Heights University Hospital

All Charges

Charge

Type

Setting

Price

HYPNOTHERAPY CHILD

Facility

$750.00

Service Code	HCPCS 90880
Hospital Charge Code	4832523
Hospital Revenue Code	914
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

HYPNOTHERAPY CHILD

Facility

$750.00

Service Code	HCPCS 90880
Hospital Charge Code	4517523
Hospital Revenue Code	914
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

HYPNOTHERAPY CHILD

Facility

$750.00

Service Code	HCPCS 90880
Hospital Charge Code	4822523
Hospital Revenue Code	914
Min. Negotiated Rate	$58.22
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	$58.22
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

HYPNOTHERAPY CHILD

Facility

$750.00

Service Code	HCPCS 90880
Hospital Charge Code	4518518
Hospital Revenue Code	914
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

HYPNOTHERAPY CHILD

Facility

$750.00

Service Code	HCPCS 90880
Hospital Charge Code	4822523
Hospital Revenue Code	914
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

HYPNOTHERAPY CHILD

Facility

$750.00

Service Code	HCPCS 90880
Hospital Charge Code	4824523
Hospital Revenue Code	914
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

HYPNOTHERAPY CHILD

Facility

$750.00

Service Code	HCPCS 90880
Hospital Charge Code	4511523
Hospital Revenue Code	914
Min. Negotiated Rate	$58.22
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	$58.22
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

HYPNOTHERAPY CHILD

Facility

$750.00

Service Code	HCPCS 90880
Hospital Charge Code	4518617
Hospital Revenue Code	914
Min. Negotiated Rate	$58.22
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	$58.22
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

HYPNOTHERAPY CHILD

Facility

$750.00

Service Code	HCPCS 90880
Hospital Charge Code	4504523
Hospital Revenue Code	914
Min. Negotiated Rate	$58.22
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	$58.22
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

HYPNOTHERAPY CHILD

Facility

$750.00

Service Code	HCPCS 90880
Hospital Charge Code	4510523
Hospital Revenue Code	914
Min. Negotiated Rate	$58.22
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	$58.22
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

HYPOGLYCEMIC PANEL SERUM/PLSMA

Facility

$500.00

Service Code	HCPCS 83789
Hospital Charge Code	401083789
Hospital Revenue Code	301
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$78.12
Rate for Payer: Aetna Medicare Advantage	$24.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.34
Rate for Payer: Cigna Commercial	$24.11
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$22.90
Rate for Payer: EmblemHealth Commercial	$72.33
Rate for Payer: Humana Medicare Advantage	$24.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.11
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.56
Rate for Payer: Wellcare Medicare Advantage	$24.11

HYPOGLYCEMIC PANEL SERUM/PLSMA

Facility

$500.00

Service Code	HCPCS 83789
Hospital Charge Code	401083789
Hospital Revenue Code	301
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

HYPOTEARS 1% OPHTH/30ML

Facility

$58.69

Service Code	NDC 536197072
Hospital Charge Code	60633142
Hospital Revenue Code	250
Min. Negotiated Rate	$7.63
Max. Negotiated Rate	$29.34
Rate for Payer: Aetna Commercial	$17.61
Rate for Payer: Aetna Medicare Advantage	$17.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.97
Rate for Payer: Cigna Commercial	$29.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.63
Rate for Payer: Oxford Commercial	$29.34
Rate for Payer: Qualcare PPO/HMO/WC	$8.80
Rate for Payer: UnitedHealthcare Commercial	$29.34

HYPOTEARS 1% OPHTH/30ML

Facility

$58.69

Service Code	NDC 536197072
Hospital Charge Code	60633142
Hospital Revenue Code	250
Min. Negotiated Rate	$8.80
Max. Negotiated Rate	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$8.80

HYPOTHERMIA MACHINE

Facility

$133.65

Hospital Charge Code	2708000879
Hospital Revenue Code	270
Min. Negotiated Rate	$17.37
Max. Negotiated Rate	$66.83
Rate for Payer: Aetna Commercial	$40.09
Rate for Payer: Aetna Medicare Advantage	$40.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.08
Rate for Payer: Cigna Commercial	$66.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.37
Rate for Payer: Oxford Commercial	$66.83
Rate for Payer: Qualcare PPO/HMO/WC	$20.05
Rate for Payer: UnitedHealthcare Commercial	$66.83

HYPOTHERMIA MACHINE

Facility

$133.65

Hospital Charge Code	2708000879
Hospital Revenue Code	270
Min. Negotiated Rate	$20.05
Max. Negotiated Rate	$20.05
Rate for Payer: Qualcare PPO/HMO/WC	$20.05

HYPOTHERMIA PER DAY****

Facility

$52.00

Hospital Charge Code	8000879
Hospital Revenue Code	279
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

HYPOTHERMIA PER DAY****

Facility

$52.00

Hospital Charge Code	8000879
Hospital Revenue Code	279
Min. Negotiated Rate	$6.76
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$15.60
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.76
Rate for Payer: Oxford Commercial	$26.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$26.00

HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS

Facility

$16,747.24

Service Code	APR-DRG 4224
Min. Negotiated Rate	$14,456.65
Max. Negotiated Rate	$16,747.24
Rate for Payer: Aetna Better Health Medicaid	$16,418.86
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,747.24
Rate for Payer: Wellpoint Medicaid Managed Care	$14,456.65

HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS

Facility

$6,933.46

Service Code	APR-DRG 4222
Min. Negotiated Rate	$4,563.38
Max. Negotiated Rate	$6,933.46
Rate for Payer: Aetna Better Health Medicaid	$6,797.51
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,933.46
Rate for Payer: Wellpoint Medicaid Managed Care	$4,563.38

HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS

Facility

$4,798.78

Service Code	APR-DRG 4221
Min. Negotiated Rate	$3,181.00
Max. Negotiated Rate	$4,798.78
Rate for Payer: Aetna Better Health Medicaid	$4,704.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,798.78
Rate for Payer: Wellpoint Medicaid Managed Care	$3,181.00

HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS

Facility

$10,101.68

Service Code	APR-DRG 4223
Min. Negotiated Rate	$6,674.95
Max. Negotiated Rate	$10,101.68
Rate for Payer: Aetna Better Health Medicaid	$9,903.61
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,101.68
Rate for Payer: Wellpoint Medicaid Managed Care	$6,674.95

HYPROCURE DEVICE SZ 6

Facility

$7,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270677410
Hospital Revenue Code	278
Min. Negotiated Rate	$1,087.50
Max. Negotiated Rate	$3,625.00
Rate for Payer: Aetna Commercial	$2,175.00
Rate for Payer: Aetna Medicare Advantage	$2,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,848.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,848.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,848.75
Rate for Payer: Cigna Commercial	$3,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,754.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,087.50

HYPROCURE DEVICE SZ 6

Facility

$7,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270677410
Hospital Revenue Code	278
Min. Negotiated Rate	$1,087.50
Max. Negotiated Rate	$1,754.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,754.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,087.50

HYPROCURE DEVICE SZ7

Facility

$9,900.00

Hospital Charge Code	270675464
Hospital Revenue Code	278
Min. Negotiated Rate	$1,485.00
Max. Negotiated Rate	$2,395.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,395.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,485.00

Know your out-of-pocket cost for care.

All Charges