Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PT LOW FREQ NON CONT/THERM PER

Facility

$1,105.55

Service Code	HCPCS 97610GP
Hospital Charge Code	422597610
Hospital Revenue Code	420
Min. Negotiated Rate	$165.83
Max. Negotiated Rate	$165.83
Rate for Payer: Qualcare PPO/HMO/WC	$165.83

PT MANUAL THERAPY EA 15 MIN

Facility

$159.00

Service Code	HCPCS 97140GP
Hospital Charge Code	9100155
Hospital Revenue Code	420
Min. Negotiated Rate	$23.85
Max. Negotiated Rate	$23.85
Rate for Payer: Qualcare PPO/HMO/WC	$23.85

PT MANUAL THERAPY EA 15 MIN

Facility

$159.00

Service Code	HCPCS 97140GP
Hospital Charge Code	9100155
Hospital Revenue Code	420
Min. Negotiated Rate	$4.52
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$60.42
Rate for Payer: Aetna Medicare Advantage	$47.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.55
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	$40.55
Rate for Payer: Cigna Commercial	$79.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.34
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.85
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$5.02
Rate for Payer: Wellpoint Medicaid Managed Care	$4.52

PT MANUAL THRPY EA 15 MIN

Facility

$286.00

Service Code	HCPCS 97140GP
Hospital Charge Code	422597140
Hospital Revenue Code	420
Min. Negotiated Rate	$42.90
Max. Negotiated Rate	$42.90
Rate for Payer: Qualcare PPO/HMO/WC	$42.90

PT MANUAL THRPY EA 15 MIN

Facility

$286.00

Service Code	HCPCS 97140GP
Hospital Charge Code	422597140
Hospital Revenue Code	420
Min. Negotiated Rate	$8.12
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$108.68
Rate for Payer: Aetna Medicare Advantage	$85.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.93
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	$72.93
Rate for Payer: Cigna Commercial	$143.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.36
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.90
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$8.12

PT MASSAGE EA 15 MIN

Facility

$328.00

Service Code	HCPCS 97124GP
Hospital Charge Code	422597124
Hospital Revenue Code	420
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$124.64
Rate for Payer: Aetna Medicare Advantage	$98.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.64
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	$83.64
Rate for Payer: Cigna Commercial	$164.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.28
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.20
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$10.36
Rate for Payer: Wellpoint Medicaid Managed Care	$9.32

PT MASSAGE EA 15 MIN

Facility

$328.00

Service Code	HCPCS 97124GP
Hospital Charge Code	422597124
Hospital Revenue Code	420
Min. Negotiated Rate	$49.20
Max. Negotiated Rate	$49.20
Rate for Payer: Qualcare PPO/HMO/WC	$49.20

PT MASSAGE THERAPY EA 15 MIN

Facility

$328.00

Service Code	HCPCS 97124GP
Hospital Charge Code	9100075
Hospital Revenue Code	420
Min. Negotiated Rate	$49.20
Max. Negotiated Rate	$49.20
Rate for Payer: Qualcare PPO/HMO/WC	$49.20

PT MASSAGE THERAPY EA 15 MIN

Facility

$328.00

Service Code	HCPCS 97124GP
Hospital Charge Code	9100075
Hospital Revenue Code	420
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$124.64
Rate for Payer: Aetna Medicare Advantage	$98.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.64
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	$83.64
Rate for Payer: Cigna Commercial	$164.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.28
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.20
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$10.36
Rate for Payer: Wellpoint Medicaid Managed Care	$9.32

PT MODALITY ELC STM WOUND CARE

Facility

$91.00

Service Code	HCPCS G0281GP
Hospital Charge Code	9100165
Hospital Revenue Code	420
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$34.58
Rate for Payer: Aetna Medicare Advantage	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.20
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	$23.20
Rate for Payer: Cigna Commercial	$45.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.66
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$2.88
Rate for Payer: Wellpoint Medicaid Managed Care	$2.58

PT MODALITY ELC STM WOUND CARE

Facility

$91.00

Service Code	HCPCS G0281GP
Hospital Charge Code	9100165
Hospital Revenue Code	420
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$13.65
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

PT NEG PRESSURE WOUND <=50 CM

Facility

$2,127.92

Service Code	HCPCS 97607GP
Hospital Charge Code	422597607
Hospital Revenue Code	420
Min. Negotiated Rate	$60.43
Max. Negotiated Rate	$1,063.96
Rate for Payer: Aetna Commercial	$808.61
Rate for Payer: Aetna Medicare Advantage	$638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$542.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$542.62
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	$542.62
Rate for Payer: Cigna Commercial	$1,063.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$553.26
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$319.19
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$67.24
Rate for Payer: Wellpoint Medicaid Managed Care	$60.43

PT NEG PRESSURE WOUND <=50 CM

Facility

$2,127.92

Service Code	HCPCS 97607GP
Hospital Charge Code	422597607
Hospital Revenue Code	420
Min. Negotiated Rate	$319.19
Max. Negotiated Rate	$319.19
Rate for Payer: Qualcare PPO/HMO/WC	$319.19

PT NEG PRESSURE WOUND >50 CM

Facility

$2,127.92

Service Code	HCPCS 97608GP
Hospital Charge Code	422597608
Hospital Revenue Code	420
Min. Negotiated Rate	$319.19
Max. Negotiated Rate	$319.19
Rate for Payer: Qualcare PPO/HMO/WC	$319.19

PT NEG PRESSURE WOUND >50 CM

Facility

$2,127.92

Service Code	HCPCS 97608GP
Hospital Charge Code	422597608
Hospital Revenue Code	420
Min. Negotiated Rate	$60.43
Max. Negotiated Rate	$1,063.96
Rate for Payer: Aetna Commercial	$808.61
Rate for Payer: Aetna Medicare Advantage	$638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$542.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$542.62
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	$542.62
Rate for Payer: Cigna Commercial	$1,063.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$553.26
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$319.19
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$67.24
Rate for Payer: Wellpoint Medicaid Managed Care	$60.43

PT NEG PRESS WND THER DME <=50

Facility

$1,105.55

Service Code	HCPCS 97605GP
Hospital Charge Code	422597605
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 NEG PRESS WND THER DME <=50

Facility

$1,105.55

Service Code	HCPCS 97605GP
Hospital Charge Code	422597605
Hospital Revenue Code	420
Min. Negotiated Rate	$165.83
Max. Negotiated Rate	$165.83
Rate for Payer: Qualcare PPO/HMO/WC	$165.83

PT NEG PRESS WND THER DME >50

Facility

$2,127.92

Service Code	HCPCS 97606GP
Hospital Charge Code	422597606
Hospital Revenue Code	420
Min. Negotiated Rate	$60.43
Max. Negotiated Rate	$1,063.96
Rate for Payer: Aetna Commercial	$808.61
Rate for Payer: Aetna Medicare Advantage	$638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$542.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$542.62
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	$542.62
Rate for Payer: Cigna Commercial	$1,063.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$553.26
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$319.19
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$67.24
Rate for Payer: Wellpoint Medicaid Managed Care	$60.43

PT NEG PRESS WND THER DME >50

Facility

$2,127.92

Service Code	HCPCS 97606GP
Hospital Charge Code	422597606
Hospital Revenue Code	420
Min. Negotiated Rate	$319.19
Max. Negotiated Rate	$319.19
Rate for Payer: Qualcare PPO/HMO/WC	$319.19

PT NEUROMUSCULAR RE-EDUCATION

Facility

$186.00

Service Code	HCPCS 97112
Hospital Charge Code	409297112
Hospital Revenue Code	420
Min. Negotiated Rate	$5.28
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$70.68
Rate for Payer: Aetna Medicare Advantage	$55.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.43
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	$47.43
Rate for Payer: Cigna Commercial	$93.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.36
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.90
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$5.88
Rate for Payer: Wellpoint Medicaid Managed Care	$5.28

PT NEUROMUSCULAR RE-EDUCATION

Facility

$314.00

Service Code	HCPCS 97112GP
Hospital Charge Code	9100080
Hospital Revenue Code	420
Min. Negotiated Rate	$47.10
Max. Negotiated Rate	$47.10
Rate for Payer: Qualcare PPO/HMO/WC	$47.10

PT NEUROMUSCULAR RE-EDUCATION

Facility

$314.00

Service Code	HCPCS 97112GP
Hospital Charge Code	9100080
Hospital Revenue Code	420
Min. Negotiated Rate	$8.92
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$119.32
Rate for Payer: Aetna Medicare Advantage	$94.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.07
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	$80.07
Rate for Payer: Cigna Commercial	$157.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.64
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$47.10
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$9.92
Rate for Payer: Wellpoint Medicaid Managed Care	$8.92

PT NEUROMUSCULAR RE-EDUCATION

Facility

$186.00

Service Code	HCPCS 97112
Hospital Charge Code	409297112
Hospital Revenue Code	420
Min. Negotiated Rate	$27.90
Max. Negotiated Rate	$27.90
Rate for Payer: Qualcare PPO/HMO/WC	$27.90

PT NEUROMUSCUL RE-ED EA 15 MIN

Facility

$314.00

Service Code	HCPCS 97112GP
Hospital Charge Code	422597112
Hospital Revenue Code	420
Min. Negotiated Rate	$47.10
Max. Negotiated Rate	$47.10
Rate for Payer: Qualcare PPO/HMO/WC	$47.10

PT NEUROMUSCUL RE-ED EA 15 MIN

Facility

$314.00

Service Code	HCPCS 97112GP
Hospital Charge Code	422597112
Hospital Revenue Code	420
Min. Negotiated Rate	$8.92
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$119.32
Rate for Payer: Aetna Medicare Advantage	$94.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.07
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	$80.07
Rate for Payer: Cigna Commercial	$157.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.64
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$47.10
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$9.92
Rate for Payer: Wellpoint Medicaid Managed Care	$8.92

Know your out-of-pocket cost for care.

All Charges