Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$17.48
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$40.35
Rate for Payer: Aetna Medicare Advantage	$40.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.30
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	$34.30
Rate for Payer: Cigna Commercial	$67.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.48
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.18
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT ORTHOTIC FITTNG/TRAING EA**

Facility

$55.00

Service Code	HCPCS 97504GP
Hospital Charge Code	9001022
Hospital Revenue Code	420
Min. Negotiated Rate	$7.15
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$16.50
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
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	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.15
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT ORTHOTIC FITTNG/TRAING EA**

Facility

$55.00

Service Code	HCPCS 97504GP
Hospital Charge Code	9001022
Hospital Revenue Code	420
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

PT-ORTHOTICS FITTIN 15MIN

Facility

$158.00

Hospital Charge Code	9109115
Hospital Revenue Code	420
Min. Negotiated Rate	$20.54
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$47.40
Rate for Payer: Aetna Medicare Advantage	$47.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.29
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	$40.29
Rate for Payer: Cigna Commercial	$79.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.54
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.70
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT-ORTHOTICS FITTIN 15MIN

Facility

$158.00

Hospital Charge Code	9109115
Hospital Revenue Code	420
Min. Negotiated Rate	$23.70
Max. Negotiated Rate	$23.70
Rate for Payer: Qualcare PPO/HMO/WC	$23.70

PT ORTH/PROST MGMT EA 15 MIN

Facility

$299.00

Service Code	HCPCS 97763GP
Hospital Charge Code	422597763
Hospital Revenue Code	420
Min. Negotiated Rate	$38.87
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$89.70
Rate for Payer: Aetna Medicare Advantage	$89.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.25
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	$76.25
Rate for Payer: Cigna Commercial	$149.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.87
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.85
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT ORTH/PROST MGMT EA 15 MIN

Facility

$299.00

Service Code	HCPCS 97763GP
Hospital Charge Code	422597763
Hospital Revenue Code	420
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$44.85
Rate for Payer: Qualcare PPO/HMO/WC	$44.85

PT PARAFFIN BATH THRPY

Facility

$266.00

Service Code	HCPCS 97018GP
Hospital Charge Code	422597018
Hospital Revenue Code	420
Min. Negotiated Rate	$39.90
Max. Negotiated Rate	$39.90
Rate for Payer: Qualcare PPO/HMO/WC	$39.90

PT PARAFFIN BATH THRPY

Facility

$266.00

Service Code	HCPCS 97018GP
Hospital Charge Code	422597018
Hospital Revenue Code	420
Min. Negotiated Rate	$34.58
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$79.80
Rate for Payer: Aetna Medicare Advantage	$79.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.83
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	$67.83
Rate for Payer: Cigna Commercial	$133.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.58
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.90
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT PERFORMANCE TEST EA 15 MIN

Facility

$186.15

Service Code	HCPCS 97750GP
Hospital Charge Code	422597750
Hospital Revenue Code	420
Min. Negotiated Rate	$24.20
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$55.84
Rate for Payer: Aetna Medicare Advantage	$55.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.47
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	$47.47
Rate for Payer: Cigna Commercial	$93.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.20
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.92
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT PERFORMANCE TEST EA 15 MIN

Facility

$186.15

Service Code	HCPCS 97750GP
Hospital Charge Code	422597750
Hospital Revenue Code	420
Min. Negotiated Rate	$27.92
Max. Negotiated Rate	$27.92
Rate for Payer: Qualcare PPO/HMO/WC	$27.92

PT PHYSICAL MEDICINE PROCEDURE

Facility

$161.00

Service Code	HCPCS 97139GP
Hospital Charge Code	422597139
Hospital Revenue Code	420
Min. Negotiated Rate	$20.93
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$48.30
Rate for Payer: Aetna Medicare Advantage	$48.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.05
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	$41.05
Rate for Payer: Cigna Commercial	$80.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.93
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.15
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT PHYSICAL MEDICINE PROCEDURE

Facility

$161.00

Service Code	HCPCS 97139GP
Hospital Charge Code	422597139
Hospital Revenue Code	420
Min. Negotiated Rate	$24.15
Max. Negotiated Rate	$24.15
Rate for Payer: Qualcare PPO/HMO/WC	$24.15

PT-PHYS PERF TST 15MIN

Facility

$195.00

Hospital Charge Code	9109120
Hospital Revenue Code	420
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$29.25
Rate for Payer: Qualcare PPO/HMO/WC	$29.25

PT-PHYS PERF TST 15MIN

Facility

$195.00

Hospital Charge Code	9109120
Hospital Revenue Code	420
Min. Negotiated Rate	$25.35
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$58.50
Rate for Payer: Aetna Medicare Advantage	$58.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.73
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	$49.73
Rate for Payer: Cigna Commercial	$97.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.35
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.25
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT PROSTHETIC TRAIN EA 15 MIN

Facility

$130.50

Service Code	HCPCS 97761GP
Hospital Charge Code	422597761
Hospital Revenue Code	420
Min. Negotiated Rate	$16.96
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$39.15
Rate for Payer: Aetna Medicare Advantage	$39.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.28
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	$33.28
Rate for Payer: Cigna Commercial	$65.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.96
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.57
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT PROSTHETIC TRAIN EA 15 MIN

Facility

$130.50

Service Code	HCPCS 97761GP
Hospital Charge Code	422597761
Hospital Revenue Code	420
Min. Negotiated Rate	$19.57
Max. Negotiated Rate	$19.57
Rate for Payer: Qualcare PPO/HMO/WC	$19.57

PT PROSTHETIC TRAINING*****

Facility

$45.00

Service Code	HCPCS 97520GP
Hospital Charge Code	9100085
Hospital Revenue Code	420
Min. Negotiated Rate	$5.85
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$13.50
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
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	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.85
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT PROSTHETIC TRAINING*****

Facility

$45.00

Service Code	HCPCS 97520GP
Hospital Charge Code	9100085
Hospital Revenue Code	420
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

PT PROSTH TRAIN UE/LE/15 MIN 1

Facility

$134.50

Service Code	HCPCS 97760GP
Hospital Charge Code	9100160
Hospital Revenue Code	420
Min. Negotiated Rate	$20.18
Max. Negotiated Rate	$20.18
Rate for Payer: Qualcare PPO/HMO/WC	$20.18

PT PROSTH TRAIN UE/LE/15 MIN 1

Facility

$134.50

Service Code	HCPCS 97760GP
Hospital Charge Code	9100160
Hospital Revenue Code	420
Min. Negotiated Rate	$17.48
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$40.35
Rate for Payer: Aetna Medicare Advantage	$40.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.30
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	$34.30
Rate for Payer: Cigna Commercial	$67.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.48
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.18
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT- PT/CHILDSTUDY******

Facility

$175.00

Service Code	HCPCS Q0086
Hospital Charge Code	900407
Hospital Revenue Code	429
Min. Negotiated Rate	$22.75
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$52.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
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	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.75
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT- PT/CHILDSTUDY******

Facility

$175.00

Service Code	HCPCS Q0086
Hospital Charge Code	900407
Hospital Revenue Code	429
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

PT / PTT MIX****

Facility

$125.00

Service Code	HCPCS 85610
Hospital Charge Code	3032521
Hospital Revenue Code	301
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

PT / PTT MIX****

Facility

$125.00

Service Code	HCPCS 85610
Hospital Charge Code	3032521
Hospital Revenue Code	301
Min. Negotiated Rate	$2.15
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.90
Rate for Payer: Aetna Medicare Advantage	$4.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.72
Rate for Payer: Cigna Commercial	$4.29
Rate for Payer: Cigna Medicare Advantage	$2.15
Rate for Payer: Clover Medicare Advantage	$4.08
Rate for Payer: EmblemHealth Commercial	$12.87
Rate for Payer: Humana Medicare Advantage	$4.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.29
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.55
Rate for Payer: Wellcare Medicare Advantage	$4.29

Know your out-of-pocket cost for care.

All Charges