoint Medicaid Managed Care	$1.68

CATH URET POLLK 6F 70cm 021306

Facility

$92.45

Service Code	HCPCS C1758
Hospital Charge Code	270643425
Hospital Revenue Code	278
Min. Negotiated Rate	$13.87
Max. Negotiated Rate	$22.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.37
Rate for Payer: Qualcare PPO/HMO/WC	$13.87

CATH URET POLLK 6F 70cm 021306

Facility

$92.45

Service Code	HCPCS C1758
Hospital Charge Code	270643425
Hospital Revenue Code	278
Min. Negotiated Rate	$2.63
Max. Negotiated Rate	$46.23
Rate for Payer: Aetna Commercial	$35.13
Rate for Payer: Aetna Medicare Advantage	$27.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.57
Rate for Payer: Cigna Commercial	$46.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.37
Rate for Payer: Qualcare PPO/HMO/WC	$13.87
Rate for Payer: UnitedHealthcare Community & State	$2.92
Rate for Payer: Wellpoint Medicaid Managed Care	$2.63

CATH URET SPRL TIP 4FR

Facility

$135.00

Hospital Charge Code	270331134
Hospital Revenue Code	278
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$32.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

CATH URET SPRL TIP 4FR

Facility

$135.00

Hospital Charge Code	270331134
Hospital Revenue Code	278
Min. Negotiated Rate	$3.83
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$51.30
Rate for Payer: Aetna Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.42
Rate for Payer: Cigna Commercial	$67.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$20.25
Rate for Payer: UnitedHealthcare Community & State	$4.27
Rate for Payer: Wellpoint Medicaid Managed Care	$3.83

CATH VCF HIGH FLOW 4FR .035X65

Facility

$550.00

Service Code	HCPCS C1887
Hospital Charge Code	270662848
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

CATH VCF HIGH FLOW 4FR .035X65

Facility

$550.00

Service Code	HCPCS C1887
Hospital Charge Code	270662848S
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

CATH VCF HIGH FLOW 4FR .035X65

Facility

$550.00

Service Code	HCPCS C1887
Hospital Charge Code	270662848N
Hospital Revenue Code	278
Min. Negotiated Rate	$15.62
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$17.38
Rate for Payer: Wellpoint Medicaid Managed Care	$15.62

CATH VCF HIGH FLOW 4FR .035X65

Facility

$550.00

Service Code	HCPCS C1887
Hospital Charge Code	270662848S
Hospital Revenue Code	278
Min. Negotiated Rate	$15.62
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$17.38
Rate for Payer: Wellpoint Medicaid Managed Care	$15.62

CATH VCF HIGH FLOW 4FR .035X65

Facility

$550.00

Service Code	HCPCS C1887
Hospital Charge Code	270662848
Hospital Revenue Code	278
Min. Negotiated Rate	$15.62
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$17.38
Rate for Payer: Wellpoint Medicaid Managed Care	$15.62

CATH VCF HIGH FLOW 4FR .035X65

Facility

$550.00

Service Code	HCPCS C1887
Hospital Charge Code	270662848N
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

Know your out-of-pocket cost for care.

All Charges