Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TCM OSTEO MANIPULTIN 1-2 AREA

Facility

$149.85

Service Code	HCPCS 98925
Hospital Charge Code	93950123
Hospital Revenue Code	761
Min. Negotiated Rate	$22.48
Max. Negotiated Rate	$22.48
Rate for Payer: Qualcare PPO/HMO/WC	$22.48

TCM OSTEO MANIPULTIN 1-2 AREA

Facility

$149.85

Service Code	HCPCS 98925
Hospital Charge Code	93950123
Hospital Revenue Code	761
Min. Negotiated Rate	$4.26
Max. Negotiated Rate	$93.05
Rate for Payer: Aetna Commercial	$69.77
Rate for Payer: Aetna Medicare Advantage	$83.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.05
Rate for Payer: Cigna Commercial	$51.42
Rate for Payer: Cigna Medicare Advantage	$25.65
Rate for Payer: Clover Medicare Advantage	$24.37
Rate for Payer: EmblemHealth Commercial	$76.95
Rate for Payer: Humana Medicare Advantage	$26.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.96
Rate for Payer: Oxford Commercial	$29.97
Rate for Payer: Qualcare PPO/HMO/WC	$22.48
Rate for Payer: UnitedHealthcare Commercial	$29.97
Rate for Payer: UnitedHealthcare Community & State	$4.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.65
Rate for Payer: Wellcare Medicare Advantage	$25.65
Rate for Payer: Wellpoint Medicaid Managed Care	$4.26

TCM OSTEO MANIPULTIN 3-4 AREA

Facility

$149.85

Service Code	HCPCS 98926
Hospital Charge Code	93950125
Hospital Revenue Code	761
Min. Negotiated Rate	$22.48
Max. Negotiated Rate	$22.48
Rate for Payer: Qualcare PPO/HMO/WC	$22.48

TCM OSTEO MANIPULTIN 3-4 AREA

Facility

$149.85

Service Code	HCPCS 98926
Hospital Charge Code	93950125
Hospital Revenue Code	761
Min. Negotiated Rate	$4.26
Max. Negotiated Rate	$93.05
Rate for Payer: Aetna Commercial	$69.77
Rate for Payer: Aetna Medicare Advantage	$83.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.05
Rate for Payer: Cigna Commercial	$51.42
Rate for Payer: Cigna Medicare Advantage	$25.65
Rate for Payer: Clover Medicare Advantage	$24.37
Rate for Payer: EmblemHealth Commercial	$76.95
Rate for Payer: Humana Medicare Advantage	$26.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.96
Rate for Payer: Oxford Commercial	$29.97
Rate for Payer: Qualcare PPO/HMO/WC	$22.48
Rate for Payer: UnitedHealthcare Commercial	$29.97
Rate for Payer: UnitedHealthcare Community & State	$4.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.65
Rate for Payer: Wellcare Medicare Advantage	$25.65
Rate for Payer: Wellpoint Medicaid Managed Care	$4.26

TCM OSTEO MANIPULTIN 5-6 AREA

Facility

$149.85

Service Code	HCPCS 98927
Hospital Charge Code	93950127
Hospital Revenue Code	761
Min. Negotiated Rate	$22.48
Max. Negotiated Rate	$22.48
Rate for Payer: Qualcare PPO/HMO/WC	$22.48

TCM OSTEO MANIPULTIN 5-6 AREA

Facility

$149.85

Service Code	HCPCS 98927
Hospital Charge Code	93950127
Hospital Revenue Code	761
Min. Negotiated Rate	$4.26
Max. Negotiated Rate	$93.05
Rate for Payer: Aetna Commercial	$69.77
Rate for Payer: Aetna Medicare Advantage	$83.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.05
Rate for Payer: Cigna Commercial	$51.42
Rate for Payer: Cigna Medicare Advantage	$25.65
Rate for Payer: Clover Medicare Advantage	$24.37
Rate for Payer: EmblemHealth Commercial	$76.95
Rate for Payer: Humana Medicare Advantage	$26.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.96
Rate for Payer: Oxford Commercial	$29.97
Rate for Payer: Qualcare PPO/HMO/WC	$22.48
Rate for Payer: UnitedHealthcare Commercial	$29.97
Rate for Payer: UnitedHealthcare Community & State	$4.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.65
Rate for Payer: Wellcare Medicare Advantage	$25.65
Rate for Payer: Wellpoint Medicaid Managed Care	$4.26

TCM OSTEO MANIPULTIN 7-8 AREA

Facility

$149.85

Service Code	HCPCS 98928
Hospital Charge Code	93950129
Hospital Revenue Code	761
Min. Negotiated Rate	$22.48
Max. Negotiated Rate	$22.48
Rate for Payer: Qualcare PPO/HMO/WC	$22.48

TCM OSTEO MANIPULTIN 7-8 AREA

Facility

$149.85

Service Code	HCPCS 98928
Hospital Charge Code	93950129
Hospital Revenue Code	761
Min. Negotiated Rate	$4.26
Max. Negotiated Rate	$93.05
Rate for Payer: Aetna Commercial	$69.77
Rate for Payer: Aetna Medicare Advantage	$83.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.05
Rate for Payer: Cigna Commercial	$51.42
Rate for Payer: Cigna Medicare Advantage	$25.65
Rate for Payer: Clover Medicare Advantage	$24.37
Rate for Payer: EmblemHealth Commercial	$76.95
Rate for Payer: Humana Medicare Advantage	$26.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.96
Rate for Payer: Oxford Commercial	$29.97
Rate for Payer: Qualcare PPO/HMO/WC	$22.48
Rate for Payer: UnitedHealthcare Commercial	$29.97
Rate for Payer: UnitedHealthcare Community & State	$4.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.65
Rate for Payer: Wellcare Medicare Advantage	$25.65
Rate for Payer: Wellpoint Medicaid Managed Care	$4.26

TCM OSTEO MANIPULTN 9-10 AREA

Facility

$376.35

Service Code	HCPCS 98929
Hospital Charge Code	93950131
Hospital Revenue Code	761
Min. Negotiated Rate	$10.69
Max. Negotiated Rate	$97.85
Rate for Payer: Aetna Commercial	$69.77
Rate for Payer: Aetna Medicare Advantage	$83.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.05
Rate for Payer: Cigna Commercial	$51.42
Rate for Payer: Cigna Medicare Advantage	$25.65
Rate for Payer: Clover Medicare Advantage	$24.37
Rate for Payer: EmblemHealth Commercial	$76.95
Rate for Payer: Humana Medicare Advantage	$26.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.85
Rate for Payer: Oxford Commercial	$75.27
Rate for Payer: Qualcare PPO/HMO/WC	$56.45
Rate for Payer: UnitedHealthcare Commercial	$75.27
Rate for Payer: UnitedHealthcare Community & State	$11.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.65
Rate for Payer: Wellcare Medicare Advantage	$25.65
Rate for Payer: Wellpoint Medicaid Managed Care	$10.69

TCM OSTEO MANIPULTN 9-10 AREA

Facility

$376.35

Service Code	HCPCS 98929
Hospital Charge Code	93950131
Hospital Revenue Code	761
Min. Negotiated Rate	$56.45
Max. Negotiated Rate	$56.45
Rate for Payer: Qualcare PPO/HMO/WC	$56.45

TCM PPD INTRADERMAL

Facility

$390.00

Service Code	HCPCS 86580
Hospital Charge Code	93950057
Hospital Revenue Code	302
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$93.46
Rate for Payer: Aetna Medicare Advantage	$111.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.64
Rate for Payer: Cigna Commercial	$68.87
Rate for Payer: Cigna Medicare Advantage	$34.36
Rate for Payer: Clover Medicare Advantage	$32.64
Rate for Payer: EmblemHealth Commercial	$103.08
Rate for Payer: Humana Medicare Advantage	$35.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$34.36
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	$8.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.36
Rate for Payer: Wellcare Medicare Advantage	$34.36
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

TCM PPD INTRADERMAL

Facility

$390.00

Service Code	HCPCS 86580
Hospital Charge Code	93950057
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TCM PREVENTIVE EST PAT 1-4YRS

Facility

$175.00

Service Code	HCPCS 99392
Hospital Charge Code	93950189
Hospital Revenue Code	510
Min. Negotiated Rate	$4.97
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Community & State	$5.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.97

TCM PREVENTIVE EST PAT 1-4YRS

Facility

$175.00

Service Code	HCPCS 99392
Hospital Charge Code	93950189
Hospital Revenue Code	510
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

TCM PREVENTIVE EST PAT <1 YR

Facility

$175.00

Service Code	HCPCS 99391
Hospital Charge Code	93950187
Hospital Revenue Code	510
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

TCM PREVENTIVE EST PAT <1 YR

Facility

$175.00

Service Code	HCPCS 99391
Hospital Charge Code	93950187
Hospital Revenue Code	510
Min. Negotiated Rate	$4.97
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Community & State	$5.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.97

TCM PREVENTIVE EST PAT 65+YRS

Facility

$175.00

Service Code	HCPCS 99397
Hospital Charge Code	93950199
Hospital Revenue Code	510
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

TCM PREVENTIVE EST PAT 65+YRS

Facility

$175.00

Service Code	HCPCS 99397
Hospital Charge Code	93950199
Hospital Revenue Code	510
Min. Negotiated Rate	$4.97
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Community & State	$5.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.97

TCM PREVENTIVE EST PT 5-11YRS

Facility

$175.00

Service Code	HCPCS 99393
Hospital Charge Code	93950191
Hospital Revenue Code	510
Min. Negotiated Rate	$4.97
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Community & State	$5.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.97

TCM PREVENTIVE EST PT 5-11YRS

Facility

$175.00

Service Code	HCPCS 99393
Hospital Charge Code	93950191
Hospital Revenue Code	510
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

TCM PREVENTIVE NEW PAT 65+YRS

Facility

$175.00

Service Code	HCPCS 99387
Hospital Charge Code	93950185
Hospital Revenue Code	510
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

TCM PREVENTIVE NEW PAT 65+YRS

Facility

$175.00

Service Code	HCPCS 99387
Hospital Charge Code	93950185
Hospital Revenue Code	510
Min. Negotiated Rate	$4.97
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Community & State	$5.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.97

TCM PREVENTIVE NEW PT <1 YEAR

Facility

$175.00

Service Code	HCPCS 99381
Hospital Charge Code	93950173
Hospital Revenue Code	510
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

TCM PREVENTIVE NEW PT <1 YEAR

Facility

$175.00

Service Code	HCPCS 99381
Hospital Charge Code	93950173
Hospital Revenue Code	510
Min. Negotiated Rate	$4.97
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Community & State	$5.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.97

TCM PREVNTVE EST PT 12-17 YRS

Facility

$175.00

Service Code	HCPCS 99394
Hospital Charge Code	93950193
Hospital Revenue Code	510
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

Know your out-of-pocket cost for care.

All Charges