Heights University Hospital

All Charges

Charge

Type

Setting

Price

INTERACTIVE COMPLEXITY

Facility

$76.25

Service Code	HCPCS 90785
Hospital Charge Code	84518049
Hospital Revenue Code	900
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$1,994.00
Rate for Payer: Aetna Commercial	$22.88
Rate for Payer: Aetna Medicare Advantage	$22.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.44
Rate for Payer: Cigna Commercial	$12.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.91
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.44
Rate for Payer: UnitedHealthcare Commercial	$1,994.00

INTERACTIVE COMPLEXITY

Facility

$76.25

Service Code	HCPCS 90785
Hospital Charge Code	84509049
Hospital Revenue Code	900
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$1,994.00
Rate for Payer: Aetna Commercial	$22.88
Rate for Payer: Aetna Medicare Advantage	$22.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.44
Rate for Payer: Cigna Commercial	$12.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.91
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.44
Rate for Payer: UnitedHealthcare Commercial	$1,994.00

INTERACTIVE COMPLEXITY

Facility

$76.25

Service Code	HCPCS 90785
Hospital Charge Code	84511049
Hospital Revenue Code	900
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$1,994.00
Rate for Payer: Aetna Commercial	$22.88
Rate for Payer: Aetna Medicare Advantage	$22.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.44
Rate for Payer: Cigna Commercial	$12.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.91
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.44
Rate for Payer: UnitedHealthcare Commercial	$1,994.00

INTERACTIVE COMPLEXITY

Facility

$6,800.00

Service Code	HCPCS 90785
Hospital Charge Code	83246150
Hospital Revenue Code	900
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$2,040.00
Rate for Payer: Aetna Commercial	$2,040.00
Rate for Payer: Aetna Medicare Advantage	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,734.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,734.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,734.00
Rate for Payer: Cigna Commercial	$12.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$884.00
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.00
Rate for Payer: UnitedHealthcare Commercial	$1,994.00

INTERACTIVE COMPLEXITY

Facility

$550.00

Service Code	HCPCS 90785
Hospital Charge Code	87504130
Hospital Revenue Code	900
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$1,994.00
Rate for Payer: Aetna Commercial	$165.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$12.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$1,994.00

INTERACTIVE COMPLEXITY NON MD

Facility

$275.00

Service Code	HCPCS 90785
Hospital Charge Code	4546776
Hospital Revenue Code	914
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$82.50
Rate for Payer: Aetna Commercial	$82.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$12.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.75
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

INTERACTIVE COMPLEXITY NON MD

Facility

$275.00

Service Code	HCPCS 90785
Hospital Charge Code	4546776
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

INTERACTIVE COMPLXTY CLIN

Facility

$6,800.00

Service Code	HCPCS 90785
Hospital Charge Code	94810140
Hospital Revenue Code	900
Min. Negotiated Rate	$1,020.00
Max. Negotiated Rate	$1,020.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.00

INTERACTIVE COMPLXTY CLIN

Facility

$6,800.00

Service Code	HCPCS 90785
Hospital Charge Code	94810140
Hospital Revenue Code	900
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$2,040.00
Rate for Payer: Aetna Commercial	$2,040.00
Rate for Payer: Aetna Medicare Advantage	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,734.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,734.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,734.00
Rate for Payer: Cigna Commercial	$12.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$884.00
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.00
Rate for Payer: UnitedHealthcare Commercial	$1,994.00

INTERACTIVE GROUP PSYCHOTHERPY

Facility

$628.50

Service Code	HCPCS 90857
Hospital Charge Code	9310145
Hospital Revenue Code	915
Min. Negotiated Rate	$81.70
Max. Negotiated Rate	$314.25
Rate for Payer: Aetna Commercial	$188.55
Rate for Payer: Aetna Medicare Advantage	$188.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.27
Rate for Payer: Cigna Commercial	$314.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.70
Rate for Payer: Qualcare PPO/HMO/WC	$94.28

INTERACTIVE GROUP PSYCHOTHERPY

Facility

$628.50

Service Code	HCPCS 90857
Hospital Charge Code	9310145
Hospital Revenue Code	915
Min. Negotiated Rate	$94.28
Max. Negotiated Rate	$94.28
Rate for Payer: Qualcare PPO/HMO/WC	$94.28

INTERACT PSYCH DX INTERVIEW

Facility

$751.40

Service Code	HCPCS 90802
Hospital Charge Code	9310125
Hospital Revenue Code	914
Min. Negotiated Rate	$112.71
Max. Negotiated Rate	$112.71
Rate for Payer: Qualcare PPO/HMO/WC	$112.71

INTERACT PSYCH DX INTERVIEW

Facility

$751.40

Service Code	HCPCS 90802
Hospital Charge Code	9310125
Hospital Revenue Code	914
Min. Negotiated Rate	$97.68
Max. Negotiated Rate	$375.70
Rate for Payer: Aetna Commercial	$225.42
Rate for Payer: Aetna Medicare Advantage	$225.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.61
Rate for Payer: Cigna Commercial	$375.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.68
Rate for Payer: Qualcare PPO/HMO/WC	$112.71

INTERBODY 14MM X 12MM X 7MM 7

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270686932
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$2,904.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

INTERBODY 14MM X 12MM X 7MM 7

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270686932
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$6,000.00
Rate for Payer: Aetna Commercial	$3,600.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

INTERBODY 14 MM X 12 MM X 8 MM

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270687502
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$2,904.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

INTERBODY 14 MM X 12 MM X 8 MM

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270687502
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$6,000.00
Rate for Payer: Aetna Commercial	$3,600.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

INTERBODY 16X14X7MM 7 DEG RT

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270694170
Hospital Revenue Code	278
Min. Negotiated Rate	$3,637.50
Max. Negotiated Rate	$5,868.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50

INTERBODY 16X14X7MM 7 DEG RT

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270694170
Hospital Revenue Code	278
Min. Negotiated Rate	$3,637.50
Max. Negotiated Rate	$12,125.00
Rate for Payer: Aetna Commercial	$7,275.00
Rate for Payer: Aetna Medicare Advantage	$7,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,183.75
Rate for Payer: Cigna Commercial	$12,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50

INTERBODY 18X15X7MM 7 DEG RT

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270694169
Hospital Revenue Code	278
Min. Negotiated Rate	$3,637.50
Max. Negotiated Rate	$12,125.00
Rate for Payer: Aetna Commercial	$7,275.00
Rate for Payer: Aetna Medicare Advantage	$7,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,183.75
Rate for Payer: Cigna Commercial	$12,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50

INTERBODY 18X15X7MM 7 DEG RT

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270694169
Hospital Revenue Code	278
Min. Negotiated Rate	$3,637.50
Max. Negotiated Rate	$5,868.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50

INTERBODY CAGE 15X13X6MM 6DEG

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704836
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

INTERBODY CAGE 15X13X6MM 6DEG

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704836
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$1,800.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

INTERBODY CS FUS DEV 120X15MM

Facility

$20,000.00

Hospital Charge Code	270702967
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

INTERBODY CS FUS DEV 120X15MM

Facility

$20,000.00

Hospital Charge Code	270702967
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$10,000.00
Rate for Payer: Aetna Commercial	$6,000.00
Rate for Payer: Aetna Medicare Advantage	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,100.00
Rate for Payer: Cigna Commercial	$10,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

Know your out-of-pocket cost for care.

All Charges