Heights University Hospital

All Charges

Charge

Type

Setting

Price

MED MNG CHILD/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4517618
Hospital Revenue Code	919
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4515618
Hospital Revenue Code	919
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4832618
Hospital Revenue Code	919
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$112.50
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) PPO	$95.62
Rate for Payer: Cigna Commercial	$8.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4527618
Hospital Revenue Code	919
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$112.50
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) PPO	$95.62
Rate for Payer: Cigna Commercial	$8.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4822618
Hospital Revenue Code	919
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4518618
Hospital Revenue Code	919
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4504618
Hospital Revenue Code	919
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$112.50
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) PPO	$95.62
Rate for Payer: Cigna Commercial	$8.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4511618
Hospital Revenue Code	919
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4527618
Hospital Revenue Code	919
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4515618
Hospital Revenue Code	919
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$112.50
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) PPO	$95.62
Rate for Payer: Cigna Commercial	$8.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4518618
Hospital Revenue Code	919
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$112.50
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) PPO	$95.62
Rate for Payer: Cigna Commercial	$8.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4535618
Hospital Revenue Code	919
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$112.50
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) PPO	$95.62
Rate for Payer: Cigna Commercial	$8.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4824618
Hospital Revenue Code	919
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$112.50
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) PPO	$95.62
Rate for Payer: Cigna Commercial	$8.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4824618
Hospital Revenue Code	919
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4822618
Hospital Revenue Code	919
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$112.50
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) PPO	$95.62
Rate for Payer: Cigna Commercial	$8.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4546618
Hospital Revenue Code	919
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$112.50
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) PPO	$95.62
Rate for Payer: Cigna Commercial	$8.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4535618
Hospital Revenue Code	919
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN PH MCAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4509628
Hospital Revenue Code	919
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN PH MCAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4510628
Hospital Revenue Code	919
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$112.50
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) PPO	$95.62
Rate for Payer: Cigna Commercial	$8.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN PH MCAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4509628
Hospital Revenue Code	919
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$112.50
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) PPO	$95.62
Rate for Payer: Cigna Commercial	$8.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN PH MCAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4510628
Hospital Revenue Code	919
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN PH MCAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4824628
Hospital Revenue Code	919
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$112.50
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) PPO	$95.62
Rate for Payer: Cigna Commercial	$8.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN PH MCAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4822628
Hospital Revenue Code	919
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$112.50
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) PPO	$95.62
Rate for Payer: Cigna Commercial	$8.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN PH MCAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4824628
Hospital Revenue Code	919
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG CHILD/15MIN PH MCAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4822628
Hospital Revenue Code	919
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

Know your out-of-pocket cost for care.

All Charges