Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

JANSSEN COVID19 BOOSTER ADMIN

Facility

$50.00

Service Code	HCPCS 0034A
Hospital Charge Code	30420034A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

JANSSEN COVID19 BOOSTER ADMIN

Facility

$50.00

Service Code	HCPCS 0034A
Hospital Charge Code	43080034A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

JANSSEN COVID19 BOOSTER ADMIN

Facility

$50.00

Service Code	HCPCS 0034A
Hospital Charge Code	45020034A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

JANSSEN COVID19 BOOSTER ADMIN

Facility

$50.00

Service Code	HCPCS 0034A
Hospital Charge Code	32460034A
Hospital Revenue Code	771
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

JANSSEN COVID19 BOOSTER ADMIN

Facility

$50.00

Service Code	HCPCS 0034A
Hospital Charge Code	31900034A
Hospital Revenue Code	771
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

JANSSEN COVID19 BOOSTER ADMIN

Facility

$50.00

Service Code	HCPCS 0034A
Hospital Charge Code	48220034A
Hospital Revenue Code	771
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

JANSSEN COVID19 BOOSTER ADMIN

Facility

$50.00

Service Code	HCPCS 0034A
Hospital Charge Code	30340034A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

JANSSEN COVID19 BOOSTER ADMIN

Facility

$50.00

Service Code	HCPCS 0034A
Hospital Charge Code	30370034A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

JANSSEN COVID19 BOOSTER ADMIN

Facility

$50.00

Service Code	HCPCS 0034A
Hospital Charge Code	30490034A
Hospital Revenue Code	771
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	36550031A
Hospital Revenue Code	771
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	32470031A
Hospital Revenue Code	771
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	36530031A
Hospital Revenue Code	771
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	32400031A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	30470031A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	32300031A
Hospital Revenue Code	771
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	43100031A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	32400031A
Hospital Revenue Code	771
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	36550031A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	30800031A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	43080031A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	48180031A
Hospital Revenue Code	771
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	39200031A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	45090031A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	30370031A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	32460031A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

Know your out-of-pocket cost for care.

All Charges