Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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	$24.15
Max. Negotiated Rate	$24.15
Rate for Payer: Qualcare PPO/HMO/WC	$24.15

PT CONTRAST BATH EA 15 MIN

Facility

$106.00

Service Code	HCPCS 97034GP
Hospital Charge Code	422597034
Hospital Revenue Code	420
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$40.28
Rate for Payer: Aetna Medicare Advantage	$31.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.03
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	$27.03
Rate for Payer: Cigna Commercial	$53.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.56
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.90
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$3.35
Rate for Payer: Wellpoint Medicaid Managed Care	$3.01

PT CONTRAST BATH EA 15 MIN

Facility

$106.00

Service Code	HCPCS 97034GP
Hospital Charge Code	422597034
Hospital Revenue Code	420
Min. Negotiated Rate	$15.90
Max. Negotiated Rate	$15.90
Rate for Payer: Qualcare PPO/HMO/WC	$15.90

PT CONTRAST BATH EACH 15 MIN

Facility

$63.00

Service Code	HCPCS 97034GP
Hospital Charge Code	1008185
Hospital Revenue Code	420
Min. Negotiated Rate	$9.45
Max. Negotiated Rate	$9.45
Rate for Payer: Qualcare PPO/HMO/WC	$9.45

PT CONTRAST BATH EACH 15 MIN

Facility

$63.00

Service Code	HCPCS 97034GP
Hospital Charge Code	1008185
Hospital Revenue Code	420
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$23.94
Rate for Payer: Aetna Medicare Advantage	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.07
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	$16.07
Rate for Payer: Cigna Commercial	$31.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.38
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.45
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$1.99
Rate for Payer: Wellpoint Medicaid Managed Care	$1.79

PT CONTRAST BATH EACH 15 MIN

Facility

$106.00

Service Code	HCPCS 97034
Hospital Charge Code	9108045
Hospital Revenue Code	420
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$40.28
Rate for Payer: Aetna Medicare Advantage	$31.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.03
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	$27.03
Rate for Payer: Cigna Commercial	$53.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.56
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.90
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$3.35
Rate for Payer: Wellpoint Medicaid Managed Care	$3.01

PT CONTRAST BATH EACH 15 MIN

Facility

$106.00

Service Code	HCPCS 97034
Hospital Charge Code	9108045
Hospital Revenue Code	420
Min. Negotiated Rate	$15.90
Max. Negotiated Rate	$15.90
Rate for Payer: Qualcare PPO/HMO/WC	$15.90

PT-CONTRAST BATHS 15 MIN

Facility

$106.00

Service Code	HCPCS 97034GP
Hospital Charge Code	9109045
Hospital Revenue Code	420
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$40.28
Rate for Payer: Aetna Medicare Advantage	$31.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.03
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	$27.03
Rate for Payer: Cigna Commercial	$53.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.56
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.90
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$3.35
Rate for Payer: Wellpoint Medicaid Managed Care	$3.01

PT-CONTRAST BATHS 15 MIN

Facility

$106.00

Service Code	HCPCS 97034GP
Hospital Charge Code	9109045
Hospital Revenue Code	420
Min. Negotiated Rate	$15.90
Max. Negotiated Rate	$15.90
Rate for Payer: Qualcare PPO/HMO/WC	$15.90

PT DEBR NON-SELECTIVE W/O ANES

Facility

$1,105.55

Service Code	HCPCS 97602GP
Hospital Charge Code	422597602
Hospital Revenue Code	420
Min. Negotiated Rate	$165.83
Max. Negotiated Rate	$165.83
Rate for Payer: Qualcare PPO/HMO/WC	$165.83

PT DEBR NON-SELECTIVE W/O ANES

Facility

$1,105.55

Service Code	HCPCS 97602GP
Hospital Charge Code	422597602
Hospital Revenue Code	420
Min. Negotiated Rate	$31.40
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$420.11
Rate for Payer: Aetna Medicare Advantage	$331.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$281.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$281.92
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	$281.92
Rate for Payer: Cigna Commercial	$552.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.44
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.83
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$34.94
Rate for Payer: Wellpoint Medicaid Managed Care	$31.40

PT DEBR/REM DEV TISS <20 SQ CM

Facility

$1,105.55

Service Code	HCPCS 97597GP
Hospital Charge Code	422597597
Hospital Revenue Code	420
Min. Negotiated Rate	$165.83
Max. Negotiated Rate	$165.83
Rate for Payer: Qualcare PPO/HMO/WC	$165.83

PT DEBR/REM DEV TISS <20 SQ CM

Facility

$1,105.55

Service Code	HCPCS 97597GP
Hospital Charge Code	422597597
Hospital Revenue Code	420
Min. Negotiated Rate	$31.40
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$420.11
Rate for Payer: Aetna Medicare Advantage	$331.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$281.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$281.92
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	$281.92
Rate for Payer: Cigna Commercial	$552.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.44
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.83
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$34.94
Rate for Payer: Wellpoint Medicaid Managed Care	$31.40

PT DEBR/REM TISS ADDL 20 SQ CM

Facility

$1,105.55

Service Code	HCPCS 97598GP
Hospital Charge Code	422597598
Hospital Revenue Code	420
Min. Negotiated Rate	$31.40
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$420.11
Rate for Payer: Aetna Medicare Advantage	$331.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$281.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$281.92
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	$281.92
Rate for Payer: Cigna Commercial	$552.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.44
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.83
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$34.94
Rate for Payer: Wellpoint Medicaid Managed Care	$31.40

PT DEBR/REM TISS ADDL 20 SQ CM

Facility

$1,105.55

Service Code	HCPCS 97598GP
Hospital Charge Code	422597598
Hospital Revenue Code	420
Min. Negotiated Rate	$165.83
Max. Negotiated Rate	$165.83
Rate for Payer: Qualcare PPO/HMO/WC	$165.83

PT DIATHERMY THRPY

Facility

$120.75

Service Code	HCPCS 97024GP
Hospital Charge Code	422597024
Hospital Revenue Code	420
Min. Negotiated Rate	$3.43
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$45.88
Rate for Payer: Aetna Medicare Advantage	$36.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.79
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	$30.79
Rate for Payer: Cigna Commercial	$60.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.39
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.11
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$3.82
Rate for Payer: Wellpoint Medicaid Managed Care	$3.43

PT DIATHERMY THRPY

Facility

$120.75

Service Code	HCPCS 97024GP
Hospital Charge Code	422597024
Hospital Revenue Code	420
Min. Negotiated Rate	$18.11
Max. Negotiated Rate	$18.11
Rate for Payer: Qualcare PPO/HMO/WC	$18.11

PT ELEC STIM MANUAL EA 15 MIN

Facility

$247.00

Service Code	HCPCS 97032GP
Hospital Charge Code	9000266
Hospital Revenue Code	420
Min. Negotiated Rate	$37.05
Max. Negotiated Rate	$37.05
Rate for Payer: Qualcare PPO/HMO/WC	$37.05

PT ELEC STIM MANUAL EA 15 MIN

Facility

$247.00

Service Code	HCPCS 97032GP
Hospital Charge Code	9000266
Hospital Revenue Code	420
Min. Negotiated Rate	$7.01
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$93.86
Rate for Payer: Aetna Medicare Advantage	$74.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.98
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	$62.98
Rate for Payer: Cigna Commercial	$123.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.22
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.05
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$7.81
Rate for Payer: Wellpoint Medicaid Managed Care	$7.01

PT ELECTRIC STIM UNATTENDED

Facility

$91.25

Service Code	HCPCS G0283GP
Hospital Charge Code	9100177
Hospital Revenue Code	420
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$13.69
Rate for Payer: Qualcare PPO/HMO/WC	$13.69

PT ELECTRIC STIM UNATTENDED

Facility

$91.25

Service Code	HCPCS G0283GP
Hospital Charge Code	9100177
Hospital Revenue Code	420
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$34.67
Rate for Payer: Aetna Medicare Advantage	$27.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.27
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	$23.27
Rate for Payer: Cigna Commercial	$45.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.73
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.69
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$2.88
Rate for Payer: Wellpoint Medicaid Managed Care	$2.59

PT E-STIM ATTENDED EA 15 MIN

Facility

$247.00

Service Code	HCPCS 97032GP
Hospital Charge Code	422597032
Hospital Revenue Code	420
Min. Negotiated Rate	$37.05
Max. Negotiated Rate	$37.05
Rate for Payer: Qualcare PPO/HMO/WC	$37.05

PT E-STIM ATTENDED EA 15 MIN

Facility

$247.00

Service Code	HCPCS 97032GP
Hospital Charge Code	422597032
Hospital Revenue Code	420
Min. Negotiated Rate	$7.01
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$93.86
Rate for Payer: Aetna Medicare Advantage	$74.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.98
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	$62.98
Rate for Payer: Cigna Commercial	$123.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.22
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.05
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$7.81
Rate for Payer: Wellpoint Medicaid Managed Care	$7.01

PT E-STIM UNATTENDED

Facility

$206.00

Service Code	HCPCS 97014GP
Hospital Charge Code	422597014
Hospital Revenue Code	420
Min. Negotiated Rate	$30.90
Max. Negotiated Rate	$30.90
Rate for Payer: Qualcare PPO/HMO/WC	$30.90

PT E-STIM UNATTENDED

Facility

$206.00

Service Code	HCPCS 97014GP
Hospital Charge Code	422597014
Hospital Revenue Code	420
Min. Negotiated Rate	$5.85
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$78.28
Rate for Payer: Aetna Medicare Advantage	$61.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.53
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	$52.53
Rate for Payer: Cigna Commercial	$103.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.56
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.90
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$6.51
Rate for Payer: Wellpoint Medicaid Managed Care	$5.85

Know your out-of-pocket cost for care.

All Charges