Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE BENTSON .035 260cm

Facility

$51.30

Service Code	HCPCS C1769
Hospital Charge Code	270630133N
Hospital Revenue Code	278
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$25.65
Rate for Payer: Aetna Commercial	$19.49
Rate for Payer: Aetna Medicare Advantage	$15.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.08
Rate for Payer: Cigna Commercial	$25.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.41
Rate for Payer: Qualcare PPO/HMO/WC	$7.70
Rate for Payer: UnitedHealthcare Community & State	$1.62
Rate for Payer: Wellpoint Medicaid Managed Care	$1.46

GUIDEWIRE BENTSON .035 260cm

Facility

$51.30

Service Code	HCPCS C1769
Hospital Charge Code	270630133N
Hospital Revenue Code	278
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$12.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.41
Rate for Payer: Qualcare PPO/HMO/WC	$7.70

GUIDEWIRE BENTSON .035 260cm

Facility

$99.57

Service Code	HCPCS C1769
Hospital Charge Code	270630133
Hospital Revenue Code	278
Min. Negotiated Rate	$2.83
Max. Negotiated Rate	$49.78
Rate for Payer: Aetna Commercial	$37.84
Rate for Payer: Aetna Medicare Advantage	$29.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.39
Rate for Payer: Cigna Commercial	$49.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.10
Rate for Payer: Qualcare PPO/HMO/WC	$14.94
Rate for Payer: UnitedHealthcare Community & State	$3.15
Rate for Payer: Wellpoint Medicaid Managed Care	$2.83

GUIDEWIRE BENTSON .035 260cm

Facility

$99.57

Service Code	HCPCS C1769
Hospital Charge Code	270630133S
Hospital Revenue Code	278
Min. Negotiated Rate	$2.83
Max. Negotiated Rate	$49.78
Rate for Payer: Aetna Commercial	$37.84
Rate for Payer: Aetna Medicare Advantage	$29.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.39
Rate for Payer: Cigna Commercial	$49.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.10
Rate for Payer: Qualcare PPO/HMO/WC	$14.94
Rate for Payer: UnitedHealthcare Community & State	$3.15
Rate for Payer: Wellpoint Medicaid Managed Care	$2.83

GUIDEWIRE BENTSON .035 260cm

Facility

$99.57

Service Code	HCPCS C1769
Hospital Charge Code	270630133S
Hospital Revenue Code	278
Min. Negotiated Rate	$14.94
Max. Negotiated Rate	$24.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.10
Rate for Payer: Qualcare PPO/HMO/WC	$14.94

GUIDEWIRE BENTSON .035 260cm

Facility

$99.57

Service Code	HCPCS C1769
Hospital Charge Code	270630133
Hospital Revenue Code	278
Min. Negotiated Rate	$14.94
Max. Negotiated Rate	$24.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.10
Rate for Payer: Qualcare PPO/HMO/WC	$14.94

GUIDE WIRE BLUNT

Facility

$265.00

Service Code	HCPCS C1769
Hospital Charge Code	270699143
Hospital Revenue Code	278
Min. Negotiated Rate	$7.53
Max. Negotiated Rate	$132.50
Rate for Payer: Aetna Commercial	$100.70
Rate for Payer: Aetna Medicare Advantage	$79.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.58
Rate for Payer: Cigna Commercial	$132.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.13
Rate for Payer: Qualcare PPO/HMO/WC	$39.75
Rate for Payer: UnitedHealthcare Community & State	$8.37
Rate for Payer: Wellpoint Medicaid Managed Care	$7.53

GUIDE WIRE BLUNT

Facility

$265.00

Service Code	HCPCS C1769
Hospital Charge Code	270699143
Hospital Revenue Code	278
Min. Negotiated Rate	$39.75
Max. Negotiated Rate	$64.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.13
Rate for Payer: Qualcare PPO/HMO/WC	$39.75

GUIDEWIRE BLUNT 21INCH

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270692304
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

GUIDEWIRE BLUNT 21INCH

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270692304
Hospital Revenue Code	278
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Community & State	$3.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.55

GUIDEWIRE BMW STRAIGHT 300CM

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270666650S
Hospital Revenue Code	278
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

GUIDEWIRE BMW STRAIGHT 300CM

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270666650S
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

GUIDEWIRE BMW UNIV II190CM

Facility

$3,750.00

Service Code	HCPCS C1769
Hospital Charge Code	270645901
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

GUIDEWIRE BMW UNIV II190CM

Facility

$3,750.00

Service Code	HCPCS C1769
Hospital Charge Code	270645901
Hospital Revenue Code	278
Min. Negotiated Rate	$106.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$118.50
Rate for Payer: Wellpoint Medicaid Managed Care	$106.50

GUIDEWIRE BMW UNIV II 300CM

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270645900
Hospital Revenue Code	278
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

GUIDEWIRE BMW UNIV II 300CM

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270645900
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

GUIDEWIRE BMW UNIV JII 300CM

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270642951
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

GUIDEWIRE BMW UNIV JII 300CM

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270642951
Hospital Revenue Code	278
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

GUIDEWIRE B/U MEIER JTIP 185cm

Facility

$159.65

Service Code	HCPCS C1769
Hospital Charge Code	270629981
Hospital Revenue Code	278
Min. Negotiated Rate	$23.95
Max. Negotiated Rate	$38.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.64
Rate for Payer: Qualcare PPO/HMO/WC	$23.95

GUIDEWIRE B/U MEIER JTIP 185cm

Facility

$159.65

Service Code	HCPCS C1769
Hospital Charge Code	270629981
Hospital Revenue Code	278
Min. Negotiated Rate	$4.53
Max. Negotiated Rate	$79.83
Rate for Payer: Aetna Commercial	$60.67
Rate for Payer: Aetna Medicare Advantage	$47.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.71
Rate for Payer: Cigna Commercial	$79.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.64
Rate for Payer: Qualcare PPO/HMO/WC	$23.95
Rate for Payer: UnitedHealthcare Community & State	$5.04
Rate for Payer: Wellpoint Medicaid Managed Care	$4.53

GUIDEWIRE B/U MEIER JTIP 300cm

Facility

$159.65

Service Code	HCPCS C1769
Hospital Charge Code	270631344
Hospital Revenue Code	278
Min. Negotiated Rate	$4.53
Max. Negotiated Rate	$79.83
Rate for Payer: Aetna Commercial	$60.67
Rate for Payer: Aetna Medicare Advantage	$47.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.71
Rate for Payer: Cigna Commercial	$79.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.64
Rate for Payer: Qualcare PPO/HMO/WC	$23.95
Rate for Payer: UnitedHealthcare Community & State	$5.04
Rate for Payer: Wellpoint Medicaid Managed Care	$4.53

GUIDEWIRE B/U MEIER JTIP 300cm

Facility

$159.65

Service Code	HCPCS C1769
Hospital Charge Code	270631344
Hospital Revenue Code	278
Min. Negotiated Rate	$23.95
Max. Negotiated Rate	$38.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.64
Rate for Payer: Qualcare PPO/HMO/WC	$23.95

GUIDEWIRE CHICE PT 300C ST TIP

Facility

$430.00

Service Code	HCPCS C1769
Hospital Charge Code	270653634
Hospital Revenue Code	278
Min. Negotiated Rate	$64.50
Max. Negotiated Rate	$104.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.06
Rate for Payer: Qualcare PPO/HMO/WC	$64.50

GUIDEWIRE CHICE PT 300C ST TIP

Facility

$430.00

Service Code	HCPCS C1769
Hospital Charge Code	270653634
Hospital Revenue Code	278
Min. Negotiated Rate	$12.21
Max. Negotiated Rate	$215.00
Rate for Payer: Aetna Commercial	$163.40
Rate for Payer: Aetna Medicare Advantage	$129.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.65
Rate for Payer: Cigna Commercial	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.06
Rate for Payer: Qualcare PPO/HMO/WC	$64.50
Rate for Payer: UnitedHealthcare Community & State	$13.59
Rate for Payer: Wellpoint Medicaid Managed Care	$12.21

GUIDEWIRE CHICE PT 300C ST TIP

Facility

$430.00

Service Code	HCPCS C1769
Hospital Charge Code	270653634S
Hospital Revenue Code	278
Min. Negotiated Rate	$64.50
Max. Negotiated Rate	$104.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.06
Rate for Payer: Qualcare PPO/HMO/WC	$64.50

Know your out-of-pocket cost for care.

All Charges