Heights University Hospital

All Charges

Charge

Type

Setting

Price

PTB CAST

Facility

$1,066.99

Service Code	HCPCS 29435
Hospital Charge Code	5780145
Hospital Revenue Code	450
Min. Negotiated Rate	$160.05
Max. Negotiated Rate	$160.05
Rate for Payer: Qualcare PPO/HMO/WC	$160.05

PTB CAST

Facility

$1,066.99

Service Code	HCPCS 29435
Hospital Charge Code	5780145
Hospital Revenue Code	450
Min. Negotiated Rate	$75.90
Max. Negotiated Rate	$666.07
Rate for Payer: Aetna Commercial	$320.10
Rate for Payer: Aetna Medicare Advantage	$320.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.08
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.71
Rate for Payer: Qualcare PPO/HMO/WC	$160.05

PT BIO FEEDBACK

Facility

$236.20

Service Code	HCPCS 90901GP
Hospital Charge Code	9000340
Hospital Revenue Code	917
Min. Negotiated Rate	$35.43
Max. Negotiated Rate	$35.43
Rate for Payer: Qualcare PPO/HMO/WC	$35.43

PT BIO FEEDBACK

Facility

$236.20

Service Code	HCPCS 90901GP
Hospital Charge Code	9000340
Hospital Revenue Code	917
Min. Negotiated Rate	$30.71
Max. Negotiated Rate	$1,994.00
Rate for Payer: Aetna Commercial	$70.86
Rate for Payer: Aetna Medicare Advantage	$70.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.23
Rate for Payer: Cigna Commercial	$118.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.71
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.43
Rate for Payer: UnitedHealthcare Commercial	$1,994.00

PT BIO FEEDBACK****

Facility

$115.00

Service Code	HCPCS 90910
Hospital Charge Code	90000340
Hospital Revenue Code	420
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$17.25
Rate for Payer: Qualcare PPO/HMO/WC	$17.25

PT BIO FEEDBACK****

Facility

$115.00

Service Code	HCPCS 90910
Hospital Charge Code	90000340
Hospital Revenue Code	420
Min. Negotiated Rate	$14.95
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$34.50
Rate for Payer: Aetna Medicare Advantage	$34.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.32
Rate for Payer: Cigna Commercial	$57.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.95
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.25
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT BIOFEEDBACK

Facility

$236.20

Service Code	HCPCS 90901GP
Hospital Charge Code	422590901
Hospital Revenue Code	420
Min. Negotiated Rate	$30.71
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$70.86
Rate for Payer: Aetna Medicare Advantage	$70.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.23
Rate for Payer: Cigna Commercial	$118.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.71
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.43
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT BIOFEEDBACK

Facility

$236.20

Service Code	HCPCS 90901GP
Hospital Charge Code	422590901
Hospital Revenue Code	420
Min. Negotiated Rate	$35.43
Max. Negotiated Rate	$35.43
Rate for Payer: Qualcare PPO/HMO/WC	$35.43

PT BIOFEEDBACK W/EMG 1ST 15

Facility

$236.20

Service Code	HCPCS 90912GP
Hospital Charge Code	422590912
Hospital Revenue Code	420
Min. Negotiated Rate	$35.43
Max. Negotiated Rate	$35.43
Rate for Payer: Qualcare PPO/HMO/WC	$35.43

PT BIOFEEDBACK W/EMG 1ST 15

Facility

$236.20

Service Code	HCPCS 90912GP
Hospital Charge Code	422590912
Hospital Revenue Code	420
Min. Negotiated Rate	$30.71
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$70.86
Rate for Payer: Aetna Medicare Advantage	$70.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.23
Rate for Payer: Cigna Commercial	$118.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.71
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.43
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT BIOFEEDBACK W/EMG ADDL 15 M

Facility

$236.20

Service Code	HCPCS 90913GP
Hospital Charge Code	422590913
Hospital Revenue Code	420
Min. Negotiated Rate	$30.71
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$70.86
Rate for Payer: Aetna Medicare Advantage	$70.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.23
Rate for Payer: Cigna Commercial	$118.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.71
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.43
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT BIOFEEDBACK W/EMG ADDL 15 M

Facility

$236.20

Service Code	HCPCS 90913GP
Hospital Charge Code	422590913
Hospital Revenue Code	420
Min. Negotiated Rate	$35.43
Max. Negotiated Rate	$35.43
Rate for Payer: Qualcare PPO/HMO/WC	$35.43

PT-BURNS DECUBITIS ULCER CA***

Facility

$178.20

Service Code	HCPCS 16020
Hospital Charge Code	9000357
Hospital Revenue Code	420
Min. Negotiated Rate	$26.73
Max. Negotiated Rate	$26.73
Rate for Payer: Qualcare PPO/HMO/WC	$26.73

PT-BURNS DECUBITIS ULCER CA***

Facility

$178.20

Service Code	HCPCS 16020
Hospital Charge Code	9000357
Hospital Revenue Code	420
Min. Negotiated Rate	$23.17
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$53.46
Rate for Payer: Aetna Medicare Advantage	$53.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.44
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.17
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.73
Rate for Payer: UnitedHealthcare Commercial	$686.00

PTCA DRU EL STEN AD/VE-LC

Facility

$28,383.00

Hospital Charge Code	7411289
Hospital Revenue Code	481
Min. Negotiated Rate	$4,257.45
Max. Negotiated Rate	$4,257.45
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA DRU EL STEN AD/VE-LC

Facility

$28,383.00

Hospital Charge Code	7411289
Hospital Revenue Code	481
Min. Negotiated Rate	$3,689.79
Max. Negotiated Rate	$14,191.50
Rate for Payer: Aetna Commercial	$8,514.90
Rate for Payer: Aetna Medicare Advantage	$8,514.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,237.66
Rate for Payer: Cigna Commercial	$14,191.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,689.79
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA DRU EL STEN AD/VE-LD

Facility

$28,383.00

Hospital Charge Code	7411291
Hospital Revenue Code	481
Min. Negotiated Rate	$3,689.79
Max. Negotiated Rate	$14,191.50
Rate for Payer: Aetna Commercial	$8,514.90
Rate for Payer: Aetna Medicare Advantage	$8,514.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,237.66
Rate for Payer: Cigna Commercial	$14,191.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,689.79
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA DRU EL STEN AD/VE-LD

Facility

$28,383.00

Hospital Charge Code	7411291
Hospital Revenue Code	481
Min. Negotiated Rate	$4,257.45
Max. Negotiated Rate	$4,257.45
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA DRU EL STEN AD/VE-RC

Facility

$28,383.00

Hospital Charge Code	7411293
Hospital Revenue Code	481
Min. Negotiated Rate	$4,257.45
Max. Negotiated Rate	$4,257.45
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA DRU EL STEN AD/VE-RC

Facility

$28,383.00

Hospital Charge Code	7411293
Hospital Revenue Code	481
Min. Negotiated Rate	$3,689.79
Max. Negotiated Rate	$14,191.50
Rate for Payer: Aetna Commercial	$8,514.90
Rate for Payer: Aetna Medicare Advantage	$8,514.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,237.66
Rate for Payer: Cigna Commercial	$14,191.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,689.79
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA DRU ELU STEN 1VES-LC

Facility

$28,383.00

Hospital Charge Code	7411271
Hospital Revenue Code	481
Min. Negotiated Rate	$4,257.45
Max. Negotiated Rate	$4,257.45
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA DRU ELU STEN 1VES-LC

Facility

$28,383.00

Hospital Charge Code	7411271
Hospital Revenue Code	481
Min. Negotiated Rate	$3,689.79
Max. Negotiated Rate	$14,191.50
Rate for Payer: Aetna Commercial	$8,514.90
Rate for Payer: Aetna Medicare Advantage	$8,514.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,237.66
Rate for Payer: Cigna Commercial	$14,191.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,689.79
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA DRU ELU STEN 1VES-LD

Facility

$28,383.00

Hospital Charge Code	7411277
Hospital Revenue Code	481
Min. Negotiated Rate	$3,689.79
Max. Negotiated Rate	$14,191.50
Rate for Payer: Aetna Commercial	$8,514.90
Rate for Payer: Aetna Medicare Advantage	$8,514.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,237.66
Rate for Payer: Cigna Commercial	$14,191.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,689.79
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA DRU ELU STEN 1VES-LD

Facility

$28,383.00

Hospital Charge Code	7411277
Hospital Revenue Code	481
Min. Negotiated Rate	$4,257.45
Max. Negotiated Rate	$4,257.45
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

PTCA DRU ELU STEN 1VES-RC

Facility

$28,383.00

Hospital Charge Code	7411273
Hospital Revenue Code	481
Min. Negotiated Rate	$3,689.79
Max. Negotiated Rate	$14,191.50
Rate for Payer: Aetna Commercial	$8,514.90
Rate for Payer: Aetna Medicare Advantage	$8,514.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,237.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,237.66
Rate for Payer: Cigna Commercial	$14,191.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,689.79
Rate for Payer: Qualcare PPO/HMO/WC	$4,257.45

Know your out-of-pocket cost for care.

All Charges