Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

WIRE UNIGLIDE ANGL .035x260

Facility

$175.00

Hospital Charge Code	270677157
Hospital Revenue Code	272
Min. Negotiated Rate	$4.97
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.50
Rate for Payer: Oxford Commercial	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$35.00
Rate for Payer: UnitedHealthcare Community & State	$5.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.97

WIRE UNIGLIDE ANGL .035x260

Facility

$175.00

Hospital Charge Code	270677157N
Hospital Revenue Code	272
Min. Negotiated Rate	$4.97
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.50
Rate for Payer: Oxford Commercial	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$35.00
Rate for Payer: UnitedHealthcare Community & State	$5.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.97

WIRE UNIGLIDE ANGL .035x320

Facility

$175.00

Hospital Charge Code	270677158
Hospital Revenue Code	272
Min. Negotiated Rate	$4.97
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.50
Rate for Payer: Oxford Commercial	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$35.00
Rate for Payer: UnitedHealthcare Community & State	$5.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.97

WIRE UNIGLIDE ANGL .035x320

Facility

$175.00

Hospital Charge Code	270677158
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

WIRE UNIGLIDE STF ANG .035x150

Facility

$215.00

Hospital Charge Code	270677159
Hospital Revenue Code	272
Min. Negotiated Rate	$32.25
Max. Negotiated Rate	$32.25
Rate for Payer: Qualcare PPO/HMO/WC	$32.25

WIRE UNIGLIDE STF ANG .035x150

Facility

$215.00

Hospital Charge Code	270677159
Hospital Revenue Code	272
Min. Negotiated Rate	$6.11
Max. Negotiated Rate	$107.50
Rate for Payer: Aetna Commercial	$81.70
Rate for Payer: Aetna Medicare Advantage	$64.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.83
Rate for Payer: Cigna Commercial	$107.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.90
Rate for Payer: Oxford Commercial	$43.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.25
Rate for Payer: UnitedHealthcare Commercial	$43.00
Rate for Payer: UnitedHealthcare Community & State	$6.79
Rate for Payer: Wellpoint Medicaid Managed Care	$6.11

WIRE UNIGLIDE STF ANG .035x180

Facility

$215.00

Hospital Charge Code	270677160
Hospital Revenue Code	272
Min. Negotiated Rate	$32.25
Max. Negotiated Rate	$32.25
Rate for Payer: Qualcare PPO/HMO/WC	$32.25

WIRE UNIGLIDE STF ANG .035x180

Facility

$215.00

Hospital Charge Code	270677160N
Hospital Revenue Code	272
Min. Negotiated Rate	$6.11
Max. Negotiated Rate	$107.50
Rate for Payer: Aetna Commercial	$81.70
Rate for Payer: Aetna Medicare Advantage	$64.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.83
Rate for Payer: Cigna Commercial	$107.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.90
Rate for Payer: Oxford Commercial	$43.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.25
Rate for Payer: UnitedHealthcare Commercial	$43.00
Rate for Payer: UnitedHealthcare Community & State	$6.79
Rate for Payer: Wellpoint Medicaid Managed Care	$6.11

WIRE UNIGLIDE STF ANG .035x180

Facility

$215.00

Hospital Charge Code	270677160
Hospital Revenue Code	272
Min. Negotiated Rate	$6.11
Max. Negotiated Rate	$107.50
Rate for Payer: Aetna Commercial	$81.70
Rate for Payer: Aetna Medicare Advantage	$64.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.83
Rate for Payer: Cigna Commercial	$107.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.90
Rate for Payer: Oxford Commercial	$43.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.25
Rate for Payer: UnitedHealthcare Commercial	$43.00
Rate for Payer: UnitedHealthcare Community & State	$6.79
Rate for Payer: Wellpoint Medicaid Managed Care	$6.11

WIRE UNIGLIDE STF ANG .035x180

Facility

$215.00

Hospital Charge Code	270677160N
Hospital Revenue Code	272
Min. Negotiated Rate	$32.25
Max. Negotiated Rate	$32.25
Rate for Payer: Qualcare PPO/HMO/WC	$32.25

WIRE UNIGLIDE STF ANG .035x260

Facility

$215.00

Hospital Charge Code	270677161
Hospital Revenue Code	272
Min. Negotiated Rate	$32.25
Max. Negotiated Rate	$32.25
Rate for Payer: Qualcare PPO/HMO/WC	$32.25

WIRE UNIGLIDE STF ANG .035x260

Facility

$215.00

Hospital Charge Code	270677161N
Hospital Revenue Code	272
Min. Negotiated Rate	$32.25
Max. Negotiated Rate	$32.25
Rate for Payer: Qualcare PPO/HMO/WC	$32.25

WIRE UNIGLIDE STF ANG .035x260

Facility

$215.00

Hospital Charge Code	270677161
Hospital Revenue Code	272
Min. Negotiated Rate	$6.11
Max. Negotiated Rate	$107.50
Rate for Payer: Aetna Commercial	$81.70
Rate for Payer: Aetna Medicare Advantage	$64.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.83
Rate for Payer: Cigna Commercial	$107.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.90
Rate for Payer: Oxford Commercial	$43.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.25
Rate for Payer: UnitedHealthcare Commercial	$43.00
Rate for Payer: UnitedHealthcare Community & State	$6.79
Rate for Payer: Wellpoint Medicaid Managed Care	$6.11

WIRE UNIGLIDE STF ANG .035x260

Facility

$215.00

Hospital Charge Code	270677161N
Hospital Revenue Code	272
Min. Negotiated Rate	$6.11
Max. Negotiated Rate	$107.50
Rate for Payer: Aetna Commercial	$81.70
Rate for Payer: Aetna Medicare Advantage	$64.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.83
Rate for Payer: Cigna Commercial	$107.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.90
Rate for Payer: Oxford Commercial	$43.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.25
Rate for Payer: UnitedHealthcare Commercial	$43.00
Rate for Payer: UnitedHealthcare Community & State	$6.79
Rate for Payer: Wellpoint Medicaid Managed Care	$6.11

WIRE UNIGLIDE STF ANG .035x320

Facility

$215.00

Hospital Charge Code	270677162
Hospital Revenue Code	272
Min. Negotiated Rate	$6.11
Max. Negotiated Rate	$107.50
Rate for Payer: Aetna Commercial	$81.70
Rate for Payer: Aetna Medicare Advantage	$64.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.83
Rate for Payer: Cigna Commercial	$107.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.90
Rate for Payer: Oxford Commercial	$43.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.25
Rate for Payer: UnitedHealthcare Commercial	$43.00
Rate for Payer: UnitedHealthcare Community & State	$6.79
Rate for Payer: Wellpoint Medicaid Managed Care	$6.11

WIRE UNIGLIDE STF ANG .035x320

Facility

$215.00

Hospital Charge Code	270677162
Hospital Revenue Code	272
Min. Negotiated Rate	$32.25
Max. Negotiated Rate	$32.25
Rate for Payer: Qualcare PPO/HMO/WC	$32.25

WIRE VIPER ADVANCED VPR-GW-17

Facility

$850.00

Hospital Charge Code	270644368C
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

WIRE VIPER ADVANCED VPR-GW-17

Facility

$850.00

Hospital Charge Code	270644368C
Hospital Revenue Code	272
Min. Negotiated Rate	$24.14
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.00
Rate for Payer: Oxford Commercial	$170.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$170.00
Rate for Payer: UnitedHealthcare Community & State	$26.86
Rate for Payer: Wellpoint Medicaid Managed Care	$24.14

WIRE VIPER ADVANCED VPR-GW-17

Facility

$850.00

Hospital Charge Code	270644368A
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

WIRE VIPER ADVANCED VPR-GW-17

Facility

$850.00

Hospital Charge Code	270644368A
Hospital Revenue Code	272
Min. Negotiated Rate	$24.14
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.00
Rate for Payer: Oxford Commercial	$170.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$170.00
Rate for Payer: UnitedHealthcare Community & State	$26.86
Rate for Payer: Wellpoint Medicaid Managed Care	$24.14

WIRE VLX K .45 K100-11

Facility

$25.00

Service Code	HCPCS C1769
Hospital Charge Code	270621470
Hospital Revenue Code	278
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$6.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.05
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

WIRE VLX K .45 K100-11

Facility

$25.00

Service Code	HCPCS C1769
Hospital Charge Code	270621470
Hospital Revenue Code	278
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$9.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.05
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Community & State	$0.79
Rate for Payer: Wellpoint Medicaid Managed Care	$0.71

WIRE ZIM K .032 186-01-69

Facility

$36.51

Service Code	HCPCS C1769
Hospital Charge Code	270601978
Hospital Revenue Code	278
Min. Negotiated Rate	$5.48
Max. Negotiated Rate	$8.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.84
Rate for Payer: Qualcare PPO/HMO/WC	$5.48

WIRE ZIM K .032 186-01-69

Facility

$36.51

Service Code	HCPCS C1769
Hospital Charge Code	270601978
Hospital Revenue Code	278
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$18.25
Rate for Payer: Aetna Commercial	$13.87
Rate for Payer: Aetna Medicare Advantage	$10.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.31
Rate for Payer: Cigna Commercial	$18.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.84
Rate for Payer: Qualcare PPO/HMO/WC	$5.48
Rate for Payer: UnitedHealthcare Community & State	$1.15
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

WIRE ZIM K .045 186-02-69

Facility

$36.81

Service Code	HCPCS C1769
Hospital Charge Code	270601917
Hospital Revenue Code	278
Min. Negotiated Rate	$5.52
Max. Negotiated Rate	$8.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.91
Rate for Payer: Qualcare PPO/HMO/WC	$5.52

Know your out-of-pocket cost for care.

All Charges