Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	45110031A
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	32460031A
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	43080031A
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	31900031A
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	32350031A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.42
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	$13.00
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.42

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	30430031A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.42
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	$13.00
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.42

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	30480031A
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	32460031A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.42
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	$13.00
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.42

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	30480031A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.42
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	$13.00
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.42

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	31200031A
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	31900031A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.42
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	$13.00
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.42

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	30470031A
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	32350031A
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	$1.42
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	$13.00
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.42

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	30330031A
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	30330031A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.42
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	$13.00
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.42

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	30200031A
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	30370031A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.42
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	$13.00
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.42

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	42010031A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.42
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	$13.00
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.42

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	42010031A
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	30430031A
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	42060031A
Hospital Revenue Code	771
Min. Negotiated Rate	$1.42
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	$13.00
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.42

JANSSEN COVID19 VACC ADM DOSE

Facility

$50.00

Service Code	HCPCS 0031A
Hospital Charge Code	43100031A
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	31350031A
Hospital Revenue Code	771
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

Know your out-of-pocket cost for care.

All Charges