Heights University Hospital

All Charges

Charge

Type

Setting

Price

TCM INIT HOSPITAL ADMISSION 3

Facility

$275.00

Service Code	HCPCS 99223
Hospital Charge Code	93950157
Hospital Revenue Code	510
Min. Negotiated Rate	$35.75
Max. Negotiated Rate	$169.13
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) PPO	$70.12
Rate for Payer: Cigna Commercial	$169.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.75
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

TCM INIT HOSPITAL ADMISSION 3

Facility

$275.00

Service Code	HCPCS 99223
Hospital Charge Code	93950157
Hospital Revenue Code	510
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

TCM INTRALSNL INJCTNS UP TO 7

Facility

$1,033.25

Service Code	HCPCS 11900
Hospital Charge Code	93950023
Hospital Revenue Code	761
Min. Negotiated Rate	$23.11
Max. Negotiated Rate	$516.62
Rate for Payer: Aetna Commercial	$309.98
Rate for Payer: Aetna Medicare Advantage	$309.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.48
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.32
Rate for Payer: Oxford Commercial	$516.62
Rate for Payer: Qualcare PPO/HMO/WC	$154.99
Rate for Payer: UnitedHealthcare Commercial	$516.62

TCM INTRALSNL INJCTNS UP TO 7

Facility

$1,033.25

Service Code	HCPCS 11900
Hospital Charge Code	93950023
Hospital Revenue Code	761
Min. Negotiated Rate	$154.99
Max. Negotiated Rate	$154.99
Rate for Payer: Qualcare PPO/HMO/WC	$154.99

TCM JOINT/BURSA TP AND/OR INJ

Facility

$440.00

Service Code	HCPCS 20610
Hospital Charge Code	93950037
Hospital Revenue Code	761
Min. Negotiated Rate	$66.00
Max. Negotiated Rate	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.00

TCM JOINT/BURSA TP AND/OR INJ

Facility

$440.00

Service Code	HCPCS 20610
Hospital Charge Code	93950037
Hospital Revenue Code	761
Min. Negotiated Rate	$45.06
Max. Negotiated Rate	$730.97
Rate for Payer: Aetna Commercial	$132.00
Rate for Payer: Aetna Medicare Advantage	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.20
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.20
Rate for Payer: Oxford Commercial	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.00
Rate for Payer: UnitedHealthcare Commercial	$220.00

TCM LACERATION REPAIR

Facility

$732.95

Service Code	HCPCS 12001
Hospital Charge Code	93950025
Hospital Revenue Code	761
Min. Negotiated Rate	$43.70
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$219.88
Rate for Payer: Aetna Medicare Advantage	$219.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.90
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.28
Rate for Payer: Oxford Commercial	$366.48
Rate for Payer: Qualcare PPO/HMO/WC	$109.94
Rate for Payer: UnitedHealthcare Commercial	$366.48

TCM LACERATION REPAIR

Facility

$732.95

Service Code	HCPCS 12001
Hospital Charge Code	93950025
Hospital Revenue Code	761
Min. Negotiated Rate	$109.94
Max. Negotiated Rate	$109.94
Rate for Payer: Qualcare PPO/HMO/WC	$109.94

TCM MENINGOCOCCAL

Facility

$193.00

Service Code	HCPCS 90733
Hospital Charge Code	93950105
Hospital Revenue Code	636
Min. Negotiated Rate	$28.95
Max. Negotiated Rate	$46.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.71
Rate for Payer: Qualcare PPO/HMO/WC	$28.95

TCM MENINGOCOCCAL

Facility

$193.00

Service Code	HCPCS 90733
Hospital Charge Code	93950105
Hospital Revenue Code	636
Min. Negotiated Rate	$28.95
Max. Negotiated Rate	$105.32
Rate for Payer: Aetna Commercial	$57.90
Rate for Payer: Aetna Medicare Advantage	$57.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.22
Rate for Payer: Cigna Commercial	$96.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.71
Rate for Payer: Qualcare PPO/HMO/WC	$28.95

TCM MMR, SO LIVE

Facility

$130.00

Service Code	HCPCS 90707
Hospital Charge Code	93950089
Hospital Revenue Code	636
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$65.00
Rate for Payer: Aetna Commercial	$39.00
Rate for Payer: Aetna Medicare Advantage	$39.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.15
Rate for Payer: Cigna Commercial	$65.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.46
Rate for Payer: Qualcare PPO/HMO/WC	$19.50

TCM MMR, SO LIVE

Facility

$130.00

Service Code	HCPCS 90707
Hospital Charge Code	93950089
Hospital Revenue Code	636
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$31.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.46
Rate for Payer: Qualcare PPO/HMO/WC	$19.50

TCM MOD MED COMPLEX

Facility

$645.75

Service Code	HCPCS 99495
Hospital Charge Code	412399495
Hospital Revenue Code	510
Min. Negotiated Rate	$96.86
Max. Negotiated Rate	$96.86
Rate for Payer: Qualcare PPO/HMO/WC	$96.86

TCM MOD MED COMPLEX

Facility

$645.75

Service Code	HCPCS 99495
Hospital Charge Code	412399495
Hospital Revenue Code	510
Min. Negotiated Rate	$83.95
Max. Negotiated Rate	$317.04
Rate for Payer: Aetna Commercial	$193.72
Rate for Payer: Aetna Medicare Advantage	$193.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.67
Rate for Payer: Cigna Commercial	$317.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.95
Rate for Payer: Qualcare PPO/HMO/WC	$96.86

TCM NONPRESS INHALE TREATMENT

Facility

$503.00

Service Code	HCPCS 94640
Hospital Charge Code	93950115
Hospital Revenue Code	410
Min. Negotiated Rate	$42.55
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$150.90
Rate for Payer: Aetna Medicare Advantage	$150.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.26
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.39
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.45
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

TCM NONPRESS INHALE TREATMENT

Facility

$503.00

Service Code	HCPCS 94640
Hospital Charge Code	93950115
Hospital Revenue Code	410
Min. Negotiated Rate	$75.45
Max. Negotiated Rate	$75.45
Rate for Payer: Qualcare PPO/HMO/WC	$75.45

TCM OFFICE VST EST PAT MINIML

Facility

$114.00

Service Code	HCPCS 99211
Hospital Charge Code	93950143
Hospital Revenue Code	510
Min. Negotiated Rate	$17.10
Max. Negotiated Rate	$17.10
Rate for Payer: Qualcare PPO/HMO/WC	$17.10

TCM OFFICE VST EST PAT MINIML

Facility

$114.00

Service Code	HCPCS 99211
Hospital Charge Code	93950143
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

TCM OSTEO MANIPULTIN 1-2 AREA

Facility

$149.85

Service Code	HCPCS 98925
Hospital Charge Code	93950123
Hospital Revenue Code	761
Min. Negotiated Rate	$13.71
Max. Negotiated Rate	$74.92
Rate for Payer: Aetna Commercial	$44.95
Rate for Payer: Aetna Medicare Advantage	$44.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.21
Rate for Payer: Cigna Commercial	$51.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.48
Rate for Payer: Oxford Commercial	$74.92
Rate for Payer: Qualcare PPO/HMO/WC	$22.48
Rate for Payer: UnitedHealthcare Commercial	$74.92

TCM OSTEO MANIPULTIN 1-2 AREA

Facility

$149.85

Service Code	HCPCS 98925
Hospital Charge Code	93950123
Hospital Revenue Code	761
Min. Negotiated Rate	$22.48
Max. Negotiated Rate	$22.48
Rate for Payer: Qualcare PPO/HMO/WC	$22.48

TCM OSTEO MANIPULTIN 3-4 AREA

Facility

$149.85

Service Code	HCPCS 98926
Hospital Charge Code	93950125
Hospital Revenue Code	761
Min. Negotiated Rate	$22.48
Max. Negotiated Rate	$22.48
Rate for Payer: Qualcare PPO/HMO/WC	$22.48

TCM OSTEO MANIPULTIN 3-4 AREA

Facility

$149.85

Service Code	HCPCS 98926
Hospital Charge Code	93950125
Hospital Revenue Code	761
Min. Negotiated Rate	$19.48
Max. Negotiated Rate	$74.92
Rate for Payer: Qualcare PPO/HMO/WC	$22.48
Rate for Payer: Aetna Commercial	$44.95
Rate for Payer: Aetna Medicare Advantage	$44.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.21
Rate for Payer: Cigna Commercial	$51.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.48
Rate for Payer: Oxford Commercial	$74.92
Rate for Payer: UnitedHealthcare Commercial	$74.92

TCM OSTEO MANIPULTIN 5-6 AREA

Facility

$149.85

Service Code	HCPCS 98927
Hospital Charge Code	93950127
Hospital Revenue Code	761
Min. Negotiated Rate	$22.48
Max. Negotiated Rate	$22.48
Rate for Payer: Qualcare PPO/HMO/WC	$22.48

TCM OSTEO MANIPULTIN 5-6 AREA

Facility

$149.85

Service Code	HCPCS 98927
Hospital Charge Code	93950127
Hospital Revenue Code	761
Min. Negotiated Rate	$19.48
Max. Negotiated Rate	$74.92
Rate for Payer: Aetna Commercial	$44.95
Rate for Payer: Aetna Medicare Advantage	$44.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.21
Rate for Payer: Cigna Commercial	$51.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.48
Rate for Payer: Oxford Commercial	$74.92
Rate for Payer: Qualcare PPO/HMO/WC	$22.48
Rate for Payer: UnitedHealthcare Commercial	$74.92

TCM OSTEO MANIPULTIN 7-8 AREA

Facility

$149.85

Service Code	HCPCS 98928
Hospital Charge Code	93950129
Hospital Revenue Code	761
Min. Negotiated Rate	$19.48
Max. Negotiated Rate	$74.92
Rate for Payer: Aetna Commercial	$44.95
Rate for Payer: Aetna Medicare Advantage	$44.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.21
Rate for Payer: Cigna Commercial	$51.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.48
Rate for Payer: Oxford Commercial	$74.92
Rate for Payer: Qualcare PPO/HMO/WC	$22.48
Rate for Payer: UnitedHealthcare Commercial	$74.92

Know your out-of-pocket cost for care.

All Charges