Heights University Hospital

All Charges

Charge

Type

Setting

Price

CRISIS PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4824708
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

CRISIS PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4818708
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 PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4527708
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 PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4510708
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 PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4515708
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 PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4509708
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 PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4509708
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

CRISIS PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4517708
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

CRISIS PSYCHOTX MD EAADD 30MIN

Facility

$275.00

Service Code	HCPCS 90840
Hospital Charge Code	4511708
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

CRISIS PSYCHTHERAPY 60MIN

Facility

$1,879.97

Service Code	HCPCS 90839
Hospital Charge Code	94810180
Hospital Revenue Code	914
Min. Negotiated Rate	$139.23
Max. Negotiated Rate	$563.99
Rate for Payer: Aetna Commercial	$563.99
Rate for Payer: Aetna Medicare Advantage	$563.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$479.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$479.39
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	$479.39
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.40
Rate for Payer: Qualcare PPO/HMO/WC	$282.00

CRISIS PSYCHTHERAPY 60MIN

Facility

$1,879.97

Service Code	HCPCS 90839
Hospital Charge Code	94810180
Hospital Revenue Code	914
Min. Negotiated Rate	$282.00
Max. Negotiated Rate	$282.00
Rate for Payer: Qualcare PPO/HMO/WC	$282.00

CRISIS PSYCHTHERAPY 60MIN

Facility

$1,879.97

Service Code	HCPCS 90839
Hospital Charge Code	94810145
Hospital Revenue Code	914
Min. Negotiated Rate	$139.23
Max. Negotiated Rate	$563.99
Rate for Payer: Aetna Commercial	$563.99
Rate for Payer: Aetna Medicare Advantage	$563.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$479.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$479.39
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	$479.39
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.40
Rate for Payer: Qualcare PPO/HMO/WC	$282.00

CRISIS PSYCHTHERAPY 60MIN

Facility

$1,879.97

Service Code	HCPCS 90839
Hospital Charge Code	94810145
Hospital Revenue Code	914
Min. Negotiated Rate	$282.00
Max. Negotiated Rate	$282.00
Rate for Payer: Qualcare PPO/HMO/WC	$282.00

CRITIC AID AF OINT

Facility

$55.81

Service Code	NDC 11701006723
Hospital Charge Code	6063943264
Hospital Revenue Code	250
Min. Negotiated Rate	$7.26
Max. Negotiated Rate	$27.91
Rate for Payer: Aetna Commercial	$16.74
Rate for Payer: Aetna Medicare Advantage	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.23
Rate for Payer: Cigna Commercial	$27.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.26
Rate for Payer: Oxford Commercial	$27.91
Rate for Payer: Qualcare PPO/HMO/WC	$8.37
Rate for Payer: UnitedHealthcare Commercial	$27.91

CRITIC AID AF OINT

Facility

$55.81

Service Code	NDC 11701006723
Hospital Charge Code	6063943264
Hospital Revenue Code	250
Min. Negotiated Rate	$8.37
Max. Negotiated Rate	$8.37
Rate for Payer: Qualcare PPO/HMO/WC	$8.37

CRITICAL CARE 1ST HOUR

Facility

$10,659.26

Service Code	HCPCS 99291
Hospital Charge Code	411099291
Hospital Revenue Code	361
Min. Negotiated Rate	$1,598.89
Max. Negotiated Rate	$1,598.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,598.89

CRITICAL CARE 1ST HOUR

Facility

$10,659.26

Service Code	HCPCS 99291
Hospital Charge Code	411099291
Hospital Revenue Code	361
Min. Negotiated Rate	$1,385.70
Max. Negotiated Rate	$3,197.78
Rate for Payer: Aetna Commercial	$3,197.78
Rate for Payer: Aetna Medicare Advantage	$3,197.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,718.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,718.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,718.11
Rate for Payer: Cigna Commercial	$1,967.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,385.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,598.89

CRITICAL EA ADDL 30 MIN

Facility

$837.50

Service Code	HCPCS 99292
Hospital Charge Code	411099292
Hospital Revenue Code	361
Min. Negotiated Rate	$108.24
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$251.25
Rate for Payer: Aetna Medicare Advantage	$251.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$213.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$213.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$213.56
Rate for Payer: Cigna Commercial	$108.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.88
Rate for Payer: Qualcare PPO/HMO/WC	$125.62

CRITICAL EA ADDL 30 MIN

Facility

$837.50

Service Code	HCPCS 99292
Hospital Charge Code	411099292
Hospital Revenue Code	361
Min. Negotiated Rate	$125.62
Max. Negotiated Rate	$125.62
Rate for Payer: Qualcare PPO/HMO/WC	$125.62

CRIXIVAN 200MG

Facility

$8.00

Hospital Charge Code	60635154
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

CRIXIVAN 200MG

Facility

$8.00

Hospital Charge Code	60635154
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$2.40
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$4.00

CRNEA HUMAN TISSUE IMPLNTABLE

Facility

$19,000.00

Service Code	HCPCS V2785
Hospital Charge Code	270660661
Hospital Revenue Code	810
Min. Negotiated Rate	$2,470.00
Max. Negotiated Rate	$9,500.00
Rate for Payer: Aetna Commercial	$5,700.00
Rate for Payer: Aetna Medicare Advantage	$5,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,845.00
Rate for Payer: Cigna Commercial	$9,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,470.00
Rate for Payer: Oxford Commercial	$9,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00
Rate for Payer: UnitedHealthcare Commercial	$9,500.00

CRNEA HUMAN TISSUE IMPLNTABLE

Facility

$19,000.00

Service Code	HCPCS V2785
Hospital Charge Code	270660661
Hospital Revenue Code	810
Min. Negotiated Rate	$2,850.00
Max. Negotiated Rate	$2,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00

CROMOLYN 4% OPHTH SOLN

Facility

$186.25

Hospital Charge Code	60628007
Hospital Revenue Code	250
Min. Negotiated Rate	$24.21
Max. Negotiated Rate	$93.12
Rate for Payer: Aetna Commercial	$55.88
Rate for Payer: Aetna Medicare Advantage	$55.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.49
Rate for Payer: Cigna Commercial	$93.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.21
Rate for Payer: Oxford Commercial	$93.12
Rate for Payer: Qualcare PPO/HMO/WC	$27.94
Rate for Payer: UnitedHealthcare Commercial	$93.12

CROMOLYN 4% OPHTH SOLN

Facility

$186.25

Hospital Charge Code	60628007
Hospital Revenue Code	250
Min. Negotiated Rate	$27.94
Max. Negotiated Rate	$27.94
Rate for Payer: Qualcare PPO/HMO/WC	$27.94

Know your out-of-pocket cost for care.

All Charges