Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE CHICE PT 300C ST TIP

Facility

$415.00

Service Code	HCPCS C1769
Hospital Charge Code	270653634N
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

GUIDEWIRE CHICE PT 300C ST TIP

Facility

$430.00

Service Code	HCPCS C1769
Hospital Charge Code	270653634S
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

$415.00

Service Code	HCPCS C1769
Hospital Charge Code	270653634N
Hospital Revenue Code	278
Min. Negotiated Rate	$62.25
Max. Negotiated Rate	$100.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$83.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.43
Rate for Payer: Qualcare PPO/HMO/WC	$62.25

GUIDEWIRE CHIKAI 10 MM

Facility

$2,745.00

Service Code	HCPCS C1769
Hospital Charge Code	270696455S
Hospital Revenue Code	278
Min. Negotiated Rate	$77.96
Max. Negotiated Rate	$1,372.50
Rate for Payer: Aetna Commercial	$1,043.10
Rate for Payer: Aetna Medicare Advantage	$823.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$699.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$699.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$549.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$699.98
Rate for Payer: Cigna Commercial	$1,372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$664.29
Rate for Payer: Qualcare PPO/HMO/WC	$411.75
Rate for Payer: UnitedHealthcare Community & State	$86.74
Rate for Payer: Wellpoint Medicaid Managed Care	$77.96

GUIDEWIRE CHIKAI 10 MM

Facility

$2,745.00

Service Code	HCPCS C1769
Hospital Charge Code	270696455S
Hospital Revenue Code	278
Min. Negotiated Rate	$411.75
Max. Negotiated Rate	$664.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$549.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$664.29
Rate for Payer: Qualcare PPO/HMO/WC	$411.75

GUIDEWIRE CHOIC PT 300 1215501

Facility

$430.00

Service Code	HCPCS C1769
Hospital Charge Code	270637306
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 CHOIC PT 300 1215501

Facility

$430.00

Service Code	HCPCS C1769
Hospital Charge Code	270637306
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 CLEVER CUT V

Facility

$810.00

Service Code	HCPCS C1769
Hospital Charge Code	270684736
Hospital Revenue Code	278
Min. Negotiated Rate	$121.50
Max. Negotiated Rate	$196.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.02
Rate for Payer: Qualcare PPO/HMO/WC	$121.50

GUIDEWIRE CLEVER CUT V

Facility

$810.00

Service Code	HCPCS C1769
Hospital Charge Code	270684736
Hospital Revenue Code	278
Min. Negotiated Rate	$23.00
Max. Negotiated Rate	$405.00
Rate for Payer: Aetna Commercial	$307.80
Rate for Payer: Aetna Medicare Advantage	$243.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$206.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$206.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$206.55
Rate for Payer: Cigna Commercial	$405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.02
Rate for Payer: Qualcare PPO/HMO/WC	$121.50
Rate for Payer: UnitedHealthcare Community & State	$25.60
Rate for Payer: Wellpoint Medicaid Managed Care	$23.00

GUIDEWIRE CONTROL 8x300CM STR

Facility

$798.25

Service Code	HCPCS C1769
Hospital Charge Code	270670509
Hospital Revenue Code	278
Min. Negotiated Rate	$22.67
Max. Negotiated Rate	$399.12
Rate for Payer: Aetna Commercial	$303.33
Rate for Payer: Aetna Medicare Advantage	$239.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$203.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$203.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$203.55
Rate for Payer: Cigna Commercial	$399.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.18
Rate for Payer: Qualcare PPO/HMO/WC	$119.74
Rate for Payer: UnitedHealthcare Community & State	$25.22
Rate for Payer: Wellpoint Medicaid Managed Care	$22.67

GUIDEWIRE CONTROL 8x300CM STR

Facility

$798.25

Service Code	HCPCS C1769
Hospital Charge Code	270670509
Hospital Revenue Code	278
Min. Negotiated Rate	$119.74
Max. Negotiated Rate	$193.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.18
Rate for Payer: Qualcare PPO/HMO/WC	$119.74

GUIDEWIRE COPE MANDRIL 60cm

Facility

$251.45

Service Code	HCPCS C1769
Hospital Charge Code	270632089
Hospital Revenue Code	278
Min. Negotiated Rate	$7.14
Max. Negotiated Rate	$125.72
Rate for Payer: Aetna Commercial	$95.55
Rate for Payer: Aetna Medicare Advantage	$75.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.12
Rate for Payer: Cigna Commercial	$125.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.85
Rate for Payer: Qualcare PPO/HMO/WC	$37.72
Rate for Payer: UnitedHealthcare Community & State	$7.95
Rate for Payer: Wellpoint Medicaid Managed Care	$7.14

GUIDEWIRE COPE MANDRIL 60cm

Facility

$251.45

Service Code	HCPCS C1769
Hospital Charge Code	270632089
Hospital Revenue Code	278
Min. Negotiated Rate	$37.72
Max. Negotiated Rate	$60.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.85
Rate for Payer: Qualcare PPO/HMO/WC	$37.72

GUIDEWIRE COPE NITINOL 218125

Facility

$251.45

Service Code	HCPCS C1769
Hospital Charge Code	270630862
Hospital Revenue Code	278
Min. Negotiated Rate	$7.14
Max. Negotiated Rate	$125.72
Rate for Payer: Aetna Commercial	$95.55
Rate for Payer: Aetna Medicare Advantage	$75.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.12
Rate for Payer: Cigna Commercial	$125.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.85
Rate for Payer: Qualcare PPO/HMO/WC	$37.72
Rate for Payer: UnitedHealthcare Community & State	$7.95
Rate for Payer: Wellpoint Medicaid Managed Care	$7.14

GUIDEWIRE COPE NITINOL 218125

Facility

$251.45

Service Code	HCPCS C1769
Hospital Charge Code	270630862
Hospital Revenue Code	278
Min. Negotiated Rate	$37.72
Max. Negotiated Rate	$60.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.85
Rate for Payer: Qualcare PPO/HMO/WC	$37.72

GUIDE WIRE COPILOT

Facility

$325.00

Service Code	HCPCS C1769
Hospital Charge Code	270682243S
Hospital Revenue Code	278
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$123.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.65
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Community & State	$10.27
Rate for Payer: Wellpoint Medicaid Managed Care	$9.23

GUIDE WIRE COPILOT

Facility

$250.00

Service Code	HCPCS C1789
Hospital Charge Code	270682243N
Hospital Revenue Code	278
Min. Negotiated Rate	$7.10
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Community & State	$7.90
Rate for Payer: Wellpoint Medicaid Managed Care	$7.10

GUIDE WIRE COPILOT

Facility

$325.00

Service Code	HCPCS C1769
Hospital Charge Code	270682243
Hospital Revenue Code	278
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$78.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.65
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

GUIDE WIRE COPILOT

Facility

$325.00

Service Code	HCPCS C1769
Hospital Charge Code	270682243S
Hospital Revenue Code	278
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$78.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.65
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

GUIDE WIRE COPILOT

Facility

$325.00

Service Code	HCPCS C1769
Hospital Charge Code	270682243
Hospital Revenue Code	278
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$123.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.65
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Community & State	$10.27
Rate for Payer: Wellpoint Medicaid Managed Care	$9.23

GUIDE WIRE COPILOT

Facility

$250.00

Service Code	HCPCS C1789
Hospital Charge Code	270682243N
Hospital Revenue Code	278
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

GUIDEWIRE, CORDIS SPECIALTY J

Facility

$2,002.00

Service Code	HCPCS C1769
Hospital Charge Code	2008130
Hospital Revenue Code	278
Min. Negotiated Rate	$300.30
Max. Negotiated Rate	$484.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.48
Rate for Payer: Qualcare PPO/HMO/WC	$300.30

GUIDEWIRE, CORDIS SPECIALTY J

Facility

$2,002.00

Service Code	HCPCS C1769
Hospital Charge Code	2008130
Hospital Revenue Code	278
Min. Negotiated Rate	$56.86
Max. Negotiated Rate	$1,001.00
Rate for Payer: Aetna Commercial	$760.76
Rate for Payer: Aetna Medicare Advantage	$600.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.51
Rate for Payer: Cigna Commercial	$1,001.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.48
Rate for Payer: Qualcare PPO/HMO/WC	$300.30
Rate for Payer: UnitedHealthcare Community & State	$63.26
Rate for Payer: Wellpoint Medicaid Managed Care	$56.86

GUIDEWIRE CRD .025 ST 502-549

Facility

$37.75

Service Code	HCPCS C1769
Hospital Charge Code	270617435
Hospital Revenue Code	278
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$18.88
Rate for Payer: Aetna Commercial	$14.35
Rate for Payer: Aetna Medicare Advantage	$11.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.63
Rate for Payer: Cigna Commercial	$18.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.14
Rate for Payer: Qualcare PPO/HMO/WC	$5.66
Rate for Payer: UnitedHealthcare Community & State	$1.19
Rate for Payer: Wellpoint Medicaid Managed Care	$1.07

GUIDEWIRE CRD .025 ST 502-549

Facility

$37.75

Service Code	HCPCS C1769
Hospital Charge Code	270617435
Hospital Revenue Code	278
Min. Negotiated Rate	$5.66
Max. Negotiated Rate	$9.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.14
Rate for Payer: Qualcare PPO/HMO/WC	$5.66

Know your out-of-pocket cost for care.

All Charges