Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

DILATOR URETHRAL MEATAL

Facility

$43.00

Hospital Charge Code	270676433
Hospital Revenue Code	272
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

DILATOR URETHRAL MEATAL

Facility

$43.00

Hospital Charge Code	270676433
Hospital Revenue Code	272
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$16.34
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.18
Rate for Payer: Oxford Commercial	$8.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$8.60
Rate for Payer: UnitedHealthcare Community & State	$1.36
Rate for Payer: Wellpoint Medicaid Managed Care	$1.22

DILATOR, VASC/FASC

Facility

$62.00

Hospital Charge Code	2008120
Hospital Revenue Code	272
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$31.00
Rate for Payer: Aetna Commercial	$23.56
Rate for Payer: Aetna Medicare Advantage	$18.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.81
Rate for Payer: Cigna Commercial	$31.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.12
Rate for Payer: Oxford Commercial	$12.40
Rate for Payer: Qualcare PPO/HMO/WC	$9.30
Rate for Payer: UnitedHealthcare Commercial	$12.40
Rate for Payer: UnitedHealthcare Community & State	$1.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.76

DILATOR, VASC/FASC

Facility

$62.00

Hospital Charge Code	2008120
Hospital Revenue Code	272
Min. Negotiated Rate	$9.30
Max. Negotiated Rate	$9.30
Rate for Payer: Qualcare PPO/HMO/WC	$9.30

DILATOR VASCULAR

Facility

$325.00

Hospital Charge Code	270650777
Hospital Revenue Code	272
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$123.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.50
Rate for Payer: Oxford Commercial	$65.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Commercial	$65.00
Rate for Payer: UnitedHealthcare Community & State	$10.27
Rate for Payer: Wellpoint Medicaid Managed Care	$9.23

DILATOR VASCULAR

Facility

$325.00

Hospital Charge Code	270650777
Hospital Revenue Code	272
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

DILATOR VESSEL 10FR .038 20cm

Facility

$36.70

Service Code	HCPCS C1725
Hospital Charge Code	270624076
Hospital Revenue Code	278
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$18.35
Rate for Payer: Aetna Commercial	$13.95
Rate for Payer: Aetna Medicare Advantage	$11.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.36
Rate for Payer: Cigna Commercial	$18.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.88
Rate for Payer: Qualcare PPO/HMO/WC	$5.50
Rate for Payer: UnitedHealthcare Community & State	$1.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

DILATOR VESSEL 10FR .038 20cm

Facility

$36.70

Service Code	HCPCS C1725
Hospital Charge Code	270624076
Hospital Revenue Code	278
Min. Negotiated Rate	$5.50
Max. Negotiated Rate	$8.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.88
Rate for Payer: Qualcare PPO/HMO/WC	$5.50

DILATOR VESSEL 12FR .038 20cm

Facility

$36.70

Service Code	HCPCS C1725
Hospital Charge Code	270624077
Hospital Revenue Code	278
Min. Negotiated Rate	$5.50
Max. Negotiated Rate	$8.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.88
Rate for Payer: Qualcare PPO/HMO/WC	$5.50

DILATOR VESSEL 12FR .038 20cm

Facility

$36.70

Service Code	HCPCS C1725
Hospital Charge Code	270624077
Hospital Revenue Code	278
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$18.35
Rate for Payer: Aetna Commercial	$13.95
Rate for Payer: Aetna Medicare Advantage	$11.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.36
Rate for Payer: Cigna Commercial	$18.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.88
Rate for Payer: Qualcare PPO/HMO/WC	$5.50
Rate for Payer: UnitedHealthcare Community & State	$1.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

DILATOR VESSEL 14F .038 20CM

Facility

$36.70

Service Code	HCPCS C1725
Hospital Charge Code	270601491S
Hospital Revenue Code	278
Min. Negotiated Rate	$5.50
Max. Negotiated Rate	$8.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.88
Rate for Payer: Qualcare PPO/HMO/WC	$5.50

DILATOR VESSEL 14F .038 20CM

Facility

$36.70

Service Code	HCPCS C1725
Hospital Charge Code	270601491S
Hospital Revenue Code	278
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$18.35
Rate for Payer: Aetna Commercial	$13.95
Rate for Payer: Aetna Medicare Advantage	$11.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.36
Rate for Payer: Cigna Commercial	$18.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.88
Rate for Payer: Qualcare PPO/HMO/WC	$5.50
Rate for Payer: UnitedHealthcare Community & State	$1.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

DILATOR VESSEL 14FR .038 20cm

Facility

$36.70

Service Code	HCPCS C1725
Hospital Charge Code	270601491
Hospital Revenue Code	278
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$18.35
Rate for Payer: Aetna Commercial	$13.95
Rate for Payer: Aetna Medicare Advantage	$11.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.36
Rate for Payer: Cigna Commercial	$18.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.88
Rate for Payer: Qualcare PPO/HMO/WC	$5.50
Rate for Payer: UnitedHealthcare Community & State	$1.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

DILATOR VESSEL 14FR .038 20cm

Facility

$36.70

Service Code	HCPCS C1725
Hospital Charge Code	270601491
Hospital Revenue Code	278
Min. Negotiated Rate	$5.50
Max. Negotiated Rate	$8.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.88
Rate for Payer: Qualcare PPO/HMO/WC	$5.50

DILATOR VESSEL 4FR

Facility

$26.00

Hospital Charge Code	270677538A
Hospital Revenue Code	272
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$3.90
Rate for Payer: Qualcare PPO/HMO/WC	$3.90

DILATOR VESSEL 4FR

Facility

$26.00

Hospital Charge Code	270677538A
Hospital Revenue Code	272
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$13.00
Rate for Payer: Aetna Commercial	$9.88
Rate for Payer: Aetna Medicare Advantage	$7.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.63
Rate for Payer: Cigna Commercial	$13.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.76
Rate for Payer: Oxford Commercial	$5.20
Rate for Payer: Qualcare PPO/HMO/WC	$3.90
Rate for Payer: UnitedHealthcare Commercial	$5.20
Rate for Payer: UnitedHealthcare Community & State	$0.82
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

DILATOR VESSEL 4FR- 3339-31

Facility

$260.00

Hospital Charge Code	270677538
Hospital Revenue Code	279
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$39.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00

DILATOR VESSEL 4FR- 3339-31

Facility

$260.00

Hospital Charge Code	270677538
Hospital Revenue Code	279
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$130.00
Rate for Payer: Aetna Commercial	$98.80
Rate for Payer: Aetna Medicare Advantage	$78.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.30
Rate for Payer: Cigna Commercial	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.60
Rate for Payer: Oxford Commercial	$52.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00
Rate for Payer: UnitedHealthcare Commercial	$52.00
Rate for Payer: UnitedHealthcare Community & State	$8.22
Rate for Payer: Wellpoint Medicaid Managed Care	$7.38

DILATOR VESSEL 5FR .038 20cm

Facility

$39.80

Hospital Charge Code	270624075
Hospital Revenue Code	272
Min. Negotiated Rate	$5.97
Max. Negotiated Rate	$5.97
Rate for Payer: Qualcare PPO/HMO/WC	$5.97

DILATOR VESSEL 5FR .038 20cm

Facility

$39.80

Hospital Charge Code	270624075
Hospital Revenue Code	272
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$19.90
Rate for Payer: Aetna Commercial	$15.12
Rate for Payer: Aetna Medicare Advantage	$11.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.15
Rate for Payer: Cigna Commercial	$19.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.35
Rate for Payer: Oxford Commercial	$7.96
Rate for Payer: Qualcare PPO/HMO/WC	$5.97
Rate for Payer: UnitedHealthcare Commercial	$7.96
Rate for Payer: UnitedHealthcare Community & State	$1.26
Rate for Payer: Wellpoint Medicaid Managed Care	$1.13

DILATOR VESSEL 5FR 20CM

Facility

$50.00

Hospital Charge Code	270331443
Hospital Revenue Code	278
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$12.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.10
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

DILATOR VESSEL 5FR 20CM

Facility

$50.00

Hospital Charge Code	270331443
Hospital Revenue Code	278
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$25.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.10
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.42

DILATOR VESSEL 5FR.22CM

Facility

$52.00

Hospital Charge Code	270331242
Hospital Revenue Code	278
Min. Negotiated Rate	$1.48
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.58
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Community & State	$1.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1.48

DILATOR VESSEL 5FR.22CM

Facility

$52.00

Hospital Charge Code	270331242
Hospital Revenue Code	278
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$12.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.58
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

DILATOR VESSEL 6FR .038 20cm

Facility

$36.70

Service Code	HCPCS C1725
Hospital Charge Code	270624073
Hospital Revenue Code	278
Min. Negotiated Rate	$5.50
Max. Negotiated Rate	$8.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.88
Rate for Payer: Qualcare PPO/HMO/WC	$5.50

Know your out-of-pocket cost for care.

All Charges