Heights University Hospital

All Charges

Charge

Type

Setting

Price

EEG CONT REC W VID EEG TECH

Facility

$1,481.95

Service Code	HCPCS 95700
Hospital Charge Code	403395700
Hospital Revenue Code	740
Min. Negotiated Rate	$222.29
Max. Negotiated Rate	$222.29
Rate for Payer: Qualcare PPO/HMO/WC	$222.29

EEG CONT REC W VID EEG TECH

Facility

$1,481.95

Service Code	HCPCS 95700
Hospital Charge Code	403395700
Hospital Revenue Code	740
Min. Negotiated Rate	$192.65
Max. Negotiated Rate	$3,847.00
Rate for Payer: Aetna Commercial	$444.58
Rate for Payer: Aetna Medicare Advantage	$444.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$377.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$377.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$377.90
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.65
Rate for Payer: Oxford Commercial	$3,390.00
Rate for Payer: Qualcare PPO/HMO/WC	$222.29
Rate for Payer: UnitedHealthcare Commercial	$3,847.00

EEG DIGITAL ANALYSIS

Facility

$2,539.78

Service Code	HCPCS 95957
Hospital Charge Code	5500024
Hospital Revenue Code	920
Min. Negotiated Rate	$380.97
Max. Negotiated Rate	$380.97
Rate for Payer: Qualcare PPO/HMO/WC	$380.97

EEG DIGITAL ANALYSIS

Facility

$2,539.78

Service Code	HCPCS 95957
Hospital Charge Code	5500024
Hospital Revenue Code	920
Min. Negotiated Rate	$330.17
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$761.93
Rate for Payer: Aetna Medicare Advantage	$761.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$647.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$647.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$601.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$647.64
Rate for Payer: Cigna Commercial	$352.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.17
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$380.97
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

EEG ELECTROCEREBRAL SILENCE

Facility

$548.00

Service Code	HCPCS 95824
Hospital Charge Code	5400064
Hospital Revenue Code	740
Min. Negotiated Rate	$82.20
Max. Negotiated Rate	$82.20
Rate for Payer: Qualcare PPO/HMO/WC	$82.20

EEG ELECTROCEREBRAL SILENCE

Facility

$548.00

Service Code	HCPCS 95824
Hospital Charge Code	5400064
Hospital Revenue Code	740
Min. Negotiated Rate	$23.23
Max. Negotiated Rate	$3,847.00
Rate for Payer: Aetna Commercial	$164.40
Rate for Payer: Aetna Medicare Advantage	$164.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.74
Rate for Payer: Cigna Commercial	$888.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.24
Rate for Payer: Oxford Commercial	$3,390.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.20
Rate for Payer: UnitedHealthcare Commercial	$3,847.00

EEG FOR ECT

Facility

$1,290.00

Service Code	HCPCS 95816
Hospital Charge Code	84033005
Hospital Revenue Code	740
Min. Negotiated Rate	$167.70
Max. Negotiated Rate	$3,847.00
Rate for Payer: Aetna Commercial	$387.00
Rate for Payer: Aetna Medicare Advantage	$387.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$294.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.95
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.70
Rate for Payer: Oxford Commercial	$3,390.00
Rate for Payer: Qualcare PPO/HMO/WC	$193.50
Rate for Payer: UnitedHealthcare Commercial	$3,847.00

EEG FOR ECT

Facility

$1,290.00

Service Code	HCPCS 95816
Hospital Charge Code	84033005
Hospital Revenue Code	740
Min. Negotiated Rate	$193.50
Max. Negotiated Rate	$193.50
Rate for Payer: Qualcare PPO/HMO/WC	$193.50

EEG PORTABLE

Facility

$576.00

Service Code	HCPCS 95816
Hospital Charge Code	5400072
Hospital Revenue Code	740
Min. Negotiated Rate	$86.40
Max. Negotiated Rate	$86.40
Rate for Payer: Qualcare PPO/HMO/WC	$86.40

EEG PORTABLE

Facility

$576.00

Service Code	HCPCS 95816
Hospital Charge Code	5400072
Hospital Revenue Code	740
Min. Negotiated Rate	$74.88
Max. Negotiated Rate	$3,847.00
Rate for Payer: Aetna Commercial	$172.80
Rate for Payer: Aetna Medicare Advantage	$172.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$294.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.88
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.88
Rate for Payer: Oxford Commercial	$3,390.00
Rate for Payer: Qualcare PPO/HMO/WC	$86.40
Rate for Payer: UnitedHealthcare Commercial	$3,847.00

EEG ROUTINE

Facility

$1,491.00

Service Code	HCPCS 95816
Hospital Charge Code	36540014
Hospital Revenue Code	740
Min. Negotiated Rate	$223.65
Max. Negotiated Rate	$223.65
Rate for Payer: Qualcare PPO/HMO/WC	$223.65

EEG ROUTINE

Facility

$1,491.00

Service Code	HCPCS 95816
Hospital Charge Code	36540014
Hospital Revenue Code	740
Min. Negotiated Rate	$193.83
Max. Negotiated Rate	$3,847.00
Rate for Payer: Aetna Commercial	$447.30
Rate for Payer: Aetna Medicare Advantage	$447.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$380.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$380.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$294.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$380.20
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.83
Rate for Payer: Oxford Commercial	$3,390.00
Rate for Payer: Qualcare PPO/HMO/WC	$223.65
Rate for Payer: UnitedHealthcare Commercial	$3,847.00

EEG ROUTINE > 1 HR

Facility

$1,477.50

Service Code	HCPCS 95813
Hospital Charge Code	5500030
Hospital Revenue Code	740
Min. Negotiated Rate	$124.20
Max. Negotiated Rate	$3,847.00
Rate for Payer: Aetna Commercial	$443.25
Rate for Payer: Aetna Medicare Advantage	$443.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.76
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.07
Rate for Payer: Oxford Commercial	$3,390.00
Rate for Payer: Qualcare PPO/HMO/WC	$221.62
Rate for Payer: UnitedHealthcare Commercial	$3,847.00

EEG ROUTINE > 1 HR

Facility

$1,477.50

Service Code	HCPCS 95813
Hospital Charge Code	5500030
Hospital Revenue Code	740
Min. Negotiated Rate	$221.62
Max. Negotiated Rate	$221.62
Rate for Payer: Qualcare PPO/HMO/WC	$221.62

EEG ROUTINE UP TO 1 HR

Facility

$2,762.45

Service Code	HCPCS 95812
Hospital Charge Code	5500032
Hospital Revenue Code	740
Min. Negotiated Rate	$414.37
Max. Negotiated Rate	$414.37
Rate for Payer: Qualcare PPO/HMO/WC	$414.37

EEG ROUTINE UP TO 1 HR

Facility

$2,762.45

Service Code	HCPCS 95812
Hospital Charge Code	5500032
Hospital Revenue Code	740
Min. Negotiated Rate	$286.35
Max. Negotiated Rate	$3,847.00
Rate for Payer: Aetna Commercial	$828.74
Rate for Payer: Aetna Medicare Advantage	$828.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$704.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$704.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$704.42
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$359.12
Rate for Payer: Oxford Commercial	$3,390.00
Rate for Payer: Qualcare PPO/HMO/WC	$414.37
Rate for Payer: UnitedHealthcare Commercial	$3,847.00

EEG SLEEP ******

Facility

$289.30

Service Code	HCPCS 95819
Hospital Charge Code	5400056
Hospital Revenue Code	749
Min. Negotiated Rate	$43.40
Max. Negotiated Rate	$43.40
Rate for Payer: Qualcare PPO/HMO/WC	$43.40

EEG SLEEP ******

Facility

$289.30

Service Code	HCPCS 95819
Hospital Charge Code	5400056
Hospital Revenue Code	749
Min. Negotiated Rate	$37.61
Max. Negotiated Rate	$514.20
Rate for Payer: Aetna Commercial	$86.79
Rate for Payer: Aetna Medicare Advantage	$86.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.77
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.61
Rate for Payer: Qualcare PPO/HMO/WC	$43.40

EEG SLEEP DEPRIVED

Facility

$2,804.90

Service Code	HCPCS 95819
Hospital Charge Code	36540016
Hospital Revenue Code	740
Min. Negotiated Rate	$277.15
Max. Negotiated Rate	$3,847.00
Rate for Payer: Aetna Commercial	$841.47
Rate for Payer: Aetna Medicare Advantage	$841.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$715.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$715.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$715.25
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.64
Rate for Payer: Oxford Commercial	$3,390.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.74
Rate for Payer: UnitedHealthcare Commercial	$3,847.00

EEG SLEEP DEPRIVED

Facility

$2,804.90

Service Code	HCPCS 95819
Hospital Charge Code	36540016
Hospital Revenue Code	740
Min. Negotiated Rate	$420.74
Max. Negotiated Rate	$420.74
Rate for Payer: Qualcare PPO/HMO/WC	$420.74

EEG SLEEP ONLY

Facility

$576.00

Service Code	HCPCS 95822
Hospital Charge Code	5500020
Hospital Revenue Code	740
Min. Negotiated Rate	$74.88
Max. Negotiated Rate	$3,847.00
Rate for Payer: Aetna Medicare Advantage	$172.80
Rate for Payer: Aetna Commercial	$172.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$269.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.88
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.88
Rate for Payer: Oxford Commercial	$3,390.00
Rate for Payer: Qualcare PPO/HMO/WC	$86.40
Rate for Payer: UnitedHealthcare Commercial	$3,847.00

EEG SLEEP ONLY

Facility

$576.00

Service Code	HCPCS 95822
Hospital Charge Code	5500020
Hospital Revenue Code	740
Min. Negotiated Rate	$86.40
Max. Negotiated Rate	$86.40
Rate for Payer: Qualcare PPO/HMO/WC	$86.40

EEG/VIDEO MON/RECORD </= 12 HR

Facility

$2,647.00

Service Code	HCPCS 9595152
Hospital Charge Code	403395951P
Hospital Revenue Code	740
Min. Negotiated Rate	$397.05
Max. Negotiated Rate	$397.05
Rate for Payer: Qualcare PPO/HMO/WC	$397.05

EEG/VIDEO MON/RECORD </= 12 HR

Facility

$2,647.00

Service Code	HCPCS 9595152
Hospital Charge Code	403395951P
Hospital Revenue Code	740
Min. Negotiated Rate	$344.11
Max. Negotiated Rate	$3,847.00
Rate for Payer: Aetna Commercial	$794.10
Rate for Payer: Aetna Medicare Advantage	$794.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$674.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$674.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$674.99
Rate for Payer: Cigna Commercial	$1,323.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.11
Rate for Payer: Oxford Commercial	$3,390.00
Rate for Payer: Qualcare PPO/HMO/WC	$397.05
Rate for Payer: UnitedHealthcare Commercial	$3,847.00

EEG/VIDEO MON/RECORD PER 24 HR

Facility

$5,294.00

Service Code	HCPCS 95951
Hospital Charge Code	403395951
Hospital Revenue Code	740
Min. Negotiated Rate	$794.10
Max. Negotiated Rate	$794.10
Rate for Payer: Qualcare PPO/HMO/WC	$794.10

Know your out-of-pocket cost for care.

All Charges