Heights University Hospital

All Charges

Charge

Type

Setting

Price

RW EST. PT - VISIT - FOCUSED

Facility

$236.00

Service Code	HCPCS 99212
Hospital Charge Code	84206340
Hospital Revenue Code	510
Min. Negotiated Rate	$30.68
Max. Negotiated Rate	$70.80
Rate for Payer: Aetna Commercial	$70.80
Rate for Payer: Aetna Medicare Advantage	$70.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.18
Rate for Payer: Cigna Commercial	$33.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.68
Rate for Payer: Qualcare PPO/HMO/WC	$35.40

RW EST. PT - VISIT - FOCUSED

Facility

$236.00

Service Code	HCPCS 99212
Hospital Charge Code	84206340
Hospital Revenue Code	510
Min. Negotiated Rate	$35.40
Max. Negotiated Rate	$35.40
Rate for Payer: Qualcare PPO/HMO/WC	$35.40

RW EST. PT - VISIT - MINIMAL

Facility

$114.00

Service Code	HCPCS 99211
Hospital Charge Code	84206335
Hospital Revenue Code	510
Min. Negotiated Rate	$17.10
Max. Negotiated Rate	$17.10
Rate for Payer: Qualcare PPO/HMO/WC	$17.10

RW EST. PT - VISIT - MINIMAL

Facility

$114.00

Service Code	HCPCS 99211
Hospital Charge Code	84206335
Hospital Revenue Code	510
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$34.20
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$34.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.07
Rate for Payer: Cigna Commercial	$8.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.82
Rate for Payer: Qualcare PPO/HMO/WC	$17.10

RW FB REMOVAL, EAR

Facility

$299.00

Service Code	HCPCS 69200
Hospital Charge Code	84206125
Hospital Revenue Code	761
Min. Negotiated Rate	$20.93
Max. Negotiated Rate	$316.85
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	$20.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.25
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.87
Rate for Payer: Oxford Commercial	$149.50
Rate for Payer: Qualcare PPO/HMO/WC	$44.85
Rate for Payer: UnitedHealthcare Commercial	$149.50

RW FB REMOVAL, EAR

Facility

$299.00

Service Code	HCPCS 69200
Hospital Charge Code	84206125
Hospital Revenue Code	761
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$44.85
Rate for Payer: Qualcare PPO/HMO/WC	$44.85

RW FB REMOVAL-EAR

Facility

$299.00

Service Code	HCPCS 69200
Hospital Charge Code	87502095
Hospital Revenue Code	761
Min. Negotiated Rate	$20.93
Max. Negotiated Rate	$316.85
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	$20.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.25
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.87
Rate for Payer: Oxford Commercial	$149.50
Rate for Payer: Qualcare PPO/HMO/WC	$44.85
Rate for Payer: UnitedHealthcare Commercial	$149.50

RW FB REMOVAL-EAR

Facility

$299.00

Service Code	HCPCS 69200
Hospital Charge Code	87502095
Hospital Revenue Code	761
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$44.85
Rate for Payer: Qualcare PPO/HMO/WC	$44.85

RW FB REMOVAL - EYE

Facility

$397.00

Service Code	HCPCS 65205
Hospital Charge Code	87502100
Hospital Revenue Code	361
Min. Negotiated Rate	$59.55
Max. Negotiated Rate	$59.55
Rate for Payer: Qualcare PPO/HMO/WC	$59.55

RW FB REMOVAL - EYE

Facility

$397.00

Service Code	HCPCS 65205
Hospital Charge Code	87502100
Hospital Revenue Code	361
Min. Negotiated Rate	$51.61
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$119.10
Rate for Payer: Aetna Medicare Advantage	$119.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.23
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.61
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.55
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

RW FB REMOVAL,EYE

Facility

$397.00

Service Code	HCPCS 65205
Hospital Charge Code	84206120
Hospital Revenue Code	361
Min. Negotiated Rate	$51.61
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$119.10
Rate for Payer: Aetna Medicare Advantage	$119.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.23
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.61
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.55
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

RW FB REMOVAL,EYE

Facility

$397.00

Service Code	HCPCS 65205
Hospital Charge Code	84206120
Hospital Revenue Code	361
Min. Negotiated Rate	$59.55
Max. Negotiated Rate	$59.55
Rate for Payer: Qualcare PPO/HMO/WC	$59.55

RW GARDISIL

Facility

$273.00

Service Code	HCPCS 90649
Hospital Charge Code	87502857
Hospital Revenue Code	636
Min. Negotiated Rate	$40.95
Max. Negotiated Rate	$66.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.07
Rate for Payer: Qualcare PPO/HMO/WC	$40.95

RW GARDISIL

Facility

$273.00

Service Code	HCPCS 90649
Hospital Charge Code	87502857
Hospital Revenue Code	636
Min. Negotiated Rate	$40.95
Max. Negotiated Rate	$146.33
Rate for Payer: Aetna Commercial	$81.90
Rate for Payer: Aetna Medicare Advantage	$81.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.61
Rate for Payer: Cigna Commercial	$136.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.07
Rate for Payer: Qualcare PPO/HMO/WC	$40.95

RW GROUP PSYCHOTHERAPY

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	87502010
Hospital Revenue Code	915
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$241.93
Rate for Payer: Aetna Commercial	$240.24
Rate for Payer: Aetna Medicare Advantage	$240.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.20
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.10
Rate for Payer: Qualcare PPO/HMO/WC	$120.12
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48

RW GROUP PSYCHOTHERAPY

Facility

$367.85

Service Code	HCPCS 90853
Hospital Charge Code	87502920
Hospital Revenue Code	915
Min. Negotiated Rate	$55.18
Max. Negotiated Rate	$55.18
Rate for Payer: Qualcare PPO/HMO/WC	$55.18

RW GROUP PSYCHOTHERAPY

Facility

$367.85

Service Code	HCPCS 90853
Hospital Charge Code	87502920
Hospital Revenue Code	915
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$241.93
Rate for Payer: Aetna Commercial	$110.36
Rate for Payer: Aetna Medicare Advantage	$110.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.80
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.82
Rate for Payer: Qualcare PPO/HMO/WC	$55.18
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48

RW GROUP PSYCHOTHERAPY

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	87502010
Hospital Revenue Code	915
Min. Negotiated Rate	$120.12
Max. Negotiated Rate	$120.12
Rate for Payer: Qualcare PPO/HMO/WC	$120.12

RW HEMOCULT

Facility

$390.00

Service Code	HCPCS 82270
Hospital Charge Code	87502330
Hospital Revenue Code	301
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$14.19
Rate for Payer: Aetna Medicare Advantage	$4.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.05
Rate for Payer: Cigna Commercial	$4.38
Rate for Payer: Cigna Medicare Advantage	$2.19
Rate for Payer: Clover Medicare Advantage	$4.16
Rate for Payer: EmblemHealth Commercial	$13.14
Rate for Payer: Humana Medicare Advantage	$4.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.38
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.64
Rate for Payer: Wellcare Medicare Advantage	$4.38

RW HEMOCULT

Facility

$23.00

Service Code	HCPCS 82270
Hospital Charge Code	84206145
Hospital Revenue Code	301
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

RW HEMOCULT

Facility

$390.00

Service Code	HCPCS 82270
Hospital Charge Code	87502330
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

RW HEMOCULT

Facility

$23.00

Service Code	HCPCS 82270
Hospital Charge Code	84206145
Hospital Revenue Code	301
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$14.19
Rate for Payer: Aetna Medicare Advantage	$4.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.05
Rate for Payer: Cigna Commercial	$4.38
Rate for Payer: Cigna Medicare Advantage	$2.19
Rate for Payer: Clover Medicare Advantage	$4.16
Rate for Payer: EmblemHealth Commercial	$13.14
Rate for Payer: Humana Medicare Advantage	$4.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.99
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.38
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.64
Rate for Payer: Wellcare Medicare Advantage	$4.38

RW HEPATITIS A VACCINE ADULT

Facility

$91.00

Service Code	HCPCS 90632
Hospital Charge Code	87502850
Hospital Revenue Code	636
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$22.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.02
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

RW HEPATITIS A VACCINE ADULT

Facility

$91.00

Service Code	HCPCS 90632
Hospital Charge Code	87502850
Hospital Revenue Code	636
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$91.24
Rate for Payer: Aetna Commercial	$27.30
Rate for Payer: Aetna Medicare Advantage	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.20
Rate for Payer: Cigna Commercial	$73.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.02
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

RW HEPATITIS B VACCINE ADULT

Facility

$114.00

Service Code	HCPCS 90746
Hospital Charge Code	87502845
Hospital Revenue Code	636
Min. Negotiated Rate	$17.10
Max. Negotiated Rate	$75.15
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$34.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.07
Rate for Payer: Cigna Commercial	$75.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.59
Rate for Payer: Qualcare PPO/HMO/WC	$17.10

Know your out-of-pocket cost for care.

All Charges