Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE MAGIC TORQUE 180cm

Facility

$258.33

Service Code	HCPCS C1769
Hospital Charge Code	270629355
Hospital Revenue Code	278
Min. Negotiated Rate	$7.34
Max. Negotiated Rate	$129.16
Rate for Payer: Aetna Commercial	$98.17
Rate for Payer: Aetna Medicare Advantage	$77.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.87
Rate for Payer: Cigna Commercial	$129.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.52
Rate for Payer: Qualcare PPO/HMO/WC	$38.75
Rate for Payer: UnitedHealthcare Community & State	$8.16
Rate for Payer: Wellpoint Medicaid Managed Care	$7.34

GUIDEWIRE MAGIC TORQUE 180cm

Facility

$258.33

Service Code	HCPCS C1769
Hospital Charge Code	270629355
Hospital Revenue Code	278
Min. Negotiated Rate	$38.75
Max. Negotiated Rate	$62.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.52
Rate for Payer: Qualcare PPO/HMO/WC	$38.75

GUIDEWIRE MAGIC TORUQE 260CM

Facility

$258.33

Hospital Charge Code	270675891
Hospital Revenue Code	278
Min. Negotiated Rate	$7.34
Max. Negotiated Rate	$129.16
Rate for Payer: Aetna Commercial	$98.17
Rate for Payer: Aetna Medicare Advantage	$77.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.87
Rate for Payer: Cigna Commercial	$129.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.52
Rate for Payer: Qualcare PPO/HMO/WC	$38.75
Rate for Payer: UnitedHealthcare Community & State	$8.16
Rate for Payer: Wellpoint Medicaid Managed Care	$7.34

GUIDEWIRE MAGIC TORUQE 260CM

Facility

$258.33

Hospital Charge Code	270675891
Hospital Revenue Code	278
Min. Negotiated Rate	$38.75
Max. Negotiated Rate	$62.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.52
Rate for Payer: Qualcare PPO/HMO/WC	$38.75

GUIDEWIRE MAILMAN JTIP 300CM

Facility

$86.00

Service Code	HCPCS C1769
Hospital Charge Code	270689907
Hospital Revenue Code	278
Min. Negotiated Rate	$12.90
Max. Negotiated Rate	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.81
Rate for Payer: Qualcare PPO/HMO/WC	$12.90

GUIDEWIRE MAILMAN JTIP 300CM

Facility

$86.00

Service Code	HCPCS C1769
Hospital Charge Code	270689907
Hospital Revenue Code	278
Min. Negotiated Rate	$2.44
Max. Negotiated Rate	$43.00
Rate for Payer: Aetna Commercial	$32.68
Rate for Payer: Aetna Medicare Advantage	$25.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.93
Rate for Payer: Cigna Commercial	$43.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.81
Rate for Payer: Qualcare PPO/HMO/WC	$12.90
Rate for Payer: UnitedHealthcare Community & State	$2.72
Rate for Payer: Wellpoint Medicaid Managed Care	$2.44

GUIDEWIRE MAXXWIRE SUPER .035

Facility

$750.00

Service Code	HCPCS C1769
Hospital Charge Code	270688796
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

GUIDEWIRE MAXXWIRE SUPER .035

Facility

$750.00

Service Code	HCPCS C1769
Hospital Charge Code	270688796
Hospital Revenue Code	278
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

GUIDEWIRE MICRO CTO 18G 300CM

Facility

$765.00

Service Code	HCPCS C1769
Hospital Charge Code	270671137N
Hospital Revenue Code	278
Min. Negotiated Rate	$21.73
Max. Negotiated Rate	$382.50
Rate for Payer: Aetna Commercial	$290.70
Rate for Payer: Aetna Medicare Advantage	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.07
Rate for Payer: Cigna Commercial	$382.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.13
Rate for Payer: Qualcare PPO/HMO/WC	$114.75
Rate for Payer: UnitedHealthcare Community & State	$24.17
Rate for Payer: Wellpoint Medicaid Managed Care	$21.73

GUIDEWIRE MICRO CTO 18G 300CM

Facility

$765.00

Service Code	HCPCS C1769
Hospital Charge Code	270671137S
Hospital Revenue Code	278
Min. Negotiated Rate	$114.75
Max. Negotiated Rate	$185.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.13
Rate for Payer: Qualcare PPO/HMO/WC	$114.75

GUIDEWIRE MICRO CTO 18G 300CM

Facility

$765.00

Service Code	HCPCS C1769
Hospital Charge Code	270671137
Hospital Revenue Code	278
Min. Negotiated Rate	$114.75
Max. Negotiated Rate	$185.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.13
Rate for Payer: Qualcare PPO/HMO/WC	$114.75

GUIDEWIRE MICRO CTO 18G 300CM

Facility

$765.00

Service Code	HCPCS C1769
Hospital Charge Code	270671137
Hospital Revenue Code	278
Min. Negotiated Rate	$21.73
Max. Negotiated Rate	$382.50
Rate for Payer: Aetna Commercial	$290.70
Rate for Payer: Aetna Medicare Advantage	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.07
Rate for Payer: Cigna Commercial	$382.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.13
Rate for Payer: Qualcare PPO/HMO/WC	$114.75
Rate for Payer: UnitedHealthcare Community & State	$24.17
Rate for Payer: Wellpoint Medicaid Managed Care	$21.73

GUIDEWIRE MICRO CTO 18G 300CM

Facility

$765.00

Service Code	HCPCS C1769
Hospital Charge Code	270671137S
Hospital Revenue Code	278
Min. Negotiated Rate	$21.73
Max. Negotiated Rate	$382.50
Rate for Payer: Aetna Commercial	$290.70
Rate for Payer: Aetna Medicare Advantage	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.07
Rate for Payer: Cigna Commercial	$382.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.13
Rate for Payer: Qualcare PPO/HMO/WC	$114.75
Rate for Payer: UnitedHealthcare Community & State	$24.17
Rate for Payer: Wellpoint Medicaid Managed Care	$21.73

GUIDEWIRE MICRO CTO 18G 300CM

Facility

$765.00

Service Code	HCPCS C1769
Hospital Charge Code	270671137N
Hospital Revenue Code	278
Min. Negotiated Rate	$114.75
Max. Negotiated Rate	$185.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.13
Rate for Payer: Qualcare PPO/HMO/WC	$114.75

GUIDEWIRE MIRAC 12X300 8290302

Facility

$625.00

Service Code	HCPCS C1769
Hospital Charge Code	270642967
Hospital Revenue Code	278
Min. Negotiated Rate	$17.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

GUIDEWIRE MIRAC 12X300 8290302

Facility

$625.00

Service Code	HCPCS C1769
Hospital Charge Code	270642967
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

GUIDEWIRE MM .035 150 668241

Facility

$39.25

Service Code	HCPCS C1769
Hospital Charge Code	270623751
Hospital Revenue Code	278
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$19.62
Rate for Payer: Aetna Commercial	$14.91
Rate for Payer: Aetna Medicare Advantage	$11.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.01
Rate for Payer: Cigna Commercial	$19.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.50
Rate for Payer: Qualcare PPO/HMO/WC	$5.89
Rate for Payer: UnitedHealthcare Community & State	$1.24
Rate for Payer: Wellpoint Medicaid Managed Care	$1.11

GUIDEWIRE MM .035 150 668241

Facility

$39.25

Service Code	HCPCS C1769
Hospital Charge Code	270623751
Hospital Revenue Code	278
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$9.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.50
Rate for Payer: Qualcare PPO/HMO/WC	$5.89

GUIDE WIRE MULTI HOLE

Facility

$5,310.45

Service Code	HCPCS C1769
Hospital Charge Code	270691508
Hospital Revenue Code	278
Min. Negotiated Rate	$150.82
Max. Negotiated Rate	$2,655.22
Rate for Payer: Aetna Commercial	$2,017.97
Rate for Payer: Aetna Medicare Advantage	$1,593.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,354.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,354.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,062.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,354.16
Rate for Payer: Cigna Commercial	$2,655.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,285.13
Rate for Payer: Qualcare PPO/HMO/WC	$796.57
Rate for Payer: UnitedHealthcare Community & State	$167.81
Rate for Payer: Wellpoint Medicaid Managed Care	$150.82

GUIDE WIRE MULTI HOLE

Facility

$5,310.45

Service Code	HCPCS C1769
Hospital Charge Code	270691508
Hospital Revenue Code	278
Min. Negotiated Rate	$796.57
Max. Negotiated Rate	$1,285.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,062.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,285.13
Rate for Payer: Qualcare PPO/HMO/WC	$796.57

GUIDEWIRE NAVIPRO .018 STR

Facility

$517.65

Hospital Charge Code	270677500
Hospital Revenue Code	278
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$258.82
Rate for Payer: Aetna Commercial	$196.71
Rate for Payer: Aetna Medicare Advantage	$155.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.00
Rate for Payer: Cigna Commercial	$258.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.27
Rate for Payer: Qualcare PPO/HMO/WC	$77.65
Rate for Payer: UnitedHealthcare Community & State	$16.36
Rate for Payer: Wellpoint Medicaid Managed Care	$14.70

GUIDEWIRE NAVIPRO .018 STR

Facility

$517.65

Hospital Charge Code	270677500
Hospital Revenue Code	278
Min. Negotiated Rate	$77.65
Max. Negotiated Rate	$125.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.27
Rate for Payer: Qualcare PPO/HMO/WC	$77.65

GUIDEWIRE NEWTON J .035 150cm

Facility

$65.36

Service Code	HCPCS C1769
Hospital Charge Code	270643672
Hospital Revenue Code	278
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$32.68
Rate for Payer: Aetna Commercial	$24.84
Rate for Payer: Aetna Medicare Advantage	$19.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.67
Rate for Payer: Cigna Commercial	$32.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.82
Rate for Payer: Qualcare PPO/HMO/WC	$9.80
Rate for Payer: UnitedHealthcare Community & State	$2.07
Rate for Payer: Wellpoint Medicaid Managed Care	$1.86

GUIDEWIRE NEWTON J .035 150cm

Facility

$65.36

Service Code	HCPCS C1769
Hospital Charge Code	270643672
Hospital Revenue Code	278
Min. Negotiated Rate	$9.80
Max. Negotiated Rate	$15.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.82
Rate for Payer: Qualcare PPO/HMO/WC	$9.80

GUIDEWIRE NEWTON J .035 150cm

Facility

$56.58

Service Code	HCPCS C1769
Hospital Charge Code	270626619
Hospital Revenue Code	278
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$28.29
Rate for Payer: Aetna Commercial	$21.50
Rate for Payer: Aetna Medicare Advantage	$16.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.43
Rate for Payer: Cigna Commercial	$28.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.69
Rate for Payer: Qualcare PPO/HMO/WC	$8.49
Rate for Payer: UnitedHealthcare Community & State	$1.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1.61

Know your out-of-pocket cost for care.

All Charges