Heights University Hospital

All Charges

Charge

Type

Setting

Price

GROUP ADULT PH MEDICAID

Facility

$750.00

Service Code	HCPCS 90853
Hospital Charge Code	4822619
Hospital Revenue Code	915
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

GROUP ADULT PH MEDICAID

Facility

$750.00

Service Code	HCPCS 90853
Hospital Charge Code	4822619
Hospital Revenue Code	915
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$241.93
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48

GROUP ADULT PH MEDICAID

Facility

$750.00

Service Code	HCPCS H0035
Hospital Charge Code	4509619
Hospital Revenue Code	912
Min. Negotiated Rate	$17.91
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17.91

GROUP ADULT PH MEDICAID

Facility

$750.00

Service Code	HCPCS H0035
Hospital Charge Code	4509619
Hospital Revenue Code	912
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

GROUP B STREP CULTURE

Facility

$585.00

Hospital Charge Code	3035124
Hospital Revenue Code	301
Min. Negotiated Rate	$76.05
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$175.50
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Commercial	$114.00

GROUP B STREP CULTURE

Facility

$585.00

Hospital Charge Code	3035124
Hospital Revenue Code	301
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$87.75
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

GROUP CHILD OP Medicaid

Facility

$750.00

Service Code	HCPCS 90853
Hospital Charge Code	4527616
Hospital Revenue Code	915
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

GROUP CHILD OP Medicaid

Facility

$750.00

Service Code	HCPCS 90853
Hospital Charge Code	4822616
Hospital Revenue Code	915
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

GROUP CHILD OP Medicaid

Facility

$750.00

Service Code	HCPCS 90853
Hospital Charge Code	4515616
Hospital Revenue Code	915
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$241.93
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48

GROUP CHILD OP Medicaid

Facility

$750.00

Service Code	HCPCS 90853
Hospital Charge Code	4515616
Hospital Revenue Code	915
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

GROUP CHILD OP Medicaid

Facility

$750.00

Service Code	HCPCS 90853
Hospital Charge Code	4517616
Hospital Revenue Code	915
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$241.93
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48

GROUP CHILD OP Medicaid

Facility

$750.00

Service Code	HCPCS 90853
Hospital Charge Code	4546616
Hospital Revenue Code	915
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

GROUP CHILD OP Medicaid

Facility

$750.00

Service Code	HCPCS 90853
Hospital Charge Code	4511616
Hospital Revenue Code	915
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

GROUP CHILD OP Medicaid

Facility

$750.00

Service Code	HCPCS 90853
Hospital Charge Code	4546616
Hospital Revenue Code	915
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$241.93
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48

GROUP CHILD OP Medicaid

Facility

$750.00

Service Code	HCPCS 90853
Hospital Charge Code	4511616
Hospital Revenue Code	915
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$241.93
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48

GROUP CHILD OP Medicaid

Facility

$750.00

Service Code	HCPCS 90853
Hospital Charge Code	4518616
Hospital Revenue Code	915
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$241.93
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48

GROUP CHILD OP Medicaid

Facility

$750.00

Service Code	HCPCS 90853
Hospital Charge Code	4822616
Hospital Revenue Code	915
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$241.93
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48

GROUP CHILD OP Medicaid

Facility

$750.00

Service Code	HCPCS 90853
Hospital Charge Code	4527616
Hospital Revenue Code	915
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$241.93
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48

GROUP CHILD OP Medicaid

Facility

$750.00

Service Code	HCPCS 90853
Hospital Charge Code	4504616
Hospital Revenue Code	915
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$241.93
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48

GROUP CHILD OP Medicaid

Facility

$750.00

Service Code	HCPCS 90853
Hospital Charge Code	4517616
Hospital Revenue Code	915
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

GROUP CHILD OP Medicaid

Facility

$750.00

Service Code	HCPCS 90853
Hospital Charge Code	4824616
Hospital Revenue Code	915
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$241.93
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48

GROUP CHILD OP Medicaid

Facility

$750.00

Service Code	HCPCS 90853
Hospital Charge Code	4832616
Hospital Revenue Code	915
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$241.93
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48

GROUP CHILD OP Medicaid

Facility

$750.00

Service Code	HCPCS 90853
Hospital Charge Code	4832616
Hospital Revenue Code	915
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

GROUP CHILD OP Medicaid

Facility

$750.00

Service Code	HCPCS 90853
Hospital Charge Code	4518616
Hospital Revenue Code	915
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

GROUP CHILD OP Medicaid

Facility

$750.00

Service Code	HCPCS 90853
Hospital Charge Code	4535616
Hospital Revenue Code	915
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$241.93
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48

Know your out-of-pocket cost for care.

All Charges