Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PTHYBRID GLEN POST REGENEREX

Facility

$2,875.00

Service Code	HCPCS C1776
Hospital Charge Code	270687347
Hospital Revenue Code	278
Min. Negotiated Rate	$431.25
Max. Negotiated Rate	$695.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$632.50
Rate for Payer: Qualcare PPO/HMO/WC	$431.25

PT HYDROTHERAPY

Facility

$62.10

Service Code	HCPCS 97022GP
Hospital Charge Code	9000175
Hospital Revenue Code	420
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$23.60
Rate for Payer: Aetna Medicare Advantage	$18.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.84
Rate for Payer: Cigna Commercial	$31.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.63
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.31
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$1.50
Rate for Payer: Wellpoint Medicaid Managed Care	$1.65

PT HYDROTHERAPY

Facility

$62.10

Service Code	HCPCS 97022GP
Hospital Charge Code	9000175
Hospital Revenue Code	420
Min. Negotiated Rate	$9.31
Max. Negotiated Rate	$9.31
Rate for Payer: Qualcare PPO/HMO/WC	$9.31

PT-HYDROTHERAPY DBL SESSION***

Facility

$88.00

Hospital Charge Code	9000183
Hospital Revenue Code	429
Min. Negotiated Rate	$13.20
Max. Negotiated Rate	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$13.20

PT-HYDROTHERAPY DBL SESSION***

Facility

$88.00

Hospital Charge Code	9000183
Hospital Revenue Code	429
Min. Negotiated Rate	$2.12
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$33.44
Rate for Payer: Aetna Medicare Advantage	$26.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.44
Rate for Payer: Cigna Commercial	$44.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.40
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.20
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$2.12
Rate for Payer: Wellpoint Medicaid Managed Care	$2.33

PT HYDROTHERAPY EA 15 MIN

Facility

$96.00

Service Code	HCPCS 97036GP
Hospital Charge Code	422597036
Hospital Revenue Code	420
Min. Negotiated Rate	$14.40
Max. Negotiated Rate	$14.40
Rate for Payer: Qualcare PPO/HMO/WC	$14.40

PT HYDROTHERAPY EA 15 MIN

Facility

$96.00

Service Code	HCPCS 97036GP
Hospital Charge Code	422597036
Hospital Revenue Code	420
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$36.48
Rate for Payer: Aetna Medicare Advantage	$28.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.48
Rate for Payer: Cigna Commercial	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.80
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.40
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$2.31
Rate for Payer: Wellpoint Medicaid Managed Care	$2.54

PT-INDIV THERAPY SESSION DBL**

Facility

$150.00

Service Code	HCPCS 97110
Hospital Charge Code	9000050
Hospital Revenue Code	429
Min. Negotiated Rate	$3.62
Max. Negotiated Rate	$1,060.00
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) NJ Health	$116.00
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	$45.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$3.62
Rate for Payer: Wellpoint Medicaid Managed Care	$3.98

PT-INDIV THERAPY SESSION DBL**

Facility

$150.00

Service Code	HCPCS 97110
Hospital Charge Code	9000050
Hospital Revenue Code	429
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

PT INFRARED THRPY

Facility

$102.50

Service Code	HCPCS 97026GP
Hospital Charge Code	422597026
Hospital Revenue Code	420
Min. Negotiated Rate	$2.47
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$38.95
Rate for Payer: Aetna Medicare Advantage	$30.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.14
Rate for Payer: Cigna Commercial	$51.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.75
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.38
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$2.47
Rate for Payer: Wellpoint Medicaid Managed Care	$2.72

PT INFRARED THRPY

Facility

$102.50

Service Code	HCPCS 97026GP
Hospital Charge Code	422597026
Hospital Revenue Code	420
Min. Negotiated Rate	$15.38
Max. Negotiated Rate	$15.38
Rate for Payer: Qualcare PPO/HMO/WC	$15.38

PT INSERT NEEDLE 1 OR 2 MUSCLE

Facility

$152.09

Service Code	HCPCS 20560GP
Hospital Charge Code	422520560
Hospital Revenue Code	420
Min. Negotiated Rate	$22.81
Max. Negotiated Rate	$22.81
Rate for Payer: Qualcare PPO/HMO/WC	$22.81

PT INSERT NEEDLE 1 OR 2 MUSCLE

Facility

$152.09

Service Code	HCPCS 20560GP
Hospital Charge Code	422520560
Hospital Revenue Code	420
Min. Negotiated Rate	$3.67
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$57.79
Rate for Payer: Aetna Medicare Advantage	$45.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.78
Rate for Payer: Cigna Commercial	$76.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.63
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.81
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$3.67
Rate for Payer: Wellpoint Medicaid Managed Care	$4.03

PT INSERT NEEDLE 3+ MUSCLE(S)

Facility

$152.08

Service Code	HCPCS 20561GP
Hospital Charge Code	422520561
Hospital Revenue Code	420
Min. Negotiated Rate	$3.67
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$57.79
Rate for Payer: Aetna Medicare Advantage	$45.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.78
Rate for Payer: Cigna Commercial	$76.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.62
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.81
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$3.67
Rate for Payer: Wellpoint Medicaid Managed Care	$4.03

PT INSERT NEEDLE 3+ MUSCLE(S)

Facility

$152.08

Service Code	HCPCS 20561GP
Hospital Charge Code	422520561
Hospital Revenue Code	420
Min. Negotiated Rate	$22.81
Max. Negotiated Rate	$22.81
Rate for Payer: Qualcare PPO/HMO/WC	$22.81

PT INSTRUCT/HOME PROGRAM EA 15

Facility

$384.00

Service Code	HCPCS 97535GO
Hospital Charge Code	1008325
Hospital Revenue Code	430
Min. Negotiated Rate	$9.25
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$145.92
Rate for Payer: Aetna Medicare Advantage	$115.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.92
Rate for Payer: Cigna Commercial	$192.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.20
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.60
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$9.25
Rate for Payer: Wellpoint Medicaid Managed Care	$10.18

PT INSTRUCT/HOME PROGRAM EA 15

Facility

$384.00

Service Code	HCPCS 97535GO
Hospital Charge Code	1008325
Hospital Revenue Code	430
Min. Negotiated Rate	$57.60
Max. Negotiated Rate	$57.60
Rate for Payer: Qualcare PPO/HMO/WC	$57.60

PT INSTRUCTION/HOME PROG 15 MI

Facility

$508.00

Service Code	HCPCS 97535GP
Hospital Charge Code	1008335
Hospital Revenue Code	420
Min. Negotiated Rate	$12.24
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$193.04
Rate for Payer: Aetna Medicare Advantage	$152.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$129.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$129.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$129.54
Rate for Payer: Cigna Commercial	$254.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.40
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$76.20
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$12.24
Rate for Payer: Wellpoint Medicaid Managed Care	$13.46

PT INSTRUCTION/HOME PROG 15 MI

Facility

$508.00

Service Code	HCPCS 97535GP
Hospital Charge Code	1008335
Hospital Revenue Code	420
Min. Negotiated Rate	$76.20
Max. Negotiated Rate	$76.20
Rate for Payer: Qualcare PPO/HMO/WC	$76.20

PT IONTOPHOPRESIS EA 15 MIN

Facility

$77.65

Service Code	HCPCS 97033GP
Hospital Charge Code	9000423
Hospital Revenue Code	420
Min. Negotiated Rate	$11.65
Max. Negotiated Rate	$11.65
Rate for Payer: Qualcare PPO/HMO/WC	$11.65

PT IONTOPHOPRESIS EA 15 MIN

Facility

$77.65

Service Code	HCPCS 97033GP
Hospital Charge Code	9000423
Hospital Revenue Code	420
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$29.51
Rate for Payer: Aetna Medicare Advantage	$23.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.80
Rate for Payer: Cigna Commercial	$38.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.30
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.65
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$1.87
Rate for Payer: Wellpoint Medicaid Managed Care	$2.06

PT IONTOPHORESIS EA 15 MIN

Facility

$373.00

Service Code	HCPCS 97033GP
Hospital Charge Code	422597033
Hospital Revenue Code	420
Min. Negotiated Rate	$55.95
Max. Negotiated Rate	$55.95
Rate for Payer: Qualcare PPO/HMO/WC	$55.95

PT IONTOPHORESIS EA 15 MIN

Facility

$373.00

Service Code	HCPCS 97033GP
Hospital Charge Code	422597033
Hospital Revenue Code	420
Min. Negotiated Rate	$8.99
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$141.74
Rate for Payer: Aetna Medicare Advantage	$111.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.11
Rate for Payer: Cigna Commercial	$186.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.90
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.95
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$8.99
Rate for Payer: Wellpoint Medicaid Managed Care	$9.88

PT JOINT MOBILIZATION EA 15 MI

Facility

$141.65

Service Code	HCPCS 97140GP
Hospital Charge Code	9100070
Hospital Revenue Code	420
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

PT JOINT MOBILIZATION EA 15 MI

Facility

$141.65

Service Code	HCPCS 97140GP
Hospital Charge Code	9100070
Hospital Revenue Code	420
Min. Negotiated Rate	$3.41
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$53.83
Rate for Payer: Aetna Medicare Advantage	$42.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.12
Rate for Payer: Cigna Commercial	$70.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.49
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$3.41
Rate for Payer: Wellpoint Medicaid Managed Care	$3.75

Know your out-of-pocket cost for care.

All Charges