Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$27.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.59
Rate for Payer: Qualcare PPO/HMO/WC	$17.10

RW HEPVAX A & B ADULTS

Facility

$142.00

Service Code	HCPCS 90636
Hospital Charge Code	84206180
Hospital Revenue Code	636
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$34.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.36
Rate for Payer: Qualcare PPO/HMO/WC	$21.30

RW HEPVAX A & B ADULTS

Facility

$142.00

Service Code	HCPCS 90636
Hospital Charge Code	84206180
Hospital Revenue Code	636
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$128.16
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	$128.16
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	$34.36
Rate for Payer: Qualcare PPO/HMO/WC	$21.30

RW I&D ABCESS COMPLICATED

Facility

$610.00

Service Code	HCPCS 10061
Hospital Charge Code	87502120
Hospital Revenue Code	761
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

RW I&D ABCESS COMPLICATED

Facility

$610.00

Service Code	HCPCS 10061
Hospital Charge Code	87502120
Hospital Revenue Code	761
Min. Negotiated Rate	$79.30
Max. Negotiated Rate	$968.07
Rate for Payer: Aetna Commercial	$183.00
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$127.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.30
Rate for Payer: Oxford Commercial	$305.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Commercial	$305.00

RW I&D ABCESS-SIMPLE

Facility

$610.00

Service Code	HCPCS 10060
Hospital Charge Code	87502115
Hospital Revenue Code	761
Min. Negotiated Rate	$29.34
Max. Negotiated Rate	$962.01
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Aetna Better Health Medicaid	$943.15
Rate for Payer: Aetna Commercial	$183.00
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.30
Rate for Payer: Oxford Commercial	$305.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Commercial	$305.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$962.01

RW I&D ABCESS-SIMPLE

Facility

$610.00

Service Code	HCPCS 10060
Hospital Charge Code	87502115
Hospital Revenue Code	761
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

RW I&D ABSCESS COMPLICATED

Facility

$610.00

Service Code	HCPCS 10061
Hospital Charge Code	84206005
Hospital Revenue Code	761
Min. Negotiated Rate	$79.30
Max. Negotiated Rate	$968.07
Rate for Payer: Aetna Commercial	$183.00
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$127.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.30
Rate for Payer: Oxford Commercial	$305.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Commercial	$305.00

RW I&D ABSCESS COMPLICATED

Facility

$610.00

Service Code	HCPCS 10061
Hospital Charge Code	84206005
Hospital Revenue Code	761
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

RW I&D ABSCESS,SIMPLE

Facility

$610.00

Service Code	HCPCS 10060
Hospital Charge Code	84206001
Hospital Revenue Code	761
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

RW I&D ABSCESS,SIMPLE

Facility

$610.00

Service Code	HCPCS 10060
Hospital Charge Code	84206001
Hospital Revenue Code	761
Min. Negotiated Rate	$29.34
Max. Negotiated Rate	$962.01
Rate for Payer: Aetna Better Health Medicaid	$943.15
Rate for Payer: Aetna Commercial	$183.00
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.30
Rate for Payer: Oxford Commercial	$305.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Commercial	$305.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$962.01

RW I&D HEMATOMA

Facility

$882.00

Service Code	HCPCS 10140
Hospital Charge Code	84206015
Hospital Revenue Code	761
Min. Negotiated Rate	$132.30
Max. Negotiated Rate	$132.30
Rate for Payer: Qualcare PPO/HMO/WC	$132.30

RW I&D HEMATOMA

Facility

$882.00

Service Code	HCPCS 10140
Hospital Charge Code	84206015
Hospital Revenue Code	761
Min. Negotiated Rate	$43.47
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$264.60
Rate for Payer: Aetna Medicare Advantage	$264.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.91
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.66
Rate for Payer: Oxford Commercial	$441.00
Rate for Payer: Qualcare PPO/HMO/WC	$132.30
Rate for Payer: UnitedHealthcare Commercial	$441.00

RW IM INJECTION

Facility

$149.00

Service Code	HCPCS 96372
Hospital Charge Code	87502840
Hospital Revenue Code	940
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$1,558.00
Rate for Payer: Aetna Commercial	$44.70
Rate for Payer: Aetna Medicare Advantage	$44.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.99
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.37
Rate for Payer: Oxford Commercial	$1,373.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.35
Rate for Payer: UnitedHealthcare Commercial	$1,558.00

RW IM INJECTION

Facility

$149.00

Service Code	HCPCS 96372
Hospital Charge Code	87502840
Hospital Revenue Code	940
Min. Negotiated Rate	$22.35
Max. Negotiated Rate	$22.35
Rate for Payer: Qualcare PPO/HMO/WC	$22.35

RW IND PSY 45-50 MINS W/MD

Facility

$550.00

Service Code	HCPCS 90836
Hospital Charge Code	87502915
Hospital Revenue Code	914
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

RW IND PSY 45-50 MINS W/MD

Facility

$550.00

Service Code	HCPCS 90836
Hospital Charge Code	87502915
Hospital Revenue Code	914
Min. Negotiated Rate	$71.50
Max. Negotiated Rate	$165.00
Rate for Payer: Aetna Commercial	$165.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$89.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$94.46

RW IND PSYCHOTHER 20-30 MINS

Facility

$1,296.00

Service Code	HCPCS 90804
Hospital Charge Code	87502015
Hospital Revenue Code	914
Min. Negotiated Rate	$168.48
Max. Negotiated Rate	$648.00
Rate for Payer: Aetna Commercial	$388.80
Rate for Payer: Aetna Medicare Advantage	$388.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.48
Rate for Payer: Cigna Commercial	$648.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.48
Rate for Payer: Qualcare PPO/HMO/WC	$194.40

RW IND PSYCHOTHER 20-30 MINS

Facility

$1,296.00

Service Code	HCPCS 90804
Hospital Charge Code	87502015
Hospital Revenue Code	914
Min. Negotiated Rate	$194.40
Max. Negotiated Rate	$194.40
Rate for Payer: Qualcare PPO/HMO/WC	$194.40

RW IND PSY THER 45-50 MINS

Facility

$425.00

Service Code	HCPCS 90834
Hospital Charge Code	87502910
Hospital Revenue Code	914
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.25
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$94.46

RW IND PSY THER 45-50 MINS

Facility

$425.00

Service Code	HCPCS 90834
Hospital Charge Code	87502910
Hospital Revenue Code	914
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

RW IND PSYTHERAPY INTACT 20-30

Facility

$275.00

Service Code	HCPCS 90832
Hospital Charge Code	87502900
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

RW IND PSYTHERAPY INTACT 20-30

Facility

$275.00

Service Code	HCPCS 90832
Hospital Charge Code	87502900
Hospital Revenue Code	914
Min. Negotiated Rate	$35.75
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$82.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.75
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$71.39

RW IND PSY THER INT 20-30 W/MD

Facility

$350.00

Service Code	HCPCS 90833
Hospital Charge Code	87502905
Hospital Revenue Code	914
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

RW IND PSY THER INT 20-30 W/MD

Facility

$350.00

Service Code	HCPCS 90833
Hospital Charge Code	87502905
Hospital Revenue Code	914
Min. Negotiated Rate	$45.50
Max. Negotiated Rate	$122.43
Rate for Payer: Aetna Commercial	$105.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$70.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$73.61

Know your out-of-pocket cost for care.

All Charges