Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE ROSEN .035 260cm

Facility

$147.50

Service Code	HCPCS C1769
Hospital Charge Code	270624343N
Hospital Revenue Code	278
Min. Negotiated Rate	$4.19
Max. Negotiated Rate	$73.75
Rate for Payer: Aetna Commercial	$56.05
Rate for Payer: Aetna Medicare Advantage	$44.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.61
Rate for Payer: Cigna Commercial	$73.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.70
Rate for Payer: Qualcare PPO/HMO/WC	$22.12
Rate for Payer: UnitedHealthcare Community & State	$4.66
Rate for Payer: Wellpoint Medicaid Managed Care	$4.19

GUIDEWIRE ROSEN .035 260cm J

Facility

$86.13

Service Code	HCPCS C1769
Hospital Charge Code	270623263
Hospital Revenue Code	278
Min. Negotiated Rate	$12.92
Max. Negotiated Rate	$20.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.92

GUIDEWIRE ROSEN .035 260cm J

Facility

$86.13

Service Code	HCPCS C1769
Hospital Charge Code	270623263
Hospital Revenue Code	278
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$43.06
Rate for Payer: Aetna Commercial	$32.73
Rate for Payer: Aetna Medicare Advantage	$25.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.96
Rate for Payer: Cigna Commercial	$43.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.92
Rate for Payer: UnitedHealthcare Community & State	$2.72
Rate for Payer: Wellpoint Medicaid Managed Care	$2.45

GUIDEWIRE ROSEN THSCF 35-145-1

Facility

$56.80

Hospital Charge Code	270658311S
Hospital Revenue Code	272
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$28.40
Rate for Payer: Aetna Commercial	$21.58
Rate for Payer: Aetna Medicare Advantage	$17.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.48
Rate for Payer: Cigna Commercial	$28.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.77
Rate for Payer: Oxford Commercial	$11.36
Rate for Payer: Qualcare PPO/HMO/WC	$8.52
Rate for Payer: UnitedHealthcare Commercial	$11.36
Rate for Payer: UnitedHealthcare Community & State	$1.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1.61

GUIDEWIRE ROSEN THSCF 35-145-1

Facility

$56.80

Hospital Charge Code	270658311S
Hospital Revenue Code	272
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$8.52
Rate for Payer: Qualcare PPO/HMO/WC	$8.52

GUIDEWIRE ROSEN THSCF 35-145-1

Facility

$70.00

Hospital Charge Code	270658311N
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

GUIDEWIRE ROSEN THSCF 35-145-1

Facility

$56.80

Hospital Charge Code	270658311
Hospital Revenue Code	272
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$28.40
Rate for Payer: Aetna Commercial	$21.58
Rate for Payer: Aetna Medicare Advantage	$17.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.48
Rate for Payer: Cigna Commercial	$28.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.77
Rate for Payer: Oxford Commercial	$11.36
Rate for Payer: Qualcare PPO/HMO/WC	$8.52
Rate for Payer: UnitedHealthcare Commercial	$11.36
Rate for Payer: UnitedHealthcare Community & State	$1.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1.61

GUIDEWIRE ROSEN THSCF 35-145-1

Facility

$70.00

Hospital Charge Code	270658311N
Hospital Revenue Code	272
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.50

GUIDEWIRE ROSEN THSCF 35-145-1

Facility

$56.80

Hospital Charge Code	270658311
Hospital Revenue Code	272
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$8.52
Rate for Payer: Qualcare PPO/HMO/WC	$8.52

GUIDEWIRE RUNTHR NS 180 251011

Facility

$530.00

Service Code	HCPCS C1769
Hospital Charge Code	270642945C
Hospital Revenue Code	278
Min. Negotiated Rate	$15.05
Max. Negotiated Rate	$265.00
Rate for Payer: Aetna Commercial	$201.40
Rate for Payer: Aetna Medicare Advantage	$159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.15
Rate for Payer: Cigna Commercial	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.26
Rate for Payer: Qualcare PPO/HMO/WC	$79.50
Rate for Payer: UnitedHealthcare Community & State	$16.75
Rate for Payer: Wellpoint Medicaid Managed Care	$15.05

GUIDEWIRE RUNTHR NS 180 251011

Facility

$530.00

Service Code	HCPCS C1769
Hospital Charge Code	270642945C
Hospital Revenue Code	278
Min. Negotiated Rate	$79.50
Max. Negotiated Rate	$128.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.26
Rate for Payer: Qualcare PPO/HMO/WC	$79.50

GUIDEWIRE RUNTHROUGH NS .014

Facility

$420.00

Hospital Charge Code	270642946
Hospital Revenue Code	278
Min. Negotiated Rate	$11.93
Max. Negotiated Rate	$210.00
Rate for Payer: Aetna Commercial	$159.60
Rate for Payer: Aetna Medicare Advantage	$126.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.10
Rate for Payer: Cigna Commercial	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.64
Rate for Payer: Qualcare PPO/HMO/WC	$63.00
Rate for Payer: UnitedHealthcare Community & State	$13.27
Rate for Payer: Wellpoint Medicaid Managed Care	$11.93

GUIDEWIRE RUNTHROUGH NS .014

Facility

$420.00

Hospital Charge Code	270642946
Hospital Revenue Code	278
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$101.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.64
Rate for Payer: Qualcare PPO/HMO/WC	$63.00

GUIDEWIRE RUNTHROUGH NS 300c

Facility

$530.00

Service Code	HCPCS C1769
Hospital Charge Code	270642946C
Hospital Revenue Code	278
Min. Negotiated Rate	$15.05
Max. Negotiated Rate	$265.00
Rate for Payer: Aetna Commercial	$201.40
Rate for Payer: Aetna Medicare Advantage	$159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.15
Rate for Payer: Cigna Commercial	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.26
Rate for Payer: Qualcare PPO/HMO/WC	$79.50
Rate for Payer: UnitedHealthcare Community & State	$16.75
Rate for Payer: Wellpoint Medicaid Managed Care	$15.05

GUIDEWIRE RUNTHROUGH NS 300c

Facility

$530.00

Service Code	HCPCS C1769
Hospital Charge Code	270642946C
Hospital Revenue Code	278
Min. Negotiated Rate	$79.50
Max. Negotiated Rate	$128.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.26
Rate for Payer: Qualcare PPO/HMO/WC	$79.50

GUIDEWIRES

Facility

$1,680.00

Hospital Charge Code	270702849
Hospital Revenue Code	278
Min. Negotiated Rate	$252.00
Max. Negotiated Rate	$406.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$336.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$406.56
Rate for Payer: Qualcare PPO/HMO/WC	$252.00

GUIDEWIRES

Facility

$1,680.00

Hospital Charge Code	270702849
Hospital Revenue Code	278
Min. Negotiated Rate	$47.71
Max. Negotiated Rate	$840.00
Rate for Payer: Aetna Commercial	$638.40
Rate for Payer: Aetna Medicare Advantage	$504.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$428.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$428.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$428.40
Rate for Payer: Cigna Commercial	$840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$406.56
Rate for Payer: Qualcare PPO/HMO/WC	$252.00
Rate for Payer: UnitedHealthcare Community & State	$53.09
Rate for Payer: Wellpoint Medicaid Managed Care	$47.71

GUIDE WIRES 1.2MMX70MM

Facility

$265.00

Hospital Charge Code	270657351
Hospital Revenue Code	278
Min. Negotiated Rate	$7.53
Max. Negotiated Rate	$132.50
Rate for Payer: Aetna Commercial	$100.70
Rate for Payer: Aetna Medicare Advantage	$79.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.58
Rate for Payer: Cigna Commercial	$132.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.13
Rate for Payer: Qualcare PPO/HMO/WC	$39.75
Rate for Payer: UnitedHealthcare Community & State	$8.37
Rate for Payer: Wellpoint Medicaid Managed Care	$7.53

GUIDE WIRES 1.2MMX70MM

Facility

$265.00

Hospital Charge Code	270657351
Hospital Revenue Code	278
Min. Negotiated Rate	$39.75
Max. Negotiated Rate	$64.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.13
Rate for Payer: Qualcare PPO/HMO/WC	$39.75

GUIDEWIRE SCIMD 300 GW 1210001

Facility

$430.00

Service Code	HCPCS C1769
Hospital Charge Code	270629662
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 SCIMD 300 GW 1210001

Facility

$430.00

Service Code	HCPCS C1769
Hospital Charge Code	270629662
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 SENSOR .035 SENSOR

Facility

$374.66

Service Code	HCPCS C1769
Hospital Charge Code	270685946
Hospital Revenue Code	278
Min. Negotiated Rate	$56.20
Max. Negotiated Rate	$90.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.67
Rate for Payer: Qualcare PPO/HMO/WC	$56.20

GUIDEWIRE SENSOR .035 SENSOR

Facility

$374.66

Service Code	HCPCS C1769
Hospital Charge Code	270685946
Hospital Revenue Code	278
Min. Negotiated Rate	$10.64
Max. Negotiated Rate	$187.33
Rate for Payer: Aetna Commercial	$142.37
Rate for Payer: Aetna Medicare Advantage	$112.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.54
Rate for Payer: Cigna Commercial	$187.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.67
Rate for Payer: Qualcare PPO/HMO/WC	$56.20
Rate for Payer: UnitedHealthcare Community & State	$11.84
Rate for Payer: Wellpoint Medicaid Managed Care	$10.64

GUIDEWIRE SINGLE SHARP THREADE

Facility

$1,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270695152
Hospital Revenue Code	278
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

GUIDEWIRE SINGLE SHARP THREADE

Facility

$1,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270695152
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

Know your out-of-pocket cost for care.

All Charges