Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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	$222.78
Max. Negotiated Rate	$222.78
Rate for Payer: Qualcare PPO/HMO/WC	$222.78

PT REM/BIV CST GAUNTLT/BOOT/BD

Facility

$1,485.20

Service Code	HCPCS 29700GP
Hospital Charge Code	422529700
Hospital Revenue Code	420
Min. Negotiated Rate	$222.78
Max. Negotiated Rate	$222.78
Rate for Payer: Qualcare PPO/HMO/WC	$222.78

PT REM/BIV CST GAUNTLT/BOOT/BD

Facility

$1,485.20

Service Code	HCPCS 29700GP
Hospital Charge Code	422529700
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

PT REM CAST SPICA/MINER/RISSER

Facility

$1,485.20

Service Code	HCPCS 29710GP
Hospital Charge Code	422529710
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

PT REM CAST SPICA/MINER/RISSER

Facility

$1,485.20

Service Code	HCPCS 29710GP
Hospital Charge Code	422529710
Hospital Revenue Code	420
Min. Negotiated Rate	$222.78
Max. Negotiated Rate	$222.78
Rate for Payer: Qualcare PPO/HMO/WC	$222.78

PT RPR SPICA/CAST BODY/JACKET

Facility

$869.79

Service Code	HCPCS 29720GP
Hospital Charge Code	422529720
Hospital Revenue Code	420
Min. Negotiated Rate	$130.47
Max. Negotiated Rate	$130.47
Rate for Payer: Qualcare PPO/HMO/WC	$130.47

PT RPR SPICA/CAST BODY/JACKET

Facility

$869.79

Service Code	HCPCS 29720GP
Hospital Charge Code	422529720
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 SCREW 4X50MM

Facility

$2,554.40

Service Code	HCPCS C1713
Hospital Charge Code	270705012
Hospital Revenue Code	278
Min. Negotiated Rate	$383.16
Max. Negotiated Rate	$618.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$510.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$618.16
Rate for Payer: Qualcare PPO/HMO/WC	$383.16

PT SCREW 4X50MM

Facility

$2,554.40

Service Code	HCPCS C1713
Hospital Charge Code	270507725
Hospital Revenue Code	278
Min. Negotiated Rate	$383.16
Max. Negotiated Rate	$618.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$510.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$618.16
Rate for Payer: Qualcare PPO/HMO/WC	$383.16

PT SCREW 4X50MM

Facility

$2,554.40

Service Code	HCPCS C1713
Hospital Charge Code	270507725
Hospital Revenue Code	278
Min. Negotiated Rate	$72.54
Max. Negotiated Rate	$1,277.20
Rate for Payer: Aetna Commercial	$970.67
Rate for Payer: Aetna Medicare Advantage	$766.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$651.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$651.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$510.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$651.37
Rate for Payer: Cigna Commercial	$1,277.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$618.16
Rate for Payer: Qualcare PPO/HMO/WC	$383.16
Rate for Payer: UnitedHealthcare Community & State	$80.72
Rate for Payer: Wellpoint Medicaid Managed Care	$72.54

PT SCREW 4X50MM

Facility

$2,554.40

Service Code	HCPCS C1713
Hospital Charge Code	270705012
Hospital Revenue Code	278
Min. Negotiated Rate	$72.54
Max. Negotiated Rate	$1,277.20
Rate for Payer: Aetna Commercial	$970.67
Rate for Payer: Aetna Medicare Advantage	$766.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$651.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$651.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$510.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$651.37
Rate for Payer: Cigna Commercial	$1,277.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$618.16
Rate for Payer: Qualcare PPO/HMO/WC	$383.16
Rate for Payer: UnitedHealthcare Community & State	$80.72
Rate for Payer: Wellpoint Medicaid Managed Care	$72.54

PT SELF/HOME MGT/ADL EA 15 MIN

Facility

$508.00

Service Code	HCPCS 97535GP
Hospital Charge Code	422597535
Hospital Revenue Code	420
Min. Negotiated Rate	$14.43
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$193.04
Rate for Payer: Aetna Medicare Advantage	$152.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$129.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$129.54
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	$129.54
Rate for Payer: Cigna Commercial	$254.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.08
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$76.20
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$16.05
Rate for Payer: Wellpoint Medicaid Managed Care	$14.43

PT SELF/HOME MGT/ADL EA 15 MIN

Facility

$508.00

Service Code	HCPCS 97535GP
Hospital Charge Code	422597535
Hospital Revenue Code	420
Min. Negotiated Rate	$76.20
Max. Negotiated Rate	$76.20
Rate for Payer: Qualcare PPO/HMO/WC	$76.20

PT SENSORY TECHNIQUE 15 MIN

Facility

$112.00

Service Code	HCPCS 97533GP
Hospital Charge Code	422597533
Hospital Revenue Code	420
Min. Negotiated Rate	$3.18
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$42.56
Rate for Payer: Aetna Medicare Advantage	$33.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.56
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	$28.56
Rate for Payer: Cigna Commercial	$56.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.12
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.80
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$3.54
Rate for Payer: Wellpoint Medicaid Managed Care	$3.18

PT SENSORY TECHNIQUE 15 MIN

Facility

$112.00

Service Code	HCPCS 97533GP
Hospital Charge Code	422597533
Hospital Revenue Code	420
Min. Negotiated Rate	$16.80
Max. Negotiated Rate	$16.80
Rate for Payer: Qualcare PPO/HMO/WC	$16.80

PT SEP & ID HIGH REST

Facility

$118.00

Service Code	HCPCS 83909
Hospital Charge Code	38479508
Hospital Revenue Code	301
Min. Negotiated Rate	$17.70
Max. Negotiated Rate	$17.70
Rate for Payer: Qualcare PPO/HMO/WC	$17.70

PT SEP & ID HIGH REST

Facility

$118.00

Service Code	HCPCS 83909
Hospital Charge Code	38479508
Hospital Revenue Code	301
Min. Negotiated Rate	$3.35
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$44.84
Rate for Payer: Aetna Medicare Advantage	$35.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.09
Rate for Payer: Cigna Commercial	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.68
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.70
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.73
Rate for Payer: Wellpoint Medicaid Managed Care	$3.35

PT STIM US BONE LOW DENSITY

Facility

$152.08

Service Code	HCPCS 20979GP
Hospital Charge Code	422520979
Hospital Revenue Code	420
Min. Negotiated Rate	$4.32
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$57.79
Rate for Payer: Aetna Medicare Advantage	$45.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.78
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	$38.78
Rate for Payer: Cigna Commercial	$76.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.54
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.81
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$4.81
Rate for Payer: Wellpoint Medicaid Managed Care	$4.32

PT STIM US BONE LOW DENSITY

Facility

$152.08

Service Code	HCPCS 20979GP
Hospital Charge Code	422520979
Hospital Revenue Code	420
Min. Negotiated Rate	$22.81
Max. Negotiated Rate	$22.81
Rate for Payer: Qualcare PPO/HMO/WC	$22.81

PT STRAPPING KNEE

Facility

$244.50

Service Code	HCPCS 29530GP
Hospital Charge Code	9100150
Hospital Revenue Code	420
Min. Negotiated Rate	$6.94
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$92.91
Rate for Payer: Aetna Medicare Advantage	$73.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.35
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	$62.35
Rate for Payer: Cigna Commercial	$122.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.57
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.67
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$7.73
Rate for Payer: Wellpoint Medicaid Managed Care	$6.94

PT STRAPPING KNEE

Facility

$244.50

Service Code	HCPCS 29530GP
Hospital Charge Code	9100150
Hospital Revenue Code	420
Min. Negotiated Rate	$36.67
Max. Negotiated Rate	$36.67
Rate for Payer: Qualcare PPO/HMO/WC	$36.67

PT SUBSTITUTION

Facility

$119.00

Service Code	HCPCS 85611
Hospital Charge Code	38478009
Hospital Revenue Code	305
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$10.72
Rate for Payer: Aetna Medicare Advantage	$12.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.29
Rate for Payer: Cigna Commercial	$59.50
Rate for Payer: Cigna Medicare Advantage	$3.94
Rate for Payer: Clover Medicare Advantage	$3.74
Rate for Payer: EmblemHealth Commercial	$11.82
Rate for Payer: Humana Medicare Advantage	$4.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.94
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.85
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.94
Rate for Payer: Wellcare Medicare Advantage	$3.94
Rate for Payer: Wellpoint Medicaid Managed Care	$3.38

PT SUBSTITUTION

Facility

$119.00

Service Code	HCPCS 85611
Hospital Charge Code	38478009
Hospital Revenue Code	305
Min. Negotiated Rate	$17.85
Max. Negotiated Rate	$17.85
Rate for Payer: Qualcare PPO/HMO/WC	$17.85

PTT DILUTION STUDY

Facility

$183.00

Service Code	HCPCS 85732
Hospital Charge Code	38479072
Hospital Revenue Code	305
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$17.60
Rate for Payer: Aetna Medicare Advantage	$20.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.47
Rate for Payer: Cigna Commercial	$91.50
Rate for Payer: Cigna Medicare Advantage	$6.47
Rate for Payer: Clover Medicare Advantage	$6.15
Rate for Payer: EmblemHealth Commercial	$19.41
Rate for Payer: Humana Medicare Advantage	$6.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.58
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.45
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$5.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.47
Rate for Payer: Wellcare Medicare Advantage	$6.47
Rate for Payer: Wellpoint Medicaid Managed Care	$5.20

PTT DILUTION STUDY

Facility

$183.00

Service Code	HCPCS 85732
Hospital Charge Code	38479072
Hospital Revenue Code	305
Min. Negotiated Rate	$27.45
Max. Negotiated Rate	$27.45
Rate for Payer: Qualcare PPO/HMO/WC	$27.45

Know your out-of-pocket cost for care.

All Charges