Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE STR .035 5FR 150C

Facility

$155.00

Hospital Charge Code	270667806
Hospital Revenue Code	278
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$77.50
Rate for Payer: Aetna Commercial	$58.90
Rate for Payer: Aetna Medicare Advantage	$46.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.52
Rate for Payer: Cigna Commercial	$77.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.51
Rate for Payer: Qualcare PPO/HMO/WC	$23.25
Rate for Payer: UnitedHealthcare Community & State	$4.90
Rate for Payer: Wellpoint Medicaid Managed Care	$4.40

GUIDE WIRE STRAIGHT TIP

Facility

$116.00

Hospital Charge Code	270331521
Hospital Revenue Code	278
Min. Negotiated Rate	$3.29
Max. Negotiated Rate	$58.00
Rate for Payer: Aetna Commercial	$44.08
Rate for Payer: Aetna Medicare Advantage	$34.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.58
Rate for Payer: Cigna Commercial	$58.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.07
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Community & State	$3.67
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

GUIDE WIRE STRAIGHT TIP

Facility

$116.00

Hospital Charge Code	270331521
Hospital Revenue Code	278
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$28.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.07
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

GUIDE WIRE STRAIGHT TIP O35X

Facility

$84.00

Hospital Charge Code	270331516
Hospital Revenue Code	278
Min. Negotiated Rate	$2.39
Max. Negotiated Rate	$42.00
Rate for Payer: Aetna Commercial	$31.92
Rate for Payer: Aetna Medicare Advantage	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.42
Rate for Payer: Cigna Commercial	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.33
Rate for Payer: Qualcare PPO/HMO/WC	$12.60
Rate for Payer: UnitedHealthcare Community & State	$2.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.39

GUIDE WIRE STRAIGHT TIP O35X

Facility

$84.00

Hospital Charge Code	270331516
Hospital Revenue Code	278
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$20.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.33
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

GUIDEWIRE STR TIP .035 180cm

Facility

$219.58

Service Code	HCPCS C1769
Hospital Charge Code	270651264
Hospital Revenue Code	278
Min. Negotiated Rate	$6.24
Max. Negotiated Rate	$109.79
Rate for Payer: Aetna Commercial	$83.44
Rate for Payer: Aetna Medicare Advantage	$65.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.99
Rate for Payer: Cigna Commercial	$109.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.14
Rate for Payer: Qualcare PPO/HMO/WC	$32.94
Rate for Payer: UnitedHealthcare Community & State	$6.94
Rate for Payer: Wellpoint Medicaid Managed Care	$6.24

GUIDEWIRE STR TIP .035 180cm

Facility

$219.58

Service Code	HCPCS C1769
Hospital Charge Code	270651264
Hospital Revenue Code	278
Min. Negotiated Rate	$32.94
Max. Negotiated Rate	$53.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.14
Rate for Payer: Qualcare PPO/HMO/WC	$32.94

GUIDEWIRE SUPER STIFF .035/500

Facility

$557.09

Service Code	HCPCS C1769
Hospital Charge Code	270644082
Hospital Revenue Code	278
Min. Negotiated Rate	$83.56
Max. Negotiated Rate	$134.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.82
Rate for Payer: Qualcare PPO/HMO/WC	$83.56

GUIDEWIRE SUPER STIFF .035/500

Facility

$557.09

Service Code	HCPCS C1769
Hospital Charge Code	270644082
Hospital Revenue Code	278
Min. Negotiated Rate	$15.82
Max. Negotiated Rate	$278.55
Rate for Payer: Aetna Commercial	$211.69
Rate for Payer: Aetna Medicare Advantage	$167.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.06
Rate for Payer: Cigna Commercial	$278.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.82
Rate for Payer: Qualcare PPO/HMO/WC	$83.56
Rate for Payer: UnitedHealthcare Community & State	$17.60
Rate for Payer: Wellpoint Medicaid Managed Care	$15.82

GUIDEWIRE SYNCHNO .014IN X200

Facility

$3,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270682516S
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

GUIDEWIRE SYNCHNO .014IN X200

Facility

$2,850.00

Service Code	HCPCS C1769
Hospital Charge Code	270682516
Hospital Revenue Code	278
Min. Negotiated Rate	$427.50
Max. Negotiated Rate	$689.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$570.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$689.70
Rate for Payer: Qualcare PPO/HMO/WC	$427.50

GUIDEWIRE SYNCHNO .014IN X200

Facility

$3,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270682516S
Hospital Revenue Code	278
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$94.80
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

GUIDEWIRE SYNCHNO .014IN X200

Facility

$3,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270682516N
Hospital Revenue Code	278
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$94.80
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

GUIDEWIRE SYNCHNO .014IN X200

Facility

$3,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270682516N
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

GUIDEWIRE SYNCHNO .014IN X200

Facility

$2,850.00

Service Code	HCPCS C1769
Hospital Charge Code	270682516
Hospital Revenue Code	278
Min. Negotiated Rate	$80.94
Max. Negotiated Rate	$1,425.00
Rate for Payer: Aetna Commercial	$1,083.00
Rate for Payer: Aetna Medicare Advantage	$855.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$726.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$726.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$726.75
Rate for Payer: Cigna Commercial	$1,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$689.70
Rate for Payer: Qualcare PPO/HMO/WC	$427.50
Rate for Payer: UnitedHealthcare Community & State	$90.06
Rate for Payer: Wellpoint Medicaid Managed Care	$80.94

GUIDEWIRE SYNCHRO10 .01IN200CM

Facility

$3,058.00

Service Code	HCPCS C1769
Hospital Charge Code	270699939S
Hospital Revenue Code	278
Min. Negotiated Rate	$458.70
Max. Negotiated Rate	$740.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$611.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.04
Rate for Payer: Qualcare PPO/HMO/WC	$458.70

GUIDEWIRE SYNCHRO10 .01IN200CM

Facility

$3,058.00

Service Code	HCPCS C1769
Hospital Charge Code	270699939S
Hospital Revenue Code	278
Min. Negotiated Rate	$86.85
Max. Negotiated Rate	$1,529.00
Rate for Payer: Aetna Commercial	$1,162.04
Rate for Payer: Aetna Medicare Advantage	$917.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$779.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$779.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$611.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$779.79
Rate for Payer: Cigna Commercial	$1,529.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.04
Rate for Payer: Qualcare PPO/HMO/WC	$458.70
Rate for Payer: UnitedHealthcare Community & State	$96.63
Rate for Payer: Wellpoint Medicaid Managed Care	$86.85

GUIDEWIRE SYNCHRO 200CM

Facility

$3,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270685069S
Hospital Revenue Code	278
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$94.80
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

GUIDEWIRE SYNCHRO 200CM

Facility

$3,000.00

Service Code	HCPCS C1789
Hospital Charge Code	270685069
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

GUIDEWIRE SYNCHRO 200CM

Facility

$3,000.00

Service Code	HCPCS C1789
Hospital Charge Code	270685069
Hospital Revenue Code	278
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$94.80
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

GUIDEWIRE SYNCHRO 200CM

Facility

$3,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270685069S
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

GUIDEWIRE SYNCHRO 300CM

Facility

$3,750.00

Service Code	HCPCS C1789
Hospital Charge Code	270685070
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

GUIDEWIRE SYNCHRO 300CM

Facility

$3,750.00

Service Code	HCPCS C1789
Hospital Charge Code	270685070
Hospital Revenue Code	278
Min. Negotiated Rate	$106.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$118.50
Rate for Payer: Wellpoint Medicaid Managed Care	$106.50

GUIDEWIRE SYNCHRO 300CM

Facility

$3,750.00

Service Code	HCPCS C1769
Hospital Charge Code	270685070S
Hospital Revenue Code	278
Min. Negotiated Rate	$106.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$118.50
Rate for Payer: Wellpoint Medicaid Managed Care	$106.50

GUIDEWIRE SYNCHRO 300CM

Facility

$3,750.00

Service Code	HCPCS C1769
Hospital Charge Code	270685070S
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

Know your out-of-pocket cost for care.

All Charges