Heights University Hospital

All Charges

Charge

Type

Setting

Price

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4546513
Hospital Revenue Code	914
Min. Negotiated Rate	$66.85
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$66.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4518513
Hospital Revenue Code	914
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4818513
Hospital Revenue Code	914
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4822513
Hospital Revenue Code	914
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4527513
Hospital Revenue Code	914
Min. Negotiated Rate	$66.85
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$66.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4504513
Hospital Revenue Code	914
Min. Negotiated Rate	$66.85
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$66.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4822513
Hospital Revenue Code	914
Min. Negotiated Rate	$66.85
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$66.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4832513
Hospital Revenue Code	914
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4517513
Hospital Revenue Code	914
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4515513
Hospital Revenue Code	914
Min. Negotiated Rate	$66.85
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$66.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4515513
Hospital Revenue Code	914
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4511513
Hospital Revenue Code	914
Min. Negotiated Rate	$66.85
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$66.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4511513
Hospital Revenue Code	914
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4518513
Hospital Revenue Code	914
Min. Negotiated Rate	$66.85
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$66.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4527513
Hospital Revenue Code	914
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4509513
Hospital Revenue Code	914
Min. Negotiated Rate	$66.85
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$66.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4824513
Hospital Revenue Code	914
Min. Negotiated Rate	$66.85
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$66.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4510513
Hospital Revenue Code	914
Min. Negotiated Rate	$66.85
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$66.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4517513
Hospital Revenue Code	914
Min. Negotiated Rate	$66.85
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$66.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4832513
Hospital Revenue Code	914
Min. Negotiated Rate	$66.85
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$66.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4546513
Hospital Revenue Code	914
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4824513
Hospital Revenue Code	914
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4535513
Hospital Revenue Code	914
Min. Negotiated Rate	$66.85
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$66.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX EAADD 30MIN CH

Facility

$1,000.00

Service Code	HCPCS 90840
Hospital Charge Code	4504513
Hospital Revenue Code	914
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CRISIS PSYCHOTX MD 1ST HOUR

Facility

$500.00

Service Code	HCPCS 90839
Hospital Charge Code	4509707
Hospital Revenue Code	914
Min. Negotiated Rate	$65.00
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
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	$127.50
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

Know your out-of-pocket cost for care.

All Charges