Heights University Hospital

All Charges

Charge

Type

Setting

Price

CRISIS PSYCHOTHERAPY 60 MINS

Facility

$1,094.00

Service Code	HCPCS 90839
Hospital Charge Code	87504045
Hospital Revenue Code	914
Min. Negotiated Rate	$139.23
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$328.20
Rate for Payer: Aetna Medicare Advantage	$328.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$278.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$278.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$278.97
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.22
Rate for Payer: Qualcare PPO/HMO/WC	$164.10

CRISIS PSYCHOTHERAPY 60 MINS

Facility

$550.00

Service Code	HCPCS 90839
Hospital Charge Code	84310090
Hospital Revenue Code	914
Min. Negotiated Rate	$71.50
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$165.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

CRISIS PSYCHOTHERAPY 60 MINS

Facility

$550.00

Service Code	HCPCS 90839
Hospital Charge Code	84511017
Hospital Revenue Code	914
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

CRISIS PSYCHOTHERAPY 60 MINS

Facility

$550.00

Service Code	HCPCS 90839
Hospital Charge Code	84517017
Hospital Revenue Code	914
Min. Negotiated Rate	$71.50
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Aetna Commercial	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

CRISIS PSYCHOTHERAPY 60 MINS

Facility

$1,094.00

Service Code	HCPCS 90839
Hospital Charge Code	87504045
Hospital Revenue Code	914
Min. Negotiated Rate	$164.10
Max. Negotiated Rate	$164.10
Rate for Payer: Qualcare PPO/HMO/WC	$164.10

CRISIS PSYCHOTHERAPY 60 MINS

Facility

$550.00

Service Code	HCPCS 90839
Hospital Charge Code	84511017
Hospital Revenue Code	914
Min. Negotiated Rate	$71.50
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$165.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

CRISIS PSYCHOTHERAPY 60 MINS

Facility

$550.00

Service Code	HCPCS 90839
Hospital Charge Code	84509017
Hospital Revenue Code	914
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

CRISIS PSYCHOTHERAPY 60 MINS

Facility

$550.00

Service Code	HCPCS 90839
Hospital Charge Code	8450917
Hospital Revenue Code	914
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

CRISIS PSYCHOTHERAPY 60 MINS

Facility

$550.00

Service Code	HCPCS 90839
Hospital Charge Code	84310090
Hospital Revenue Code	914
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

CRISIS PSYCHOTHERAPY 60 MINS

Facility

$550.00

Service Code	HCPCS 90839
Hospital Charge Code	84518017
Hospital Revenue Code	914
Min. Negotiated Rate	$71.50
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$165.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

CRISIS PSYCHOTHERAPY 60 MINS

Facility

$550.00

Service Code	HCPCS 90839
Hospital Charge Code	84509017
Hospital Revenue Code	914
Min. Negotiated Rate	$71.50
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$165.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

CRISIS PSYCHOTHERAPY 60 MINS

Facility

$550.00

Service Code	HCPCS 90839
Hospital Charge Code	8450917
Hospital Revenue Code	914
Min. Negotiated Rate	$71.50
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$165.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

CRISIS PSYCHOTHERAPY ADD30MINS

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	84517019
Hospital Revenue Code	914
Min. Negotiated Rate	$35.75
Max. Negotiated Rate	$82.50
Rate for Payer: Aetna Commercial	$82.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$66.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.75
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

CRISIS PSYCHOTHERAPY ADD30MINS

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	84518019
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

CRISIS PSYCHOTHERAPY ADD30MINS

Facility

$1,094.00

Service Code	HCPCS 90840
Hospital Charge Code	87504050
Hospital Revenue Code	914
Min. Negotiated Rate	$66.85
Max. Negotiated Rate	$328.20
Rate for Payer: Aetna Commercial	$328.20
Rate for Payer: Aetna Medicare Advantage	$328.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$278.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$278.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$278.97
Rate for Payer: Cigna Commercial	$66.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.22
Rate for Payer: Qualcare PPO/HMO/WC	$164.10

CRISIS PSYCHOTHERAPY ADD30MINS

Facility

$1,094.00

Service Code	HCPCS 90840
Hospital Charge Code	97504050
Hospital Revenue Code	914
Min. Negotiated Rate	$66.85
Max. Negotiated Rate	$328.20
Rate for Payer: Aetna Commercial	$328.20
Rate for Payer: Aetna Medicare Advantage	$328.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$278.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$278.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$278.97
Rate for Payer: Cigna Commercial	$66.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.22
Rate for Payer: Qualcare PPO/HMO/WC	$164.10

CRISIS PSYCHOTHERAPY ADD30MINS

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	84509019
Hospital Revenue Code	914
Min. Negotiated Rate	$35.75
Max. Negotiated Rate	$82.50
Rate for Payer: Aetna Commercial	$82.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$66.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.75
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

CRISIS PSYCHOTHERAPY ADD30MINS

Facility

$1,094.00

Service Code	HCPCS 90840
Hospital Charge Code	87504050
Hospital Revenue Code	914
Min. Negotiated Rate	$164.10
Max. Negotiated Rate	$164.10
Rate for Payer: Qualcare PPO/HMO/WC	$164.10

CRISIS PSYCHOTHERAPY ADD30MINS

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	84509019
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

CRISIS PSYCHOTHERAPY ADD30MINS

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	84310095
Hospital Revenue Code	914
Min. Negotiated Rate	$35.75
Max. Negotiated Rate	$82.50
Rate for Payer: Aetna Commercial	$82.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$66.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.75
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

CRISIS PSYCHOTHERAPY ADD30MINS

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	84511019
Hospital Revenue Code	914
Min. Negotiated Rate	$35.75
Max. Negotiated Rate	$82.50
Rate for Payer: Aetna Commercial	$82.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$66.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.75
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

CRISIS PSYCHOTHERAPY ADD30MINS

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	84511019
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

CRISIS PSYCHOTHERAPY ADD30MINS

Facility

$1,094.00

Service Code	HCPCS 90840
Hospital Charge Code	97504050
Hospital Revenue Code	914
Min. Negotiated Rate	$164.10
Max. Negotiated Rate	$164.10
Rate for Payer: Qualcare PPO/HMO/WC	$164.10

CRISIS PSYCHOTHERAPY ADD30MINS

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	84517019
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

CRISIS PSYCHOTHERAPY ADD30MINS

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	84518019
Hospital Revenue Code	914
Min. Negotiated Rate	$35.75
Max. Negotiated Rate	$82.50
Rate for Payer: Aetna Commercial	$82.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$66.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.75
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

Know your out-of-pocket cost for care.

All Charges