Heights University Hospital

All Charges

Charge

Type

Setting

Price

VACCINE ADMIN EA ADDL

Facility

$156.00

Service Code	HCPCS 90472
Hospital Charge Code	3408015
Hospital Revenue Code	771
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$103.00
Rate for Payer: Aetna Commercial	$46.80
Rate for Payer: Aetna Medicare Advantage	$46.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.78
Rate for Payer: Cigna Commercial	$18.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.28
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.40
Rate for Payer: UnitedHealthcare Commercial	$103.00

VACCINE ADMIN EA ADDL

Facility

$156.00

Service Code	HCPCS 90472
Hospital Charge Code	3408015
Hospital Revenue Code	771
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$23.40
Rate for Payer: Qualcare PPO/HMO/WC	$23.40

VACCINE ADMIN EA ADDL

Facility

$89.07

Service Code	HCPCS 90472
Hospital Charge Code	93950063
Hospital Revenue Code	771
Min. Negotiated Rate	$13.36
Max. Negotiated Rate	$13.36
Rate for Payer: Qualcare PPO/HMO/WC	$13.36

VACCINE ADMIN EA ADDL

Facility

$89.07

Service Code	HCPCS 90472
Hospital Charge Code	83652297
Hospital Revenue Code	771
Min. Negotiated Rate	$13.36
Max. Negotiated Rate	$13.36
Rate for Payer: Qualcare PPO/HMO/WC	$13.36

VACCINE ADMIN EA ADDL

Facility

$89.07

Service Code	HCPCS 90472
Hospital Charge Code	93500184
Hospital Revenue Code	771
Min. Negotiated Rate	$11.58
Max. Negotiated Rate	$103.00
Rate for Payer: Aetna Commercial	$26.72
Rate for Payer: Aetna Medicare Advantage	$26.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.71
Rate for Payer: Cigna Commercial	$18.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.58
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.36
Rate for Payer: UnitedHealthcare Commercial	$103.00

VACCINE ADMIN EA ADDL

Facility

$65.00

Service Code	HCPCS 90472
Hospital Charge Code	84206175
Hospital Revenue Code	771
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

VACCINE ADMIN EA ADDL

Facility

$89.07

Service Code	HCPCS 90472
Hospital Charge Code	87502255
Hospital Revenue Code	771
Min. Negotiated Rate	$11.58
Max. Negotiated Rate	$103.00
Rate for Payer: Aetna Commercial	$26.72
Rate for Payer: Aetna Medicare Advantage	$26.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.71
Rate for Payer: Cigna Commercial	$18.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.58
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.36
Rate for Payer: UnitedHealthcare Commercial	$103.00

VACCINE ADMIN EA ADDL

Facility

$65.00

Service Code	HCPCS 90472
Hospital Charge Code	84206175
Hospital Revenue Code	771
Min. Negotiated Rate	$8.45
Max. Negotiated Rate	$103.00
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	$12.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.57
Rate for Payer: Cigna Commercial	$18.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.45
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.75
Rate for Payer: UnitedHealthcare Commercial	$103.00

VACCINE ADMIN FLU

Facility

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	83652625
Hospital Revenue Code	771
Min. Negotiated Rate	$38.12
Max. Negotiated Rate	$38.12
Rate for Payer: Qualcare PPO/HMO/WC	$38.12

VACCINE ADMIN FLU

Facility

$201.60

Service Code	HCPCS 90471
Hospital Charge Code	5700685
Hospital Revenue Code	771
Min. Negotiated Rate	$30.24
Max. Negotiated Rate	$30.24
Rate for Payer: Qualcare PPO/HMO/WC	$30.24

VACCINE ADMIN FLU

Facility

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	83652625
Hospital Revenue Code	771
Min. Negotiated Rate	$21.85
Max. Negotiated Rate	$171.47
Rate for Payer: Aetna Commercial	$76.25
Rate for Payer: Aetna Medicare Advantage	$76.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.81
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.04
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.12
Rate for Payer: UnitedHealthcare Commercial	$103.00

VACCINE ADMIN FLU

Facility

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	87502400
Hospital Revenue Code	771
Min. Negotiated Rate	$21.85
Max. Negotiated Rate	$171.47
Rate for Payer: Aetna Commercial	$76.25
Rate for Payer: Aetna Medicare Advantage	$76.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.81
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.04
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.12
Rate for Payer: UnitedHealthcare Commercial	$103.00

VACCINE ADMIN FLU

Facility

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	93500180
Hospital Revenue Code	771
Min. Negotiated Rate	$38.12
Max. Negotiated Rate	$38.12
Rate for Payer: Qualcare PPO/HMO/WC	$38.12

VACCINE ADMIN FLU

Facility

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	100140
Hospital Revenue Code	771
Min. Negotiated Rate	$38.12
Max. Negotiated Rate	$38.12
Rate for Payer: Qualcare PPO/HMO/WC	$38.12

VACCINE ADMIN FLU

Facility

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	87502050
Hospital Revenue Code	771
Min. Negotiated Rate	$38.12
Max. Negotiated Rate	$38.12
Rate for Payer: Qualcare PPO/HMO/WC	$38.12

VACCINE ADMIN FLU

Facility

$175.19

Service Code	HCPCS 90471
Hospital Charge Code	73237028
Hospital Revenue Code	771
Min. Negotiated Rate	$21.85
Max. Negotiated Rate	$171.47
Rate for Payer: Aetna Commercial	$52.56
Rate for Payer: Aetna Medicare Advantage	$52.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.67
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.77
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.28
Rate for Payer: UnitedHealthcare Commercial	$103.00

VACCINE ADMIN FLU

Facility

$201.60

Service Code	HCPCS 90471
Hospital Charge Code	5700685
Hospital Revenue Code	771
Min. Negotiated Rate	$21.85
Max. Negotiated Rate	$171.47
Rate for Payer: Aetna Commercial	$60.48
Rate for Payer: Aetna Medicare Advantage	$60.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.41
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.21
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.24
Rate for Payer: UnitedHealthcare Commercial	$103.00

VACCINE ADMIN FLU

Facility

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	83652295
Hospital Revenue Code	771
Min. Negotiated Rate	$21.85
Max. Negotiated Rate	$171.47
Rate for Payer: Aetna Commercial	$76.25
Rate for Payer: Aetna Medicare Advantage	$76.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.81
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.04
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.12
Rate for Payer: UnitedHealthcare Commercial	$103.00

VACCINE ADMIN FLU

Facility

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	100140
Hospital Revenue Code	771
Min. Negotiated Rate	$21.85
Max. Negotiated Rate	$171.47
Rate for Payer: Aetna Commercial	$76.25
Rate for Payer: Aetna Medicare Advantage	$76.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.81
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.04
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.12
Rate for Payer: UnitedHealthcare Commercial	$103.00

VACCINE ADMIN FLU

Facility

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	87502400
Hospital Revenue Code	771
Min. Negotiated Rate	$38.12
Max. Negotiated Rate	$38.12
Rate for Payer: Qualcare PPO/HMO/WC	$38.12

VACCINE ADMIN FLU

Facility

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	83652519
Hospital Revenue Code	771
Min. Negotiated Rate	$21.85
Max. Negotiated Rate	$171.47
Rate for Payer: Aetna Commercial	$76.25
Rate for Payer: Aetna Medicare Advantage	$76.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.81
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.04
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.12
Rate for Payer: UnitedHealthcare Commercial	$103.00

VACCINE ADMIN FLU

Facility

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	5792170
Hospital Revenue Code	771
Min. Negotiated Rate	$38.12
Max. Negotiated Rate	$38.12
Rate for Payer: Qualcare PPO/HMO/WC	$38.12

VACCINE ADMIN FLU

Facility

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	83652519
Hospital Revenue Code	771
Min. Negotiated Rate	$38.12
Max. Negotiated Rate	$38.12
Rate for Payer: Qualcare PPO/HMO/WC	$38.12

VACCINE ADMIN FLU

Facility

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	93500180
Hospital Revenue Code	771
Min. Negotiated Rate	$21.85
Max. Negotiated Rate	$171.47
Rate for Payer: Aetna Commercial	$76.25
Rate for Payer: Aetna Medicare Advantage	$76.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.81
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.04
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.12
Rate for Payer: UnitedHealthcare Commercial	$103.00

VACCINE ADMIN FLU

Facility

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	83652295
Hospital Revenue Code	771
Min. Negotiated Rate	$38.12
Max. Negotiated Rate	$38.12
Rate for Payer: Qualcare PPO/HMO/WC	$38.12

Know your out-of-pocket cost for care.

All Charges