Heights University Hospital

All Charges

Charge

Type

Setting

Price

SPEECH LANG D/C STATUS

Facility

$0.01

Service Code	HCPCS G9176GN
Hospital Charge Code	84201105
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SPEECH LANG D/C STATUS

Facility

$0.01

Service Code	HCPCS G9178GN
Hospital Charge Code	84201179
Hospital Revenue Code	449
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

SPEECH LANG D/C STATUS

Facility

$0.01

Service Code	HCPCS G9176GN
Hospital Charge Code	84201105
Hospital Revenue Code	440
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

SPEECH LANG D/C STATUS

Facility

$0.01

Service Code	HCPCS G9178GN
Hospital Charge Code	84201179
Hospital Revenue Code	449
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SPEECH LANG GOAL STATUS

Facility

$0.01

Service Code	HCPCS G9175GN
Hospital Charge Code	84201178
Hospital Revenue Code	449
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

SPEECH LANG GOAL STATUS

Facility

$0.01

Service Code	HCPCS G9175GN
Hospital Charge Code	84201178
Hospital Revenue Code	449
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SPEECH LANG GOAL STATUS

Facility

$0.01

Service Code	HCPCS G9175GN
Hospital Charge Code	84201100
Hospital Revenue Code	440
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

SPEECH LANG GOAL STATUS

Facility

$0.01

Service Code	HCPCS G9175GN
Hospital Charge Code	84201100
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SPEECH THERAPY/CHILD STUDY****

Facility

$65.00

Service Code	HCPCS 92507
Hospital Charge Code	9000472
Hospital Revenue Code	449
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

SPEECH THERAPY/CHILD STUDY****

Facility

$65.00

Service Code	HCPCS 92507
Hospital Charge Code	9000472
Hospital Revenue Code	449
Min. Negotiated Rate	$8.45
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$19.50
Rate for Payer: Aetna Medicare Advantage	$19.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.57
Rate for Payer: Cigna Commercial	$84.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.45
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.75
Rate for Payer: UnitedHealthcare Commercial	$686.00

SPEECH THERAPY SESSION DBL****

Facility

$65.00

Service Code	HCPCS 92507GN
Hospital Charge Code	9000324
Hospital Revenue Code	449
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

SPEECH THERAPY SESSION DBL****

Facility

$65.00

Service Code	HCPCS 92507GN
Hospital Charge Code	9000324
Hospital Revenue Code	449
Min. Negotiated Rate	$8.45
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$19.50
Rate for Payer: Aetna Medicare Advantage	$19.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.57
Rate for Payer: Cigna Commercial	$32.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.45
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.75
Rate for Payer: UnitedHealthcare Commercial	$686.00

SPEEDAKIN RAP COMP IMP 9MMX9MM

Facility

$9,370.00

Hospital Charge Code	270702792
Hospital Revenue Code	278
Min. Negotiated Rate	$1,405.50
Max. Negotiated Rate	$4,685.00
Rate for Payer: Aetna Commercial	$2,811.00
Rate for Payer: Aetna Medicare Advantage	$2,811.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,389.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,389.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,874.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,389.35
Rate for Payer: Cigna Commercial	$4,685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,267.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,405.50

SPEEDAKIN RAP COMP IMP 9MMX9MM

Facility

$9,370.00

Hospital Charge Code	270702792
Hospital Revenue Code	278
Min. Negotiated Rate	$1,405.50
Max. Negotiated Rate	$2,267.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,874.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,267.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,405.50

SPEEDBAND MCV 6500

Facility

$3,064.85

Hospital Charge Code	270603918
Hospital Revenue Code	270
Min. Negotiated Rate	$459.73
Max. Negotiated Rate	$459.73
Rate for Payer: Qualcare PPO/HMO/WC	$459.73

SPEEDBAND MCV 6500

Facility

$3,064.85

Hospital Charge Code	270603918
Hospital Revenue Code	270
Min. Negotiated Rate	$398.43
Max. Negotiated Rate	$1,532.42
Rate for Payer: Aetna Commercial	$919.46
Rate for Payer: Aetna Medicare Advantage	$919.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$781.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$781.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$781.54
Rate for Payer: Cigna Commercial	$1,532.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$398.43
Rate for Payer: Oxford Commercial	$1,532.42
Rate for Payer: Qualcare PPO/HMO/WC	$459.73
Rate for Payer: UnitedHealthcare Commercial	$1,532.42

SPEEDBRG IMP SYS W/BIO

Facility

$1,910.00

Hospital Charge Code	270687030
Hospital Revenue Code	272
Min. Negotiated Rate	$248.30
Max. Negotiated Rate	$955.00
Rate for Payer: Aetna Commercial	$573.00
Rate for Payer: Aetna Medicare Advantage	$573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$487.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$487.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$487.05
Rate for Payer: Cigna Commercial	$955.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.30
Rate for Payer: Oxford Commercial	$955.00
Rate for Payer: Qualcare PPO/HMO/WC	$286.50
Rate for Payer: UnitedHealthcare Commercial	$955.00

SPEEDBRG IMP SYS W/BIO

Facility

$1,910.00

Hospital Charge Code	270687030
Hospital Revenue Code	272
Min. Negotiated Rate	$286.50
Max. Negotiated Rate	$286.50
Rate for Payer: Qualcare PPO/HMO/WC	$286.50

SPEEDBRIDGE, ACHILLES

Facility

$14,160.00

Hospital Charge Code	270701993
Hospital Revenue Code	278
Min. Negotiated Rate	$2,124.00
Max. Negotiated Rate	$7,080.00
Rate for Payer: Aetna Commercial	$4,248.00
Rate for Payer: Aetna Medicare Advantage	$4,248.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,610.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,610.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,832.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,610.80
Rate for Payer: Cigna Commercial	$7,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,426.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,124.00

SPEEDBRIDGE, ACHILLES

Facility

$14,160.00

Hospital Charge Code	270701993
Hospital Revenue Code	278
Min. Negotiated Rate	$2,124.00
Max. Negotiated Rate	$3,426.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,832.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,426.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,124.00

SPEEDBRIDGE IMP SYS 4.75/5.5MM

Facility

$9,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270699520
Hospital Revenue Code	278
Min. Negotiated Rate	$1,432.50
Max. Negotiated Rate	$2,311.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,910.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,311.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,432.50

SPEEDBRIDGE IMP SYS 4.75/5.5MM

Facility

$9,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270699520
Hospital Revenue Code	278
Min. Negotiated Rate	$1,432.50
Max. Negotiated Rate	$4,775.00
Rate for Payer: Aetna Commercial	$2,865.00
Rate for Payer: Aetna Medicare Advantage	$2,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,435.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,435.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,910.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,435.25
Rate for Payer: Cigna Commercial	$4,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,311.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,432.50

SPEEDBRIDGE W/BIOCOMP SWLCK SP

Facility

$8,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270677723
Hospital Revenue Code	278
Min. Negotiated Rate	$1,335.00
Max. Negotiated Rate	$2,153.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,153.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,335.00

SPEEDBRIDGE W/BIOCOMP SWLCK SP

Facility

$8,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270677723
Hospital Revenue Code	278
Min. Negotiated Rate	$1,335.00
Max. Negotiated Rate	$4,450.00
Rate for Payer: Aetna Commercial	$2,670.00
Rate for Payer: Aetna Medicare Advantage	$2,670.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,269.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,269.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,780.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,269.50
Rate for Payer: Cigna Commercial	$4,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,153.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,335.00

SPEEDBRIDGE W/BIOCOMP SWLOCL

Facility

$8,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270688426
Hospital Revenue Code	278
Min. Negotiated Rate	$1,305.00
Max. Negotiated Rate	$4,350.00
Rate for Payer: Aetna Commercial	$2,610.00
Rate for Payer: Aetna Medicare Advantage	$2,610.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,218.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,218.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,740.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,218.50
Rate for Payer: Cigna Commercial	$4,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,105.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,305.00

Know your out-of-pocket cost for care.

All Charges