Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PSYCHO-ED GOALS GROUP

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	83246135
Hospital Revenue Code	915
Min. Negotiated Rate	$120.12
Max. Negotiated Rate	$120.12
Rate for Payer: Qualcare PPO/HMO/WC	$120.12

PSYCHO-ED GOALS GROUP

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	83246135
Hospital Revenue Code	915
Min. Negotiated Rate	$22.74
Max. Negotiated Rate	$437.80
Rate for Payer: Aetna Commercial	$328.28
Rate for Payer: Aetna Medicare Advantage	$391.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$437.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$437.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$120.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$437.80
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: Cigna Medicare Advantage	$120.69
Rate for Payer: Clover Medicare Advantage	$114.66
Rate for Payer: EmblemHealth Commercial	$362.07
Rate for Payer: Humana Medicare Advantage	$124.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$120.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.21
Rate for Payer: Qualcare PPO/HMO/WC	$120.12
Rate for Payer: UnitedHealthcare Community & State	$25.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$120.69
Rate for Payer: Wellcare Medicare Advantage	$120.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.74

PSYCHO-ED GROUP MEN/WOMEN

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	83246130
Hospital Revenue Code	915
Min. Negotiated Rate	$120.12
Max. Negotiated Rate	$120.12
Rate for Payer: Qualcare PPO/HMO/WC	$120.12

PSYCHO-ED GROUP MEN/WOMEN

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	83246130
Hospital Revenue Code	915
Min. Negotiated Rate	$22.74
Max. Negotiated Rate	$437.80
Rate for Payer: Aetna Commercial	$328.28
Rate for Payer: Aetna Medicare Advantage	$391.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$437.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$437.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$120.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$437.80
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: Cigna Medicare Advantage	$120.69
Rate for Payer: Clover Medicare Advantage	$114.66
Rate for Payer: EmblemHealth Commercial	$362.07
Rate for Payer: Humana Medicare Advantage	$124.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$120.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.21
Rate for Payer: Qualcare PPO/HMO/WC	$120.12
Rate for Payer: UnitedHealthcare Community & State	$25.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$120.69
Rate for Payer: Wellcare Medicare Advantage	$120.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.74

PSYCHO-ED GROUP NUTRITION

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	83246120
Hospital Revenue Code	915
Min. Negotiated Rate	$22.74
Max. Negotiated Rate	$437.80
Rate for Payer: Aetna Commercial	$328.28
Rate for Payer: Aetna Medicare Advantage	$391.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$437.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$437.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$120.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$437.80
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: Cigna Medicare Advantage	$120.69
Rate for Payer: Clover Medicare Advantage	$114.66
Rate for Payer: EmblemHealth Commercial	$362.07
Rate for Payer: Humana Medicare Advantage	$124.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$120.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.21
Rate for Payer: Qualcare PPO/HMO/WC	$120.12
Rate for Payer: UnitedHealthcare Community & State	$25.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$120.69
Rate for Payer: Wellcare Medicare Advantage	$120.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.74

PSYCHO-ED GROUP NUTRITION

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	83246120
Hospital Revenue Code	915
Min. Negotiated Rate	$120.12
Max. Negotiated Rate	$120.12
Rate for Payer: Qualcare PPO/HMO/WC	$120.12

PSYCHO-ED HEALTHY BEHAVIOR GRP

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	83246125
Hospital Revenue Code	915
Min. Negotiated Rate	$120.12
Max. Negotiated Rate	$120.12
Rate for Payer: Qualcare PPO/HMO/WC	$120.12

PSYCHO-ED HEALTHY BEHAVIOR GRP

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	83246125
Hospital Revenue Code	915
Min. Negotiated Rate	$22.74
Max. Negotiated Rate	$437.80
Rate for Payer: Aetna Commercial	$328.28
Rate for Payer: Aetna Medicare Advantage	$391.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$437.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$437.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$120.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$437.80
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: Cigna Medicare Advantage	$120.69
Rate for Payer: Clover Medicare Advantage	$114.66
Rate for Payer: EmblemHealth Commercial	$362.07
Rate for Payer: Humana Medicare Advantage	$124.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$120.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.21
Rate for Payer: Qualcare PPO/HMO/WC	$120.12
Rate for Payer: UnitedHealthcare Community & State	$25.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$120.69
Rate for Payer: Wellcare Medicare Advantage	$120.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.74

PSYCHOLOGICAL EVALUATION

Facility

$1,103.00

Service Code	HCPCS 96101
Hospital Charge Code	83246025
Hospital Revenue Code	918
Min. Negotiated Rate	$31.33
Max. Negotiated Rate	$3,080.00
Rate for Payer: Aetna Commercial	$419.14
Rate for Payer: Aetna Medicare Advantage	$330.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$281.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$281.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$281.26
Rate for Payer: Cigna Commercial	$551.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$286.78
Rate for Payer: Oxford Commercial	$2,715.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.45
Rate for Payer: UnitedHealthcare Commercial	$3,080.00
Rate for Payer: UnitedHealthcare Community & State	$34.85
Rate for Payer: Wellpoint Medicaid Managed Care	$31.33

PSYCHOLOGICAL EVALUATION

Facility

$1,103.00

Service Code	HCPCS 96101
Hospital Charge Code	83246025
Hospital Revenue Code	918
Min. Negotiated Rate	$165.45
Max. Negotiated Rate	$165.45
Rate for Payer: Qualcare PPO/HMO/WC	$165.45

PSYCHOLOGICAL TESTING

Facility

$1,103.00

Service Code	HCPCS 96101
Hospital Charge Code	83246255
Hospital Revenue Code	918
Min. Negotiated Rate	$31.33
Max. Negotiated Rate	$3,080.00
Rate for Payer: Aetna Commercial	$419.14
Rate for Payer: Aetna Medicare Advantage	$330.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$281.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$281.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$281.26
Rate for Payer: Cigna Commercial	$551.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$286.78
Rate for Payer: Oxford Commercial	$2,715.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.45
Rate for Payer: UnitedHealthcare Commercial	$3,080.00
Rate for Payer: UnitedHealthcare Community & State	$34.85
Rate for Payer: Wellpoint Medicaid Managed Care	$31.33

PSYCHOLOGICAL TESTING

Facility

$1,103.00

Service Code	HCPCS 96101
Hospital Charge Code	83246255
Hospital Revenue Code	918
Min. Negotiated Rate	$165.45
Max. Negotiated Rate	$165.45
Rate for Payer: Qualcare PPO/HMO/WC	$165.45

PSYCH OPD MEDICATION REVIEW

Facility

$421.00

Service Code	HCPCS 90862
Hospital Charge Code	84310120
Hospital Revenue Code	914
Min. Negotiated Rate	$11.96
Max. Negotiated Rate	$210.50
Rate for Payer: Aetna Commercial	$159.98
Rate for Payer: Aetna Medicare Advantage	$126.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.36
Rate for Payer: Cigna Commercial	$210.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.46
Rate for Payer: Qualcare PPO/HMO/WC	$63.15
Rate for Payer: UnitedHealthcare Community & State	$13.30
Rate for Payer: Wellpoint Medicaid Managed Care	$11.96

PSYCH OPD MEDICATION REVIEW

Facility

$421.00

Service Code	HCPCS 90862
Hospital Charge Code	84310120
Hospital Revenue Code	914
Min. Negotiated Rate	$63.15
Max. Negotiated Rate	$63.15
Rate for Payer: Qualcare PPO/HMO/WC	$63.15

PSYCHOSES

Facility

$63,594.52

Service Code	MSDRG 885
Min. Negotiated Rate	$7,161.00
Max. Negotiated Rate	$63,594.52
Rate for Payer: Aetna Commercial	$47,151.24
Rate for Payer: Aetna Medicare Advantage	$63,594.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37,955.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,756.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,161.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37,955.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,382.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37,955.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,756.00
Rate for Payer: Cigna Commercial	$31,138.86
Rate for Payer: Cigna Medicare Advantage	$20,382.86
Rate for Payer: Clover Medicare Advantage	$19,363.72
Rate for Payer: EmblemHealth Commercial	$61,148.58
Rate for Payer: Humana Medicare Advantage	$20,994.35
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,382.86
Rate for Payer: Oxford Commercial	$24,611.62
Rate for Payer: UnitedHealthcare Commercial	$32,943.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,382.86
Rate for Payer: Wellcare Medicare Advantage	$20,382.86

PSYCHOTHERAPY, 30 MIN (16-37)

Facility

$414.00

Service Code	HCPCS 90832
Hospital Charge Code	83246155
Hospital Revenue Code	914
Min. Negotiated Rate	$62.10
Max. Negotiated Rate	$62.10
Rate for Payer: Qualcare PPO/HMO/WC	$62.10

PSYCHOTHERAPY, 30 MIN (16-37)

Facility

$414.00

Service Code	HCPCS 90832
Hospital Charge Code	83246155
Hospital Revenue Code	914
Min. Negotiated Rate	$11.76
Max. Negotiated Rate	$764.93
Rate for Payer: Aetna Commercial	$573.57
Rate for Payer: Aetna Medicare Advantage	$683.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$764.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$764.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$210.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$764.93
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: Cigna Medicare Advantage	$210.87
Rate for Payer: Clover Medicare Advantage	$200.33
Rate for Payer: EmblemHealth Commercial	$632.61
Rate for Payer: Humana Medicare Advantage	$217.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$210.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.64
Rate for Payer: Qualcare PPO/HMO/WC	$62.10
Rate for Payer: UnitedHealthcare Community & State	$13.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.87
Rate for Payer: Wellcare Medicare Advantage	$210.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$71.39
Rate for Payer: Wellpoint Medicaid Managed Care	$11.76

PSYCHOTHERAPY 30 MINS ADD E&M

Facility

$275.00

Service Code	HCPCS 90833
Hospital Charge Code	84509007
Hospital Revenue Code	914
Min. Negotiated Rate	$7.81
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Community & State	$8.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$73.61
Rate for Payer: Wellpoint Medicaid Managed Care	$7.81

PSYCHOTHERAPY 30 MINS ADD E&M

Facility

$275.00

Service Code	HCPCS 90833
Hospital Charge Code	84511007
Hospital Revenue Code	914
Min. Negotiated Rate	$7.81
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Community & State	$8.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$73.61
Rate for Payer: Wellpoint Medicaid Managed Care	$7.81

PSYCHOTHERAPY 30 MINS ADD E&M

Facility

$275.00

Service Code	HCPCS 90833
Hospital Charge Code	84517007
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

PSYCHOTHERAPY 30 MINS ADD E&M

Facility

$275.00

Service Code	HCPCS 90833
Hospital Charge Code	84509007
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

PSYCHOTHERAPY 30 MINS ADD E&M

Facility

$275.00

Service Code	HCPCS 90833
Hospital Charge Code	84511007
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

PSYCHOTHERAPY 30 MINS ADD E&M

Facility

$275.00

Service Code	HCPCS 90833
Hospital Charge Code	84517007
Hospital Revenue Code	914
Min. Negotiated Rate	$7.81
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Community & State	$8.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$73.61
Rate for Payer: Wellpoint Medicaid Managed Care	$7.81

PSYCHOTHERAPY 30 MINS ADD E&M

Facility

$275.00

Service Code	HCPCS 90833
Hospital Charge Code	84518007
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

PSYCHOTHERAPY 30 MINS ADD E&M

Facility

$275.00

Service Code	HCPCS 90833
Hospital Charge Code	84518007
Hospital Revenue Code	914
Min. Negotiated Rate	$7.81
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Community & State	$8.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$73.61
Rate for Payer: Wellpoint Medicaid Managed Care	$7.81

Know your out-of-pocket cost for care.

All Charges