Heights University Hospital

All Charges

Charge

Type

Setting

Price

PARTIAL CARE GROUP

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	84517027
Hospital Revenue Code	915
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$241.93
Rate for Payer: Aetna Commercial	$240.24
Rate for Payer: Aetna Medicare Advantage	$240.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.20
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.10
Rate for Payer: Qualcare PPO/HMO/WC	$120.12
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48

PARTIAL CARE GROUP

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	84511027
Hospital Revenue Code	915
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$241.93
Rate for Payer: Aetna Commercial	$240.24
Rate for Payer: Aetna Medicare Advantage	$240.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.20
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.10
Rate for Payer: Qualcare PPO/HMO/WC	$120.12
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48

PARTIAL CARE GROUP

Facility

$433.40

Service Code	HCPCS 90853
Hospital Charge Code	84518027
Hospital Revenue Code	915
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$241.93
Rate for Payer: Aetna Commercial	$130.02
Rate for Payer: Aetna Medicare Advantage	$130.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.52
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.34
Rate for Payer: Qualcare PPO/HMO/WC	$65.01
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48

PARTIAL CARE GROUP NON MCAID

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	84509027
Hospital Revenue Code	912
Min. Negotiated Rate	$120.12
Max. Negotiated Rate	$120.12
Rate for Payer: Qualcare PPO/HMO/WC	$120.12

PARTIAL CARE GROUP NON MCAID

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	84509027
Hospital Revenue Code	912
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$241.93
Rate for Payer: Aetna Commercial	$240.24
Rate for Payer: Aetna Medicare Advantage	$240.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.20
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.10
Rate for Payer: Qualcare PPO/HMO/WC	$120.12
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48

PARTIAL CARE GROUP W/MD

Facility

$367.85

Service Code	HCPCS 90853
Hospital Charge Code	87504070
Hospital Revenue Code	915
Min. Negotiated Rate	$55.18
Max. Negotiated Rate	$55.18
Rate for Payer: Qualcare PPO/HMO/WC	$55.18

PARTIAL CARE GROUP W/MD

Facility

$367.85

Service Code	HCPCS 90853
Hospital Charge Code	87504070
Hospital Revenue Code	915
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$241.93
Rate for Payer: Aetna Commercial	$110.36
Rate for Payer: Aetna Medicare Advantage	$110.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.80
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.82
Rate for Payer: Qualcare PPO/HMO/WC	$55.18
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48

PARTIAL CARE GROUP W/NON MD

Facility

$367.85

Service Code	HCPCS 90853
Hospital Charge Code	87504075
Hospital Revenue Code	915
Min. Negotiated Rate	$55.18
Max. Negotiated Rate	$55.18
Rate for Payer: Qualcare PPO/HMO/WC	$55.18

PARTIAL CARE GROUP W/NON MD

Facility

$367.85

Service Code	HCPCS 90853
Hospital Charge Code	87504075
Hospital Revenue Code	915
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$241.93
Rate for Payer: Aetna Commercial	$110.36
Rate for Payer: Aetna Medicare Advantage	$110.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.80
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.82
Rate for Payer: Qualcare PPO/HMO/WC	$55.18
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48

PARTIAL CARE INDIV MD 20-30MIN

Facility

$409.00

Service Code	HCPCS 90817
Hospital Charge Code	84310040
Hospital Revenue Code	912
Min. Negotiated Rate	$53.17
Max. Negotiated Rate	$204.50
Rate for Payer: Aetna Commercial	$122.70
Rate for Payer: Aetna Medicare Advantage	$122.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.30
Rate for Payer: Cigna Commercial	$204.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.17
Rate for Payer: Qualcare PPO/HMO/WC	$61.35

PARTIAL CARE INDIV MD 20-30MIN

Facility

$409.00

Service Code	HCPCS 90817
Hospital Charge Code	84310040
Hospital Revenue Code	912
Min. Negotiated Rate	$61.35
Max. Negotiated Rate	$61.35
Rate for Payer: Qualcare PPO/HMO/WC	$61.35

PARTIAL CARE IND/NON MD 20-30M

Facility

$409.00

Service Code	HCPCS 90816
Hospital Charge Code	84310035
Hospital Revenue Code	912
Min. Negotiated Rate	$61.35
Max. Negotiated Rate	$61.35
Rate for Payer: Qualcare PPO/HMO/WC	$61.35

PARTIAL CARE IND/NON MD 20-30M

Facility

$409.00

Service Code	HCPCS 90816
Hospital Charge Code	84310035
Hospital Revenue Code	912
Min. Negotiated Rate	$53.17
Max. Negotiated Rate	$204.50
Rate for Payer: Aetna Commercial	$122.70
Rate for Payer: Aetna Medicare Advantage	$122.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.30
Rate for Payer: Cigna Commercial	$204.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.17
Rate for Payer: Qualcare PPO/HMO/WC	$61.35

PARTIAL CARE IND/NON MD 45-50M

Facility

$563.00

Service Code	HCPCS 90818
Hospital Charge Code	84310045
Hospital Revenue Code	912
Min. Negotiated Rate	$84.45
Max. Negotiated Rate	$84.45
Rate for Payer: Qualcare PPO/HMO/WC	$84.45

PARTIAL CARE IND/NON MD 45-50M

Facility

$563.00

Service Code	HCPCS 90818
Hospital Charge Code	84310045
Hospital Revenue Code	912
Min. Negotiated Rate	$73.19
Max. Negotiated Rate	$281.50
Rate for Payer: Aetna Commercial	$168.90
Rate for Payer: Aetna Medicare Advantage	$168.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.56
Rate for Payer: Cigna Commercial	$281.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.19
Rate for Payer: Qualcare PPO/HMO/WC	$84.45

PARTIAL CARE INDV MD 45-50 MIN

Facility

$596.00

Service Code	HCPCS 90819
Hospital Charge Code	84310050
Hospital Revenue Code	912
Min. Negotiated Rate	$77.48
Max. Negotiated Rate	$298.00
Rate for Payer: Aetna Commercial	$178.80
Rate for Payer: Aetna Medicare Advantage	$178.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.98
Rate for Payer: Cigna Commercial	$298.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.48
Rate for Payer: Qualcare PPO/HMO/WC	$89.40

PARTIAL CARE INDV MD 45-50 MIN

Facility

$596.00

Service Code	HCPCS 90819
Hospital Charge Code	84310050
Hospital Revenue Code	912
Min. Negotiated Rate	$89.40
Max. Negotiated Rate	$89.40
Rate for Payer: Qualcare PPO/HMO/WC	$89.40

PARTIAL CARE MULTI-FAMILY

Facility

$433.40

Service Code	HCPCS 90849
Hospital Charge Code	87504065
Hospital Revenue Code	912
Min. Negotiated Rate	$56.34
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$130.02
Rate for Payer: Aetna Medicare Advantage	$130.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.52
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.34
Rate for Payer: Qualcare PPO/HMO/WC	$65.01

PARTIAL CARE MULTI-FAMILY

Facility

$336.35

Service Code	HCPCS 90849
Hospital Charge Code	84310110
Hospital Revenue Code	912
Min. Negotiated Rate	$43.73
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$100.91
Rate for Payer: Aetna Medicare Advantage	$100.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.77
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.73
Rate for Payer: Qualcare PPO/HMO/WC	$50.45

PARTIAL CARE MULTI-FAMILY

Facility

$336.35

Service Code	HCPCS 90849
Hospital Charge Code	84310110
Hospital Revenue Code	912
Min. Negotiated Rate	$50.45
Max. Negotiated Rate	$50.45
Rate for Payer: Qualcare PPO/HMO/WC	$50.45

PARTIAL CARE MULTI-FAMILY

Facility

$433.40

Service Code	HCPCS 90849
Hospital Charge Code	87504065
Hospital Revenue Code	912
Min. Negotiated Rate	$65.01
Max. Negotiated Rate	$65.01
Rate for Payer: Qualcare PPO/HMO/WC	$65.01

PARTIAL DAY TX HOURLY MEDICAID

Facility

$367.85

Service Code	HCPCS 90834
Hospital Charge Code	87504155
Hospital Revenue Code	912
Min. Negotiated Rate	$47.82
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$110.36
Rate for Payer: Aetna Medicare Advantage	$110.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.80
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.82
Rate for Payer: Qualcare PPO/HMO/WC	$55.18
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$94.46

PARTIAL DAY TX HOURLY MEDICAID

Facility

$367.85

Service Code	HCPCS 90834
Hospital Charge Code	87504155
Hospital Revenue Code	912
Min. Negotiated Rate	$55.18
Max. Negotiated Rate	$55.18
Rate for Payer: Qualcare PPO/HMO/WC	$55.18

PARTIAL EC PHALANC TOE BONE

Facility

$19,998.60

Service Code	HCPCS 28124
Hospital Charge Code	16000225
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$5,999.58
Rate for Payer: Aetna Medicare Advantage	$5,999.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,099.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,099.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,099.64
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,599.82
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

PARTIAL EC PHALANC TOE BONE

Facility

$19,998.60

Service Code	HCPCS 28124
Hospital Charge Code	16000225
Hospital Revenue Code	360
Min. Negotiated Rate	$2,999.79
Max. Negotiated Rate	$2,999.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79

Know your out-of-pocket cost for care.

All Charges