Heights University Hospital

All Charges

Charge

Type

Setting

Price

IND PSYCHOTX NONMD 30MIN CHILD

Facility

$750.00

Service Code	HCPCS 90832
Hospital Charge Code	4546505
Hospital Revenue Code	914
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

IND PSYCHOTX NONMD 30MIN CHILD

Facility

$750.00

Service Code	HCPCS 90832
Hospital Charge Code	4518505
Hospital Revenue Code	914
Min. Negotiated Rate	$71.39
Max. Negotiated Rate	$422.69
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	$132.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$422.69
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	$71.39

IND PSYCHOTX NONMD 30MIN CHILD

Facility

$750.00

Service Code	HCPCS 90832
Hospital Charge Code	4518505
Hospital Revenue Code	914
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

IND PSYCHOTX NONMD 30MIN CHILD

Facility

$750.00

Service Code	HCPCS 90832
Hospital Charge Code	4509505
Hospital Revenue Code	914
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

IND PSYCHOTX NONMD 30MIN CHILD

Facility

$750.00

Service Code	HCPCS 90832
Hospital Charge Code	4515505
Hospital Revenue Code	914
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

IND PSYCHOTX NONMD 30MIN CHILD

Facility

$750.00

Service Code	HCPCS 90832
Hospital Charge Code	4546505
Hospital Revenue Code	914
Min. Negotiated Rate	$71.39
Max. Negotiated Rate	$422.69
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	$132.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$422.69
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	$71.39

IND PSYCHOTX NONMD 30MIN CHILD

Facility

$750.00

Service Code	HCPCS 90832
Hospital Charge Code	4824505
Hospital Revenue Code	914
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

IND PSYCHOTX NONMD 30MIN CHILD

Facility

$750.00

Service Code	HCPCS 90832
Hospital Charge Code	4527505
Hospital Revenue Code	914
Min. Negotiated Rate	$71.39
Max. Negotiated Rate	$422.69
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	$132.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$422.69
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	$71.39

IND PSYCHOTX NONMD 30MIN CHILD

Facility

$750.00

Service Code	HCPCS 90832
Hospital Charge Code	4822505
Hospital Revenue Code	914
Min. Negotiated Rate	$71.39
Max. Negotiated Rate	$422.69
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	$132.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$422.69
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	$71.39

IND PSYCHOTX NONMD 30MIN CHILD

Facility

$750.00

Service Code	HCPCS 90832
Hospital Charge Code	4509505
Hospital Revenue Code	914
Min. Negotiated Rate	$71.39
Max. Negotiated Rate	$422.69
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	$132.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$422.69
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	$71.39

IND PSYCHOTX NONMD 30MIN CHILD

Facility

$750.00

Service Code	HCPCS 90832
Hospital Charge Code	4535505
Hospital Revenue Code	914
Min. Negotiated Rate	$71.39
Max. Negotiated Rate	$422.69
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	$132.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$422.69
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	$71.39

IND PSYCHOTX NONMD 30MIN CHILD

Facility

$750.00

Service Code	HCPCS 90832
Hospital Charge Code	4511505
Hospital Revenue Code	914
Min. Negotiated Rate	$71.39
Max. Negotiated Rate	$422.69
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	$132.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$422.69
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	$71.39

IND PSYCHOTX NONMD 30MIN CHILD

Facility

$750.00

Service Code	HCPCS 90832
Hospital Charge Code	4535505
Hospital Revenue Code	914
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

IND PSYCHOTX NONMD 30MIN CHILD

Facility

$750.00

Service Code	HCPCS 90832
Hospital Charge Code	4504505
Hospital Revenue Code	914
Min. Negotiated Rate	$71.39
Max. Negotiated Rate	$422.69
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	$132.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$422.69
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	$71.39

IND PSYCHOTX NONMD 30MIN CHILD

Facility

$750.00

Service Code	HCPCS 90832
Hospital Charge Code	4832505
Hospital Revenue Code	914
Min. Negotiated Rate	$71.39
Max. Negotiated Rate	$422.69
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
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	$132.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$71.39

IND PSYCHOTX NONMD 30MIN CHILD

Facility

$750.00

Service Code	HCPCS 90832
Hospital Charge Code	4832505
Hospital Revenue Code	914
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

IND PSYCHOTX NONMD 30MIN CHILD

Facility

$750.00

Service Code	HCPCS 90832
Hospital Charge Code	4504505
Hospital Revenue Code	914
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

IND PSYCHOTX NONMD 45MIN ADULT

Facility

$1,500.00

Service Code	HCPCS 90834
Hospital Charge Code	4511506
Hospital Revenue Code	914
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

IND PSYCHOTX NONMD 45MIN ADULT

Facility

$1,500.00

Service Code	HCPCS 90834
Hospital Charge Code	4502506
Hospital Revenue Code	914
Min. Negotiated Rate	$94.46
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	$150.25
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	$94.46

IND PSYCHOTX NONMD 45MIN ADULT

Facility

$1,500.00

Service Code	HCPCS 90834
Hospital Charge Code	4535506
Hospital Revenue Code	914
Min. Negotiated Rate	$94.46
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	$150.25
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	$94.46

IND PSYCHOTX NONMD 45MIN ADULT

Facility

$1,500.00

Service Code	HCPCS 90834
Hospital Charge Code	4504506
Hospital Revenue Code	914
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

IND PSYCHOTX NONMD 45MIN ADULT

Facility

$1,500.00

Service Code	HCPCS 90834
Hospital Charge Code	4818506
Hospital Revenue Code	914
Min. Negotiated Rate	$94.46
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	$150.25
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	$94.46

IND PSYCHOTX NONMD 45MIN ADULT

Facility

$1,500.00

Service Code	HCPCS 90834
Hospital Charge Code	4832506
Hospital Revenue Code	914
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

IND PSYCHOTX NONMD 45MIN ADULT

Facility

$1,500.00

Service Code	HCPCS 90834
Hospital Charge Code	4832506
Hospital Revenue Code	914
Min. Negotiated Rate	$94.46
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	$150.25
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	$94.46

IND PSYCHOTX NONMD 45MIN ADULT

Facility

$1,500.00

Service Code	HCPCS 90834
Hospital Charge Code	4818506
Hospital Revenue Code	914
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

Know your out-of-pocket cost for care.

All Charges