Heights University Hospital

All Charges

Charge

Type

Setting

Price

INF THERAPEUTIC 1ST HR

Facility

$1,334.09

Service Code	HCPCS 96365
Hospital Charge Code	93082001
Hospital Revenue Code	260
Min. Negotiated Rate	$42.85
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$400.23
Rate for Payer: Aetna Medicare Advantage	$400.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$340.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$340.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$340.19
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.43
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$200.11
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC 1ST HR

Facility

$1,334.09

Service Code	HCPCS 96365
Hospital Charge Code	74308235
Hospital Revenue Code	260
Min. Negotiated Rate	$200.11
Max. Negotiated Rate	$200.11
Rate for Payer: Qualcare PPO/HMO/WC	$200.11

INF THERAPEUTIC 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96365
Hospital Charge Code	83653135
Hospital Revenue Code	260
Min. Negotiated Rate	$42.85
Max. Negotiated Rate	$840.00
Rate for Payer: Aetna Commercial	$840.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.00
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC 1ST HR

Facility

$1,334.09

Service Code	HCPCS 96365
Hospital Charge Code	73237021
Hospital Revenue Code	260
Min. Negotiated Rate	$200.11
Max. Negotiated Rate	$200.11
Rate for Payer: Qualcare PPO/HMO/WC	$200.11

INF THERAPEUTIC 1ST HR

Facility

$1,334.09

Service Code	HCPCS 96365
Hospital Charge Code	2300908
Hospital Revenue Code	260
Min. Negotiated Rate	$42.85
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$400.23
Rate for Payer: Aetna Medicare Advantage	$400.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$340.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$340.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$340.19
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.43
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$200.11
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96365
Hospital Charge Code	5700259
Hospital Revenue Code	260
Min. Negotiated Rate	$42.85
Max. Negotiated Rate	$840.00
Rate for Payer: Aetna Commercial	$840.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.00
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC 1ST HR

Facility

$1,334.09

Service Code	HCPCS 96365
Hospital Charge Code	4501035
Hospital Revenue Code	260
Min. Negotiated Rate	$200.11
Max. Negotiated Rate	$200.11
Rate for Payer: Qualcare PPO/HMO/WC	$200.11

INF THERAPEUTIC 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96365
Hospital Charge Code	93500029
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INF THERAPEUTIC 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96365
Hospital Charge Code	5700375
Hospital Revenue Code	450
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INF THERAPEUTIC 1ST HR

Facility

$1,334.09

Service Code	HCPCS 96365
Hospital Charge Code	1600530
Hospital Revenue Code	260
Min. Negotiated Rate	$42.85
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$400.23
Rate for Payer: Aetna Medicare Advantage	$400.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$340.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$340.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$340.19
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.43
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$200.11
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC 1ST HR

Facility

$1,334.09

Service Code	HCPCS 96365
Hospital Charge Code	73050915
Hospital Revenue Code	260
Min. Negotiated Rate	$200.11
Max. Negotiated Rate	$200.11
Rate for Payer: Qualcare PPO/HMO/WC	$200.11

INF THERAPEUTIC 1ST HR

Facility

$1,334.09

Service Code	HCPCS 96365
Hospital Charge Code	1600530
Hospital Revenue Code	260
Min. Negotiated Rate	$200.11
Max. Negotiated Rate	$200.11
Rate for Payer: Qualcare PPO/HMO/WC	$200.11

INF THERAPEUTIC 1ST HR

Facility

$1,405.77

Service Code	HCPCS 96365
Hospital Charge Code	74308375
Hospital Revenue Code	260
Min. Negotiated Rate	$210.87
Max. Negotiated Rate	$210.87
Rate for Payer: Qualcare PPO/HMO/WC	$210.87

INF THERAPEUTIC 1ST HR

Facility

$1,334.09

Service Code	HCPCS 96365
Hospital Charge Code	73237021
Hospital Revenue Code	260
Min. Negotiated Rate	$42.85
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$400.23
Rate for Payer: Aetna Medicare Advantage	$400.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$340.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$340.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$340.19
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.43
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$200.11
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC 1ST HR

Facility

$1,334.09

Service Code	HCPCS 96365
Hospital Charge Code	93500019
Hospital Revenue Code	260
Min. Negotiated Rate	$200.11
Max. Negotiated Rate	$200.11
Rate for Payer: Qualcare PPO/HMO/WC	$200.11

INF THERAPEUTIC 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96365
Hospital Charge Code	73190093
Hospital Revenue Code	260
Min. Negotiated Rate	$42.85
Max. Negotiated Rate	$840.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Aetna Commercial	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.00
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC 1ST HR

Facility

$1,405.77

Service Code	HCPCS 96365
Hospital Charge Code	74308375
Hospital Revenue Code	260
Min. Negotiated Rate	$42.85
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$421.73
Rate for Payer: Aetna Medicare Advantage	$421.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$358.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$358.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$358.47
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.75
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.87
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC 1ST HR

Facility

$1,334.09

Service Code	HCPCS 96365
Hospital Charge Code	8200515
Hospital Revenue Code	260
Min. Negotiated Rate	$200.11
Max. Negotiated Rate	$200.11
Rate for Payer: Qualcare PPO/HMO/WC	$200.11

INF THERAPEUTIC 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96365
Hospital Charge Code	3409020
Hospital Revenue Code	260
Min. Negotiated Rate	$42.85
Max. Negotiated Rate	$840.00
Rate for Payer: Aetna Commercial	$840.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.00
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96365
Hospital Charge Code	3409020
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INF THERAPEUTIC 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96365
Hospital Charge Code	1001175
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INF THERAPEUTIC 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96365
Hospital Charge Code	5700375
Hospital Revenue Code	450
Min. Negotiated Rate	$42.85
Max. Negotiated Rate	$840.00
Rate for Payer: Aetna Commercial	$840.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INF THERAPEUTIC 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96365
Hospital Charge Code	73092055
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INF THERAPEUTIC 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96365
Hospital Charge Code	73190093
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INF THERAPEUTIC 1ST HR

Facility

$1,334.09

Service Code	HCPCS 96365
Hospital Charge Code	73050915
Hospital Revenue Code	260
Min. Negotiated Rate	$42.85
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$400.23
Rate for Payer: Aetna Medicare Advantage	$400.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$340.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$340.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$340.19
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.43
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$200.11
Rate for Payer: UnitedHealthcare Commercial	$802.00

Know your out-of-pocket cost for care.

All Charges