Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE SMALL 2.0MM

Facility

$100.00

Service Code	HCPCS C1769
Hospital Charge Code	270698454
Hospital Revenue Code	278
Min. Negotiated Rate	$2.84
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Commercial	$38.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.20
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Community & State	$3.16
Rate for Payer: Wellpoint Medicaid Managed Care	$2.84

GUIDEWIRE SMALL 2.0MM

Facility

$100.00

Service Code	HCPCS C1769
Hospital Charge Code	270698454
Hospital Revenue Code	278
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$24.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.20
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

GUIDE WIRE SMOOTH TIPPED

Facility

$1,475.00

Hospital Charge Code	270674284
Hospital Revenue Code	272
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$221.25
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

GUIDE WIRE SMOOTH TIPPED

Facility

$1,475.00

Hospital Charge Code	270674284
Hospital Revenue Code	272
Min. Negotiated Rate	$41.89
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.50
Rate for Payer: Oxford Commercial	$295.00
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Commercial	$295.00
Rate for Payer: UnitedHealthcare Community & State	$46.61
Rate for Payer: Wellpoint Medicaid Managed Care	$41.89

GUIDE WIRE SMOOTH TIPPED

Facility

$876.65

Service Code	HCPCS C1769
Hospital Charge Code	270661240
Hospital Revenue Code	278
Min. Negotiated Rate	$24.90
Max. Negotiated Rate	$438.32
Rate for Payer: Aetna Commercial	$333.13
Rate for Payer: Aetna Medicare Advantage	$263.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.55
Rate for Payer: Cigna Commercial	$438.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.15
Rate for Payer: Qualcare PPO/HMO/WC	$131.50
Rate for Payer: UnitedHealthcare Community & State	$27.70
Rate for Payer: Wellpoint Medicaid Managed Care	$24.90

GUIDE WIRE SMOOTH TIPPED

Facility

$876.65

Service Code	HCPCS C1769
Hospital Charge Code	270661240
Hospital Revenue Code	278
Min. Negotiated Rate	$131.50
Max. Negotiated Rate	$212.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.15
Rate for Payer: Qualcare PPO/HMO/WC	$131.50

GUIDEWIRE SOLO FLEX NI .035 15

Facility

$212.00

Service Code	HCPCS C1769
Hospital Charge Code	270682482
Hospital Revenue Code	278
Min. Negotiated Rate	$6.02
Max. Negotiated Rate	$106.00
Rate for Payer: Aetna Commercial	$80.56
Rate for Payer: Aetna Medicare Advantage	$63.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.06
Rate for Payer: Cigna Commercial	$106.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.30
Rate for Payer: Qualcare PPO/HMO/WC	$31.80
Rate for Payer: UnitedHealthcare Community & State	$6.70
Rate for Payer: Wellpoint Medicaid Managed Care	$6.02

GUIDEWIRE SOLO FLEX NI .035 15

Facility

$212.00

Service Code	HCPCS C1769
Hospital Charge Code	270682482
Hospital Revenue Code	278
Min. Negotiated Rate	$31.80
Max. Negotiated Rate	$51.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.30
Rate for Payer: Qualcare PPO/HMO/WC	$31.80

GUIDEWIRE SOLO FLEX NI .038 15

Facility

$212.00

Service Code	HCPCS C1769
Hospital Charge Code	270682483
Hospital Revenue Code	278
Min. Negotiated Rate	$31.80
Max. Negotiated Rate	$51.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.30
Rate for Payer: Qualcare PPO/HMO/WC	$31.80

GUIDEWIRE SOLO FLEX NI .038 15

Facility

$212.00

Service Code	HCPCS C1769
Hospital Charge Code	270682483
Hospital Revenue Code	278
Min. Negotiated Rate	$6.02
Max. Negotiated Rate	$106.00
Rate for Payer: Aetna Commercial	$80.56
Rate for Payer: Aetna Medicare Advantage	$63.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.06
Rate for Payer: Cigna Commercial	$106.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.30
Rate for Payer: Qualcare PPO/HMO/WC	$31.80
Rate for Payer: UnitedHealthcare Community & State	$6.70
Rate for Payer: Wellpoint Medicaid Managed Care	$6.02

GUIDEWIRE SPADE-PT 1.6X150MM

Facility

$124.10

Service Code	HCPCS C1769
Hospital Charge Code	270667996
Hospital Revenue Code	278
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$62.05
Rate for Payer: Aetna Commercial	$47.16
Rate for Payer: Aetna Medicare Advantage	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.65
Rate for Payer: Cigna Commercial	$62.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.03
Rate for Payer: Qualcare PPO/HMO/WC	$18.61
Rate for Payer: UnitedHealthcare Community & State	$3.92
Rate for Payer: Wellpoint Medicaid Managed Care	$3.52

GUIDEWIRE SPADE-PT 1.6X150MM

Facility

$124.10

Service Code	HCPCS C1769
Hospital Charge Code	270667996
Hospital Revenue Code	278
Min. Negotiated Rate	$18.61
Max. Negotiated Rate	$30.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.03
Rate for Payer: Qualcare PPO/HMO/WC	$18.61

GUIDEWIRE SPARTACORE .014X300

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270676707S
Hospital Revenue Code	272
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) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$75.00
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

GUIDEWIRE SPARTACORE .014X300

Facility

$375.00

Hospital Charge Code	270676707
Hospital Revenue Code	272
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) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$75.00
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

GUIDEWIRE SPARTACORE .014X300

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270676707S
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

GUIDEWIRE SPARTACORE .014X300

Facility

$375.00

Hospital Charge Code	270676707
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

GUIDEWIRE SPHINRX JAGTOME 20MM

Facility

$1,515.00

Service Code	HCPCS C1769
Hospital Charge Code	270684463
Hospital Revenue Code	278
Min. Negotiated Rate	$227.25
Max. Negotiated Rate	$366.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$303.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$366.63
Rate for Payer: Qualcare PPO/HMO/WC	$227.25

GUIDEWIRE SPHINRX JAGTOME 20MM

Facility

$1,515.00

Service Code	HCPCS C1769
Hospital Charge Code	270684463
Hospital Revenue Code	278
Min. Negotiated Rate	$43.03
Max. Negotiated Rate	$757.50
Rate for Payer: Aetna Commercial	$575.70
Rate for Payer: Aetna Medicare Advantage	$454.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$386.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$386.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$303.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$386.32
Rate for Payer: Cigna Commercial	$757.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$366.63
Rate for Payer: Qualcare PPO/HMO/WC	$227.25
Rate for Payer: UnitedHealthcare Community & State	$47.87
Rate for Payer: Wellpoint Medicaid Managed Care	$43.03

GUIDEWIRE STIFF SHAFT STRAIGHT

Facility

$117.00

Hospital Charge Code	270651204
Hospital Revenue Code	278
Min. Negotiated Rate	$3.32
Max. Negotiated Rate	$58.50
Rate for Payer: Aetna Commercial	$44.46
Rate for Payer: Aetna Medicare Advantage	$35.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.84
Rate for Payer: Cigna Commercial	$58.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.31
Rate for Payer: Qualcare PPO/HMO/WC	$17.55
Rate for Payer: UnitedHealthcare Community & State	$3.70
Rate for Payer: Wellpoint Medicaid Managed Care	$3.32

GUIDEWIRE STIFF SHAFT STRAIGHT

Facility

$117.00

Hospital Charge Code	270651204
Hospital Revenue Code	278
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$28.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.31
Rate for Payer: Qualcare PPO/HMO/WC	$17.55

GUIDEWIRE STIFF SHAFT STRAIGHT

Facility

$117.00

Hospital Charge Code	270651200
Hospital Revenue Code	278
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$28.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.31
Rate for Payer: Qualcare PPO/HMO/WC	$17.55

GUIDEWIRE STIFF SHAFT STRAIGHT

Facility

$117.00

Hospital Charge Code	270651200
Hospital Revenue Code	278
Min. Negotiated Rate	$3.32
Max. Negotiated Rate	$58.50
Rate for Payer: Aetna Commercial	$44.46
Rate for Payer: Aetna Medicare Advantage	$35.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.84
Rate for Payer: Cigna Commercial	$58.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.31
Rate for Payer: Qualcare PPO/HMO/WC	$17.55
Rate for Payer: UnitedHealthcare Community & State	$3.70
Rate for Payer: Wellpoint Medicaid Managed Care	$3.32

GUIDEWIRE STIFF SHAFT/STR TIP

Facility

$2,187.25

Hospital Charge Code	270675205
Hospital Revenue Code	272
Min. Negotiated Rate	$62.12
Max. Negotiated Rate	$1,093.62
Rate for Payer: Aetna Commercial	$831.15
Rate for Payer: Aetna Medicare Advantage	$656.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$557.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$557.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$557.75
Rate for Payer: Cigna Commercial	$1,093.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$568.68
Rate for Payer: Oxford Commercial	$437.45
Rate for Payer: Qualcare PPO/HMO/WC	$328.09
Rate for Payer: UnitedHealthcare Commercial	$437.45
Rate for Payer: UnitedHealthcare Community & State	$69.12
Rate for Payer: Wellpoint Medicaid Managed Care	$62.12

GUIDEWIRE STIFF SHAFT/STR TIP

Facility

$2,187.25

Hospital Charge Code	270675205
Hospital Revenue Code	272
Min. Negotiated Rate	$328.09
Max. Negotiated Rate	$328.09
Rate for Payer: Qualcare PPO/HMO/WC	$328.09

GUIDEWIRE STR .035 5FR 150C

Facility

$155.00

Hospital Charge Code	270667806
Hospital Revenue Code	278
Min. Negotiated Rate	$23.25
Max. Negotiated Rate	$37.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.51
Rate for Payer: Qualcare PPO/HMO/WC	$23.25

Know your out-of-pocket cost for care.

All Charges