Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE FIXEDCORE .035 180cm

Facility

$71.25

Hospital Charge Code	270640146
Hospital Revenue Code	278
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$35.62
Rate for Payer: Aetna Commercial	$27.07
Rate for Payer: Aetna Medicare Advantage	$21.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.17
Rate for Payer: Cigna Commercial	$35.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.24
Rate for Payer: Qualcare PPO/HMO/WC	$10.69
Rate for Payer: UnitedHealthcare Community & State	$2.25
Rate for Payer: Wellpoint Medicaid Managed Care	$2.02

GUIDE WIRE FIXED CORE .035X

Facility

$132.00

Hospital Charge Code	270331525
Hospital Revenue Code	278
Min. Negotiated Rate	$19.80
Max. Negotiated Rate	$31.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.94
Rate for Payer: Qualcare PPO/HMO/WC	$19.80

GUIDE WIRE FIXED CORE .035X

Facility

$132.00

Hospital Charge Code	270331525
Hospital Revenue Code	278
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$66.00
Rate for Payer: Aetna Commercial	$50.16
Rate for Payer: Aetna Medicare Advantage	$39.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.66
Rate for Payer: Cigna Commercial	$66.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.94
Rate for Payer: Qualcare PPO/HMO/WC	$19.80
Rate for Payer: UnitedHealthcare Community & State	$4.17
Rate for Payer: Wellpoint Medicaid Managed Care	$3.75

GUIDEWIRE FIXO 0.9X70MM

Facility

$455.00

Service Code	HCPCS C1713
Hospital Charge Code	270699952
Hospital Revenue Code	278
Min. Negotiated Rate	$12.92
Max. Negotiated Rate	$227.50
Rate for Payer: Aetna Commercial	$172.90
Rate for Payer: Aetna Medicare Advantage	$136.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.03
Rate for Payer: Cigna Commercial	$227.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.11
Rate for Payer: Qualcare PPO/HMO/WC	$68.25
Rate for Payer: UnitedHealthcare Community & State	$14.38
Rate for Payer: Wellpoint Medicaid Managed Care	$12.92

GUIDEWIRE FIXO 0.9X70MM

Facility

$455.00

Service Code	HCPCS C1713
Hospital Charge Code	270699952
Hospital Revenue Code	278
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$110.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.11
Rate for Payer: Qualcare PPO/HMO/WC	$68.25

GUIDEWIRE FLOPPY 14x300 22359M

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270632557
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 FLOPPY 14x300 22359M

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270632557
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 HBS-G-WIRE

Facility

$70.00

Hospital Charge Code	270636599
Hospital Revenue Code	272
Min. Negotiated Rate	$1.99
Max. Negotiated Rate	$35.00
Rate for Payer: Aetna Commercial	$26.60
Rate for Payer: Aetna Medicare Advantage	$21.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.85
Rate for Payer: Cigna Commercial	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.20
Rate for Payer: Oxford Commercial	$14.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.50
Rate for Payer: UnitedHealthcare Commercial	$14.00
Rate for Payer: UnitedHealthcare Community & State	$2.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

GUIDE WIRE HBS-G-WIRE

Facility

$70.00

Hospital Charge Code	270636599
Hospital Revenue Code	272
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.50

GUIDEWIRE H FLP 014x190 22339M

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270632556
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 H FLP 014x190 22339M

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270632556
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 HIQUE COMD ES 208175

Facility

$650.00

Service Code	HCPCS C1769
Hospital Charge Code	270659350
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

GUIDEWIRE HIQUE COMD ES 208175

Facility

$650.00

Service Code	HCPCS C1769
Hospital Charge Code	270659350
Hospital Revenue Code	278
Min. Negotiated Rate	$18.46
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Community & State	$20.54
Rate for Payer: Wellpoint Medicaid Managed Care	$18.46

GUIDEWIRE HIQUE COMD ES 208175

Facility

$650.00

Service Code	HCPCS C1769
Hospital Charge Code	270659350S
Hospital Revenue Code	278
Min. Negotiated Rate	$18.46
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Community & State	$20.54
Rate for Payer: Wellpoint Medicaid Managed Care	$18.46

GUIDEWIRE HIQUE COMD ES 208175

Facility

$900.00

Service Code	HCPCS C1769
Hospital Charge Code	270659350N
Hospital Revenue Code	278
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) NJ Health	$180.00
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	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$28.44
Rate for Payer: Wellpoint Medicaid Managed Care	$25.56

GUIDEWIRE HIQUE COMD ES 208175

Facility

$900.00

Service Code	HCPCS C1769
Hospital Charge Code	270659350N
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

GUIDEWIRE HIQUE COMD ES 208175

Facility

$650.00

Service Code	HCPCS C1769
Hospital Charge Code	270659350S
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

GUIDEWIRE HI-T COMMAND 18 ST 2

Facility

$650.00

Service Code	HCPCS C1769
Hospital Charge Code	270687204A
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

GUIDEWIRE HI-T COMMAND 18 ST 2

Facility

$815.00

Service Code	HCPCS C1769
Hospital Charge Code	270687204
Hospital Revenue Code	278
Min. Negotiated Rate	$23.15
Max. Negotiated Rate	$407.50
Rate for Payer: Aetna Commercial	$309.70
Rate for Payer: Aetna Medicare Advantage	$244.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.82
Rate for Payer: Cigna Commercial	$407.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$197.23
Rate for Payer: Qualcare PPO/HMO/WC	$122.25
Rate for Payer: UnitedHealthcare Community & State	$25.75
Rate for Payer: Wellpoint Medicaid Managed Care	$23.15

GUIDEWIRE HI-T COMMAND 18 ST 2

Facility

$815.00

Service Code	HCPCS C1769
Hospital Charge Code	270687204
Hospital Revenue Code	278
Min. Negotiated Rate	$122.25
Max. Negotiated Rate	$197.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$197.23
Rate for Payer: Qualcare PPO/HMO/WC	$122.25

GUIDEWIRE HI-T COMMAND 18 ST 2

Facility

$650.00

Service Code	HCPCS C1769
Hospital Charge Code	270687204A
Hospital Revenue Code	278
Min. Negotiated Rate	$18.46
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Community & State	$20.54
Rate for Payer: Wellpoint Medicaid Managed Care	$18.46

GUIDEWIRE HI-T COMMAND 18 ST 3

Facility

$650.00

Service Code	HCPCS C1769
Hospital Charge Code	270687203S
Hospital Revenue Code	278
Min. Negotiated Rate	$18.46
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Community & State	$20.54
Rate for Payer: Wellpoint Medicaid Managed Care	$18.46

GUIDEWIRE HI-T COMMAND 18 ST 3

Facility

$650.00

Service Code	HCPCS C1769
Hospital Charge Code	270687203S
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

GUIDEWIRE HI-T COMMAND 18 ST 3

Facility

$815.00

Service Code	HCPCS C1769
Hospital Charge Code	270687203
Hospital Revenue Code	278
Min. Negotiated Rate	$122.25
Max. Negotiated Rate	$197.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$197.23
Rate for Payer: Qualcare PPO/HMO/WC	$122.25

GUIDEWIRE HI-T COMMAND 18 ST 3

Facility

$815.00

Service Code	HCPCS C1769
Hospital Charge Code	270687203
Hospital Revenue Code	278
Min. Negotiated Rate	$23.15
Max. Negotiated Rate	$407.50
Rate for Payer: Aetna Commercial	$309.70
Rate for Payer: Aetna Medicare Advantage	$244.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.82
Rate for Payer: Cigna Commercial	$407.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$197.23
Rate for Payer: Qualcare PPO/HMO/WC	$122.25
Rate for Payer: UnitedHealthcare Community & State	$25.75
Rate for Payer: Wellpoint Medicaid Managed Care	$23.15

Know your out-of-pocket cost for care.

All Charges