Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

GLIDEWIRE 035 180 ANGL GR3508

Facility

$205.75

Service Code	HCPCS C1769
Hospital Charge Code	270638087S
Hospital Revenue Code	278
Min. Negotiated Rate	$5.84
Max. Negotiated Rate	$102.88
Rate for Payer: Aetna Commercial	$78.19
Rate for Payer: Aetna Medicare Advantage	$61.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.47
Rate for Payer: Cigna Commercial	$102.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.79
Rate for Payer: Qualcare PPO/HMO/WC	$30.86
Rate for Payer: UnitedHealthcare Community & State	$6.50
Rate for Payer: Wellpoint Medicaid Managed Care	$5.84

GLIDEWIRE 035 180 ANGL GR3508

Facility

$1,450.00

Hospital Charge Code	270638087
Hospital Revenue Code	278
Min. Negotiated Rate	$41.18
Max. Negotiated Rate	$725.00
Rate for Payer: Aetna Commercial	$551.00
Rate for Payer: Aetna Medicare Advantage	$435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$369.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$369.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$369.75
Rate for Payer: Cigna Commercial	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.90
Rate for Payer: Qualcare PPO/HMO/WC	$217.50
Rate for Payer: UnitedHealthcare Community & State	$45.82
Rate for Payer: Wellpoint Medicaid Managed Care	$41.18

GLIDEWIRE 035 260 ANGL GR3509

Facility

$230.00

Service Code	HCPCS C1769
Hospital Charge Code	270642562C
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 035 260 ANGL GR3509

Facility

$230.00

Service Code	HCPCS C1769
Hospital Charge Code	270642562A
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 035 260 ANGL GR3509

Facility

$230.00

Service Code	HCPCS C1769
Hospital Charge Code	270642562A
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 035 260 ANGL GR3509

Facility

$230.00

Service Code	HCPCS C1769
Hospital Charge Code	270642562C
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 035 260 STF GS3509

Facility

$281.50

Service Code	HCPCS C1769
Hospital Charge Code	270637622S
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 035 260 STF GS3509

Facility

$1,800.00

Hospital Charge Code	270637622
Hospital Revenue Code	279
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$270.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

GLIDEWIRE 035 260 STF GS3509

Facility

$1,800.00

Hospital Charge Code	270637622
Hospital Revenue Code	279
Min. Negotiated Rate	$51.12
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$684.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$468.00
Rate for Payer: Oxford Commercial	$360.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Commercial	$360.00
Rate for Payer: UnitedHealthcare Community & State	$56.88
Rate for Payer: Wellpoint Medicaid Managed Care	$51.12

GLIDEWIRE 035 260 STF GS3509

Facility

$281.50

Service Code	HCPCS C1769
Hospital Charge Code	270637622S
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 .035 450CM SS ANGLED

Facility

$186.00

Hospital Charge Code	270654320
Hospital Revenue Code	270
Min. Negotiated Rate	$27.90
Max. Negotiated Rate	$27.90
Rate for Payer: Qualcare PPO/HMO/WC	$27.90

GLIDEWIRE .035 450CM SS ANGLED

Facility

$186.00

Hospital Charge Code	270654320
Hospital Revenue Code	270
Min. Negotiated Rate	$5.28
Max. Negotiated Rate	$93.00
Rate for Payer: Aetna Commercial	$70.68
Rate for Payer: Aetna Medicare Advantage	$55.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.43
Rate for Payer: Cigna Commercial	$93.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.36
Rate for Payer: Oxford Commercial	$37.20
Rate for Payer: Qualcare PPO/HMO/WC	$27.90
Rate for Payer: UnitedHealthcare Commercial	$37.20
Rate for Payer: UnitedHealthcare Community & State	$5.88
Rate for Payer: Wellpoint Medicaid Managed Care	$5.28

GLIDEWIRE .038 150CM STRAIGHT

Facility

$320.00

Service Code	HCPCS C1769
Hospital Charge Code	270658605
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 .038 150CM STRAIGHT

Facility

$320.00

Service Code	HCPCS C1769
Hospital Charge Code	270658605
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 .038 180 CM STN ANG

Facility

$224.25

Hospital Charge Code	270684296
Hospital Revenue Code	272
Min. Negotiated Rate	$6.37
Max. Negotiated Rate	$112.12
Rate for Payer: Aetna Commercial	$85.22
Rate for Payer: Aetna Medicare Advantage	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.18
Rate for Payer: Cigna Commercial	$112.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.30
Rate for Payer: Oxford Commercial	$44.85
Rate for Payer: Qualcare PPO/HMO/WC	$33.64
Rate for Payer: UnitedHealthcare Commercial	$44.85
Rate for Payer: UnitedHealthcare Community & State	$7.09
Rate for Payer: Wellpoint Medicaid Managed Care	$6.37

GLIDEWIRE .038 180 CM STN ANG

Facility

$224.25

Hospital Charge Code	270684296N
Hospital Revenue Code	272
Min. Negotiated Rate	$6.37
Max. Negotiated Rate	$112.12
Rate for Payer: Aetna Commercial	$85.22
Rate for Payer: Aetna Medicare Advantage	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.18
Rate for Payer: Cigna Commercial	$112.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.30
Rate for Payer: Oxford Commercial	$44.85
Rate for Payer: Qualcare PPO/HMO/WC	$33.64
Rate for Payer: UnitedHealthcare Commercial	$44.85
Rate for Payer: UnitedHealthcare Community & State	$7.09
Rate for Payer: Wellpoint Medicaid Managed Care	$6.37

GLIDEWIRE .038 180 CM STN ANG

Facility

$224.25

Hospital Charge Code	270684296N
Hospital Revenue Code	272
Min. Negotiated Rate	$33.64
Max. Negotiated Rate	$33.64
Rate for Payer: Qualcare PPO/HMO/WC	$33.64

GLIDEWIRE .038 180 CM STN ANG

Facility

$224.25

Hospital Charge Code	270684296
Hospital Revenue Code	272
Min. Negotiated Rate	$33.64
Max. Negotiated Rate	$33.64
Rate for Payer: Qualcare PPO/HMO/WC	$33.64

GLIDEWIRE .038X150CM BENTS STF

Facility

$270.00

Service Code	HCPCS C1769
Hospital Charge Code	270658529
Hospital Revenue Code	278
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$65.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.34
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

GLIDEWIRE .038X150CM BENTS STF

Facility

$270.00

Service Code	HCPCS C1769
Hospital Charge Code	270658529
Hospital Revenue Code	278
Min. Negotiated Rate	$7.67
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$102.60
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.34
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Community & State	$8.53
Rate for Payer: Wellpoint Medicaid Managed Care	$7.67

GLIDEWIRE .038X150CM DUAL FLEX

Facility

$374.66

Service Code	HCPCS C1769
Hospital Charge Code	270684750
Hospital Revenue Code	278
Min. Negotiated Rate	$10.64
Max. Negotiated Rate	$187.33
Rate for Payer: Aetna Commercial	$142.37
Rate for Payer: Aetna Medicare Advantage	$112.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.54
Rate for Payer: Cigna Commercial	$187.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.67
Rate for Payer: Qualcare PPO/HMO/WC	$56.20
Rate for Payer: UnitedHealthcare Community & State	$11.84
Rate for Payer: Wellpoint Medicaid Managed Care	$10.64

GLIDEWIRE .038X150CM DUAL FLEX

Facility

$374.66

Service Code	HCPCS C1769
Hospital Charge Code	270684750
Hospital Revenue Code	278
Min. Negotiated Rate	$56.20
Max. Negotiated Rate	$90.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.67
Rate for Payer: Qualcare PPO/HMO/WC	$56.20

GLIDEWIRE 150CM 18MM

Facility

$191.25

Hospital Charge Code	270664201
Hospital Revenue Code	270
Min. Negotiated Rate	$5.43
Max. Negotiated Rate	$95.62
Rate for Payer: Aetna Commercial	$72.67
Rate for Payer: Aetna Medicare Advantage	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.77
Rate for Payer: Cigna Commercial	$95.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.73
Rate for Payer: Oxford Commercial	$38.25
Rate for Payer: Qualcare PPO/HMO/WC	$28.69
Rate for Payer: UnitedHealthcare Commercial	$38.25
Rate for Payer: UnitedHealthcare Community & State	$6.04
Rate for Payer: Wellpoint Medicaid Managed Care	$5.43

GLIDEWIRE 150CM 18MM

Facility

$191.25

Hospital Charge Code	270664201
Hospital Revenue Code	270
Min. Negotiated Rate	$28.69
Max. Negotiated Rate	$28.69
Rate for Payer: Qualcare PPO/HMO/WC	$28.69

GLIDEWIRE ADVANTAGE ANGLED

Facility

$245.00

Service Code	HCPCS C1769
Hospital Charge Code	270658283N
Hospital Revenue Code	278
Min. Negotiated Rate	$6.96
Max. Negotiated Rate	$122.50
Rate for Payer: Aetna Commercial	$93.10
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Community & State	$7.74
Rate for Payer: Wellpoint Medicaid Managed Care	$6.96

Know your out-of-pocket cost for care.

All Charges