Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

GLIDEWIRE 0.035 180CM STN STR

Facility

$258.25

Service Code	HCPCS C1769
Hospital Charge Code	270658275S
Hospital Revenue Code	278
Min. Negotiated Rate	$38.74
Max. Negotiated Rate	$62.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$38.74

Glidewire 0.035 260cm STIF STR

Facility

$281.50

Service Code	HCPCS C1769
Hospital Charge Code	270658277
Hospital Revenue Code	278
Min. Negotiated Rate	$42.23
Max. Negotiated Rate	$68.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.12
Rate for Payer: Qualcare PPO/HMO/WC	$42.23

Glidewire 0.035 260cm STIF STR

Facility

$281.50

Service Code	HCPCS C1769
Hospital Charge Code	270658277N
Hospital Revenue Code	278
Min. Negotiated Rate	$7.99
Max. Negotiated Rate	$140.75
Rate for Payer: Aetna Commercial	$106.97
Rate for Payer: Aetna Medicare Advantage	$84.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.78
Rate for Payer: Cigna Commercial	$140.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.12
Rate for Payer: Qualcare PPO/HMO/WC	$42.23
Rate for Payer: UnitedHealthcare Community & State	$8.90
Rate for Payer: Wellpoint Medicaid Managed Care	$7.99

Glidewire 0.035 260cm STIF STR

Facility

$281.50

Service Code	HCPCS C1769
Hospital Charge Code	270658277
Hospital Revenue Code	278
Min. Negotiated Rate	$7.99
Max. Negotiated Rate	$140.75
Rate for Payer: Aetna Commercial	$106.97
Rate for Payer: Aetna Medicare Advantage	$84.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.78
Rate for Payer: Cigna Commercial	$140.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.12
Rate for Payer: Qualcare PPO/HMO/WC	$42.23
Rate for Payer: UnitedHealthcare Community & State	$8.90
Rate for Payer: Wellpoint Medicaid Managed Care	$7.99

Glidewire 0.035 260cm STIF STR

Facility

$281.50

Service Code	HCPCS C1769
Hospital Charge Code	270658277N
Hospital Revenue Code	278
Min. Negotiated Rate	$42.23
Max. Negotiated Rate	$68.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.12
Rate for Payer: Qualcare PPO/HMO/WC	$42.23

Glidewire 0.035 260cm STN STR

Facility

$250.70

Service Code	HCPCS C1769
Hospital Charge Code	270684295N
Hospital Revenue Code	278
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$125.35
Rate for Payer: Aetna Commercial	$95.27
Rate for Payer: Aetna Medicare Advantage	$75.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.93
Rate for Payer: Cigna Commercial	$125.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.67
Rate for Payer: Qualcare PPO/HMO/WC	$37.60
Rate for Payer: UnitedHealthcare Community & State	$7.92
Rate for Payer: Wellpoint Medicaid Managed Care	$7.12

Glidewire 0.035 260cm STN STR

Facility

$250.70

Service Code	HCPCS C1769
Hospital Charge Code	270684295N
Hospital Revenue Code	278
Min. Negotiated Rate	$37.60
Max. Negotiated Rate	$60.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.67
Rate for Payer: Qualcare PPO/HMO/WC	$37.60

Glidewire 0.035 260cm STN STR

Facility

$250.70

Service Code	HCPCS C1769
Hospital Charge Code	270684295
Hospital Revenue Code	278
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$125.35
Rate for Payer: Aetna Commercial	$95.27
Rate for Payer: Aetna Medicare Advantage	$75.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.93
Rate for Payer: Cigna Commercial	$125.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.67
Rate for Payer: Qualcare PPO/HMO/WC	$37.60
Rate for Payer: UnitedHealthcare Community & State	$7.92
Rate for Payer: Wellpoint Medicaid Managed Care	$7.12

Glidewire 0.035 260cm STN STR

Facility

$250.70

Service Code	HCPCS C1769
Hospital Charge Code	270684295
Hospital Revenue Code	278
Min. Negotiated Rate	$37.60
Max. Negotiated Rate	$60.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.67
Rate for Payer: Qualcare PPO/HMO/WC	$37.60

Glidewire 0.038 180cm STN ANG

Facility

$224.05

Service Code	HCPCS C1769
Hospital Charge Code	270662586
Hospital Revenue Code	278
Min. Negotiated Rate	$6.36
Max. Negotiated Rate	$112.03
Rate for Payer: Aetna Commercial	$85.14
Rate for Payer: Aetna Medicare Advantage	$67.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.13
Rate for Payer: Cigna Commercial	$112.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.22
Rate for Payer: Qualcare PPO/HMO/WC	$33.61
Rate for Payer: UnitedHealthcare Community & State	$7.08
Rate for Payer: Wellpoint Medicaid Managed Care	$6.36

Glidewire 0.038 180cm STN ANG

Facility

$224.05

Service Code	HCPCS C1769
Hospital Charge Code	270662586N
Hospital Revenue Code	278
Min. Negotiated Rate	$33.61
Max. Negotiated Rate	$54.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.22
Rate for Payer: Qualcare PPO/HMO/WC	$33.61

Glidewire 0.038 180cm STN ANG

Facility

$224.05

Service Code	HCPCS C1769
Hospital Charge Code	270662586
Hospital Revenue Code	278
Min. Negotiated Rate	$33.61
Max. Negotiated Rate	$54.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.22
Rate for Payer: Qualcare PPO/HMO/WC	$33.61

Glidewire 0.038 180cm STN ANG

Facility

$224.05

Service Code	HCPCS C1769
Hospital Charge Code	270662586N
Hospital Revenue Code	278
Min. Negotiated Rate	$6.36
Max. Negotiated Rate	$112.03
Rate for Payer: Aetna Commercial	$85.14
Rate for Payer: Aetna Medicare Advantage	$67.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.13
Rate for Payer: Cigna Commercial	$112.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.22
Rate for Payer: Qualcare PPO/HMO/WC	$33.61
Rate for Payer: UnitedHealthcare Community & State	$7.08
Rate for Payer: Wellpoint Medicaid Managed Care	$6.36

GLIDEWIRE .016 180cm GT D/ANGL

Facility

$1,545.00

Hospital Charge Code	270683666
Hospital Revenue Code	272
Min. Negotiated Rate	$43.88
Max. Negotiated Rate	$772.50
Rate for Payer: Aetna Commercial	$587.10
Rate for Payer: Aetna Medicare Advantage	$463.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$393.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$393.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$393.98
Rate for Payer: Cigna Commercial	$772.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.70
Rate for Payer: Oxford Commercial	$309.00
Rate for Payer: Qualcare PPO/HMO/WC	$231.75
Rate for Payer: UnitedHealthcare Commercial	$309.00
Rate for Payer: UnitedHealthcare Community & State	$48.82
Rate for Payer: Wellpoint Medicaid Managed Care	$43.88

GLIDEWIRE .016 180cm GT D/ANGL

Facility

$1,545.00

Hospital Charge Code	270683666
Hospital Revenue Code	272
Min. Negotiated Rate	$231.75
Max. Negotiated Rate	$231.75
Rate for Payer: Qualcare PPO/HMO/WC	$231.75

GLIDEWIRE .025 150cm SV STR

Facility

$219.58

Service Code	HCPCS C1769
Hospital Charge Code	270601258
Hospital Revenue Code	278
Min. Negotiated Rate	$32.94
Max. Negotiated Rate	$53.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.14
Rate for Payer: Qualcare PPO/HMO/WC	$32.94

GLIDEWIRE .025 150cm SV STR

Facility

$219.58

Service Code	HCPCS C1769
Hospital Charge Code	270601258
Hospital Revenue Code	278
Min. Negotiated Rate	$6.24
Max. Negotiated Rate	$109.79
Rate for Payer: Aetna Commercial	$83.44
Rate for Payer: Aetna Medicare Advantage	$65.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.99
Rate for Payer: Cigna Commercial	$109.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.14
Rate for Payer: Qualcare PPO/HMO/WC	$32.94
Rate for Payer: UnitedHealthcare Community & State	$6.94
Rate for Payer: Wellpoint Medicaid Managed Care	$6.24

GLIDEWIRE .035 150CM ANGL STF

Facility

$320.00

Service Code	HCPCS C1769
Hospital Charge Code	270655439
Hospital Revenue Code	278
Min. Negotiated Rate	$48.00
Max. Negotiated Rate	$77.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: Qualcare PPO/HMO/WC	$48.00

GLIDEWIRE .035 150CM ANGL STF

Facility

$320.00

Service Code	HCPCS C1769
Hospital Charge Code	270655439
Hospital Revenue Code	278
Min. Negotiated Rate	$9.09
Max. Negotiated Rate	$160.00
Rate for Payer: Aetna Commercial	$121.60
Rate for Payer: Aetna Medicare Advantage	$96.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.60
Rate for Payer: Cigna Commercial	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: Qualcare PPO/HMO/WC	$48.00
Rate for Payer: UnitedHealthcare Community & State	$10.11
Rate for Payer: Wellpoint Medicaid Managed Care	$9.09

GLIDEWIRE .035 150CM STRAIGHT

Facility

$229.99

Service Code	HCPCS C1769
Hospital Charge Code	270655401
Hospital Revenue Code	278
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$115.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.66
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Community & State	$7.27
Rate for Payer: Wellpoint Medicaid Managed Care	$6.53

GLIDEWIRE .035 150CM STRAIGHT

Facility

$229.99

Service Code	HCPCS C1769
Hospital Charge Code	270655401
Hospital Revenue Code	278
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$55.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.66
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

GLIDEWIRE 035 180 ANGL GR3508

Facility

$205.75

Service Code	HCPCS C1769
Hospital Charge Code	270638087S
Hospital Revenue Code	278
Min. Negotiated Rate	$30.86
Max. Negotiated Rate	$49.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.79
Rate for Payer: Qualcare PPO/HMO/WC	$30.86

GLIDEWIRE 035 180 ANGL GR3508

Facility

$1,219.00

Service Code	HCPCS C1769
Hospital Charge Code	270638087N
Hospital Revenue Code	278
Min. Negotiated Rate	$182.85
Max. Negotiated Rate	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$243.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.00
Rate for Payer: Qualcare PPO/HMO/WC	$182.85

GLIDEWIRE 035 180 ANGL GR3508

Facility

$1,219.00

Service Code	HCPCS C1769
Hospital Charge Code	270638087N
Hospital Revenue Code	278
Min. Negotiated Rate	$34.62
Max. Negotiated Rate	$609.50
Rate for Payer: Aetna Commercial	$463.22
Rate for Payer: Aetna Medicare Advantage	$365.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$243.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.85
Rate for Payer: Cigna Commercial	$609.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.00
Rate for Payer: Qualcare PPO/HMO/WC	$182.85
Rate for Payer: UnitedHealthcare Community & State	$38.52
Rate for Payer: Wellpoint Medicaid Managed Care	$34.62

GLIDEWIRE 035 180 ANGL GR3508

Facility

$1,450.00

Hospital Charge Code	270638087
Hospital Revenue Code	278
Min. Negotiated Rate	$217.50
Max. Negotiated Rate	$350.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.90
Rate for Payer: Qualcare PPO/HMO/WC	$217.50

Know your out-of-pocket cost for care.

All Charges