Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PT ADD WALKER TO CAST

Facility

$468.75

Service Code	HCPCS 29440GP
Hospital Charge Code	422529440
Hospital Revenue Code	420
Min. Negotiated Rate	$13.31
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$178.12
Rate for Payer: Aetna Medicare Advantage	$140.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.53
Rate for Payer: Cigna Commercial	$234.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.88
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.31
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$14.81
Rate for Payer: Wellpoint Medicaid Managed Care	$13.31

PT ADL SESSION EA 15 MIN

Facility

$384.00

Service Code	HCPCS 97535GP
Hospital Charge Code	9000084
Hospital Revenue Code	420
Min. Negotiated Rate	$57.60
Max. Negotiated Rate	$57.60
Rate for Payer: Qualcare PPO/HMO/WC	$57.60

PT ADL SESSION EA 15 MIN

Facility

$384.00

Service Code	HCPCS 97535GP
Hospital Charge Code	9000084
Hospital Revenue Code	420
Min. Negotiated Rate	$10.91
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	$69.00
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	$99.84
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.60
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$12.13
Rate for Payer: Wellpoint Medicaid Managed Care	$10.91

PT ADL SESSION EA 15 MIN

Facility

$169.00

Service Code	HCPCS 97535
Hospital Charge Code	409297535
Hospital Revenue Code	420
Min. Negotiated Rate	$25.35
Max. Negotiated Rate	$25.35
Rate for Payer: Qualcare PPO/HMO/WC	$25.35

PT ADL SESSION EA 15 MIN

Facility

$169.00

Service Code	HCPCS 97535
Hospital Charge Code	409297535
Hospital Revenue Code	420
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$64.22
Rate for Payer: Aetna Medicare Advantage	$50.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.09
Rate for Payer: Cigna Commercial	$84.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.94
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.35
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$5.34
Rate for Payer: Wellpoint Medicaid Managed Care	$4.80

PT APPL CAST CLUBFOOT

Facility

$869.79

Service Code	HCPCS 29450GP
Hospital Charge Code	422529450
Hospital Revenue Code	420
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$330.52
Rate for Payer: Aetna Medicare Advantage	$260.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$221.80
Rate for Payer: Cigna Commercial	$434.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.15
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$130.47
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$27.49
Rate for Payer: Wellpoint Medicaid Managed Care	$24.70

PT APPL CAST CLUBFOOT

Facility

$869.79

Service Code	HCPCS 29450GP
Hospital Charge Code	422529450
Hospital Revenue Code	420
Min. Negotiated Rate	$130.47
Max. Negotiated Rate	$130.47
Rate for Payer: Qualcare PPO/HMO/WC	$130.47

PT APPL CAST GAUNTLET

Facility

$475.00

Service Code	HCPCS 29085GP
Hospital Charge Code	422529085
Hospital Revenue Code	420
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$180.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.50
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$15.01
Rate for Payer: Wellpoint Medicaid Managed Care	$13.49

PT APPL CAST GAUNTLET

Facility

$475.00

Service Code	HCPCS 29085GP
Hospital Charge Code	422529085
Hospital Revenue Code	420
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$71.25
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

PT APPL CAST LEG LONG BRACE

Facility

$1,360.45

Service Code	HCPCS 29358GP
Hospital Charge Code	422529358
Hospital Revenue Code	420
Min. Negotiated Rate	$204.07
Max. Negotiated Rate	$204.07
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

PT APPL CAST LEG LONG BRACE

Facility

$1,360.45

Service Code	HCPCS 29358GP
Hospital Charge Code	422529358
Hospital Revenue Code	420
Min. Negotiated Rate	$38.64
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$516.97
Rate for Payer: Aetna Medicare Advantage	$408.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$346.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$346.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$346.91
Rate for Payer: Cigna Commercial	$680.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$353.72
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$204.07
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$42.99
Rate for Payer: Wellpoint Medicaid Managed Care	$38.64

PT APPL CAST LEG LONG WALK/AMB

Facility

$1,360.45

Service Code	HCPCS 29355GP
Hospital Charge Code	422529355
Hospital Revenue Code	420
Min. Negotiated Rate	$38.64
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$516.97
Rate for Payer: Aetna Medicare Advantage	$408.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$346.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$346.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$346.91
Rate for Payer: Cigna Commercial	$680.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$353.72
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$204.07
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$42.99
Rate for Payer: Wellpoint Medicaid Managed Care	$38.64

PT APPL CAST LEG LONG WALK/AMB

Facility

$1,360.45

Service Code	HCPCS 29355GP
Hospital Charge Code	422529355
Hospital Revenue Code	420
Min. Negotiated Rate	$204.07
Max. Negotiated Rate	$204.07
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

PT APPL CAST LEG SHORT WALKING

Facility

$1,066.99

Service Code	HCPCS 29425GP
Hospital Charge Code	422529425
Hospital Revenue Code	420
Min. Negotiated Rate	$30.30
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$405.46
Rate for Payer: Aetna Medicare Advantage	$320.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.08
Rate for Payer: Cigna Commercial	$533.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.42
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$160.05
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$33.72
Rate for Payer: Wellpoint Medicaid Managed Care	$30.30

PT APPL CAST LEG SHORT WALKING

Facility

$1,066.99

Service Code	HCPCS 29425GP
Hospital Charge Code	422529425
Hospital Revenue Code	420
Min. Negotiated Rate	$160.05
Max. Negotiated Rate	$160.05
Rate for Payer: Qualcare PPO/HMO/WC	$160.05

PT APPL CAST LONG LEG

Facility

$1,360.45

Service Code	HCPCS 29345GP
Hospital Charge Code	422529345
Hospital Revenue Code	420
Min. Negotiated Rate	$38.64
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$516.97
Rate for Payer: Aetna Medicare Advantage	$408.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$346.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$346.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$346.91
Rate for Payer: Cigna Commercial	$680.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$353.72
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$204.07
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$42.99
Rate for Payer: Wellpoint Medicaid Managed Care	$38.64

PT APPL CAST LONG LEG

Facility

$1,360.45

Service Code	HCPCS 29345GP
Hospital Charge Code	422529345
Hospital Revenue Code	420
Min. Negotiated Rate	$204.07
Max. Negotiated Rate	$204.07
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

PT APPL CAST SHLDER TO HIPS

Facility

$1,360.45

Service Code	HCPCS 29035GP
Hospital Charge Code	422529035
Hospital Revenue Code	420
Min. Negotiated Rate	$204.07
Max. Negotiated Rate	$204.07
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

PT APPL CAST SHLDER TO HIPS

Facility

$1,360.45

Service Code	HCPCS 29035GP
Hospital Charge Code	422529035
Hospital Revenue Code	420
Min. Negotiated Rate	$38.64
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$516.97
Rate for Payer: Aetna Medicare Advantage	$408.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$346.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$346.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$346.91
Rate for Payer: Cigna Commercial	$680.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$353.72
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$204.07
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$42.99
Rate for Payer: Wellpoint Medicaid Managed Care	$38.64

PT APPL CAST SHORT LEG

Facility

$1,360.45

Service Code	HCPCS 29405GP
Hospital Charge Code	422529405
Hospital Revenue Code	420
Min. Negotiated Rate	$38.64
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$516.97
Rate for Payer: Aetna Medicare Advantage	$408.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$346.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$346.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$346.91
Rate for Payer: Cigna Commercial	$680.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$353.72
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$204.07
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$42.99
Rate for Payer: Wellpoint Medicaid Managed Care	$38.64

PT APPL CAST SHORT LEG

Facility

$1,360.45

Service Code	HCPCS 29405GP
Hospital Charge Code	422529405
Hospital Revenue Code	420
Min. Negotiated Rate	$204.07
Max. Negotiated Rate	$204.07
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

PT APPL RISSER JACKET BODY

Facility

$1,360.45

Service Code	HCPCS 29010GP
Hospital Charge Code	422529010
Hospital Revenue Code	420
Min. Negotiated Rate	$38.64
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$516.97
Rate for Payer: Aetna Medicare Advantage	$408.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$346.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$346.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$346.91
Rate for Payer: Cigna Commercial	$680.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$353.72
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$204.07
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$42.99
Rate for Payer: Wellpoint Medicaid Managed Care	$38.64

PT APPL RISSER JACKET BODY

Facility

$1,360.45

Service Code	HCPCS 29010GP
Hospital Charge Code	422529010
Hospital Revenue Code	420
Min. Negotiated Rate	$204.07
Max. Negotiated Rate	$204.07
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

PT APPL SPLINT ARM SHORT DYNAM

Facility

$358.00

Service Code	HCPCS 29126GP
Hospital Charge Code	422529126
Hospital Revenue Code	420
Min. Negotiated Rate	$10.17
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$136.04
Rate for Payer: Aetna Medicare Advantage	$107.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.29
Rate for Payer: Cigna Commercial	$179.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.08
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$53.70
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$11.31
Rate for Payer: Wellpoint Medicaid Managed Care	$10.17

PT APPL SPLINT ARM SHORT DYNAM

Facility

$358.00

Service Code	HCPCS 29126GP
Hospital Charge Code	422529126
Hospital Revenue Code	420
Min. Negotiated Rate	$53.70
Max. Negotiated Rate	$53.70
Rate for Payer: Qualcare PPO/HMO/WC	$53.70

Know your out-of-pocket cost for care.

All Charges