Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE 1.6MM

Facility

$85.00

Service Code	HCPCS C1769
Hospital Charge Code	270698444
Hospital Revenue Code	278
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$42.50
Rate for Payer: Aetna Commercial	$32.30
Rate for Payer: Aetna Medicare Advantage	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.68
Rate for Payer: Cigna Commercial	$42.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.57
Rate for Payer: Qualcare PPO/HMO/WC	$12.75
Rate for Payer: UnitedHealthcare Community & State	$2.69
Rate for Payer: Wellpoint Medicaid Managed Care	$2.41

GUIDEWIRE 1.6MM

Facility

$85.00

Service Code	HCPCS C1769
Hospital Charge Code	270698444
Hospital Revenue Code	278
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$20.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.57
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

GUIDE WIRE 1.6MM SPADE 150MM

Facility

$121.50

Hospital Charge Code	270665886
Hospital Revenue Code	278
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$60.75
Rate for Payer: Aetna Commercial	$46.17
Rate for Payer: Aetna Medicare Advantage	$36.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.98
Rate for Payer: Cigna Commercial	$60.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.40
Rate for Payer: Qualcare PPO/HMO/WC	$18.23
Rate for Payer: UnitedHealthcare Community & State	$3.84
Rate for Payer: Wellpoint Medicaid Managed Care	$3.45

GUIDE WIRE 1.6MM SPADE 150MM

Facility

$121.50

Hospital Charge Code	270665886
Hospital Revenue Code	278
Min. Negotiated Rate	$18.23
Max. Negotiated Rate	$29.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.40
Rate for Payer: Qualcare PPO/HMO/WC	$18.23

GUIDEWIRE 1.6x100mm

Facility

$100.00

Service Code	HCPCS C1769
Hospital Charge Code	270676445
Hospital Revenue Code	278
Min. Negotiated Rate	$2.84
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Commercial	$38.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.20
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Community & State	$3.16
Rate for Payer: Wellpoint Medicaid Managed Care	$2.84

GUIDEWIRE 1.6x100mm

Facility

$100.00

Service Code	HCPCS C1769
Hospital Charge Code	270676445
Hospital Revenue Code	278
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$24.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.20
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

GUIDE WIRE 1.6X100MM

Facility

$81.25

Hospital Charge Code	270637829
Hospital Revenue Code	278
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$40.62
Rate for Payer: Aetna Commercial	$30.88
Rate for Payer: Aetna Medicare Advantage	$24.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.72
Rate for Payer: Cigna Commercial	$40.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.66
Rate for Payer: Qualcare PPO/HMO/WC	$12.19
Rate for Payer: UnitedHealthcare Community & State	$2.57
Rate for Payer: Wellpoint Medicaid Managed Care	$2.31

GUIDE WIRE 1.6X100MM

Facility

$81.25

Hospital Charge Code	270637829
Hospital Revenue Code	278
Min. Negotiated Rate	$12.19
Max. Negotiated Rate	$19.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.66
Rate for Payer: Qualcare PPO/HMO/WC	$12.19

GUIDEWIRE 2.0X150MM

Facility

$75.00

Service Code	HCPCS C1769
Hospital Charge Code	270698541
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 2.0X150MM

Facility

$75.00

Service Code	HCPCS C1769
Hospital Charge Code	270698541
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

GUIDE WIRE 2.0x40MM

Facility

$144.45

Service Code	HCPCS C1769
Hospital Charge Code	270637808
Hospital Revenue Code	278
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$72.22
Rate for Payer: Aetna Commercial	$54.89
Rate for Payer: Aetna Medicare Advantage	$43.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.83
Rate for Payer: Cigna Commercial	$72.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.96
Rate for Payer: Qualcare PPO/HMO/WC	$21.67
Rate for Payer: UnitedHealthcare Community & State	$4.56
Rate for Payer: Wellpoint Medicaid Managed Care	$4.10

GUIDE WIRE 2.0x40MM

Facility

$144.45

Service Code	HCPCS C1769
Hospital Charge Code	270637808
Hospital Revenue Code	278
Min. Negotiated Rate	$21.67
Max. Negotiated Rate	$34.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.96
Rate for Payer: Qualcare PPO/HMO/WC	$21.67

GUIDE WIRE 22.MM X 28IN

Facility

$600.00

Service Code	HCPCS C1769
Hospital Charge Code	270685087
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

GUIDE WIRE 22.MM X 28IN

Facility

$600.00

Service Code	HCPCS C1769
Hospital Charge Code	270685087
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 2.3X200MM

Facility

$75.00

Service Code	HCPCS C1769
Hospital Charge Code	270659330
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 2.3X200MM

Facility

$75.00

Service Code	HCPCS C1769
Hospital Charge Code	270659330
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 2 4X70 BUTIP 2255008

Facility

$460.00

Hospital Charge Code	270638046
Hospital Revenue Code	272
Min. Negotiated Rate	$13.06
Max. Negotiated Rate	$230.00
Rate for Payer: Aetna Commercial	$174.80
Rate for Payer: Aetna Medicare Advantage	$138.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.30
Rate for Payer: Cigna Commercial	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.60
Rate for Payer: Oxford Commercial	$92.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.00
Rate for Payer: UnitedHealthcare Commercial	$92.00
Rate for Payer: UnitedHealthcare Community & State	$14.54
Rate for Payer: Wellpoint Medicaid Managed Care	$13.06

GUIDEWIRE 2 4X70 BUTIP 2255008

Facility

$460.00

Hospital Charge Code	270638046
Hospital Revenue Code	272
Min. Negotiated Rate	$69.00
Max. Negotiated Rate	$69.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.00

GUIDE WIRE 2.8MM X 300MM

Facility

$1,250.00

Service Code	HCPCS C1769
Hospital Charge Code	270680279
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

GUIDE WIRE 2.8MM X 300MM

Facility

$1,250.00

Service Code	HCPCS C1769
Hospital Charge Code	270680279
Hospital Revenue Code	278
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$39.50
Rate for Payer: Wellpoint Medicaid Managed Care	$35.50

GUIDEWIRE 2.8X220MM

Facility

$3,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270695400
Hospital Revenue Code	278
Min. Negotiated Rate	$453.75
Max. Negotiated Rate	$732.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$605.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.05
Rate for Payer: Qualcare PPO/HMO/WC	$453.75

GUIDEWIRE 2.8X220MM

Facility

$3,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270695400
Hospital Revenue Code	278
Min. Negotiated Rate	$85.91
Max. Negotiated Rate	$1,512.50
Rate for Payer: Aetna Commercial	$1,149.50
Rate for Payer: Aetna Medicare Advantage	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$771.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$771.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$771.38
Rate for Payer: Cigna Commercial	$1,512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.05
Rate for Payer: Qualcare PPO/HMO/WC	$453.75
Rate for Payer: UnitedHealthcare Community & State	$95.59
Rate for Payer: Wellpoint Medicaid Managed Care	$85.91

GUIDEWIRE 2.8x450 THRD 900726

Facility

$275.00

Hospital Charge Code	270632483
Hospital Revenue Code	272
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

GUIDEWIRE 2.8x450 THRD 900726

Facility

$275.00

Hospital Charge Code	270632483
Hospital Revenue Code	272
Min. Negotiated Rate	$7.81
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Oxford Commercial	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Commercial	$55.00
Rate for Payer: UnitedHealthcare Community & State	$8.69
Rate for Payer: Wellpoint Medicaid Managed Care	$7.81

GUIDEWIRE 2X200mm

Facility

$700.00

Service Code	HCPCS C1769
Hospital Charge Code	270681218
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$22.12
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

Know your out-of-pocket cost for care.

All Charges