Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

JAGTOME RX

Facility

$1,510.95

Hospital Charge Code	270680466
Hospital Revenue Code	272
Min. Negotiated Rate	$42.91
Max. Negotiated Rate	$755.48
Rate for Payer: Aetna Commercial	$574.16
Rate for Payer: Aetna Medicare Advantage	$453.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$385.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$385.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$385.29
Rate for Payer: Cigna Commercial	$755.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.85
Rate for Payer: Oxford Commercial	$302.19
Rate for Payer: Qualcare PPO/HMO/WC	$226.64
Rate for Payer: UnitedHealthcare Commercial	$302.19
Rate for Payer: UnitedHealthcare Community & State	$47.75
Rate for Payer: Wellpoint Medicaid Managed Care	$42.91

JAGTOME RX 49

Facility

$1,515.00

Hospital Charge Code	270660081
Hospital Revenue Code	272
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) PPO	$386.32
Rate for Payer: Cigna Commercial	$757.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.90
Rate for Payer: Oxford Commercial	$303.00
Rate for Payer: Qualcare PPO/HMO/WC	$227.25
Rate for Payer: UnitedHealthcare Commercial	$303.00
Rate for Payer: UnitedHealthcare Community & State	$47.87
Rate for Payer: Wellpoint Medicaid Managed Care	$43.03

JAGTOME RX 49

Facility

$1,515.00

Hospital Charge Code	270660081
Hospital Revenue Code	272
Min. Negotiated Rate	$227.25
Max. Negotiated Rate	$227.25
Rate for Payer: Qualcare PPO/HMO/WC	$227.25

JAGTOME RX SHINECTEROTOME .035

Facility

$1,562.25

Hospital Charge Code	270655970
Hospital Revenue Code	272
Min. Negotiated Rate	$234.34
Max. Negotiated Rate	$234.34
Rate for Payer: Qualcare PPO/HMO/WC	$234.34

JAGTOME RX SHINECTEROTOME .035

Facility

$1,562.25

Hospital Charge Code	270655970
Hospital Revenue Code	272
Min. Negotiated Rate	$44.37
Max. Negotiated Rate	$781.12
Rate for Payer: Aetna Commercial	$593.65
Rate for Payer: Aetna Medicare Advantage	$468.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$398.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$398.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$398.37
Rate for Payer: Cigna Commercial	$781.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$406.19
Rate for Payer: Oxford Commercial	$312.45
Rate for Payer: Qualcare PPO/HMO/WC	$234.34
Rate for Payer: UnitedHealthcare Commercial	$312.45
Rate for Payer: UnitedHealthcare Community & State	$49.37
Rate for Payer: Wellpoint Medicaid Managed Care	$44.37

JAGTOME SHORTWIRE 0.25

Facility

$2,029.75

Service Code	HCPCS C1769
Hospital Charge Code	270696133
Hospital Revenue Code	272
Min. Negotiated Rate	$57.64
Max. Negotiated Rate	$1,014.88
Rate for Payer: Aetna Commercial	$771.30
Rate for Payer: Aetna Medicare Advantage	$608.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$517.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$517.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$517.59
Rate for Payer: Cigna Commercial	$1,014.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$527.74
Rate for Payer: Oxford Commercial	$405.95
Rate for Payer: Qualcare PPO/HMO/WC	$304.46
Rate for Payer: UnitedHealthcare Commercial	$405.95
Rate for Payer: UnitedHealthcare Community & State	$64.14
Rate for Payer: Wellpoint Medicaid Managed Care	$57.64

JAGTOME SHORTWIRE 0.25

Facility

$2,029.75

Service Code	HCPCS C1769
Hospital Charge Code	270696133
Hospital Revenue Code	272
Min. Negotiated Rate	$304.46
Max. Negotiated Rate	$304.46
Rate for Payer: Qualcare PPO/HMO/WC	$304.46

JAGWIRE 0.035X260

Facility

$649.98

Hospital Charge Code	270627941
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

JAGWIRE 0.035X260

Facility

$649.98

Hospital Charge Code	270627941
Hospital Revenue Code	272
Min. Negotiated Rate	$18.46
Max. Negotiated Rate	$324.99
Rate for Payer: Aetna Commercial	$246.99
Rate for Payer: Aetna Medicare Advantage	$194.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.74
Rate for Payer: Cigna Commercial	$324.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.99
Rate for Payer: Oxford Commercial	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$130.00
Rate for Payer: UnitedHealthcare Community & State	$20.54
Rate for Payer: Wellpoint Medicaid Managed Care	$18.46

JAGWIRE .025 450 ANG BX

Facility

$1,130.05

Hospital Charge Code	270680469
Hospital Revenue Code	272
Min. Negotiated Rate	$32.09
Max. Negotiated Rate	$565.02
Rate for Payer: Aetna Commercial	$429.42
Rate for Payer: Aetna Medicare Advantage	$339.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$288.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$288.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$288.16
Rate for Payer: Cigna Commercial	$565.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$293.81
Rate for Payer: Oxford Commercial	$226.01
Rate for Payer: Qualcare PPO/HMO/WC	$169.51
Rate for Payer: UnitedHealthcare Commercial	$226.01
Rate for Payer: UnitedHealthcare Community & State	$35.71
Rate for Payer: Wellpoint Medicaid Managed Care	$32.09

JAGWIRE .025 450 ANG BX

Facility

$1,130.05

Hospital Charge Code	270680469
Hospital Revenue Code	272
Min. Negotiated Rate	$169.51
Max. Negotiated Rate	$169.51
Rate for Payer: Qualcare PPO/HMO/WC	$169.51

JAGWIRE .025 450 ANG ST

Facility

$1,130.05

Hospital Charge Code	270680470
Hospital Revenue Code	272
Min. Negotiated Rate	$32.09
Max. Negotiated Rate	$565.02
Rate for Payer: Aetna Commercial	$429.42
Rate for Payer: Aetna Medicare Advantage	$339.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$288.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$288.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$288.16
Rate for Payer: Cigna Commercial	$565.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$293.81
Rate for Payer: Oxford Commercial	$226.01
Rate for Payer: Qualcare PPO/HMO/WC	$169.51
Rate for Payer: UnitedHealthcare Commercial	$226.01
Rate for Payer: UnitedHealthcare Community & State	$35.71
Rate for Payer: Wellpoint Medicaid Managed Care	$32.09

JAGWIRE .025 450 ANG ST

Facility

$1,130.05

Hospital Charge Code	270680470
Hospital Revenue Code	272
Min. Negotiated Rate	$169.51
Max. Negotiated Rate	$169.51
Rate for Payer: Qualcare PPO/HMO/WC	$169.51

JAGWIRE 0.25x450cm STRAIGHT

Facility

$566.45

Service Code	HCPCS C1769
Hospital Charge Code	270683528
Hospital Revenue Code	278
Min. Negotiated Rate	$16.09
Max. Negotiated Rate	$283.23
Rate for Payer: Aetna Commercial	$215.25
Rate for Payer: Aetna Medicare Advantage	$169.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.44
Rate for Payer: Cigna Commercial	$283.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.08
Rate for Payer: Qualcare PPO/HMO/WC	$84.97
Rate for Payer: UnitedHealthcare Community & State	$17.90
Rate for Payer: Wellpoint Medicaid Managed Care	$16.09

JAGWIRE 0.25x450cm STRAIGHT

Facility

$566.45

Service Code	HCPCS C1769
Hospital Charge Code	270683528
Hospital Revenue Code	278
Min. Negotiated Rate	$84.97
Max. Negotiated Rate	$137.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.08
Rate for Payer: Qualcare PPO/HMO/WC	$84.97

JAGWIRE 0.35

Facility

$652.63

Hospital Charge Code	270665631
Hospital Revenue Code	272
Min. Negotiated Rate	$18.53
Max. Negotiated Rate	$326.31
Rate for Payer: Aetna Commercial	$248.00
Rate for Payer: Aetna Medicare Advantage	$195.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.42
Rate for Payer: Cigna Commercial	$326.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.68
Rate for Payer: Oxford Commercial	$130.53
Rate for Payer: Qualcare PPO/HMO/WC	$97.89
Rate for Payer: UnitedHealthcare Commercial	$130.53
Rate for Payer: UnitedHealthcare Community & State	$20.62
Rate for Payer: Wellpoint Medicaid Managed Care	$18.53

JAGWIRE 0.35

Facility

$652.63

Hospital Charge Code	270665631
Hospital Revenue Code	272
Min. Negotiated Rate	$97.89
Max. Negotiated Rate	$97.89
Rate for Payer: Qualcare PPO/HMO/WC	$97.89

JAGWIRE .035 450cm STRAIGHT

Facility

$566.45

Hospital Charge Code	270619354
Hospital Revenue Code	272
Min. Negotiated Rate	$16.09
Max. Negotiated Rate	$283.23
Rate for Payer: Aetna Commercial	$215.25
Rate for Payer: Aetna Medicare Advantage	$169.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.44
Rate for Payer: Cigna Commercial	$283.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.28
Rate for Payer: Oxford Commercial	$113.29
Rate for Payer: Qualcare PPO/HMO/WC	$84.97
Rate for Payer: UnitedHealthcare Commercial	$113.29
Rate for Payer: UnitedHealthcare Community & State	$17.90
Rate for Payer: Wellpoint Medicaid Managed Care	$16.09

JAGWIRE .035 450cm STRAIGHT

Facility

$566.45

Hospital Charge Code	270619354
Hospital Revenue Code	272
Min. Negotiated Rate	$84.97
Max. Negotiated Rate	$84.97
Rate for Payer: Qualcare PPO/HMO/WC	$84.97

JAGWIRE .038 260cm STRAIGHT

Facility

$504.08

Hospital Charge Code	270617891
Hospital Revenue Code	272
Min. Negotiated Rate	$75.61
Max. Negotiated Rate	$75.61
Rate for Payer: Qualcare PPO/HMO/WC	$75.61

JAGWIRE .038 260cm STRAIGHT

Facility

$504.08

Hospital Charge Code	270617891
Hospital Revenue Code	272
Min. Negotiated Rate	$14.32
Max. Negotiated Rate	$252.04
Rate for Payer: Aetna Commercial	$191.55
Rate for Payer: Aetna Medicare Advantage	$151.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.54
Rate for Payer: Cigna Commercial	$252.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.06
Rate for Payer: Oxford Commercial	$100.82
Rate for Payer: Qualcare PPO/HMO/WC	$75.61
Rate for Payer: UnitedHealthcare Commercial	$100.82
Rate for Payer: UnitedHealthcare Community & State	$15.93
Rate for Payer: Wellpoint Medicaid Managed Care	$14.32

JAGWIRE .35x450CM STRAIGHT

Facility

$557.13

Hospital Charge Code	270603946
Hospital Revenue Code	272
Min. Negotiated Rate	$15.82
Max. Negotiated Rate	$278.56
Rate for Payer: Aetna Commercial	$211.71
Rate for Payer: Aetna Medicare Advantage	$167.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.07
Rate for Payer: Cigna Commercial	$278.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.85
Rate for Payer: Oxford Commercial	$111.43
Rate for Payer: Qualcare PPO/HMO/WC	$83.57
Rate for Payer: UnitedHealthcare Commercial	$111.43
Rate for Payer: UnitedHealthcare Community & State	$17.61
Rate for Payer: Wellpoint Medicaid Managed Care	$15.82

JAGWIRE .35x450CM STRAIGHT

Facility

$557.13

Hospital Charge Code	270603946
Hospital Revenue Code	272
Min. Negotiated Rate	$83.57
Max. Negotiated Rate	$83.57
Rate for Payer: Qualcare PPO/HMO/WC	$83.57

JAGWIRE GUIDEWIRE ANGLED 260CM

Facility

$492.48

Service Code	HCPCS C1769
Hospital Charge Code	270660813
Hospital Revenue Code	278
Min. Negotiated Rate	$13.99
Max. Negotiated Rate	$246.24
Rate for Payer: Aetna Commercial	$187.14
Rate for Payer: Aetna Medicare Advantage	$147.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.58
Rate for Payer: Cigna Commercial	$246.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.18
Rate for Payer: Qualcare PPO/HMO/WC	$73.87
Rate for Payer: UnitedHealthcare Community & State	$15.56
Rate for Payer: Wellpoint Medicaid Managed Care	$13.99

JAGWIRE GUIDEWIRE ANGLED 260CM

Facility

$492.48

Service Code	HCPCS C1769
Hospital Charge Code	270660813
Hospital Revenue Code	278
Min. Negotiated Rate	$73.87
Max. Negotiated Rate	$119.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.18
Rate for Payer: Qualcare PPO/HMO/WC	$73.87

Know your out-of-pocket cost for care.

All Charges