Heights University Hospital

All Charges

Charge

Type

Setting

Price

PSYCHOTHERAPY NON-MD 60 MINS

Facility

$550.00

Service Code	HCPCS 90837
Hospital Charge Code	84509013
Hospital Revenue Code	914
Min. Negotiated Rate	$71.50
Max. Negotiated Rate	$422.69
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	$135.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

PSYCHOTHERAPY NON-MD 60 MINS

Facility

$550.00

Service Code	HCPCS 90837
Hospital Charge Code	87504035
Hospital Revenue Code	914
Min. Negotiated Rate	$71.50
Max. Negotiated Rate	$422.69
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	$135.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

PSYCHOTHERAPY NON-MD 60 MINS

Facility

$550.00

Service Code	HCPCS 90837
Hospital Charge Code	84518013
Hospital Revenue Code	914
Min. Negotiated Rate	$71.50
Max. Negotiated Rate	$422.69
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	$135.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

PSYCHOTHERAPY W/E&M, 45 MIN

Facility

$350.00

Service Code	HCPCS 90836
Hospital Charge Code	83246230
Hospital Revenue Code	914
Min. Negotiated Rate	$45.50
Max. Negotiated Rate	$147.87
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	$147.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$89.20
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	$94.46

PSYCHOTHERAPY W/E&M, 45 MIN

Facility

$350.00

Service Code	HCPCS 90836
Hospital Charge Code	83246230
Hospital Revenue Code	914
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

PSYCHOTHERAPY W/E&M, 45 MIN (3

Facility

$350.00

Service Code	HCPCS 90833
Hospital Charge Code	83246225
Hospital Revenue Code	914
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

PSYCHOTHERAPY W/E&M, 45 MIN (3

Facility

$350.00

Service Code	HCPCS 90833
Hospital Charge Code	83246225
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

PSYCHOTHERAPY W/E&M, 60 MIN

Facility

$350.00

Service Code	HCPCS 90838
Hospital Charge Code	83246235
Hospital Revenue Code	914
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

PSYCHOTHERAPY W/E&M, 60 MIN

Facility

$350.00

Service Code	HCPCS 90838
Hospital Charge Code	83246235
Hospital Revenue Code	914
Min. Negotiated Rate	$45.50
Max. Negotiated Rate	$141.18
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	$141.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$118.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

PSYCH PHARMACOLOGIC MANAGEMENT

Facility

$275.00

Service Code	HCPCS 90863
Hospital Charge Code	84310125
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

PSYCH PHARMACOLOGIC MANAGEMENT

Facility

$275.00

Service Code	HCPCS 90863
Hospital Charge Code	84310125
Hospital Revenue Code	914
Min. Negotiated Rate	$35.75
Max. Negotiated Rate	$137.50
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) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.75
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

PSYCH PRIVATE

Facility

$18,000.00

Hospital Charge Code	100813
Hospital Revenue Code	114
Min. Negotiated Rate	$1,109.00
Max. Negotiated Rate	$3,360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,109.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,360.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,700.00

PSYCH SEMI-PRIVATE

Facility

$18,000.00

Hospital Charge Code	100825
Hospital Revenue Code	124
Min. Negotiated Rate	$1,109.00
Max. Negotiated Rate	$3,360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,109.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,360.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,700.00

PSYCH THEARPY NON MD 30MIN

Facility

$1,879.97

Service Code	HCPCS 90832
Hospital Charge Code	94810215
Hospital Revenue Code	914
Min. Negotiated Rate	$282.00
Max. Negotiated Rate	$282.00
Rate for Payer: Qualcare PPO/HMO/WC	$282.00

PSYCH THEARPY NON MD 30MIN

Facility

$1,879.97

Service Code	HCPCS 90832
Hospital Charge Code	94810215
Hospital Revenue Code	914
Min. Negotiated Rate	$71.39
Max. Negotiated Rate	$563.99
Rate for Payer: Aetna Commercial	$563.99
Rate for Payer: Aetna Medicare Advantage	$563.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$479.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$479.39
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	$479.39
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.40
Rate for Payer: Qualcare PPO/HMO/WC	$282.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$71.39

PSYCH THERAPY 30 MINUTES

Facility

$275.00

Service Code	HCPCS 90833
Hospital Charge Code	84310065
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

PSYCH THERAPY 30 MINUTES

Facility

$275.00

Service Code	HCPCS 90833
Hospital Charge Code	84310065
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

PSYCH THERAPY 45 MINUTES

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	84310075
Hospital Revenue Code	914
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$147.87
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$89.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.25
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$94.46

PSYCH THERAPY 45 MINUTES

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	84310075
Hospital Revenue Code	914
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

PSYCH THERAPY 60 MINUTES

Facility

$550.00

Service Code	HCPCS 90838
Hospital Charge Code	84310085
Hospital Revenue Code	914
Min. Negotiated Rate	$71.50
Max. Negotiated Rate	$165.00
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	$141.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$118.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

PSYCH THERAPY 60 MINUTES

Facility

$550.00

Service Code	HCPCS 90838
Hospital Charge Code	84310085
Hospital Revenue Code	914
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

PSYCHTHERAPY NON MD 30MIN

Facility

$1,879.97

Service Code	HCPCS 90832
Hospital Charge Code	94810125
Hospital Revenue Code	914
Min. Negotiated Rate	$282.00
Max. Negotiated Rate	$282.00
Rate for Payer: Qualcare PPO/HMO/WC	$282.00

PSYCHTHERAPY NON MD 30MIN

Facility

$1,879.97

Service Code	HCPCS 90832
Hospital Charge Code	94810125
Hospital Revenue Code	914
Min. Negotiated Rate	$71.39
Max. Negotiated Rate	$563.99
Rate for Payer: Aetna Commercial	$563.99
Rate for Payer: Aetna Medicare Advantage	$563.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$479.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$479.39
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	$479.39
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.40
Rate for Payer: Qualcare PPO/HMO/WC	$282.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$71.39

PSYCHTHERAPY NON MD 45MIN

Facility

$1,879.97

Service Code	HCPCS 90834
Hospital Charge Code	94810130
Hospital Revenue Code	914
Min. Negotiated Rate	$94.46
Max. Negotiated Rate	$563.99
Rate for Payer: Aetna Commercial	$563.99
Rate for Payer: Aetna Medicare Advantage	$563.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$479.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$479.39
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	$479.39
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.40
Rate for Payer: Qualcare PPO/HMO/WC	$282.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$94.46

PSYCHTHERAPY NON MD 45MIN

Facility

$1,879.97

Service Code	HCPCS 90834
Hospital Charge Code	94810130
Hospital Revenue Code	914
Min. Negotiated Rate	$282.00
Max. Negotiated Rate	$282.00
Rate for Payer: Qualcare PPO/HMO/WC	$282.00

Know your out-of-pocket cost for care.

All Charges