Heights University Hospital

All Charges

Charge

Type

Setting

Price

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4510511
Hospital Revenue Code	914
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4518511
Hospital Revenue Code	914
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4546511
Hospital Revenue Code	914
Min. Negotiated Rate	$139.23
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
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	$510.00
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4824511
Hospital Revenue Code	914
Min. Negotiated Rate	$139.23
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
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	$510.00
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4535511
Hospital Revenue Code	914
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4822511
Hospital Revenue Code	914
Min. Negotiated Rate	$139.23
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
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	$510.00
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4824511
Hospital Revenue Code	914
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4510511
Hospital Revenue Code	914
Min. Negotiated Rate	$139.23
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
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	$510.00
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4509511
Hospital Revenue Code	914
Min. Negotiated Rate	$139.23
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
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	$510.00
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4818511
Hospital Revenue Code	914
Min. Negotiated Rate	$139.23
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
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	$510.00
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4535511
Hospital Revenue Code	914
Min. Negotiated Rate	$139.23
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
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	$510.00
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4511511
Hospital Revenue Code	914
Min. Negotiated Rate	$139.23
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
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	$510.00
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4511511
Hospital Revenue Code	914
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4504511
Hospital Revenue Code	914
Min. Negotiated Rate	$139.23
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
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	$510.00
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4509511
Hospital Revenue Code	914
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4527511
Hospital Revenue Code	914
Min. Negotiated Rate	$139.23
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
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	$510.00
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4517511
Hospital Revenue Code	914
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4546511
Hospital Revenue Code	914
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4518511
Hospital Revenue Code	914
Min. Negotiated Rate	$139.23
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
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	$510.00
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4504511
Hospital Revenue Code	914
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4527511
Hospital Revenue Code	914
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4517511
Hospital Revenue Code	914
Min. Negotiated Rate	$139.23
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
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	$510.00
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4832511
Hospital Revenue Code	914
Min. Negotiated Rate	$139.23
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
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	$510.00
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4832511
Hospital Revenue Code	914
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CRISIS PSYCHOTX 1ST HOUR CHILD

Facility

$2,000.00

Service Code	HCPCS 90839
Hospital Charge Code	4515511
Hospital Revenue Code	914
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

Know your out-of-pocket cost for care.

All Charges