Heights University Hospital

All Charges

Charge

Type

Setting

Price

PSYCHO-ED GOALS GROUP

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	83246135
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

PSYCHO-ED GROUP MEN/WOMEN

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	83246130
Hospital Revenue Code	915
Min. Negotiated Rate	$120.12
Max. Negotiated Rate	$120.12
Rate for Payer: Qualcare PPO/HMO/WC	$120.12

PSYCHO-ED GROUP MEN/WOMEN

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	83246130
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

PSYCHO-ED GROUP NUTRITION

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	83246120
Hospital Revenue Code	915
Min. Negotiated Rate	$120.12
Max. Negotiated Rate	$120.12
Rate for Payer: Qualcare PPO/HMO/WC	$120.12

PSYCHO-ED GROUP NUTRITION

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	83246120
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

PSYCHO-ED HEALTHY BEHAVIOR GRP

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	83246125
Hospital Revenue Code	915
Min. Negotiated Rate	$120.12
Max. Negotiated Rate	$120.12
Rate for Payer: Qualcare PPO/HMO/WC	$120.12

PSYCHO-ED HEALTHY BEHAVIOR GRP

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	83246125
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

PSYCH OPD MEDICATION REVIEW

Facility

$446.00

Service Code	HCPCS 90862
Hospital Charge Code	84310120
Hospital Revenue Code	914
Min. Negotiated Rate	$66.90
Max. Negotiated Rate	$66.90
Rate for Payer: Qualcare PPO/HMO/WC	$66.90

PSYCH OPD MEDICATION REVIEW

Facility

$446.00

Service Code	HCPCS 90862
Hospital Charge Code	84310120
Hospital Revenue Code	914
Min. Negotiated Rate	$57.98
Max. Negotiated Rate	$223.00
Rate for Payer: Aetna Commercial	$133.80
Rate for Payer: Aetna Medicare Advantage	$133.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.73
Rate for Payer: Cigna Commercial	$223.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.98
Rate for Payer: Qualcare PPO/HMO/WC	$66.90

PSYCHOSES

Facility

$52,365.36

Service Code	MSDRG 885
Min. Negotiated Rate	$15,242.70
Max. Negotiated Rate	$52,365.36
Rate for Payer: Aetna Commercial	$47,099.94
Rate for Payer: Aetna Medicare Advantage	$15,242.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37,766.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37,766.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17,455.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37,766.79
Rate for Payer: Cigna Commercial	$30,060.53
Rate for Payer: Cigna Medicare Advantage	$17,455.12
Rate for Payer: Clover Medicare Advantage	$16,582.36
Rate for Payer: EmblemHealth Commercial	$52,365.36
Rate for Payer: Humana Medicare Advantage	$17,978.77
Rate for Payer: Oxford Commercial	$18,786.96
Rate for Payer: UnitedHealthcare Commercial	$21,324.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$17,455.12
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18,502.43
Rate for Payer: Wellcare Medicare Advantage	$17,455.12

PSYCHOTHERAPY, 30 MIN (16-37)

Facility

$414.00

Service Code	HCPCS 90832
Hospital Charge Code	83246155
Hospital Revenue Code	914
Min. Negotiated Rate	$53.82
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$124.20
Rate for Payer: Aetna Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.57
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.82
Rate for Payer: Qualcare PPO/HMO/WC	$62.10
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$71.39

PSYCHOTHERAPY, 30 MIN (16-37)

Facility

$414.00

Service Code	HCPCS 90832
Hospital Charge Code	83246155
Hospital Revenue Code	914
Min. Negotiated Rate	$62.10
Max. Negotiated Rate	$62.10
Rate for Payer: Qualcare PPO/HMO/WC	$62.10

PSYCHOTHERAPY 30 MINS ADD E&M

Facility

$275.00

Service Code	HCPCS 90833
Hospital Charge Code	84517007
Hospital Revenue Code	914
Min. Negotiated Rate	$35.75
Max. Negotiated Rate	$122.43
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	$122.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$70.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.75
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$73.61

PSYCHOTHERAPY 30 MINS ADD E&M

Facility

$275.00

Service Code	HCPCS 90833
Hospital Charge Code	84517007
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

PSYCHOTHERAPY 30 MINS ADD E&M

Facility

$275.00

Service Code	HCPCS 90833
Hospital Charge Code	84509007
Hospital Revenue Code	914
Min. Negotiated Rate	$35.75
Max. Negotiated Rate	$122.43
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	$122.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$70.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.75
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$73.61

PSYCHOTHERAPY 30 MINS ADD E&M

Facility

$275.00

Service Code	HCPCS 90833
Hospital Charge Code	84511007
Hospital Revenue Code	914
Min. Negotiated Rate	$35.75
Max. Negotiated Rate	$122.43
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
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	$122.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$70.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.75
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$73.61

PSYCHOTHERAPY 30 MINS ADD E&M

Facility

$275.00

Service Code	HCPCS 90833
Hospital Charge Code	84509007
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

PSYCHOTHERAPY 30 MINS ADD E&M

Facility

$275.00

Service Code	HCPCS 90833
Hospital Charge Code	84518007
Hospital Revenue Code	914
Min. Negotiated Rate	$35.75
Max. Negotiated Rate	$122.43
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	$122.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$70.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.75
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$73.61

PSYCHOTHERAPY 30 MINS ADD E&M

Facility

$275.00

Service Code	HCPCS 90833
Hospital Charge Code	84518007
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

PSYCHOTHERAPY 30 MINS ADD E&M

Facility

$275.00

Service Code	HCPCS 90833
Hospital Charge Code	84511007
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

PSYCHOTHERAPY 30 MINUTES

Facility

$295.00

Service Code	HCPCS 90833
Hospital Charge Code	87506025
Hospital Revenue Code	914
Min. Negotiated Rate	$38.35
Max. Negotiated Rate	$122.43
Rate for Payer: Aetna Commercial	$88.50
Rate for Payer: Aetna Medicare Advantage	$88.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.22
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	$75.22
Rate for Payer: Cigna Commercial	$70.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.35
Rate for Payer: Qualcare PPO/HMO/WC	$44.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$73.61

PSYCHOTHERAPY 30 MINUTES

Facility

$183.00

Service Code	HCPCS 90832
Hospital Charge Code	94810165
Hospital Revenue Code	914
Min. Negotiated Rate	$27.45
Max. Negotiated Rate	$27.45
Rate for Payer: Qualcare PPO/HMO/WC	$27.45

PSYCHOTHERAPY 30 MINUTES

Facility

$295.00

Service Code	HCPCS 90833
Hospital Charge Code	87506025
Hospital Revenue Code	914
Min. Negotiated Rate	$44.25
Max. Negotiated Rate	$44.25
Rate for Payer: Qualcare PPO/HMO/WC	$44.25

PSYCHOTHERAPY 30 MINUTES

Facility

$350.00

Service Code	HCPCS 90833
Hospital Charge Code	87504020
Hospital Revenue Code	914
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

PSYCHOTHERAPY 30 MINUTES

Facility

$350.00

Service Code	HCPCS 90833
Hospital Charge Code	87504020
Hospital Revenue Code	914
Min. Negotiated Rate	$45.50
Max. Negotiated Rate	$122.43
Rate for Payer: Aetna Commercial	$105.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
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	$89.25
Rate for Payer: Cigna Commercial	$70.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$73.61

Know your out-of-pocket cost for care.

All Charges