Heights University Hospital

All Charges

Charge

Type

Setting

Price

IND PSYCHOTX MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90834
Hospital Charge Code	4509702
Hospital Revenue Code	914
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

IND PSYCHOTX MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90834
Hospital Charge Code	4518702
Hospital Revenue Code	914
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.25
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$94.46

IND PSYCHOTX MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90834
Hospital Charge Code	4517702
Hospital Revenue Code	914
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

IND PSYCHOTX MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90834
Hospital Charge Code	4515702
Hospital Revenue Code	914
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.25
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$94.46

IND PSYCHOTX MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90834
Hospital Charge Code	4822702
Hospital Revenue Code	914
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

IND PSYCHOTX MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90834
Hospital Charge Code	4822702
Hospital Revenue Code	914
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.25
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$94.46

IND PSYCHOTX MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90834
Hospital Charge Code	4502702
Hospital Revenue Code	914
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.25
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$94.46

IND PSYCHOTX MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90834
Hospital Charge Code	4832702
Hospital Revenue Code	914
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

IND PSYCHOTX MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90834
Hospital Charge Code	4502702
Hospital Revenue Code	914
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

IND PSYCHOTX MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90834
Hospital Charge Code	4504702
Hospital Revenue Code	914
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

IND PSYCHOTX MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90834
Hospital Charge Code	4510702
Hospital Revenue Code	914
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

IND PSYCHOTX MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90834
Hospital Charge Code	4546702
Hospital Revenue Code	914
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.25
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$94.46

IND PSYCHOTX MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90834
Hospital Charge Code	4546702
Hospital Revenue Code	914
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

IND PSYCHOTX MD 60 MIN

Facility

$500.00

Service Code	HCPCS 90837
Hospital Charge Code	4509703
Hospital Revenue Code	914
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

IND PSYCHOTX MD 60 MIN

Facility

$500.00

Service Code	HCPCS 90837
Hospital Charge Code	4517703
Hospital Revenue Code	914
Min. Negotiated Rate	$65.00
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

IND PSYCHOTX MD 60 MIN

Facility

$500.00

Service Code	HCPCS 90837
Hospital Charge Code	4818703
Hospital Revenue Code	914
Min. Negotiated Rate	$65.00
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

IND PSYCHOTX MD 60 MIN

Facility

$500.00

Service Code	HCPCS 90837
Hospital Charge Code	4511703
Hospital Revenue Code	914
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

IND PSYCHOTX MD 60 MIN

Facility

$500.00

Service Code	HCPCS 90837
Hospital Charge Code	4535703
Hospital Revenue Code	914
Min. Negotiated Rate	$65.00
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

IND PSYCHOTX MD 60 MIN

Facility

$500.00

Service Code	HCPCS 90837
Hospital Charge Code	4504703
Hospital Revenue Code	914
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

IND PSYCHOTX MD 60 MIN

Facility

$500.00

Service Code	HCPCS 90837
Hospital Charge Code	4527703
Hospital Revenue Code	914
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

IND PSYCHOTX MD 60 MIN

Facility

$500.00

Service Code	HCPCS 90837
Hospital Charge Code	4822703
Hospital Revenue Code	914
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

IND PSYCHOTX MD 60 MIN

Facility

$500.00

Service Code	HCPCS 90837
Hospital Charge Code	4518703
Hospital Revenue Code	914
Min. Negotiated Rate	$65.00
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

IND PSYCHOTX MD 60 MIN

Facility

$500.00

Service Code	HCPCS 90837
Hospital Charge Code	4824703
Hospital Revenue Code	914
Min. Negotiated Rate	$65.00
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

IND PSYCHOTX MD 60 MIN

Facility

$500.00

Service Code	HCPCS 90837
Hospital Charge Code	4515703
Hospital Revenue Code	914
Min. Negotiated Rate	$65.00
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

IND PSYCHOTX MD 60 MIN

Facility

$500.00

Service Code	HCPCS 90837
Hospital Charge Code	4515703
Hospital Revenue Code	914
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

Know your out-of-pocket cost for care.

All Charges