Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

VACCINE ADMIN EA ADDL

Facility

$20.38

Service Code	HCPCS 90472
Hospital Charge Code	87502255
Hospital Revenue Code	771
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$3.06
Rate for Payer: Qualcare PPO/HMO/WC	$3.06

VACCINE ADMIN EA ADDL

Facility

$20.38

Service Code	HCPCS 90472
Hospital Charge Code	93500184
Hospital Revenue Code	771
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$7.74
Rate for Payer: Aetna Medicare Advantage	$6.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.20
Rate for Payer: Cigna Commercial	$10.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.30
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.06
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

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

$20.38

Service Code	HCPCS 90472
Hospital Charge Code	100143
Hospital Revenue Code	771
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$3.06
Rate for Payer: Qualcare PPO/HMO/WC	$3.06

VACCINE ADMIN EA ADDL

Facility

$65.00

Service Code	HCPCS 90472
Hospital Charge Code	84206175
Hospital Revenue Code	771
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$24.70
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	$12.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.57
Rate for Payer: Cigna Commercial	$32.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.90
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.75
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$2.05
Rate for Payer: Wellpoint Medicaid Managed Care	$1.85

VACCINE ADMIN EA ADDL

Facility

$20.38

Service Code	HCPCS 90472
Hospital Charge Code	83652297
Hospital Revenue Code	771
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$7.74
Rate for Payer: Aetna Medicare Advantage	$6.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.20
Rate for Payer: Cigna Commercial	$10.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.30
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.06
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

VACCINE ADMIN EA ADDL

Facility

$20.38

Service Code	HCPCS 90472
Hospital Charge Code	83652297
Hospital Revenue Code	771
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$3.06
Rate for Payer: Qualcare PPO/HMO/WC	$3.06

VACCINE ADMIN EA ADDL

Facility

$20.38

Service Code	HCPCS 90472
Hospital Charge Code	83090030
Hospital Revenue Code	771
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$7.74
Rate for Payer: Aetna Medicare Advantage	$6.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.20
Rate for Payer: Cigna Commercial	$10.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.30
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.06
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

VACCINE ADMIN EA ADDL

Facility

$20.38

Service Code	HCPCS 90472
Hospital Charge Code	5700810
Hospital Revenue Code	771
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$7.74
Rate for Payer: Aetna Medicare Advantage	$6.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.20
Rate for Payer: Cigna Commercial	$10.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.30
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.06
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

VACCINE ADMIN EA ADDL

Facility

$20.35

Service Code	HCPCS 90472
Hospital Charge Code	8200501
Hospital Revenue Code	771
Min. Negotiated Rate	$3.05
Max. Negotiated Rate	$3.05
Rate for Payer: Qualcare PPO/HMO/WC	$3.05

VACCINE ADMIN EA ADDL

Facility

$20.38

Service Code	HCPCS 90472
Hospital Charge Code	83090030
Hospital Revenue Code	771
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$3.06
Rate for Payer: Qualcare PPO/HMO/WC	$3.06

VACCINE ADMIN FLU

Facility

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	87502050
Hospital Revenue Code	771
Min. Negotiated Rate	$7.22
Max. Negotiated Rate	$310.30
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.08
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.12
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$8.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$7.22

VACCINE ADMIN FLU

Facility

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	83652625
Hospital Revenue Code	771
Min. Negotiated Rate	$7.22
Max. Negotiated Rate	$310.30
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.08
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.12
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$8.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$7.22

VACCINE ADMIN FLU

Facility

$175.19

Service Code	HCPCS 90471
Hospital Charge Code	73237028
Hospital Revenue Code	771
Min. Negotiated Rate	$4.98
Max. Negotiated Rate	$310.30
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.55
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.28
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$5.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$4.98

VACCINE ADMIN FLU

Facility

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	83652519
Hospital Revenue Code	771
Min. Negotiated Rate	$7.22
Max. Negotiated Rate	$310.30
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.08
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.12
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$8.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$7.22

VACCINE ADMIN FLU

Facility

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	87502400
Hospital Revenue Code	771
Min. Negotiated Rate	$7.22
Max. Negotiated Rate	$310.30
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.08
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.12
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$8.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$7.22

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 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	83652295
Hospital Revenue Code	771
Min. Negotiated Rate	$7.22
Max. Negotiated Rate	$310.30
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.08
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.12
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$8.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$7.22

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

$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	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

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	93500180
Hospital Revenue Code	771
Min. Negotiated Rate	$7.22
Max. Negotiated Rate	$310.30
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.08
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.12
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$8.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$7.22

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

$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

Know your out-of-pocket cost for care.

All Charges