Heights University Hospital

All Charges

Charge

Type

Setting

Price

IND PSYCHOTX NONMD 60MIN CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4822509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4509509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4511509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4515509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4510509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4504509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4546509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4504509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4517509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4517509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4822509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4832509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4832509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4527509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4509509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4511509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4824509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4546509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4515509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4518509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4535509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4518509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4824509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4527509
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 CHILD

Facility

$2,000.00

Service Code	HCPCS 90837
Hospital Charge Code	4510509
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