Heights University Hospital

All Charges

Charge

Type

Setting

Price

VACCINE ADMIN FLU

Facility

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	5792170
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	87502050
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	911025
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	911025
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	$26.28
Max. Negotiated Rate	$26.28
Rate for Payer: Qualcare PPO/HMO/WC	$26.28

VACCINE ADMIN HEPATITIS B

Facility

$89.07

Service Code	HCPCS 90471
Hospital Charge Code	100141
Hospital Revenue Code	771
Min. Negotiated Rate	$11.58
Max. Negotiated Rate	$171.47
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	$21.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.71
Rate for Payer: Cigna Commercial	$171.47
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 HEPATITIS B

Facility

$89.07

Service Code	HCPCS 90471
Hospital Charge Code	93500185
Hospital Revenue Code	771
Min. Negotiated Rate	$11.58
Max. Negotiated Rate	$171.47
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	$21.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.71
Rate for Payer: Cigna Commercial	$171.47
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 HEPATITIS B

Facility

$89.07

Service Code	HCPCS 90471
Hospital Charge Code	87502410
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 HEPATITIS B

Facility

$89.07

Service Code	HCPCS 90471
Hospital Charge Code	100141
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 HEPATITIS B

Facility

$89.07

Service Code	HCPCS 90471
Hospital Charge Code	93500185
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 HEPATITIS B

Facility

$89.07

Service Code	HCPCS 90471
Hospital Charge Code	83652523
Hospital Revenue Code	771
Min. Negotiated Rate	$11.58
Max. Negotiated Rate	$171.47
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	$21.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.71
Rate for Payer: Cigna Commercial	$171.47
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 HEPATITIS B

Facility

$89.07

Service Code	HCPCS 90471
Hospital Charge Code	83652523
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 HEPATITIS B

Facility

$89.07

Service Code	HCPCS 90471
Hospital Charge Code	87502405
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 HEPATITIS B

Facility

$89.07

Service Code	HCPCS 90471
Hospital Charge Code	5792272
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 HEPATITIS B

Facility

$89.07

Service Code	HCPCS 90471
Hospital Charge Code	87502060
Hospital Revenue Code	771
Min. Negotiated Rate	$11.58
Max. Negotiated Rate	$171.47
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	$21.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.71
Rate for Payer: Cigna Commercial	$171.47
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 HEPATITIS B

Facility

$89.07

Service Code	HCPCS 90471
Hospital Charge Code	87502060
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 HEPATITIS B

Facility

$89.07

Service Code	HCPCS 90471
Hospital Charge Code	87502410
Hospital Revenue Code	771
Min. Negotiated Rate	$11.58
Max. Negotiated Rate	$171.47
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	$21.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.71
Rate for Payer: Cigna Commercial	$171.47
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 HEPATITIS B

Facility

$89.07

Service Code	HCPCS 90471
Hospital Charge Code	8200500
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 HEPATITIS B

Facility

$89.07

Service Code	HCPCS 90471
Hospital Charge Code	8200500
Hospital Revenue Code	771
Min. Negotiated Rate	$11.58
Max. Negotiated Rate	$171.47
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	$21.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.71
Rate for Payer: Cigna Commercial	$171.47
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 HEPATITIS B

Facility

$89.07

Service Code	HCPCS 90471
Hospital Charge Code	87502405
Hospital Revenue Code	771
Min. Negotiated Rate	$11.58
Max. Negotiated Rate	$171.47
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	$21.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.71
Rate for Payer: Cigna Commercial	$171.47
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 HEPATITIS B

Facility

$89.07

Service Code	HCPCS 90471
Hospital Charge Code	5792272
Hospital Revenue Code	771
Min. Negotiated Rate	$11.58
Max. Negotiated Rate	$171.47
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	$21.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.71
Rate for Payer: Cigna Commercial	$171.47
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 INITIAL

Facility

$89.07

Service Code	HCPCS 90471
Hospital Charge Code	93500178
Hospital Revenue Code	771
Min. Negotiated Rate	$11.58
Max. Negotiated Rate	$171.47
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	$21.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.71
Rate for Payer: Cigna Commercial	$171.47
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 INITIAL

Facility

$89.07

Service Code	HCPCS 90471
Hospital Charge Code	93500178
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 INITIAL

Facility

$89.07

Service Code	HCPCS 90471
Hospital Charge Code	83652701
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 INITIAL

Facility

$89.07

Service Code	HCPCS 90471
Hospital Charge Code	83652701
Hospital Revenue Code	771
Min. Negotiated Rate	$11.58
Max. Negotiated Rate	$171.47
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	$21.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.71
Rate for Payer: Cigna Commercial	$171.47
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

Know your out-of-pocket cost for care.

All Charges