Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

GUIDE WIRE V-18 .018 200CM

Facility

$435.00

Service Code	HCPCS C1769
Hospital Charge Code	270653649S
Hospital Revenue Code	278
Min. Negotiated Rate	$12.35
Max. Negotiated Rate	$217.50
Rate for Payer: Aetna Commercial	$165.30
Rate for Payer: Aetna Medicare Advantage	$130.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.92
Rate for Payer: Cigna Commercial	$217.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.27
Rate for Payer: Qualcare PPO/HMO/WC	$65.25
Rate for Payer: UnitedHealthcare Community & State	$13.75
Rate for Payer: Wellpoint Medicaid Managed Care	$12.35

GUIDE WIRE V-18 .018 200CM

Facility

$435.00

Service Code	HCPCS C1769
Hospital Charge Code	270653649
Hospital Revenue Code	278
Min. Negotiated Rate	$12.35
Max. Negotiated Rate	$217.50
Rate for Payer: Aetna Commercial	$165.30
Rate for Payer: Aetna Medicare Advantage	$130.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.92
Rate for Payer: Cigna Commercial	$217.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.27
Rate for Payer: Qualcare PPO/HMO/WC	$65.25
Rate for Payer: UnitedHealthcare Community & State	$13.75
Rate for Payer: Wellpoint Medicaid Managed Care	$12.35

GUIDE WIRE V-18 .018 200CM

Facility

$435.00

Service Code	HCPCS C1769
Hospital Charge Code	270653649
Hospital Revenue Code	278
Min. Negotiated Rate	$65.25
Max. Negotiated Rate	$105.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.27
Rate for Payer: Qualcare PPO/HMO/WC	$65.25

GUIDE WIRE V-18 .018 200CM

Facility

$435.00

Service Code	HCPCS C1769
Hospital Charge Code	270653649N
Hospital Revenue Code	278
Min. Negotiated Rate	$65.25
Max. Negotiated Rate	$105.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.27
Rate for Payer: Qualcare PPO/HMO/WC	$65.25

GUIDE WIRE V-18 .018 200CM

Facility

$435.00

Service Code	HCPCS C1769
Hospital Charge Code	270653649S
Hospital Revenue Code	278
Min. Negotiated Rate	$65.25
Max. Negotiated Rate	$105.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.27
Rate for Payer: Qualcare PPO/HMO/WC	$65.25

GUIDE WIRE V-18 .018 200CM

Facility

$435.00

Service Code	HCPCS C1769
Hospital Charge Code	270653649N
Hospital Revenue Code	278
Min. Negotiated Rate	$12.35
Max. Negotiated Rate	$217.50
Rate for Payer: Aetna Commercial	$165.30
Rate for Payer: Aetna Medicare Advantage	$130.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.92
Rate for Payer: Cigna Commercial	$217.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.27
Rate for Payer: Qualcare PPO/HMO/WC	$65.25
Rate for Payer: UnitedHealthcare Community & State	$13.75
Rate for Payer: Wellpoint Medicaid Managed Care	$12.35

GUIDEWIRE V-18 8x200cm

Facility

$420.00

Service Code	HCPCS C1769
Hospital Charge Code	270628048
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 V-18 8x200cm

Facility

$420.00

Service Code	HCPCS C1769
Hospital Charge Code	270628048
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 V-18 8X200CM

Facility

$420.00

Service Code	HCPCS C1769
Hospital Charge Code	270628048C
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 V-18 8X200CM

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270628048N
Hospital Revenue Code	278
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) NJ Health	$75.00
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	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

GUIDEWIRE V-18 8X200CM

Facility

$420.00

Service Code	HCPCS C1769
Hospital Charge Code	270628048C
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 V-18 8X200CM

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270628048N
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

GUIDEWIRE V-18 8x300cm

Facility

$420.00

Service Code	HCPCS C1769
Hospital Charge Code	270623260
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 V-18 8x300cm

Facility

$420.00

Service Code	HCPCS C1769
Hospital Charge Code	270623260
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 V18 8X300CM

Facility

$420.00

Service Code	HCPCS C1769
Hospital Charge Code	270623260S
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 V18 8X300CM

Facility

$420.00

Service Code	HCPCS C1769
Hospital Charge Code	270623260S
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 VASC .014IN 185CM

Facility

$415.00

Service Code	HCPCS C1769
Hospital Charge Code	270696459S
Hospital Revenue Code	278
Min. Negotiated Rate	$11.79
Max. Negotiated Rate	$207.50
Rate for Payer: Aetna Commercial	$157.70
Rate for Payer: Aetna Medicare Advantage	$124.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$83.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.83
Rate for Payer: Cigna Commercial	$207.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.43
Rate for Payer: Qualcare PPO/HMO/WC	$62.25
Rate for Payer: UnitedHealthcare Community & State	$13.11
Rate for Payer: Wellpoint Medicaid Managed Care	$11.79

GUIDEWIRE VASC .014IN 185CM

Facility

$415.00

Service Code	HCPCS C1769
Hospital Charge Code	270696459S
Hospital Revenue Code	278
Min. Negotiated Rate	$62.25
Max. Negotiated Rate	$100.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$83.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.43
Rate for Payer: Qualcare PPO/HMO/WC	$62.25

GUIDEWIRE VASC.038IN150CM1.5MM

Facility

$43.00

Service Code	HCPCS C1769
Hospital Charge Code	270646396
Hospital Revenue Code	272
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

GUIDEWIRE VASC.038IN150CM1.5MM

Facility

$43.00

Service Code	HCPCS C1769
Hospital Charge Code	270646396
Hospital Revenue Code	272
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$16.34
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.18
Rate for Payer: Oxford Commercial	$8.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$8.60
Rate for Payer: UnitedHealthcare Community & State	$1.36
Rate for Payer: Wellpoint Medicaid Managed Care	$1.22

GUIDEWIRE VICTORY .014X300MM

Facility

$1,055.75

Service Code	HCPCS C1769
Hospital Charge Code	270670087
Hospital Revenue Code	278
Min. Negotiated Rate	$158.36
Max. Negotiated Rate	$255.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.49
Rate for Payer: Qualcare PPO/HMO/WC	$158.36

GUIDEWIRE VICTORY .014X300MM

Facility

$1,055.75

Service Code	HCPCS C1769
Hospital Charge Code	270670087
Hospital Revenue Code	278
Min. Negotiated Rate	$29.98
Max. Negotiated Rate	$527.88
Rate for Payer: Aetna Commercial	$401.19
Rate for Payer: Aetna Medicare Advantage	$316.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.22
Rate for Payer: Cigna Commercial	$527.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.49
Rate for Payer: Qualcare PPO/HMO/WC	$158.36
Rate for Payer: UnitedHealthcare Community & State	$33.36
Rate for Payer: Wellpoint Medicaid Managed Care	$29.98

GUIDEWIRE VICTORY 18 300CM 30G

Facility

$1,004.25

Service Code	HCPCS C1769
Hospital Charge Code	270670165
Hospital Revenue Code	278
Min. Negotiated Rate	$150.64
Max. Negotiated Rate	$243.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.03
Rate for Payer: Qualcare PPO/HMO/WC	$150.64

GUIDEWIRE VICTORY 18 300CM 30G

Facility

$1,004.25

Service Code	HCPCS C1769
Hospital Charge Code	270670165
Hospital Revenue Code	278
Min. Negotiated Rate	$28.52
Max. Negotiated Rate	$502.12
Rate for Payer: Aetna Commercial	$381.62
Rate for Payer: Aetna Medicare Advantage	$301.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$256.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$256.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$256.08
Rate for Payer: Cigna Commercial	$502.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.03
Rate for Payer: Qualcare PPO/HMO/WC	$150.64
Rate for Payer: UnitedHealthcare Community & State	$31.73
Rate for Payer: Wellpoint Medicaid Managed Care	$28.52

GUIDEWIRE VICTORY 4FR .14x300

Facility

$849.75

Hospital Charge Code	270676381
Hospital Revenue Code	278
Min. Negotiated Rate	$24.13
Max. Negotiated Rate	$424.88
Rate for Payer: Aetna Commercial	$322.90
Rate for Payer: Aetna Medicare Advantage	$254.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$169.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.69
Rate for Payer: Cigna Commercial	$424.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.64
Rate for Payer: Qualcare PPO/HMO/WC	$127.46
Rate for Payer: UnitedHealthcare Community & State	$26.85
Rate for Payer: Wellpoint Medicaid Managed Care	$24.13

Know your out-of-pocket cost for care.

All Charges