Heights University Hospital

All Charges

Charge

Type

Setting

Price

PT MIXED STUDY

Facility

$200.00

Service Code	HCPCS 85611
Hospital Charge Code	3002285B
Hospital Revenue Code	305
Min. Negotiated Rate	$1.97
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$12.77
Rate for Payer: Aetna Medicare Advantage	$3.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.44
Rate for Payer: Cigna Commercial	$3.94
Rate for Payer: Cigna Medicare Advantage	$1.97
Rate for Payer: Clover Medicare Advantage	$3.74
Rate for Payer: EmblemHealth Commercial	$11.82
Rate for Payer: Humana Medicare Advantage	$4.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.94
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.18
Rate for Payer: Wellcare Medicare Advantage	$3.94

PT MIXED STUDY

Facility

$200.00

Service Code	HCPCS 85611
Hospital Charge Code	3002285B
Hospital Revenue Code	305
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

PT MODALITY ELC STM WOUND CARE

Facility

$91.25

Service Code	HCPCS G0281GP
Hospital Charge Code	9100165
Hospital Revenue Code	420
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$13.69
Rate for Payer: Qualcare PPO/HMO/WC	$13.69

PT MODALITY ELC STM WOUND CARE

Facility

$91.25

Service Code	HCPCS G0281GP
Hospital Charge Code	9100165
Hospital Revenue Code	420
Min. Negotiated Rate	$11.86
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$27.38
Rate for Payer: Aetna Medicare Advantage	$27.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.27
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	$23.27
Rate for Payer: Cigna Commercial	$45.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.86
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.69
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT NEG PRESSURE WOUND <=50 CM

Facility

$2,127.92

Service Code	HCPCS 97607GP
Hospital Charge Code	422597607
Hospital Revenue Code	420
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$1,063.96
Rate for Payer: Aetna Commercial	$638.38
Rate for Payer: Aetna Medicare Advantage	$638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$542.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$542.62
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	$542.62
Rate for Payer: Cigna Commercial	$1,063.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.63
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$319.19
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT NEG PRESSURE WOUND <=50 CM

Facility

$2,127.92

Service Code	HCPCS 97607GP
Hospital Charge Code	422597607
Hospital Revenue Code	420
Min. Negotiated Rate	$319.19
Max. Negotiated Rate	$319.19
Rate for Payer: Qualcare PPO/HMO/WC	$319.19

PT NEG PRESSURE WOUND >50 CM

Facility

$2,127.92

Service Code	HCPCS 97608GP
Hospital Charge Code	422597608
Hospital Revenue Code	420
Min. Negotiated Rate	$319.19
Max. Negotiated Rate	$319.19
Rate for Payer: Qualcare PPO/HMO/WC	$319.19

PT NEG PRESSURE WOUND >50 CM

Facility

$2,127.92

Service Code	HCPCS 97608GP
Hospital Charge Code	422597608
Hospital Revenue Code	420
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$1,063.96
Rate for Payer: Aetna Commercial	$638.38
Rate for Payer: Aetna Medicare Advantage	$638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$542.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$542.62
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	$542.62
Rate for Payer: Cigna Commercial	$1,063.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.63
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$319.19
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT NEG PRESS WND THER DME <=50

Facility

$1,105.55

Service Code	HCPCS 97605GP
Hospital Charge Code	422597605
Hospital Revenue Code	420
Min. Negotiated Rate	$165.83
Max. Negotiated Rate	$165.83
Rate for Payer: Qualcare PPO/HMO/WC	$165.83

PT NEG PRESS WND THER DME <=50

Facility

$1,105.55

Service Code	HCPCS 97605GP
Hospital Charge Code	422597605
Hospital Revenue Code	420
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$331.67
Rate for Payer: Aetna Medicare Advantage	$331.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$281.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$281.92
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	$281.92
Rate for Payer: Cigna Commercial	$552.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.72
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.83
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT NEG PRESS WND THER DME >50

Facility

$2,127.92

Service Code	HCPCS 97606GP
Hospital Charge Code	422597606
Hospital Revenue Code	420
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$1,063.96
Rate for Payer: Aetna Commercial	$638.38
Rate for Payer: Aetna Medicare Advantage	$638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$542.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$542.62
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	$542.62
Rate for Payer: Cigna Commercial	$1,063.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.63
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$319.19
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT NEG PRESS WND THER DME >50

Facility

$2,127.92

Service Code	HCPCS 97606GP
Hospital Charge Code	422597606
Hospital Revenue Code	420
Min. Negotiated Rate	$319.19
Max. Negotiated Rate	$319.19
Rate for Payer: Qualcare PPO/HMO/WC	$319.19

PT NEUROMUSC RE-EDUC EA 15M***

Facility

$50.00

Service Code	HCPCS 97112
Hospital Charge Code	9100115
Hospital Revenue Code	420
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

PT NEUROMUSC RE-EDUC EA 15M***

Facility

$50.00

Service Code	HCPCS 97112
Hospital Charge Code	9100115
Hospital Revenue Code	420
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$15.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
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	$12.75
Rate for Payer: Cigna Commercial	$36.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.50
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT NEUROMUSCULAR RE-EDUCATION

Facility

$186.00

Service Code	HCPCS 97112
Hospital Charge Code	409297112
Hospital Revenue Code	420
Min. Negotiated Rate	$24.18
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$55.80
Rate for Payer: Aetna Medicare Advantage	$55.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.43
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	$47.43
Rate for Payer: Cigna Commercial	$36.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.18
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.90
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT NEUROMUSCULAR RE-EDUCATION

Facility

$128.00

Service Code	HCPCS 97112GP
Hospital Charge Code	9100080
Hospital Revenue Code	420
Min. Negotiated Rate	$16.64
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$38.40
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
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	$32.64
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.64
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT NEUROMUSCULAR RE-EDUCATION

Facility

$128.00

Service Code	HCPCS 97112GP
Hospital Charge Code	9100080
Hospital Revenue Code	420
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

PT NEUROMUSCULAR RE-EDUCATION

Facility

$186.00

Service Code	HCPCS 97112
Hospital Charge Code	409297112
Hospital Revenue Code	420
Min. Negotiated Rate	$27.90
Max. Negotiated Rate	$27.90
Rate for Payer: Qualcare PPO/HMO/WC	$27.90

PT NEUROMUSCUL RE-ED EA 15 MIN

Facility

$314.00

Service Code	HCPCS 97112GP
Hospital Charge Code	422597112
Hospital Revenue Code	420
Min. Negotiated Rate	$47.10
Max. Negotiated Rate	$47.10
Rate for Payer: Qualcare PPO/HMO/WC	$47.10

PT NEUROMUSCUL RE-ED EA 15 MIN

Facility

$314.00

Service Code	HCPCS 97112GP
Hospital Charge Code	422597112
Hospital Revenue Code	420
Min. Negotiated Rate	$40.82
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$94.20
Rate for Payer: Aetna Medicare Advantage	$94.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.07
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	$80.07
Rate for Payer: Cigna Commercial	$157.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.82
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$47.10
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT OCCUPAT THERAPY DBL SESS***

Facility

$379.00

Hospital Charge Code	900399
Hospital Revenue Code	439
Min. Negotiated Rate	$49.27
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$113.70
Rate for Payer: Aetna Medicare Advantage	$113.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.64
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	$96.64
Rate for Payer: Cigna Commercial	$189.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.27
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.85
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT OCCUPAT THERAPY DBL SESS***

Facility

$379.00

Hospital Charge Code	900399
Hospital Revenue Code	439
Min. Negotiated Rate	$56.85
Max. Negotiated Rate	$56.85
Rate for Payer: Qualcare PPO/HMO/WC	$56.85

PT OCCUPAT THER DBL SESSION***

Facility

$379.00

Service Code	HCPCS H5300
Hospital Charge Code	9000399
Hospital Revenue Code	439
Min. Negotiated Rate	$49.27
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$113.70
Rate for Payer: Aetna Medicare Advantage	$113.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.64
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	$96.64
Rate for Payer: Cigna Commercial	$189.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.27
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.85
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT OCCUPAT THER DBL SESSION***

Facility

$379.00

Service Code	HCPCS H5300
Hospital Charge Code	9000399
Hospital Revenue Code	439
Min. Negotiated Rate	$56.85
Max. Negotiated Rate	$56.85
Rate for Payer: Qualcare PPO/HMO/WC	$56.85

PT ORTHO MGT/FIT/TRN EA 15 MIN

Facility

$134.50

Service Code	HCPCS 97760GP
Hospital Charge Code	422597760
Hospital Revenue Code	420
Min. Negotiated Rate	$20.18
Max. Negotiated Rate	$20.18
Rate for Payer: Qualcare PPO/HMO/WC	$20.18

Know your out-of-pocket cost for care.

All Charges