Heights University Hospital

All Charges

Charge

Type

Setting

Price

FAMILY THERAPY W PATIENT 50MIN

Facility

$1,094.00

Service Code	HCPCS 90847
Hospital Charge Code	4546753
Hospital Revenue Code	916
Min. Negotiated Rate	$113.84
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	$189.68
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
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$113.84

FAMILY THERAPY W PATIENT 50MIN

Facility

$1,094.00

Service Code	HCPCS 90847
Hospital Charge Code	4546753
Hospital Revenue Code	916
Min. Negotiated Rate	$164.10
Max. Negotiated Rate	$164.10
Rate for Payer: Qualcare PPO/HMO/WC	$164.10

FAMILY THERAPY W/PATIENT 50MIN

Facility

$1,500.00

Service Code	HCPCS 90847
Hospital Charge Code	4546773
Hospital Revenue Code	916
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

FAMILY THERAPY W/PATIENT 50MIN

Facility

$1,500.00

Service Code	HCPCS 90847
Hospital Charge Code	4546773
Hospital Revenue Code	916
Min. Negotiated Rate	$113.84
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$450.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$113.84

FAMILY THERAPY W PT 50 MIN IOP

Facility

$1,094.00

Service Code	HCPCS 90847
Hospital Charge Code	4546746
Hospital Revenue Code	916
Min. Negotiated Rate	$113.84
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	$189.68
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
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$113.84

FAMILY THERAPY W PT 50 MIN IOP

Facility

$1,094.00

Service Code	HCPCS 90847
Hospital Charge Code	4546746
Hospital Revenue Code	916
Min. Negotiated Rate	$164.10
Max. Negotiated Rate	$164.10
Rate for Payer: Qualcare PPO/HMO/WC	$164.10

FAMILY TX WO PATIENT 50 MIN

Facility

$1,094.00

Service Code	HCPCS 90846
Hospital Charge Code	84504055
Hospital Revenue Code	916
Min. Negotiated Rate	$142.22
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	$170.91
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

FAMILY TX WO PATIENT 50 MIN

Facility

$1,094.00

Service Code	HCPCS 90846
Hospital Charge Code	84509021
Hospital Revenue Code	916
Min. Negotiated Rate	$142.22
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	$170.91
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

FAMILY TX WO PATIENT 50 MIN

Facility

$1,047.00

Service Code	HCPCS 90846
Hospital Charge Code	84310100
Hospital Revenue Code	916
Min. Negotiated Rate	$136.11
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$314.10
Rate for Payer: Aetna Medicare Advantage	$314.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$266.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$266.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$266.99
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.11
Rate for Payer: Qualcare PPO/HMO/WC	$157.05

FAMILY TX WO PATIENT 50 MIN

Facility

$1,047.00

Service Code	HCPCS 90846
Hospital Charge Code	84310100
Hospital Revenue Code	916
Min. Negotiated Rate	$157.05
Max. Negotiated Rate	$157.05
Rate for Payer: Qualcare PPO/HMO/WC	$157.05

FAMILY TX WO PATIENT 50 MIN

Facility

$725.00

Service Code	HCPCS 90846
Hospital Charge Code	94810035
Hospital Revenue Code	916
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$108.75
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

FAMILY TX WO PATIENT 50 MIN

Facility

$640.00

Service Code	HCPCS 90846
Hospital Charge Code	83246185
Hospital Revenue Code	916
Min. Negotiated Rate	$96.00
Max. Negotiated Rate	$96.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.00

FAMILY TX WO PATIENT 50 MIN

Facility

$1,094.00

Service Code	HCPCS 90846
Hospital Charge Code	84517021
Hospital Revenue Code	916
Min. Negotiated Rate	$142.22
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	$170.91
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

FAMILY TX WO PATIENT 50 MIN

Facility

$640.00

Service Code	HCPCS 90846
Hospital Charge Code	87504055
Hospital Revenue Code	916
Min. Negotiated Rate	$96.00
Max. Negotiated Rate	$96.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.00

FAMILY TX WO PATIENT 50 MIN

Facility

$1,094.00

Service Code	HCPCS 90846
Hospital Charge Code	84518021
Hospital Revenue Code	916
Min. Negotiated Rate	$164.10
Max. Negotiated Rate	$164.10
Rate for Payer: Qualcare PPO/HMO/WC	$164.10

FAMILY TX WO PATIENT 50 MIN

Facility

$1,094.00

Service Code	HCPCS 90846
Hospital Charge Code	84504055
Hospital Revenue Code	916
Min. Negotiated Rate	$164.10
Max. Negotiated Rate	$164.10
Rate for Payer: Qualcare PPO/HMO/WC	$164.10

FAMILY TX WO PATIENT 50 MIN

Facility

$1,094.00

Service Code	HCPCS 90846
Hospital Charge Code	84511021
Hospital Revenue Code	916
Min. Negotiated Rate	$164.10
Max. Negotiated Rate	$164.10
Rate for Payer: Qualcare PPO/HMO/WC	$164.10

FAMILY TX WO PATIENT 50 MIN

Facility

$1,094.00

Service Code	HCPCS 90846
Hospital Charge Code	84509021
Hospital Revenue Code	916
Min. Negotiated Rate	$164.10
Max. Negotiated Rate	$164.10
Rate for Payer: Qualcare PPO/HMO/WC	$164.10

FAMILY TX WO PATIENT 50 MIN

Facility

$725.00

Service Code	HCPCS 90846
Hospital Charge Code	94810035
Hospital Revenue Code	916
Min. Negotiated Rate	$94.25
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$217.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.25
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

FAMILY TX WO PATIENT 50 MIN

Facility

$1,094.00

Service Code	HCPCS 90846
Hospital Charge Code	87506005
Hospital Revenue Code	916
Min. Negotiated Rate	$164.10
Max. Negotiated Rate	$164.10
Rate for Payer: Qualcare PPO/HMO/WC	$164.10

FAMILY TX WO PATIENT 50 MIN

Facility

$1,094.00

Service Code	HCPCS 90846
Hospital Charge Code	84518021
Hospital Revenue Code	916
Min. Negotiated Rate	$142.22
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	$170.91
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

FAMILY TX WO PATIENT 50 MIN

Facility

$640.00

Service Code	HCPCS 90846
Hospital Charge Code	87504055
Hospital Revenue Code	916
Min. Negotiated Rate	$83.20
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$192.00
Rate for Payer: Aetna Medicare Advantage	$192.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.20
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.20
Rate for Payer: Qualcare PPO/HMO/WC	$96.00

FAMILY TX WO PATIENT 50 MIN

Facility

$640.00

Service Code	HCPCS 90846
Hospital Charge Code	83246185
Hospital Revenue Code	916
Min. Negotiated Rate	$83.20
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$192.00
Rate for Payer: Aetna Medicare Advantage	$192.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.20
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.20
Rate for Payer: Qualcare PPO/HMO/WC	$96.00

FAMILY TX WO PATIENT 50 MIN

Facility

$1,094.00

Service Code	HCPCS 90846
Hospital Charge Code	84511021
Hospital Revenue Code	916
Min. Negotiated Rate	$142.22
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	$170.91
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

FAMILY TX WO PATIENT 50 MIN

Facility

$1,094.00

Service Code	HCPCS 90846
Hospital Charge Code	84517021
Hospital Revenue Code	916
Min. Negotiated Rate	$164.10
Max. Negotiated Rate	$164.10
Rate for Payer: Qualcare PPO/HMO/WC	$164.10

Know your out-of-pocket cost for care.

All Charges