Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CATH VENT DRAIN 3.14MMX35CM

Facility

$945.00

Service Code	HCPCS C1729
Hospital Charge Code	270695273
Hospital Revenue Code	278
Min. Negotiated Rate	$141.75
Max. Negotiated Rate	$228.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: Qualcare PPO/HMO/WC	$141.75

CATH VENT DRAIN 3.14MMX35CM

Facility

$945.00

Service Code	HCPCS C1729
Hospital Charge Code	270695273
Hospital Revenue Code	278
Min. Negotiated Rate	$26.84
Max. Negotiated Rate	$472.50
Rate for Payer: Aetna Commercial	$359.10
Rate for Payer: Aetna Medicare Advantage	$283.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.97
Rate for Payer: Cigna Commercial	$472.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: Qualcare PPO/HMO/WC	$141.75
Rate for Payer: UnitedHealthcare Community & State	$29.86
Rate for Payer: Wellpoint Medicaid Managed Care	$26.84

CATH VENTRICULAR STANDARD 23cm

Facility

$800.00

Hospital Charge Code	270647221
Hospital Revenue Code	272
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

CATH VENTRICULAR STANDARD 23cm

Facility

$800.00

Hospital Charge Code	270647221
Hospital Revenue Code	272
Min. Negotiated Rate	$22.72
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.00
Rate for Payer: Oxford Commercial	$160.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Commercial	$160.00
Rate for Payer: UnitedHealthcare Community & State	$25.28
Rate for Payer: Wellpoint Medicaid Managed Care	$22.72

CATH VERSA KATH EPIP 21G

Facility

$365.00

Service Code	HCPCS A4300
Hospital Charge Code	270638921
Hospital Revenue Code	278
Min. Negotiated Rate	$54.75
Max. Negotiated Rate	$88.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.33
Rate for Payer: Qualcare PPO/HMO/WC	$54.75

CATH VERSA KATH EPIP 21G

Facility

$365.00

Service Code	HCPCS A4300
Hospital Charge Code	270638921
Hospital Revenue Code	278
Min. Negotiated Rate	$10.37
Max. Negotiated Rate	$182.50
Rate for Payer: Aetna Commercial	$138.70
Rate for Payer: Aetna Medicare Advantage	$109.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.08
Rate for Payer: Cigna Commercial	$182.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.33
Rate for Payer: Qualcare PPO/HMO/WC	$54.75
Rate for Payer: UnitedHealthcare Community & State	$11.53
Rate for Payer: Wellpoint Medicaid Managed Care	$10.37

CATH VESSEL SIZING 5FR 65cm

Facility

$452.55

Service Code	HCPCS C1887
Hospital Charge Code	270624529
Hospital Revenue Code	278
Min. Negotiated Rate	$67.88
Max. Negotiated Rate	$109.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.52
Rate for Payer: Qualcare PPO/HMO/WC	$67.88

CATH VESSEL SIZING 5FR 65cm

Facility

$452.55

Service Code	HCPCS C1887
Hospital Charge Code	270624529
Hospital Revenue Code	278
Min. Negotiated Rate	$12.85
Max. Negotiated Rate	$226.28
Rate for Payer: Aetna Commercial	$171.97
Rate for Payer: Aetna Medicare Advantage	$135.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.40
Rate for Payer: Cigna Commercial	$226.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.52
Rate for Payer: Qualcare PPO/HMO/WC	$67.88
Rate for Payer: UnitedHealthcare Community & State	$14.30
Rate for Payer: Wellpoint Medicaid Managed Care	$12.85

CATH VIA 14+4x40 135 100818940

Facility

$1,025.00

Service Code	HCPCS C1725
Hospital Charge Code	270643584A
Hospital Revenue Code	278
Min. Negotiated Rate	$29.11
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$389.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75
Rate for Payer: UnitedHealthcare Community & State	$32.39
Rate for Payer: Wellpoint Medicaid Managed Care	$29.11

CATH VIA 14+4x40 135 100818940

Facility

$1,025.00

Service Code	HCPCS C1725
Hospital Charge Code	270643584A
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

CATH VIA 14+4x40 135 100818940

Facility

$1,025.00

Service Code	HCPCS C1725
Hospital Charge Code	270643584C
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

CATH VIA 14+4x40 135 100818940

Facility

$1,025.00

Service Code	HCPCS C1725
Hospital Charge Code	270643584C
Hospital Revenue Code	278
Min. Negotiated Rate	$29.11
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$389.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75
Rate for Payer: UnitedHealthcare Community & State	$32.39
Rate for Payer: Wellpoint Medicaid Managed Care	$29.11

CATH VIA 14+6X20 135 100819720

Facility

$1,025.00

Service Code	HCPCS C1725
Hospital Charge Code	270635817C
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

CATH VIA 14+6X20 135 100819720

Facility

$1,025.00

Service Code	HCPCS C1725
Hospital Charge Code	270635817C
Hospital Revenue Code	278
Min. Negotiated Rate	$29.11
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$389.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75
Rate for Payer: UnitedHealthcare Community & State	$32.39
Rate for Payer: Wellpoint Medicaid Managed Care	$29.11

CATH VIA 14+6X20 135 100819720

Facility

$1,425.00

Service Code	HCPCS C1725
Hospital Charge Code	270635817N
Hospital Revenue Code	278
Min. Negotiated Rate	$213.75
Max. Negotiated Rate	$344.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$285.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.85
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

CATH VIA 14+6X20 135 100819720

Facility

$1,425.00

Service Code	HCPCS C1725
Hospital Charge Code	270635817N
Hospital Revenue Code	278
Min. Negotiated Rate	$40.47
Max. Negotiated Rate	$712.50
Rate for Payer: Aetna Commercial	$541.50
Rate for Payer: Aetna Medicare Advantage	$427.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.38
Rate for Payer: Cigna Commercial	$712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.85
Rate for Payer: Qualcare PPO/HMO/WC	$213.75
Rate for Payer: UnitedHealthcare Community & State	$45.03
Rate for Payer: Wellpoint Medicaid Managed Care	$40.47

CATH VIABAHN 6MM X 15 CM 120 C

Facility

$20,950.00

Service Code	HCPCS C1874
Hospital Charge Code	270684815O
Hospital Revenue Code	278
Min. Negotiated Rate	$594.98
Max. Negotiated Rate	$10,475.00
Rate for Payer: Aetna Commercial	$7,961.00
Rate for Payer: Aetna Medicare Advantage	$6,285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,342.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,342.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,342.25
Rate for Payer: Cigna Commercial	$10,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,069.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,142.50
Rate for Payer: UnitedHealthcare Community & State	$662.02
Rate for Payer: Wellpoint Medicaid Managed Care	$594.98

CATH VIABAHN 6MM X 15 CM 120 C

Facility

$20,950.00

Service Code	HCPCS C1874
Hospital Charge Code	270684815O
Hospital Revenue Code	278
Min. Negotiated Rate	$3,142.50
Max. Negotiated Rate	$5,069.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,069.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,142.50

CATH VIABAHN 6MM X 15 CM 120 C

Facility

$20,950.00

Service Code	HCPCS C1874
Hospital Charge Code	270684815
Hospital Revenue Code	278
Min. Negotiated Rate	$594.98
Max. Negotiated Rate	$10,475.00
Rate for Payer: Aetna Commercial	$7,961.00
Rate for Payer: Aetna Medicare Advantage	$6,285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,342.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,342.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,342.25
Rate for Payer: Cigna Commercial	$10,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,069.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,142.50
Rate for Payer: UnitedHealthcare Community & State	$662.02
Rate for Payer: Wellpoint Medicaid Managed Care	$594.98

CATH VIABAHN 6MM X 15 CM 120 C

Facility

$20,950.00

Service Code	HCPCS C1874
Hospital Charge Code	270684815
Hospital Revenue Code	278
Min. Negotiated Rate	$3,142.50
Max. Negotiated Rate	$5,069.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,069.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,142.50

CATH VIABAHN 6MMX7.5CM 6FR

Facility

$19,750.00

Service Code	HCPCS C1874
Hospital Charge Code	270692151
Hospital Revenue Code	278
Min. Negotiated Rate	$2,962.50
Max. Negotiated Rate	$4,779.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,779.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,962.50

CATH VIABAHN 6MMX7.5CM 6FR

Facility

$19,750.00

Service Code	HCPCS C1874
Hospital Charge Code	270692151
Hospital Revenue Code	278
Min. Negotiated Rate	$560.90
Max. Negotiated Rate	$9,875.00
Rate for Payer: Aetna Commercial	$7,505.00
Rate for Payer: Aetna Medicare Advantage	$5,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,036.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,036.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,036.25
Rate for Payer: Cigna Commercial	$9,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,779.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,962.50
Rate for Payer: UnitedHealthcare Community & State	$624.10
Rate for Payer: Wellpoint Medicaid Managed Care	$560.90

CATH VIATRAC 14PLS V1008197-30

Facility

$1,025.00

Service Code	HCPCS C1725
Hospital Charge Code	270644113C
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

CATH VIATRAC 14PLS V1008197-30

Facility

$1,025.00

Service Code	HCPCS C1725
Hospital Charge Code	270644113C
Hospital Revenue Code	278
Min. Negotiated Rate	$29.11
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$389.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75
Rate for Payer: UnitedHealthcare Community & State	$32.39
Rate for Payer: Wellpoint Medicaid Managed Care	$29.11

CATH VIATRAC 14PLUS 4X20 135

Facility

$1,250.00

Service Code	HCPCS C1725
Hospital Charge Code	270637217N
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

Know your out-of-pocket cost for care.

All Charges