Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE

Facility

$1,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270691521
Hospital Revenue Code	278
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

GUIDEWIRE

Facility

$1,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270691521
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

GUIDEWIRE

Facility

$675.00

Hospital Charge Code	270705516
Hospital Revenue Code	279
Min. Negotiated Rate	$101.25
Max. Negotiated Rate	$101.25
Rate for Payer: Qualcare PPO/HMO/WC	$101.25

GUIDEWIRE

Facility

$600.00

Hospital Charge Code	270703310
Hospital Revenue Code	278
Min. Negotiated Rate	$17.04
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$18.96
Rate for Payer: Wellpoint Medicaid Managed Care	$17.04

GUIDEWIRE

Facility

$675.00

Hospital Charge Code	270705516
Hospital Revenue Code	279
Min. Negotiated Rate	$19.17
Max. Negotiated Rate	$337.50
Rate for Payer: Aetna Commercial	$256.50
Rate for Payer: Aetna Medicare Advantage	$202.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.12
Rate for Payer: Cigna Commercial	$337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.50
Rate for Payer: Oxford Commercial	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$101.25
Rate for Payer: UnitedHealthcare Commercial	$135.00
Rate for Payer: UnitedHealthcare Community & State	$21.33
Rate for Payer: Wellpoint Medicaid Managed Care	$19.17

GUIDEWIRE

Facility

$585.00

Service Code	HCPCS C1769
Hospital Charge Code	270681349
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$141.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

GUIDEWIRE 0.045

Facility

$75.00

Service Code	HCPCS C1769
Hospital Charge Code	270668718
Hospital Revenue Code	278
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$18.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

GUIDEWIRE 0.045

Facility

$75.00

Service Code	HCPCS C1769
Hospital Charge Code	270668718
Hospital Revenue Code	278
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Community & State	$2.37
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

GUIDEWIRE 0.078

Facility

$157.50

Service Code	HCPCS C1769
Hospital Charge Code	270656547
Hospital Revenue Code	278
Min. Negotiated Rate	$23.62
Max. Negotiated Rate	$38.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.12
Rate for Payer: Qualcare PPO/HMO/WC	$23.62

GUIDEWIRE 0.078

Facility

$157.50

Service Code	HCPCS C1769
Hospital Charge Code	270656547
Hospital Revenue Code	278
Min. Negotiated Rate	$4.47
Max. Negotiated Rate	$78.75
Rate for Payer: Aetna Commercial	$59.85
Rate for Payer: Aetna Medicare Advantage	$47.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.16
Rate for Payer: Cigna Commercial	$78.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.12
Rate for Payer: Qualcare PPO/HMO/WC	$23.62
Rate for Payer: UnitedHealthcare Community & State	$4.98
Rate for Payer: Wellpoint Medicaid Managed Care	$4.47

GUIDE WIRE 0.078X20

Facility

$380.00

Hospital Charge Code	270671065
Hospital Revenue Code	278
Min. Negotiated Rate	$10.79
Max. Negotiated Rate	$190.00
Rate for Payer: Aetna Commercial	$144.40
Rate for Payer: Aetna Medicare Advantage	$114.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.90
Rate for Payer: Cigna Commercial	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.96
Rate for Payer: Qualcare PPO/HMO/WC	$57.00
Rate for Payer: UnitedHealthcare Community & State	$12.01
Rate for Payer: Wellpoint Medicaid Managed Care	$10.79

GUIDE WIRE 0.078X20

Facility

$380.00

Hospital Charge Code	270671065
Hospital Revenue Code	278
Min. Negotiated Rate	$57.00
Max. Negotiated Rate	$91.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.96
Rate for Payer: Qualcare PPO/HMO/WC	$57.00

GUIDEWIRE .014 260cm ENDO-014

Facility

$900.00

Hospital Charge Code	270645892
Hospital Revenue Code	272
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

GUIDEWIRE .014 260cm ENDO-014

Facility

$900.00

Hospital Charge Code	270645892
Hospital Revenue Code	272
Min. Negotiated Rate	$25.56
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.00
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Commercial	$180.00
Rate for Payer: UnitedHealthcare Community & State	$28.44
Rate for Payer: Wellpoint Medicaid Managed Care	$25.56

GUIDEWIRE .014 INX 300CM

Facility

$1,840.00

Hospital Charge Code	270684951
Hospital Revenue Code	279
Min. Negotiated Rate	$52.26
Max. Negotiated Rate	$920.00
Rate for Payer: Aetna Commercial	$699.20
Rate for Payer: Aetna Medicare Advantage	$552.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$469.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$469.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$469.20
Rate for Payer: Cigna Commercial	$920.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$478.40
Rate for Payer: Oxford Commercial	$368.00
Rate for Payer: Qualcare PPO/HMO/WC	$276.00
Rate for Payer: UnitedHealthcare Commercial	$368.00
Rate for Payer: UnitedHealthcare Community & State	$58.14
Rate for Payer: Wellpoint Medicaid Managed Care	$52.26

GUIDEWIRE .014 INX 300CM

Facility

$1,840.00

Hospital Charge Code	270684951
Hospital Revenue Code	279
Min. Negotiated Rate	$276.00
Max. Negotiated Rate	$276.00
Rate for Payer: Qualcare PPO/HMO/WC	$276.00

GUIDEWIRE 014x300 ENWSD014300

Facility

$1,800.00

Service Code	HCPCS C1769
Hospital Charge Code	270660087
Hospital Revenue Code	278
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) NJ Health	$360.00
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	$435.60
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Community & State	$56.88
Rate for Payer: Wellpoint Medicaid Managed Care	$51.12

GUIDEWIRE 014x300 ENWSD014300

Facility

$1,800.00

Service Code	HCPCS C1769
Hospital Charge Code	270660087
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$435.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

GUIDEWIRE 014x300 ENWSD014300

Facility

$1,475.00

Service Code	HCPCS C1769
Hospital Charge Code	270660087N
Hospital Revenue Code	278
Min. Negotiated Rate	$41.89
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$46.61
Rate for Payer: Wellpoint Medicaid Managed Care	$41.89

GUIDEWIRE 014x300 ENWSD014300

Facility

$1,800.00

Service Code	HCPCS C1769
Hospital Charge Code	270660087S
Hospital Revenue Code	278
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) NJ Health	$360.00
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	$435.60
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Community & State	$56.88
Rate for Payer: Wellpoint Medicaid Managed Care	$51.12

GUIDEWIRE 014x300 ENWSD014300

Facility

$1,475.00

Service Code	HCPCS C1769
Hospital Charge Code	270660087N
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

GUIDEWIRE 014x300 ENWSD014300

Facility

$1,800.00

Service Code	HCPCS C1769
Hospital Charge Code	270660087S
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$435.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

GUIDEWIRE .018DIAx125cm FOR4

Facility

$50.00

Service Code	HCPCS C1769
Hospital Charge Code	270631391
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

GUIDEWIRE .018DIAx125cm FOR4

Facility

$50.00

Service Code	HCPCS C1769
Hospital Charge Code	270631391
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

GUIDEWIRE 0.18LT

Facility

$415.00

Service Code	HCPCS C1769
Hospital Charge Code	270652342
Hospital Revenue Code	278
Min. Negotiated Rate	$11.79
Max. Negotiated Rate	$207.50
Rate for Payer: Aetna Commercial	$157.70
Rate for Payer: Aetna Medicare Advantage	$124.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$83.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.83
Rate for Payer: Cigna Commercial	$207.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.43
Rate for Payer: Qualcare PPO/HMO/WC	$62.25
Rate for Payer: UnitedHealthcare Community & State	$13.11
Rate for Payer: Wellpoint Medicaid Managed Care	$11.79

Know your out-of-pocket cost for care.

All Charges