Heights University Hospital

All Charges

Charge

Type

Setting

Price

PT EVAL MOD COMPLEX 30 MIN

Facility

$2,400.00

Service Code	HCPCS 97162GP
Hospital Charge Code	422597162
Hospital Revenue Code	424
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$720.00
Rate for Payer: Aetna Medicare Advantage	$720.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.00
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	$612.00
Rate for Payer: Cigna Commercial	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT EVAL MOD COMPLEX 30 MIN

Facility

$2,400.00

Service Code	HCPCS 97162GP
Hospital Charge Code	9109161
Hospital Revenue Code	424
Min. Negotiated Rate	$360.00
Max. Negotiated Rate	$360.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00

PT EVAL MOD COMPLEX 30 MIN

Facility

$2,400.00

Service Code	HCPCS 97162GP
Hospital Charge Code	422597162
Hospital Revenue Code	424
Min. Negotiated Rate	$360.00
Max. Negotiated Rate	$360.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00

PT EVAL MOD COMPLEX 30 MIN

Facility

$394.00

Service Code	HCPCS 97162
Hospital Charge Code	409297162
Hospital Revenue Code	424
Min. Negotiated Rate	$51.22
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$118.20
Rate for Payer: Aetna Medicare Advantage	$118.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.47
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	$100.47
Rate for Payer: Cigna Commercial	$108.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.22
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.10
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT EVAL MOD COMPLEX 30 MIN

Facility

$394.00

Service Code	HCPCS 97162
Hospital Charge Code	409297162
Hospital Revenue Code	424
Min. Negotiated Rate	$59.10
Max. Negotiated Rate	$59.10
Rate for Payer: Qualcare PPO/HMO/WC	$59.10

PT EVAL MOD COMPLEX 30 MIN

Facility

$2,400.00

Service Code	HCPCS 97162GP
Hospital Charge Code	9109161
Hospital Revenue Code	424
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$720.00
Rate for Payer: Aetna Medicare Advantage	$720.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.00
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	$612.00
Rate for Payer: Cigna Commercial	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT EVALUATION

Facility

$953.34

Service Code	HCPCS 97001GP
Hospital Charge Code	9000142
Hospital Revenue Code	424
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$286.00
Rate for Payer: Aetna Medicare Advantage	$286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$243.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$243.10
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	$243.10
Rate for Payer: Cigna Commercial	$476.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.93
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$143.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT EVALUATION

Facility

$953.34

Service Code	HCPCS 97001GP
Hospital Charge Code	9000142
Hospital Revenue Code	424
Min. Negotiated Rate	$143.00
Max. Negotiated Rate	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$143.00

PT EXERCISE THERAPY EA 15 MIN

Facility

$434.00

Service Code	HCPCS 97110GP
Hospital Charge Code	422597110
Hospital Revenue Code	420
Min. Negotiated Rate	$56.42
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$130.20
Rate for Payer: Aetna Medicare Advantage	$130.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.67
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	$110.67
Rate for Payer: Cigna Commercial	$217.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.42
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$65.10
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT EXERCISE THERAPY EA 15 MIN

Facility

$434.00

Service Code	HCPCS 97110GP
Hospital Charge Code	422597110
Hospital Revenue Code	420
Min. Negotiated Rate	$65.10
Max. Negotiated Rate	$65.10
Rate for Payer: Qualcare PPO/HMO/WC	$65.10

PT:FAMILY/PATIE TEACHING 15MIN

Facility

$142.00

Service Code	HCPCS 97535GP
Hospital Charge Code	1008330
Hospital Revenue Code	420
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$21.30
Rate for Payer: Qualcare PPO/HMO/WC	$21.30

PT:FAMILY/PATIE TEACHING 15MIN

Facility

$142.00

Service Code	HCPCS 97535GP
Hospital Charge Code	1008330
Hospital Revenue Code	420
Min. Negotiated Rate	$18.46
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$42.60
Rate for Payer: Aetna Medicare Advantage	$42.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.21
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	$36.21
Rate for Payer: Cigna Commercial	$71.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.46
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.30
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT FLUIDOTHERAPY

Facility

$185.00

Service Code	HCPCS 97022GP
Hospital Charge Code	9108076
Hospital Revenue Code	420
Min. Negotiated Rate	$24.05
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$55.50
Rate for Payer: Aetna Medicare Advantage	$55.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.17
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	$47.17
Rate for Payer: Cigna Commercial	$92.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.05
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.75
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT FLUIDOTHERAPY

Facility

$77.65

Service Code	HCPCS 97022GP
Hospital Charge Code	9001017
Hospital Revenue Code	420
Min. Negotiated Rate	$11.65
Max. Negotiated Rate	$11.65
Rate for Payer: Qualcare PPO/HMO/WC	$11.65

PT FLUIDOTHERAPY

Facility

$77.65

Service Code	HCPCS 97022GP
Hospital Charge Code	9001017
Hospital Revenue Code	420
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$23.30
Rate for Payer: Aetna Medicare Advantage	$23.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.80
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	$19.80
Rate for Payer: Cigna Commercial	$38.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.09
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.65
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT FLUIDOTHERAPY

Facility

$185.00

Service Code	HCPCS 97022GP
Hospital Charge Code	9108076
Hospital Revenue Code	420
Min. Negotiated Rate	$27.75
Max. Negotiated Rate	$27.75
Rate for Payer: Qualcare PPO/HMO/WC	$27.75

PT FUNC ACTIVITY THER 15 MIN

Facility

$244.50

Service Code	HCPCS 97530GP
Hospital Charge Code	9001019
Hospital Revenue Code	420
Min. Negotiated Rate	$36.67
Max. Negotiated Rate	$36.67
Rate for Payer: Qualcare PPO/HMO/WC	$36.67

PT FUNC ACTIVITY THER 15 MIN

Facility

$244.50

Service Code	HCPCS 97530GP
Hospital Charge Code	9001019
Hospital Revenue Code	420
Min. Negotiated Rate	$31.79
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$73.35
Rate for Payer: Aetna Medicare Advantage	$73.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.35
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	$62.35
Rate for Payer: Cigna Commercial	$122.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.79
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.67
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT FUNC ACTIVITY THER 15 MIN

Facility

$182.00

Service Code	HCPCS 97530
Hospital Charge Code	409297530
Hospital Revenue Code	420
Min. Negotiated Rate	$23.66
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$54.60
Rate for Payer: Aetna Medicare Advantage	$54.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.41
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	$46.41
Rate for Payer: Cigna Commercial	$39.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.66
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.30
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT FUNC ACTIVITY THER 15 MIN

Facility

$182.00

Service Code	HCPCS 97530
Hospital Charge Code	409297530
Hospital Revenue Code	420
Min. Negotiated Rate	$27.30
Max. Negotiated Rate	$27.30
Rate for Payer: Qualcare PPO/HMO/WC	$27.30

PT GAIT TRAINING EA 15 MIN

Facility

$412.61

Service Code	HCPCS 97116GP
Hospital Charge Code	422597116
Hospital Revenue Code	420
Min. Negotiated Rate	$53.64
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$123.78
Rate for Payer: Aetna Medicare Advantage	$123.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.22
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	$105.22
Rate for Payer: Cigna Commercial	$206.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.64
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.89
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT GAIT TRAINING EA 15 MIN

Facility

$412.61

Service Code	HCPCS 97116GP
Hospital Charge Code	422597116
Hospital Revenue Code	420
Min. Negotiated Rate	$61.89
Max. Negotiated Rate	$61.89
Rate for Payer: Qualcare PPO/HMO/WC	$61.89

PT GAIT TRAINING EA 15 MIN

Facility

$157.00

Service Code	HCPCS 97116
Hospital Charge Code	409297116
Hospital Revenue Code	420
Min. Negotiated Rate	$23.55
Max. Negotiated Rate	$23.55
Rate for Payer: Qualcare PPO/HMO/WC	$23.55

PT GAIT TRAINING EA 15 MIN

Facility

$412.61

Service Code	HCPCS 97116GP
Hospital Charge Code	9000092
Hospital Revenue Code	420
Min. Negotiated Rate	$53.64
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$123.78
Rate for Payer: Aetna Medicare Advantage	$123.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.22
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	$105.22
Rate for Payer: Cigna Commercial	$206.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.64
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.89
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT GAIT TRAINING EA 15 MIN

Facility

$157.00

Service Code	HCPCS 97116
Hospital Charge Code	409297116
Hospital Revenue Code	420
Min. Negotiated Rate	$20.41
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$47.10
Rate for Payer: Aetna Medicare Advantage	$47.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.03
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	$40.03
Rate for Payer: Cigna Commercial	$32.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.41
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.55
Rate for Payer: UnitedHealthcare Commercial	$686.00

Know your out-of-pocket cost for care.

All Charges