Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

WIRE MCV GUIDE JAG .025 5656

Facility

$657.50

Service Code	HCPCS C1769
Hospital Charge Code	270608080
Hospital Revenue Code	278
Min. Negotiated Rate	$98.62
Max. Negotiated Rate	$159.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.12
Rate for Payer: Qualcare PPO/HMO/WC	$98.62

WIRE MCV ZEBRA 450CM 5168

Facility

$500.00

Service Code	HCPCS C1769
Hospital Charge Code	270604746
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

WIRE MCV ZEBRA 450CM 5168

Facility

$500.00

Service Code	HCPCS C1769
Hospital Charge Code	270604746
Hospital Revenue Code	278
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

WIRE NITREX GUIDEWIRED STIFF

Facility

$233.33

Hospital Charge Code	270653899N
Hospital Revenue Code	272
Min. Negotiated Rate	$35.00
Max. Negotiated Rate	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.00

WIRE NITREX GUIDEWIRED STIFF

Facility

$233.33

Hospital Charge Code	270653899
Hospital Revenue Code	272
Min. Negotiated Rate	$35.00
Max. Negotiated Rate	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.00

WIRE NITREX GUIDEWIRED STIFF

Facility

$233.33

Hospital Charge Code	270653899S
Hospital Revenue Code	272
Min. Negotiated Rate	$35.00
Max. Negotiated Rate	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.00

WIRE NITREX GUIDEWIRED STIFF

Facility

$233.33

Hospital Charge Code	270653899N
Hospital Revenue Code	272
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$116.67
Rate for Payer: Aetna Commercial	$88.67
Rate for Payer: Aetna Medicare Advantage	$70.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.50
Rate for Payer: Cigna Commercial	$116.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.67
Rate for Payer: Oxford Commercial	$46.67
Rate for Payer: Qualcare PPO/HMO/WC	$35.00
Rate for Payer: UnitedHealthcare Commercial	$46.67
Rate for Payer: UnitedHealthcare Community & State	$7.37
Rate for Payer: Wellpoint Medicaid Managed Care	$6.63

WIRE NITREX GUIDEWIRED STIFF

Facility

$233.33

Hospital Charge Code	270653899S
Hospital Revenue Code	272
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$116.67
Rate for Payer: Aetna Commercial	$88.67
Rate for Payer: Aetna Medicare Advantage	$70.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.50
Rate for Payer: Cigna Commercial	$116.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.67
Rate for Payer: Oxford Commercial	$46.67
Rate for Payer: Qualcare PPO/HMO/WC	$35.00
Rate for Payer: UnitedHealthcare Commercial	$46.67
Rate for Payer: UnitedHealthcare Community & State	$7.37
Rate for Payer: Wellpoint Medicaid Managed Care	$6.63

WIRE NITREX GUIDEWIRED STIFF

Facility

$233.33

Hospital Charge Code	270653899R
Hospital Revenue Code	272
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$116.67
Rate for Payer: Aetna Commercial	$88.67
Rate for Payer: Aetna Medicare Advantage	$70.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.50
Rate for Payer: Cigna Commercial	$116.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.67
Rate for Payer: Oxford Commercial	$46.67
Rate for Payer: Qualcare PPO/HMO/WC	$35.00
Rate for Payer: UnitedHealthcare Commercial	$46.67
Rate for Payer: UnitedHealthcare Community & State	$7.37
Rate for Payer: Wellpoint Medicaid Managed Care	$6.63

WIRE NITREX GUIDEWIRED STIFF

Facility

$233.33

Hospital Charge Code	270653899R
Hospital Revenue Code	272
Min. Negotiated Rate	$35.00
Max. Negotiated Rate	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.00

WIRE NITREX GUIDEWIRED STIFF

Facility

$233.33

Hospital Charge Code	270653899
Hospital Revenue Code	272
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$116.67
Rate for Payer: Aetna Commercial	$88.67
Rate for Payer: Aetna Medicare Advantage	$70.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.50
Rate for Payer: Cigna Commercial	$116.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.67
Rate for Payer: Oxford Commercial	$46.67
Rate for Payer: Qualcare PPO/HMO/WC	$35.00
Rate for Payer: UnitedHealthcare Commercial	$46.67
Rate for Payer: UnitedHealthcare Community & State	$7.37
Rate for Payer: Wellpoint Medicaid Managed Care	$6.63

WIRE OLIVE

Facility

$920.00

Hospital Charge Code	270661007
Hospital Revenue Code	279
Min. Negotiated Rate	$26.13
Max. Negotiated Rate	$460.00
Rate for Payer: Aetna Commercial	$349.60
Rate for Payer: Aetna Medicare Advantage	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.60
Rate for Payer: Cigna Commercial	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.20
Rate for Payer: Oxford Commercial	$184.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.00
Rate for Payer: UnitedHealthcare Commercial	$184.00
Rate for Payer: UnitedHealthcare Community & State	$29.07
Rate for Payer: Wellpoint Medicaid Managed Care	$26.13

WIRE OLIVE

Facility

$920.00

Hospital Charge Code	270661007
Hospital Revenue Code	279
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$138.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.00

WIRE OLIVE, 1.1MM

Facility

$150.00

Hospital Charge Code	270657194
Hospital Revenue Code	272
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

WIRE OLIVE, 1.1MM

Facility

$150.00

Hospital Charge Code	270657194
Hospital Revenue Code	272
Min. Negotiated Rate	$4.26
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.00
Rate for Payer: Oxford Commercial	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$30.00
Rate for Payer: UnitedHealthcare Community & State	$4.74
Rate for Payer: Wellpoint Medicaid Managed Care	$4.26

WIRE OLIVE 1.25 MM

Facility

$742.50

Service Code	HCPCS C1713
Hospital Charge Code	270692341
Hospital Revenue Code	278
Min. Negotiated Rate	$111.38
Max. Negotiated Rate	$179.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$179.69
Rate for Payer: Qualcare PPO/HMO/WC	$111.38

WIRE OLIVE 1.25 MM

Facility

$742.50

Service Code	HCPCS C1713
Hospital Charge Code	270692341
Hospital Revenue Code	278
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$371.25
Rate for Payer: Aetna Commercial	$282.15
Rate for Payer: Aetna Medicare Advantage	$222.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.34
Rate for Payer: Cigna Commercial	$371.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$179.69
Rate for Payer: Qualcare PPO/HMO/WC	$111.38
Rate for Payer: UnitedHealthcare Community & State	$23.46
Rate for Payer: Wellpoint Medicaid Managed Care	$21.09

WIRE OLIVE 1.25MM

Facility

$742.50

Service Code	HCPCS C1713
Hospital Charge Code	270695537
Hospital Revenue Code	278
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$371.25
Rate for Payer: Aetna Commercial	$282.15
Rate for Payer: Aetna Medicare Advantage	$222.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.34
Rate for Payer: Cigna Commercial	$371.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$179.69
Rate for Payer: Qualcare PPO/HMO/WC	$111.38
Rate for Payer: UnitedHealthcare Community & State	$23.46
Rate for Payer: Wellpoint Medicaid Managed Care	$21.09

WIRE OLIVE 1.25MM

Facility

$742.50

Service Code	HCPCS C1713
Hospital Charge Code	270695537
Hospital Revenue Code	278
Min. Negotiated Rate	$111.38
Max. Negotiated Rate	$179.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$179.69
Rate for Payer: Qualcare PPO/HMO/WC	$111.38

WIRE OLIVE SALVATION 2MM

Facility

$875.00

Hospital Charge Code	270684457
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

WIRE OLIVE SALVATION 2MM

Facility

$875.00

Hospital Charge Code	270684457
Hospital Revenue Code	272
Min. Negotiated Rate	$24.85
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$27.65
Rate for Payer: Wellpoint Medicaid Managed Care	$24.85

WIRE OLIVE SMOOTH 1.6MM

Facility

$430.00

Hospital Charge Code	270698549
Hospital Revenue Code	272
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) PPO	$109.65
Rate for Payer: Cigna Commercial	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.80
Rate for Payer: Oxford Commercial	$86.00
Rate for Payer: Qualcare PPO/HMO/WC	$64.50
Rate for Payer: UnitedHealthcare Commercial	$86.00
Rate for Payer: UnitedHealthcare Community & State	$13.59
Rate for Payer: Wellpoint Medicaid Managed Care	$12.21

WIRE OLIVE SMOOTH 1.6MM

Facility

$430.00

Hospital Charge Code	270698549
Hospital Revenue Code	272
Min. Negotiated Rate	$64.50
Max. Negotiated Rate	$64.50
Rate for Payer: Qualcare PPO/HMO/WC	$64.50

WIRE OLIVE THREADED 1.6MM

Facility

$1,100.00

Hospital Charge Code	270698548
Hospital Revenue Code	272
Min. Negotiated Rate	$31.24
Max. Negotiated Rate	$550.00
Rate for Payer: Aetna Commercial	$418.00
Rate for Payer: Aetna Medicare Advantage	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.50
Rate for Payer: Cigna Commercial	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$286.00
Rate for Payer: Oxford Commercial	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00
Rate for Payer: UnitedHealthcare Commercial	$220.00
Rate for Payer: UnitedHealthcare Community & State	$34.76
Rate for Payer: Wellpoint Medicaid Managed Care	$31.24

WIRE OLIVE THREADED 1.6MM

Facility

$1,100.00

Hospital Charge Code	270698548
Hospital Revenue Code	272
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

Know your out-of-pocket cost for care.

All Charges