Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE CRD .035 150 502-521

Facility

$37.75

Service Code	HCPCS C1769
Hospital Charge Code	270622619
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

GUIDEWIRE CRD .035 150 502-521

Facility

$37.75

Service Code	HCPCS C1769
Hospital Charge Code	270622619
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 DOC 145cm

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270651827
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 DOC 145cm

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270651827
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

GUIDE WIRE DRILL TIP 2.5x200MM

Facility

$284.85

Hospital Charge Code	270628187
Hospital Revenue Code	272
Min. Negotiated Rate	$8.09
Max. Negotiated Rate	$142.43
Rate for Payer: Aetna Commercial	$108.24
Rate for Payer: Aetna Medicare Advantage	$85.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.64
Rate for Payer: Cigna Commercial	$142.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.06
Rate for Payer: Oxford Commercial	$56.97
Rate for Payer: Qualcare PPO/HMO/WC	$42.73
Rate for Payer: UnitedHealthcare Commercial	$56.97
Rate for Payer: UnitedHealthcare Community & State	$9.00
Rate for Payer: Wellpoint Medicaid Managed Care	$8.09

GUIDE WIRE DRILL TIP 2.5x200MM

Facility

$284.85

Hospital Charge Code	270628187
Hospital Revenue Code	272
Min. Negotiated Rate	$42.73
Max. Negotiated Rate	$42.73
Rate for Payer: Qualcare PPO/HMO/WC	$42.73

GUIDE WIRE DRILL TIP 2.5x300mm

Facility

$290.45

Hospital Charge Code	270649702
Hospital Revenue Code	272
Min. Negotiated Rate	$43.57
Max. Negotiated Rate	$43.57
Rate for Payer: Qualcare PPO/HMO/WC	$43.57

GUIDE WIRE DRILL TIP 2.5x300mm

Facility

$290.45

Hospital Charge Code	270649702
Hospital Revenue Code	272
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$145.22
Rate for Payer: Aetna Commercial	$110.37
Rate for Payer: Aetna Medicare Advantage	$87.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.06
Rate for Payer: Cigna Commercial	$145.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.52
Rate for Payer: Oxford Commercial	$58.09
Rate for Payer: Qualcare PPO/HMO/WC	$43.57
Rate for Payer: UnitedHealthcare Commercial	$58.09
Rate for Payer: UnitedHealthcare Community & State	$9.18
Rate for Payer: Wellpoint Medicaid Managed Care	$8.25

GUIDE WIRE EMERALD .35INX150CM

Facility

$37.75

Service Code	HCPCS C1713
Hospital Charge Code	270622619C
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

GUIDE WIRE EMERALD .35INX150CM

Facility

$37.75

Service Code	HCPCS C1713
Hospital Charge Code	270622619C
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

GUIDEWIRE ENTEER FLEX 014x300

Facility

$1,800.00

Service Code	HCPCS C1887
Hospital Charge Code	270689918
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 ENTEER FLEX 014x300

Facility

$1,800.00

Service Code	HCPCS C1887
Hospital Charge Code	270689918
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 ENTEER STIFF 014x300

Facility

$1,800.00

Service Code	HCPCS C1887
Hospital Charge Code	270689919
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 ENTEER STIFF 014x300

Facility

$1,800.00

Service Code	HCPCS C1887
Hospital Charge Code	270689919
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 FACETFIX 25INCH

Facility

$1,250.00

Service Code	HCPCS C1769
Hospital Charge Code	270694524
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

GUIDEWIRE FACETFIX 25INCH

Facility

$1,250.00

Service Code	HCPCS C1769
Hospital Charge Code	270694524
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 FATHOM

Facility

$1,456.40

Hospital Charge Code	270640608
Hospital Revenue Code	278
Min. Negotiated Rate	$218.46
Max. Negotiated Rate	$352.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$291.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$352.45
Rate for Payer: Qualcare PPO/HMO/WC	$218.46

GUIDEWIRE FATHOM

Facility

$1,456.40

Hospital Charge Code	270640608
Hospital Revenue Code	278
Min. Negotiated Rate	$41.36
Max. Negotiated Rate	$728.20
Rate for Payer: Aetna Commercial	$553.43
Rate for Payer: Aetna Medicare Advantage	$436.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$371.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$371.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$291.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$371.38
Rate for Payer: Cigna Commercial	$728.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$352.45
Rate for Payer: Qualcare PPO/HMO/WC	$218.46
Rate for Payer: UnitedHealthcare Community & State	$46.02
Rate for Payer: Wellpoint Medicaid Managed Care	$41.36

GUIDEWIRE F/BIO-COMPR SCREW

Facility

$210.00

Service Code	HCPCS C1769
Hospital Charge Code	270661623
Hospital Revenue Code	278
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$50.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.82
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

GUIDEWIRE F/BIO-COMPR SCREW

Facility

$210.00

Service Code	HCPCS C1769
Hospital Charge Code	270661623
Hospital Revenue Code	278
Min. Negotiated Rate	$5.96
Max. Negotiated Rate	$105.00
Rate for Payer: Aetna Commercial	$79.80
Rate for Payer: Aetna Medicare Advantage	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.55
Rate for Payer: Cigna Commercial	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.82
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Community & State	$6.64
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

GUIDEWIRE FIELDER XT 190cm

Facility

$675.00

Service Code	HCPCS C1769
Hospital Charge Code	270642948C
Hospital Revenue Code	278
Min. Negotiated Rate	$101.25
Max. Negotiated Rate	$163.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.35
Rate for Payer: Qualcare PPO/HMO/WC	$101.25

GUIDEWIRE FIELDER XT 190cm

Facility

$675.00

Service Code	HCPCS C1769
Hospital Charge Code	270642948C
Hospital Revenue Code	278
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) NJ Health	$135.00
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	$163.35
Rate for Payer: Qualcare PPO/HMO/WC	$101.25
Rate for Payer: UnitedHealthcare Community & State	$21.33
Rate for Payer: Wellpoint Medicaid Managed Care	$19.17

GUIDEWIRE FIELDER XT 300cm

Facility

$675.00

Service Code	HCPCS C1769
Hospital Charge Code	270642949C
Hospital Revenue Code	278
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) NJ Health	$135.00
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	$163.35
Rate for Payer: Qualcare PPO/HMO/WC	$101.25
Rate for Payer: UnitedHealthcare Community & State	$21.33
Rate for Payer: Wellpoint Medicaid Managed Care	$19.17

GUIDEWIRE FIELDER XT 300cm

Facility

$675.00

Service Code	HCPCS C1769
Hospital Charge Code	270642949C
Hospital Revenue Code	278
Min. Negotiated Rate	$101.25
Max. Negotiated Rate	$163.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.35
Rate for Payer: Qualcare PPO/HMO/WC	$101.25

GUIDEWIRE FIXEDCORE .035 180cm

Facility

$71.25

Hospital Charge Code	270640146
Hospital Revenue Code	278
Min. Negotiated Rate	$10.69
Max. Negotiated Rate	$17.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.24
Rate for Payer: Qualcare PPO/HMO/WC	$10.69

Know your out-of-pocket cost for care.

All Charges