Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PT BIOFEEDBACK

Facility

$236.20

Service Code	HCPCS 90901GP
Hospital Charge Code	422590901
Hospital Revenue Code	420
Min. Negotiated Rate	$35.43
Max. Negotiated Rate	$35.43
Rate for Payer: Qualcare PPO/HMO/WC	$35.43

PT BIOFEEDBACK

Facility

$236.20

Service Code	HCPCS 90901GP
Hospital Charge Code	422590901
Hospital Revenue Code	420
Min. Negotiated Rate	$6.71
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$89.76
Rate for Payer: Aetna Medicare Advantage	$70.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.23
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	$60.23
Rate for Payer: Cigna Commercial	$118.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.41
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.43
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$7.46
Rate for Payer: Wellpoint Medicaid Managed Care	$6.71

PT BIOFEEDBACK W/EMG 1ST 15

Facility

$236.20

Service Code	HCPCS 90912GP
Hospital Charge Code	422590912
Hospital Revenue Code	420
Min. Negotiated Rate	$35.43
Max. Negotiated Rate	$35.43
Rate for Payer: Qualcare PPO/HMO/WC	$35.43

PT BIOFEEDBACK W/EMG 1ST 15

Facility

$236.20

Service Code	HCPCS 90912GP
Hospital Charge Code	422590912
Hospital Revenue Code	420
Min. Negotiated Rate	$6.71
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$89.76
Rate for Payer: Aetna Medicare Advantage	$70.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.23
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	$60.23
Rate for Payer: Cigna Commercial	$118.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.41
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.43
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$7.46
Rate for Payer: Wellpoint Medicaid Managed Care	$6.71

PT BIOFEEDBACK W/EMG ADDL 15 M

Facility

$236.20

Service Code	HCPCS 90913GP
Hospital Charge Code	422590913
Hospital Revenue Code	420
Min. Negotiated Rate	$35.43
Max. Negotiated Rate	$35.43
Rate for Payer: Qualcare PPO/HMO/WC	$35.43

PT BIOFEEDBACK W/EMG ADDL 15 M

Facility

$236.20

Service Code	HCPCS 90913GP
Hospital Charge Code	422590913
Hospital Revenue Code	420
Min. Negotiated Rate	$6.71
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$89.76
Rate for Payer: Aetna Medicare Advantage	$70.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.23
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	$60.23
Rate for Payer: Cigna Commercial	$118.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.41
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.43
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$7.46
Rate for Payer: Wellpoint Medicaid Managed Care	$6.71

PT CASTING/STRAPPING UNLSTD PR

Facility

$869.79

Service Code	HCPCS 29799GP
Hospital Charge Code	422529799
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 CASTING/STRAPPING UNLSTD PR

Facility

$869.79

Service Code	HCPCS 29799GP
Hospital Charge Code	422529799
Hospital Revenue Code	420
Min. Negotiated Rate	$130.47
Max. Negotiated Rate	$130.47
Rate for Payer: Qualcare PPO/HMO/WC	$130.47

PTCA UNSUCESSFUL

Facility

$61,620.70

Service Code	HCPCS C9600
Hospital Charge Code	3668C9600
Hospital Revenue Code	361
Min. Negotiated Rate	$1,750.03
Max. Negotiated Rate	$49,750.44
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,750.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,750.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49,750.44
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,021.38
Rate for Payer: Oxford Commercial	$14,968.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,243.10
Rate for Payer: UnitedHealthcare Commercial	$16,639.00
Rate for Payer: UnitedHealthcare Community & State	$1,947.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1,750.03

PTCA UNSUCESSFUL

Facility

$61,620.70

Service Code	HCPCS C9600
Hospital Charge Code	3668C9600
Hospital Revenue Code	361
Min. Negotiated Rate	$9,243.10
Max. Negotiated Rate	$9,243.10
Rate for Payer: Qualcare PPO/HMO/WC	$9,243.10

PTCA UNSUCESSFUL

Facility

$61,620.70

Service Code	HCPCS C9600
Hospital Charge Code	411039600
Hospital Revenue Code	361
Min. Negotiated Rate	$1,750.03
Max. Negotiated Rate	$49,750.44
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,750.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,750.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49,750.44
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,021.38
Rate for Payer: Oxford Commercial	$14,968.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,243.10
Rate for Payer: UnitedHealthcare Commercial	$16,639.00
Rate for Payer: UnitedHealthcare Community & State	$1,947.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1,750.03

PTCA UNSUCESSFUL

Facility

$61,620.70

Service Code	HCPCS C9600
Hospital Charge Code	5100621U
Hospital Revenue Code	480
Min. Negotiated Rate	$1,750.03
Max. Negotiated Rate	$49,750.44
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,750.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,750.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49,750.44
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,021.38
Rate for Payer: Oxford Commercial	$2,441.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,243.10
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$1,947.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1,750.03

PTCA UNSUCESSFUL

Facility

$61,620.70

Service Code	HCPCS C9600
Hospital Charge Code	5100621U
Hospital Revenue Code	480
Min. Negotiated Rate	$9,243.10
Max. Negotiated Rate	$9,243.10
Rate for Payer: Qualcare PPO/HMO/WC	$9,243.10

PTCA UNSUCESSFUL

Facility

$61,620.70

Service Code	HCPCS C9600
Hospital Charge Code	411039600
Hospital Revenue Code	361
Min. Negotiated Rate	$9,243.10
Max. Negotiated Rate	$9,243.10
Rate for Payer: Qualcare PPO/HMO/WC	$9,243.10

PT CHKOUT ORTH/PROS USE EA 15M

Facility

$259.00

Service Code	HCPCS 97763GP
Hospital Charge Code	9100140
Hospital Revenue Code	420
Min. Negotiated Rate	$38.85
Max. Negotiated Rate	$38.85
Rate for Payer: Qualcare PPO/HMO/WC	$38.85

PT CHKOUT ORTH/PROS USE EA 15M

Facility

$259.00

Service Code	HCPCS 97763GP
Hospital Charge Code	9100140
Hospital Revenue Code	420
Min. Negotiated Rate	$7.36
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$98.42
Rate for Payer: Aetna Medicare Advantage	$77.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.05
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	$66.05
Rate for Payer: Cigna Commercial	$129.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.34
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.85
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$8.18
Rate for Payer: Wellpoint Medicaid Managed Care	$7.36

PT COGNITIV FUNC DIR PT 1ST 15

Facility

$141.00

Service Code	HCPCS 97129GP
Hospital Charge Code	422597129
Hospital Revenue Code	420
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$53.58
Rate for Payer: Aetna Medicare Advantage	$42.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.95
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	$35.95
Rate for Payer: Cigna Commercial	$70.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.66
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.15
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$4.46
Rate for Payer: Wellpoint Medicaid Managed Care	$4.00

PT COGNITIV FUNC DIR PT 1ST 15

Facility

$141.00

Service Code	HCPCS 97129GP
Hospital Charge Code	422597129
Hospital Revenue Code	420
Min. Negotiated Rate	$21.15
Max. Negotiated Rate	$21.15
Rate for Payer: Qualcare PPO/HMO/WC	$21.15

PT COGNITIV FUNC DIR PT ADD 15

Facility

$117.30

Service Code	HCPCS 97130GP
Hospital Charge Code	422597130
Hospital Revenue Code	420
Min. Negotiated Rate	$3.33
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$44.57
Rate for Payer: Aetna Medicare Advantage	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.91
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	$29.91
Rate for Payer: Cigna Commercial	$58.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.50
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.59
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$3.71
Rate for Payer: Wellpoint Medicaid Managed Care	$3.33

PT COGNITIV FUNC DIR PT ADD 15

Facility

$117.30

Service Code	HCPCS 97130GP
Hospital Charge Code	422597130
Hospital Revenue Code	420
Min. Negotiated Rate	$17.59
Max. Negotiated Rate	$17.59
Rate for Payer: Qualcare PPO/HMO/WC	$17.59

PT COMMUNITY/WORK REINTERGRA

Facility

$126.00

Service Code	HCPCS 97537
Hospital Charge Code	1008040
Hospital Revenue Code	420
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$47.88
Rate for Payer: Aetna Medicare Advantage	$37.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.13
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	$32.13
Rate for Payer: Cigna Commercial	$63.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.76
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.90
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$3.98
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

PT COMMUNITY/WORK REINTERGRA

Facility

$126.00

Service Code	HCPCS 97537
Hospital Charge Code	1008040
Hospital Revenue Code	420
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$18.90
Rate for Payer: Qualcare PPO/HMO/WC	$18.90

PT COMMUNITY/WORK REINTERGRATI

Facility

$161.00

Service Code	HCPCS 97537GP
Hospital Charge Code	9107001
Hospital Revenue Code	420
Min. Negotiated Rate	$24.15
Max. Negotiated Rate	$24.15
Rate for Payer: Qualcare PPO/HMO/WC	$24.15

PT COMMUNITY/WORK REINTERGRATI

Facility

$161.00

Service Code	HCPCS 97537GP
Hospital Charge Code	9107001
Hospital Revenue Code	420
Min. Negotiated Rate	$4.57
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$61.18
Rate for Payer: Aetna Medicare Advantage	$48.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.05
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	$41.05
Rate for Payer: Cigna Commercial	$80.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.86
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.15
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$5.09
Rate for Payer: Wellpoint Medicaid Managed Care	$4.57

PT COMM/WORK REINTEG EA 15 MIN

Facility

$161.00

Service Code	HCPCS 97537GP
Hospital Charge Code	422597537
Hospital Revenue Code	420
Min. Negotiated Rate	$4.57
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$61.18
Rate for Payer: Aetna Medicare Advantage	$48.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.05
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	$41.05
Rate for Payer: Cigna Commercial	$80.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.86
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.15
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$5.09
Rate for Payer: Wellpoint Medicaid Managed Care	$4.57

Know your out-of-pocket cost for care.

All Charges