Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE NEWTON J .035 150cm

Facility

$56.58

Service Code	HCPCS C1769
Hospital Charge Code	270626619
Hospital Revenue Code	278
Min. Negotiated Rate	$8.49
Max. Negotiated Rate	$13.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.69
Rate for Payer: Qualcare PPO/HMO/WC	$8.49

GUIDEWIRE NEWTON ST 35X150

Facility

$45.00

Service Code	HCPCS C1769
Hospital Charge Code	270658324
Hospital Revenue Code	278
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Community & State	$1.42
Rate for Payer: Wellpoint Medicaid Managed Care	$1.28

GUIDEWIRE NEWTON ST 35X150

Facility

$45.00

Service Code	HCPCS C1769
Hospital Charge Code	270658324
Hospital Revenue Code	278
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$10.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

GUIDEWIRE NEWTON ST 35X150

Facility

$45.00

Service Code	HCPCS C1769
Hospital Charge Code	270658324S
Hospital Revenue Code	278
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Community & State	$1.42
Rate for Payer: Wellpoint Medicaid Managed Care	$1.28

GUIDEWIRE NEWTON ST 35X150

Facility

$47.50

Service Code	HCPCS C1769
Hospital Charge Code	270658324N
Hospital Revenue Code	278
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$11.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.49
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

GUIDEWIRE NEWTON ST 35X150

Facility

$47.50

Service Code	HCPCS C1769
Hospital Charge Code	270658324N
Hospital Revenue Code	278
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$23.75
Rate for Payer: Aetna Commercial	$18.05
Rate for Payer: Aetna Medicare Advantage	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.11
Rate for Payer: Cigna Commercial	$23.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.49
Rate for Payer: Qualcare PPO/HMO/WC	$7.12
Rate for Payer: UnitedHealthcare Community & State	$1.50
Rate for Payer: Wellpoint Medicaid Managed Care	$1.35

GUIDEWIRE NEWTON ST 35X150

Facility

$45.00

Service Code	HCPCS C1769
Hospital Charge Code	270658324S
Hospital Revenue Code	278
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$10.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

GUIDEWIRE NIT 18X60 MAK001N60

Facility

$164.75

Service Code	HCPCS C1769
Hospital Charge Code	270660310S
Hospital Revenue Code	278
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$82.38
Rate for Payer: Aetna Commercial	$62.60
Rate for Payer: Aetna Medicare Advantage	$49.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.01
Rate for Payer: Cigna Commercial	$82.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.87
Rate for Payer: Qualcare PPO/HMO/WC	$24.71
Rate for Payer: UnitedHealthcare Community & State	$5.21
Rate for Payer: Wellpoint Medicaid Managed Care	$4.68

GUIDEWIRE NIT 18X60 MAK001N60

Facility

$164.75

Service Code	HCPCS C1769
Hospital Charge Code	270660310S
Hospital Revenue Code	278
Min. Negotiated Rate	$24.71
Max. Negotiated Rate	$39.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.87
Rate for Payer: Qualcare PPO/HMO/WC	$24.71

GUIDEWIRE NIT 18X60 MAK001N60

Facility

$171.50

Service Code	HCPCS C1769
Hospital Charge Code	270660310N
Hospital Revenue Code	278
Min. Negotiated Rate	$25.73
Max. Negotiated Rate	$41.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.73

GUIDEWIRE NIT 18X60 MAK001N60

Facility

$164.75

Service Code	HCPCS C1769
Hospital Charge Code	270660310
Hospital Revenue Code	278
Min. Negotiated Rate	$24.71
Max. Negotiated Rate	$39.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.87
Rate for Payer: Qualcare PPO/HMO/WC	$24.71

GUIDEWIRE NIT 18X60 MAK001N60

Facility

$164.75

Service Code	HCPCS C1769
Hospital Charge Code	270660310
Hospital Revenue Code	278
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$82.38
Rate for Payer: Aetna Commercial	$62.60
Rate for Payer: Aetna Medicare Advantage	$49.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.01
Rate for Payer: Cigna Commercial	$82.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.87
Rate for Payer: Qualcare PPO/HMO/WC	$24.71
Rate for Payer: UnitedHealthcare Community & State	$5.21
Rate for Payer: Wellpoint Medicaid Managed Care	$4.68

GUIDEWIRE NIT 18X60 MAK001N60

Facility

$171.50

Service Code	HCPCS C1769
Hospital Charge Code	270660310N
Hospital Revenue Code	278
Min. Negotiated Rate	$4.87
Max. Negotiated Rate	$85.75
Rate for Payer: Aetna Commercial	$65.17
Rate for Payer: Aetna Medicare Advantage	$51.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.73
Rate for Payer: Cigna Commercial	$85.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.73
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$4.87

GUIDEWIRE NITINOL 1.4 MMX457

Facility

$500.00

Service Code	HCPCS C1769
Hospital Charge Code	270692234
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

GUIDEWIRE NITINOL 1.4 MMX457

Facility

$500.00

Service Code	HCPCS C1769
Hospital Charge Code	270692234
Hospital Revenue Code	278
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

GUIDE WIRE NON COLORED 2x230MM

Facility

$168.40

Service Code	HCPCS C1769
Hospital Charge Code	270645547
Hospital Revenue Code	278
Min. Negotiated Rate	$25.26
Max. Negotiated Rate	$40.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.75
Rate for Payer: Qualcare PPO/HMO/WC	$25.26

GUIDE WIRE NON COLORED 2x230MM

Facility

$168.40

Service Code	HCPCS C1769
Hospital Charge Code	270645547
Hospital Revenue Code	278
Min. Negotiated Rate	$4.78
Max. Negotiated Rate	$84.20
Rate for Payer: Aetna Commercial	$63.99
Rate for Payer: Aetna Medicare Advantage	$50.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.94
Rate for Payer: Cigna Commercial	$84.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.75
Rate for Payer: Qualcare PPO/HMO/WC	$25.26
Rate for Payer: UnitedHealthcare Community & State	$5.32
Rate for Payer: Wellpoint Medicaid Managed Care	$4.78

GUIDEWIRE NONTHREAD 1.25X150MM

Facility

$125.85

Service Code	HCPCS C1713
Hospital Charge Code	270689660
Hospital Revenue Code	278
Min. Negotiated Rate	$18.88
Max. Negotiated Rate	$30.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.46
Rate for Payer: Qualcare PPO/HMO/WC	$18.88

GUIDEWIRE NONTHREAD 1.25X150MM

Facility

$125.85

Service Code	HCPCS C1713
Hospital Charge Code	270689660
Hospital Revenue Code	278
Min. Negotiated Rate	$3.57
Max. Negotiated Rate	$62.92
Rate for Payer: Aetna Commercial	$47.82
Rate for Payer: Aetna Medicare Advantage	$37.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.09
Rate for Payer: Cigna Commercial	$62.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.46
Rate for Payer: Qualcare PPO/HMO/WC	$18.88
Rate for Payer: UnitedHealthcare Community & State	$3.98
Rate for Payer: Wellpoint Medicaid Managed Care	$3.57

GUIDEWIRE NOVAGOLD .018 260cm

Facility

$977.45

Service Code	HCPCS C1769
Hospital Charge Code	270675453
Hospital Revenue Code	278
Min. Negotiated Rate	$27.76
Max. Negotiated Rate	$488.73
Rate for Payer: Aetna Commercial	$371.43
Rate for Payer: Aetna Medicare Advantage	$293.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.25
Rate for Payer: Cigna Commercial	$488.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.54
Rate for Payer: Qualcare PPO/HMO/WC	$146.62
Rate for Payer: UnitedHealthcare Community & State	$30.89
Rate for Payer: Wellpoint Medicaid Managed Care	$27.76

GUIDEWIRE NOVAGOLD .018 260cm

Facility

$977.45

Service Code	HCPCS C1769
Hospital Charge Code	270675453
Hospital Revenue Code	278
Min. Negotiated Rate	$146.62
Max. Negotiated Rate	$236.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.54
Rate for Payer: Qualcare PPO/HMO/WC	$146.62

GUIDEWIRE NOVA GOLD 0.18x450cm

Facility

$977.45

Service Code	HCPCS C1769
Hospital Charge Code	270683529
Hospital Revenue Code	278
Min. Negotiated Rate	$27.76
Max. Negotiated Rate	$488.73
Rate for Payer: Aetna Commercial	$371.43
Rate for Payer: Aetna Medicare Advantage	$293.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.25
Rate for Payer: Cigna Commercial	$488.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.54
Rate for Payer: Qualcare PPO/HMO/WC	$146.62
Rate for Payer: UnitedHealthcare Community & State	$30.89
Rate for Payer: Wellpoint Medicaid Managed Care	$27.76

GUIDEWIRE NOVA GOLD 0.18x450cm

Facility

$977.45

Service Code	HCPCS C1769
Hospital Charge Code	270683529
Hospital Revenue Code	278
Min. Negotiated Rate	$146.62
Max. Negotiated Rate	$236.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.54
Rate for Payer: Qualcare PPO/HMO/WC	$146.62

GUIDEWIRE PANTA2 3.2X600MM

Facility

$1,905.00

Service Code	HCPCS C1713
Hospital Charge Code	270699968
Hospital Revenue Code	278
Min. Negotiated Rate	$285.75
Max. Negotiated Rate	$461.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$381.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$461.01
Rate for Payer: Qualcare PPO/HMO/WC	$285.75

GUIDEWIRE PANTA2 3.2X600MM

Facility

$1,905.00

Service Code	HCPCS C1713
Hospital Charge Code	270699968
Hospital Revenue Code	278
Min. Negotiated Rate	$54.10
Max. Negotiated Rate	$952.50
Rate for Payer: Aetna Commercial	$723.90
Rate for Payer: Aetna Medicare Advantage	$571.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$485.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$485.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$381.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$485.77
Rate for Payer: Cigna Commercial	$952.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$461.01
Rate for Payer: Qualcare PPO/HMO/WC	$285.75
Rate for Payer: UnitedHealthcare Community & State	$60.20
Rate for Payer: Wellpoint Medicaid Managed Care	$54.10

Know your out-of-pocket cost for care.

All Charges