Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PT FUNC ACTIVITY THER 15 MIN

Facility

$182.00

Service Code	HCPCS 97530
Hospital Charge Code	409297530
Hospital Revenue Code	420
Min. Negotiated Rate	$27.30
Max. Negotiated Rate	$27.30
Rate for Payer: Qualcare PPO/HMO/WC	$27.30

PT FUNC ACTIVITY THER 15 MIN

Facility

$182.00

Service Code	HCPCS 97530
Hospital Charge Code	409297530
Hospital Revenue Code	420
Min. Negotiated Rate	$5.17
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$69.16
Rate for Payer: Aetna Medicare Advantage	$54.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.41
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	$46.41
Rate for Payer: Cigna Commercial	$91.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.32
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.30
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$5.75
Rate for Payer: Wellpoint Medicaid Managed Care	$5.17

PT FUNC ACTIVITY THER 15 MIN

Facility

$245.00

Service Code	HCPCS 97530GP
Hospital Charge Code	9001019
Hospital Revenue Code	420
Min. Negotiated Rate	$6.96
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$93.10
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
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	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.70
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$7.74
Rate for Payer: Wellpoint Medicaid Managed Care	$6.96

PT GAIT TRAINING EA 15 MIN

Facility

$412.61

Service Code	HCPCS 97116GP
Hospital Charge Code	422597116
Hospital Revenue Code	420
Min. Negotiated Rate	$61.89
Max. Negotiated Rate	$61.89
Rate for Payer: Qualcare PPO/HMO/WC	$61.89

PT GAIT TRAINING EA 15 MIN

Facility

$364.00

Service Code	HCPCS 97116GP
Hospital Charge Code	9000092
Hospital Revenue Code	420
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$138.32
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
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	$92.82
Rate for Payer: Cigna Commercial	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.64
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.60
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$11.50
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

PT GAIT TRAINING EA 15 MIN

Facility

$157.00

Service Code	HCPCS 97116
Hospital Charge Code	409297116
Hospital Revenue Code	420
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$59.66
Rate for Payer: Aetna Medicare Advantage	$47.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.03
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	$40.03
Rate for Payer: Cigna Commercial	$78.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.82
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.55
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$4.96
Rate for Payer: Wellpoint Medicaid Managed Care	$4.46

PT GAIT TRAINING EA 15 MIN

Facility

$412.61

Service Code	HCPCS 97116GP
Hospital Charge Code	422597116
Hospital Revenue Code	420
Min. Negotiated Rate	$11.72
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$156.79
Rate for Payer: Aetna Medicare Advantage	$123.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.22
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	$105.22
Rate for Payer: Cigna Commercial	$206.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.28
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.89
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$13.04
Rate for Payer: Wellpoint Medicaid Managed Care	$11.72

PT GAIT TRAINING EA 15 MIN

Facility

$364.00

Service Code	HCPCS 97116GP
Hospital Charge Code	9000092
Hospital Revenue Code	420
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

PT GAIT TRAINING EA 15 MIN

Facility

$157.00

Service Code	HCPCS 97116
Hospital Charge Code	409297116
Hospital Revenue Code	420
Min. Negotiated Rate	$23.55
Max. Negotiated Rate	$23.55
Rate for Payer: Qualcare PPO/HMO/WC	$23.55

PT GAIT TRAINING EACH 15 MIN

Facility

$364.00

Service Code	HCPCS 97116GP
Hospital Charge Code	1008250
Hospital Revenue Code	420
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

PT GAIT TRAINING EACH 15 MIN

Facility

$364.00

Service Code	HCPCS 97116GP
Hospital Charge Code	1008250
Hospital Revenue Code	420
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$138.32
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
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	$92.82
Rate for Payer: Cigna Commercial	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.64
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.60
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$11.50
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

PTH INTACT

Facility

$667.59

Service Code	HCPCS 83970
Hospital Charge Code	39900116
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

PTH INTACT

Facility

$390.00

Service Code	HCPCS 83970
Hospital Charge Code	39708034A
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PTH INTACT

Facility

$390.00

Service Code	HCPCS 83970
Hospital Charge Code	39708034A
Hospital Revenue Code	306
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$112.28
Rate for Payer: Aetna Medicare Advantage	$133.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$41.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$89.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.74
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$41.28
Rate for Payer: Clover Medicare Advantage	$39.22
Rate for Payer: EmblemHealth Commercial	$123.84
Rate for Payer: Humana Medicare Advantage	$42.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$41.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$33.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$41.28
Rate for Payer: Wellcare Medicare Advantage	$41.28
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

PTH INTACT

Facility

$667.59

Service Code	HCPCS 83970
Hospital Charge Code	39900116
Hospital Revenue Code	301
Min. Negotiated Rate	$18.96
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$112.28
Rate for Payer: Aetna Medicare Advantage	$133.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$41.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$89.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.74
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$41.28
Rate for Payer: Clover Medicare Advantage	$39.22
Rate for Payer: EmblemHealth Commercial	$123.84
Rate for Payer: Humana Medicare Advantage	$42.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$41.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$33.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$41.28
Rate for Payer: Wellcare Medicare Advantage	$41.28
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

PT HOT/COLD PACK

Facility

$93.71

Service Code	HCPCS 97010GP
Hospital Charge Code	422597010
Hospital Revenue Code	420
Min. Negotiated Rate	$2.66
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$35.61
Rate for Payer: Aetna Medicare Advantage	$28.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.90
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	$23.90
Rate for Payer: Cigna Commercial	$46.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.36
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.06
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$2.96
Rate for Payer: Wellpoint Medicaid Managed Care	$2.66

PT HOT/COLD PACK

Facility

$93.71

Service Code	HCPCS 97010GP
Hospital Charge Code	422597010
Hospital Revenue Code	420
Min. Negotiated Rate	$14.06
Max. Negotiated Rate	$14.06
Rate for Payer: Qualcare PPO/HMO/WC	$14.06

PTH RELATED PROTEIN

Facility

$1,422.00

Service Code	HCPCS 83519
Hospital Charge Code	38472800
Hospital Revenue Code	301
Min. Negotiated Rate	$12.64
Max. Negotiated Rate	$711.00
Rate for Payer: Aetna Commercial	$50.05
Rate for Payer: Aetna Medicare Advantage	$59.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.75
Rate for Payer: Cigna Commercial	$711.00
Rate for Payer: Cigna Medicare Advantage	$18.40
Rate for Payer: Clover Medicare Advantage	$17.48
Rate for Payer: EmblemHealth Commercial	$55.20
Rate for Payer: Humana Medicare Advantage	$18.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.72
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$213.30
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.40
Rate for Payer: Wellcare Medicare Advantage	$18.40
Rate for Payer: Wellpoint Medicaid Managed Care	$40.38

PTH RELATED PROTEIN

Facility

$1,422.00

Service Code	HCPCS 83519
Hospital Charge Code	38472800
Hospital Revenue Code	301
Min. Negotiated Rate	$213.30
Max. Negotiated Rate	$213.30
Rate for Payer: Qualcare PPO/HMO/WC	$213.30

PTH,RELATED PROTEIN

Facility

$390.00

Service Code	HCPCS 83519
Hospital Charge Code	39900334
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$50.05
Rate for Payer: Aetna Medicare Advantage	$59.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.75
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$18.40
Rate for Payer: Clover Medicare Advantage	$17.48
Rate for Payer: EmblemHealth Commercial	$55.20
Rate for Payer: Humana Medicare Advantage	$18.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.40
Rate for Payer: Wellcare Medicare Advantage	$18.40
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

PTH,RELATED PROTEIN

Facility

$390.00

Service Code	HCPCS 83519
Hospital Charge Code	39900334
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PT HUBBARD TANK EACH 15 MIN

Facility

$96.00

Service Code	HCPCS 97036GP
Hospital Charge Code	9108065
Hospital Revenue Code	420
Min. Negotiated Rate	$2.73
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	$69.00
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	$24.96
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.40
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$3.03
Rate for Payer: Wellpoint Medicaid Managed Care	$2.73

PT HUBBARD TANK EACH 15 MIN

Facility

$96.00

Service Code	HCPCS 97036GP
Hospital Charge Code	9108065
Hospital Revenue Code	420
Min. Negotiated Rate	$14.40
Max. Negotiated Rate	$14.40
Rate for Payer: Qualcare PPO/HMO/WC	$14.40

PT HUBBARD TANK EACH 15 MIN

Facility

$96.00

Service Code	HCPCS 97036GP
Hospital Charge Code	1008200
Hospital Revenue Code	420
Min. Negotiated Rate	$2.73
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	$69.00
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	$24.96
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.40
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$3.03
Rate for Payer: Wellpoint Medicaid Managed Care	$2.73

PT HUBBARD TANK EACH 15 MIN

Facility

$96.00

Service Code	HCPCS 97036GP
Hospital Charge Code	1008200
Hospital Revenue Code	420
Min. Negotiated Rate	$14.40
Max. Negotiated Rate	$14.40
Rate for Payer: Qualcare PPO/HMO/WC	$14.40

Know your out-of-pocket cost for care.

All Charges