Heights University Hospital

All Charges

Charge

Type

Setting

Price

IND PSYCHOTX W E&M MD 30MIN

Facility

$375.00

Service Code	HCPCS 90833
Hospital Charge Code	4510704
Hospital Revenue Code	914
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

IND PSYCHOTX W E&M MD 30MIN

Facility

$375.00

Service Code	HCPCS 90833
Hospital Charge Code	4535704
Hospital Revenue Code	914
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

IND PSYCHOTX W E&M MD 30MIN

Facility

$375.00

Service Code	HCPCS 90833
Hospital Charge Code	4824704
Hospital Revenue Code	914
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

IND PSYCHOTX W E&M MD 30MIN

Facility

$375.00

Service Code	HCPCS 90833
Hospital Charge Code	4824704
Hospital Revenue Code	914
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$122.43
Rate for Payer: Aetna Commercial	$112.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$70.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$73.61

IND PSYCHOTX W E&M MD 30MIN

Facility

$375.00

Service Code	HCPCS 90833
Hospital Charge Code	4535704
Hospital Revenue Code	914
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$122.43
Rate for Payer: Aetna Commercial	$112.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$70.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$73.61

IND PSYCHOTX W E&M MD 30MIN

Facility

$375.00

Service Code	HCPCS 90833
Hospital Charge Code	4502704
Hospital Revenue Code	914
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$122.43
Rate for Payer: Aetna Commercial	$112.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$70.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$73.61

IND PSYCHOTX W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4510705
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 W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4511705
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 W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4502705
Hospital Revenue Code	914
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$147.87
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	$147.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$89.20
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 W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4509705
Hospital Revenue Code	914
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$147.87
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	$147.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$89.20
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 W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4510705
Hospital Revenue Code	914
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$147.87
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	$147.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$89.20
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 W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4515705
Hospital Revenue Code	914
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$147.87
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	$147.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$89.20
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 W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4515705
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 W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4518705
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 W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4509705
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 W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4517705
Hospital Revenue Code	914
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$147.87
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	$147.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$89.20
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 W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4818705
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 W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4527705
Hospital Revenue Code	914
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$147.87
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	$147.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$89.20
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 W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4818705
Hospital Revenue Code	914
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$147.87
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	$147.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$89.20
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 W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4504705
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 W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4535705
Hospital Revenue Code	914
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$147.87
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	$147.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$89.20
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 W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4502705
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 W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4511705
Hospital Revenue Code	914
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$147.87
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	$147.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$89.20
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 W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4504705
Hospital Revenue Code	914
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$147.87
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	$147.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$89.20
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 W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4527705
Hospital Revenue Code	914
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

Know your out-of-pocket cost for care.

All Charges