Heights University Hospital

All Charges

Charge

Type

Setting

Price

IND PSYCHOTX NONMD 45MIN CHILD

Facility

$1,500.00

Service Code	HCPCS 90834
Hospital Charge Code	4518507
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 CHILD

Facility

$1,500.00

Service Code	HCPCS 90834
Hospital Charge Code	4511507
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 CHILD

Facility

$1,500.00

Service Code	HCPCS 90834
Hospital Charge Code	4527507
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 CHILD

Facility

$1,500.00

Service Code	HCPCS 90834
Hospital Charge Code	4517507
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 CHILD

Facility

$1,500.00

Service Code	HCPCS 90834
Hospital Charge Code	4509507
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 CHILD

Facility

$1,500.00

Service Code	HCPCS 90834
Hospital Charge Code	4527507
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 CHILD

Facility

$1,500.00

Service Code	HCPCS 90834
Hospital Charge Code	4517507
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 CHILD

Facility

$1,500.00

Service Code	HCPCS 90834
Hospital Charge Code	4822507
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 CHILD

Facility

$1,500.00

Service Code	HCPCS 90834
Hospital Charge Code	4504507
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 60MIN ADULT

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4502508
Hospital Revenue Code	914
Min. Negotiated Rate	$135.39
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
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	$510.00
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

IND PSYCHOTX NONMD 60MIN ADULT

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4502508
Hospital Revenue Code	914
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

IND PSYCHOTX NONMD 60MIN ADULT

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4822508
Hospital Revenue Code	914
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

IND PSYCHOTX NONMD 60MIN ADULT

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4832508
Hospital Revenue Code	914
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

IND PSYCHOTX NONMD 60MIN ADULT

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4832508
Hospital Revenue Code	914
Min. Negotiated Rate	$135.39
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
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	$510.00
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

IND PSYCHOTX NONMD 60MIN ADULT

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4822508
Hospital Revenue Code	914
Min. Negotiated Rate	$135.39
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
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	$510.00
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

IND PSYCHOTX NONMD 60MIN ADULT

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4509508
Hospital Revenue Code	914
Min. Negotiated Rate	$135.39
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
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	$510.00
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

IND PSYCHOTX NONMD 60MIN ADULT

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4511508
Hospital Revenue Code	914
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

IND PSYCHOTX NONMD 60MIN ADULT

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4511508
Hospital Revenue Code	914
Min. Negotiated Rate	$135.39
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
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	$510.00
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

IND PSYCHOTX NONMD 60MIN ADULT

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4818508
Hospital Revenue Code	914
Min. Negotiated Rate	$135.39
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
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	$510.00
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

IND PSYCHOTX NONMD 60MIN ADULT

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4535508
Hospital Revenue Code	914
Min. Negotiated Rate	$135.39
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
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	$510.00
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

IND PSYCHOTX NONMD 60MIN ADULT

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4504508
Hospital Revenue Code	914
Min. Negotiated Rate	$135.39
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
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	$510.00
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

IND PSYCHOTX NONMD 60MIN ADULT

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4509508
Hospital Revenue Code	914
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

IND PSYCHOTX NONMD 60MIN ADULT

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4818508
Hospital Revenue Code	914
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

IND PSYCHOTX NONMD 60MIN ADULT

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4504508
Hospital Revenue Code	914
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

IND PSYCHOTX NONMD 60MIN ADULT

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4535508
Hospital Revenue Code	914
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

Know your out-of-pocket cost for care.

All Charges