Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PT ORTHO MGT/FIT/TRN EA 15 MIN

Facility

$134.50

Service Code	HCPCS 97760GP
Hospital Charge Code	422597760
Hospital Revenue Code	420
Min. Negotiated Rate	$20.18
Max. Negotiated Rate	$20.18
Rate for Payer: Qualcare PPO/HMO/WC	$20.18

PT ORTHO MGT/FIT/TRN EA 15 MIN

Facility

$134.50

Service Code	HCPCS 97760GP
Hospital Charge Code	422597760
Hospital Revenue Code	420
Min. Negotiated Rate	$3.82
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$51.11
Rate for Payer: Aetna Medicare Advantage	$40.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.30
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	$34.30
Rate for Payer: Cigna Commercial	$67.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.97
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.18
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$4.25
Rate for Payer: Wellpoint Medicaid Managed Care	$3.82

PT ORTH/PROST MGMT EA 15 MIN

Facility

$299.00

Service Code	HCPCS 97763GP
Hospital Charge Code	422597763
Hospital Revenue Code	420
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$44.85
Rate for Payer: Qualcare PPO/HMO/WC	$44.85

PT ORTH/PROST MGMT EA 15 MIN

Facility

$299.00

Service Code	HCPCS 97763GP
Hospital Charge Code	422597763
Hospital Revenue Code	420
Min. Negotiated Rate	$8.49
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$113.62
Rate for Payer: Aetna Medicare Advantage	$89.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.25
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	$76.25
Rate for Payer: Cigna Commercial	$149.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.74
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.85
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$9.45
Rate for Payer: Wellpoint Medicaid Managed Care	$8.49

PT PARAFFIN BATH THRPY

Facility

$266.00

Service Code	HCPCS 97018GP
Hospital Charge Code	422597018
Hospital Revenue Code	420
Min. Negotiated Rate	$7.55
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$101.08
Rate for Payer: Aetna Medicare Advantage	$79.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.83
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	$67.83
Rate for Payer: Cigna Commercial	$133.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.16
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.90
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$8.41
Rate for Payer: Wellpoint Medicaid Managed Care	$7.55

PT PARAFFIN BATH THRPY

Facility

$266.00

Service Code	HCPCS 97018GP
Hospital Charge Code	422597018
Hospital Revenue Code	420
Min. Negotiated Rate	$39.90
Max. Negotiated Rate	$39.90
Rate for Payer: Qualcare PPO/HMO/WC	$39.90

PT PERFORMANCE TEST EA 15 MIN

Facility

$186.15

Service Code	HCPCS 97750GP
Hospital Charge Code	422597750
Hospital Revenue Code	420
Min. Negotiated Rate	$27.92
Max. Negotiated Rate	$27.92
Rate for Payer: Qualcare PPO/HMO/WC	$27.92

PT PERFORMANCE TEST EA 15 MIN

Facility

$186.15

Service Code	HCPCS 97750GP
Hospital Charge Code	422597750
Hospital Revenue Code	420
Min. Negotiated Rate	$5.29
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$70.74
Rate for Payer: Aetna Medicare Advantage	$55.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.47
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	$47.47
Rate for Payer: Cigna Commercial	$93.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.40
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.92
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$5.88
Rate for Payer: Wellpoint Medicaid Managed Care	$5.29

PT PHYSICAL MEDICINE PROCEDURE

Facility

$161.00

Service Code	HCPCS 97139GP
Hospital Charge Code	422597139
Hospital Revenue Code	420
Min. Negotiated Rate	$24.15
Max. Negotiated Rate	$24.15
Rate for Payer: Qualcare PPO/HMO/WC	$24.15

PT PHYSICAL MEDICINE PROCEDURE

Facility

$161.00

Service Code	HCPCS 97139GP
Hospital Charge Code	422597139
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 PROSTHETIC TRAIN EA 15 MIN

Facility

$130.50

Service Code	HCPCS 97761GP
Hospital Charge Code	422597761
Hospital Revenue Code	420
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$49.59
Rate for Payer: Aetna Medicare Advantage	$39.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.28
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	$33.28
Rate for Payer: Cigna Commercial	$65.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.93
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.57
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$4.12
Rate for Payer: Wellpoint Medicaid Managed Care	$3.71

PT PROSTHETIC TRAIN EA 15 MIN

Facility

$130.50

Service Code	HCPCS 97761GP
Hospital Charge Code	422597761
Hospital Revenue Code	420
Min. Negotiated Rate	$19.57
Max. Negotiated Rate	$19.57
Rate for Payer: Qualcare PPO/HMO/WC	$19.57

PT PROSTH TRAIN UE/LE/15 MIN 1

Facility

$134.50

Service Code	HCPCS 97760GP
Hospital Charge Code	9100160
Hospital Revenue Code	420
Min. Negotiated Rate	$3.82
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$51.11
Rate for Payer: Aetna Medicare Advantage	$40.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.30
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	$34.30
Rate for Payer: Cigna Commercial	$67.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.97
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.18
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$4.25
Rate for Payer: Wellpoint Medicaid Managed Care	$3.82

PT PROSTH TRAIN UE/LE/15 MIN 1

Facility

$134.50

Service Code	HCPCS 97760GP
Hospital Charge Code	9100160
Hospital Revenue Code	420
Min. Negotiated Rate	$20.18
Max. Negotiated Rate	$20.18
Rate for Payer: Qualcare PPO/HMO/WC	$20.18

PT PULSE LAVAGE/WOUND DEBR<20c

Facility

$843.00

Service Code	HCPCS 97597
Hospital Charge Code	9100090
Hospital Revenue Code	420
Min. Negotiated Rate	$23.94
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
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	$864.65
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$166.85
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.18
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$126.45
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$26.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$23.94

PT PULSE LAVAGE/WOUND DEBR<20c

Facility

$843.00

Service Code	HCPCS 97597
Hospital Charge Code	9100090
Hospital Revenue Code	420
Min. Negotiated Rate	$126.45
Max. Negotiated Rate	$126.45
Rate for Payer: Qualcare PPO/HMO/WC	$126.45

PT PULSE LAVAGE/WOUND DEBR>20C

Facility

$843.00

Service Code	HCPCS 97598
Hospital Charge Code	9100091
Hospital Revenue Code	420
Min. Negotiated Rate	$23.94
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$320.34
Rate for Payer: Aetna Medicare Advantage	$252.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.97
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	$214.97
Rate for Payer: Cigna Commercial	$421.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.18
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$126.45
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$26.64
Rate for Payer: Wellpoint Medicaid Managed Care	$23.94

PT PULSE LAVAGE/WOUND DEBR>20C

Facility

$843.00

Service Code	HCPCS 97598
Hospital Charge Code	9100091
Hospital Revenue Code	420
Min. Negotiated Rate	$126.45
Max. Negotiated Rate	$126.45
Rate for Payer: Qualcare PPO/HMO/WC	$126.45

PT RE-EVAL 20 MIN

Facility

$2,400.00

Service Code	HCPCS 97164GP
Hospital Charge Code	422597164
Hospital Revenue Code	424
Min. Negotiated Rate	$360.00
Max. Negotiated Rate	$360.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00

PT RE-EVAL 20 MIN

Facility

$2,400.00

Service Code	HCPCS 97164GP
Hospital Charge Code	422597164
Hospital Revenue Code	424
Min. Negotiated Rate	$65.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$912.00
Rate for Payer: Aetna Medicare Advantage	$720.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.00
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	$612.00
Rate for Payer: Cigna Commercial	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$75.84
Rate for Payer: Wellpoint Medicaid Managed Care	$65.00

PT RE-EVALUATION

Facility

$2,400.00

Service Code	HCPCS 97164GP
Hospital Charge Code	9109163
Hospital Revenue Code	424
Min. Negotiated Rate	$65.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$912.00
Rate for Payer: Aetna Medicare Advantage	$720.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.00
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	$612.00
Rate for Payer: Cigna Commercial	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$75.84
Rate for Payer: Wellpoint Medicaid Managed Care	$65.00

PT RE-EVALUATION

Facility

$2,400.00

Service Code	HCPCS 97164GP
Hospital Charge Code	9109163
Hospital Revenue Code	424
Min. Negotiated Rate	$360.00
Max. Negotiated Rate	$360.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00

PT REEVALUATION

Facility

$227.00

Service Code	HCPCS 97002GP
Hospital Charge Code	9001018
Hospital Revenue Code	424
Min. Negotiated Rate	$7.17
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$86.26
Rate for Payer: Aetna Medicare Advantage	$68.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.88
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	$57.88
Rate for Payer: Cigna Commercial	$113.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.02
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.05
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$7.17
Rate for Payer: Wellpoint Medicaid Managed Care	$65.00

PT REEVALUATION

Facility

$227.00

Service Code	HCPCS 97002GP
Hospital Charge Code	9001018
Hospital Revenue Code	424
Min. Negotiated Rate	$34.05
Max. Negotiated Rate	$34.05
Rate for Payer: Qualcare PPO/HMO/WC	$34.05

PT REM/BIV CAST ARM/LEG FULL

Facility

$1,485.20

Service Code	HCPCS 29705GP
Hospital Charge Code	422529705
Hospital Revenue Code	420
Min. Negotiated Rate	$42.18
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$564.38
Rate for Payer: Aetna Medicare Advantage	$445.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$378.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$378.73
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	$378.73
Rate for Payer: Cigna Commercial	$742.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$386.15
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$222.78
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$46.93
Rate for Payer: Wellpoint Medicaid Managed Care	$42.18

Know your out-of-pocket cost for care.

All Charges