Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

LENS INTRAOCCULAR 21.5 DIOPTER

Facility

IP

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270653244
Hospital Revenue Code	276
Min. Negotiated Rate	$108.06
Max. Negotiated Rate	$174.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.49
Rate for Payer: Qualcare PPO/HMO/WC	$108.06

LENS INTRAOCCULAR 21.5 DIOPTER

Facility

OP

$425.00

Hospital Charge Code	270653257
Hospital Revenue Code	276
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

LENS INTRAOCCULAR 21.5 DIOPTER

Facility

IP

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270653322
Hospital Revenue Code	276
Min. Negotiated Rate	$243.49
Max. Negotiated Rate	$392.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.12
Rate for Payer: Qualcare PPO/HMO/WC	$243.49

LENS INTRAOCCULAR 21.5 DIOPTER

Facility

IP

$720.40

Service Code	HCPCS C1780
Hospital Charge Code	270660119
Hospital Revenue Code	276
Min. Negotiated Rate	$108.06
Max. Negotiated Rate	$174.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.49
Rate for Payer: Qualcare PPO/HMO/WC	$108.06

LENS INTRAOCCULAR 21.5 DIOPTER

Facility

OP

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270653322
Hospital Revenue Code	276
Min. Negotiated Rate	$39.12
Max. Negotiated Rate	$811.62
Rate for Payer: Aetna Commercial	$616.84
Rate for Payer: Aetna Medicare Advantage	$486.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$413.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$413.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$413.93
Rate for Payer: Cigna Commercial	$811.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.12
Rate for Payer: Qualcare PPO/HMO/WC	$243.49
Rate for Payer: UnitedHealthcare Community & State	$39.12
Rate for Payer: Wellpoint Medicaid Managed Care	$43.02

LENS INTRAOCCULAR 21.5 DIOPTER

Facility

IP

$425.00

Hospital Charge Code	270653257
Hospital Revenue Code	276
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$102.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

LENS INTRAOCCULAR+21.5 DIOPTER

Facility

OP

$1,548.25

Service Code	HCPCS V2632
Hospital Charge Code	270650864
Hospital Revenue Code	276
Min. Negotiated Rate	$37.31
Max. Negotiated Rate	$774.12
Rate for Payer: Aetna Commercial	$588.34
Rate for Payer: Aetna Medicare Advantage	$464.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.80
Rate for Payer: Cigna Commercial	$774.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$374.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$340.62
Rate for Payer: Qualcare PPO/HMO/WC	$232.24
Rate for Payer: UnitedHealthcare Community & State	$37.31
Rate for Payer: Wellpoint Medicaid Managed Care	$41.03

LENS INTRAOCCULAR+21.5 DIOPTER

Facility

IP

$1,548.25

Service Code	HCPCS V2632
Hospital Charge Code	270650864
Hospital Revenue Code	276
Min. Negotiated Rate	$232.24
Max. Negotiated Rate	$374.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$374.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$340.62
Rate for Payer: Qualcare PPO/HMO/WC	$232.24

LENS INTRAOCCULAR +21.5DIOPTER

Facility

IP

$887.00

Hospital Charge Code	270653233
Hospital Revenue Code	276
Min. Negotiated Rate	$133.05
Max. Negotiated Rate	$214.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$195.14
Rate for Payer: Qualcare PPO/HMO/WC	$133.05

LENS INTRAOCCULAR +21.5DIOPTER

Facility

OP

$887.00

Hospital Charge Code	270653233
Hospital Revenue Code	276
Min. Negotiated Rate	$21.38
Max. Negotiated Rate	$443.50
Rate for Payer: Aetna Commercial	$337.06
Rate for Payer: Aetna Medicare Advantage	$266.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.19
Rate for Payer: Cigna Commercial	$443.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$195.14
Rate for Payer: Qualcare PPO/HMO/WC	$133.05
Rate for Payer: UnitedHealthcare Community & State	$21.38
Rate for Payer: Wellpoint Medicaid Managed Care	$23.51

LENS INTRAOCCULAR 21DIO FOLD

Facility

IP

$720.40

Hospital Charge Code	270650615
Hospital Revenue Code	276
Min. Negotiated Rate	$108.06
Max. Negotiated Rate	$174.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.49
Rate for Payer: Qualcare PPO/HMO/WC	$108.06

LENS INTRAOCCULAR 21DIO FOLD

Facility

OP

$720.40

Hospital Charge Code	270650615
Hospital Revenue Code	276
Min. Negotiated Rate	$17.36
Max. Negotiated Rate	$360.20
Rate for Payer: Aetna Commercial	$273.75
Rate for Payer: Aetna Medicare Advantage	$216.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.70
Rate for Payer: Cigna Commercial	$360.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.49
Rate for Payer: Qualcare PPO/HMO/WC	$108.06
Rate for Payer: UnitedHealthcare Community & State	$17.36
Rate for Payer: Wellpoint Medicaid Managed Care	$19.09

LENS INTRAOCCULAR 22.0 DIO

Facility

IP

$887.00

Service Code	HCPCS C1780
Hospital Charge Code	270653276
Hospital Revenue Code	276
Min. Negotiated Rate	$133.05
Max. Negotiated Rate	$214.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$195.14
Rate for Payer: Qualcare PPO/HMO/WC	$133.05

LENS INTRAOCCULAR 22.0 DIO

Facility

OP

$887.00

Service Code	HCPCS C1780
Hospital Charge Code	270653276
Hospital Revenue Code	276
Min. Negotiated Rate	$21.38
Max. Negotiated Rate	$443.50
Rate for Payer: Aetna Commercial	$337.06
Rate for Payer: Aetna Medicare Advantage	$266.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.19
Rate for Payer: Cigna Commercial	$443.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$195.14
Rate for Payer: Qualcare PPO/HMO/WC	$133.05
Rate for Payer: UnitedHealthcare Community & State	$21.38
Rate for Payer: Wellpoint Medicaid Managed Care	$23.51

LENS INTRAOCCULAR 22.0 DIOPTER

Facility

IP

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270653245
Hospital Revenue Code	276
Min. Negotiated Rate	$108.06
Max. Negotiated Rate	$174.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.49
Rate for Payer: Qualcare PPO/HMO/WC	$108.06

LENS INTRAOCCULAR 22.0 DIOPTER

Facility

IP

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270653323
Hospital Revenue Code	276
Min. Negotiated Rate	$243.49
Max. Negotiated Rate	$392.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.12
Rate for Payer: Qualcare PPO/HMO/WC	$243.49

LENS INTRAOCCULAR 22.0 DIOPTER

Facility

OP

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270653245
Hospital Revenue Code	276
Min. Negotiated Rate	$17.36
Max. Negotiated Rate	$360.20
Rate for Payer: Aetna Commercial	$273.75
Rate for Payer: Aetna Medicare Advantage	$216.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.70
Rate for Payer: Cigna Commercial	$360.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.49
Rate for Payer: Qualcare PPO/HMO/WC	$108.06
Rate for Payer: UnitedHealthcare Community & State	$17.36
Rate for Payer: Wellpoint Medicaid Managed Care	$19.09

LENS INTRAOCCULAR 22.0 DIOPTER

Facility

OP

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270653323
Hospital Revenue Code	276
Min. Negotiated Rate	$39.12
Max. Negotiated Rate	$811.62
Rate for Payer: Aetna Commercial	$616.84
Rate for Payer: Aetna Medicare Advantage	$486.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$413.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$413.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$413.93
Rate for Payer: Cigna Commercial	$811.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.12
Rate for Payer: Qualcare PPO/HMO/WC	$243.49
Rate for Payer: UnitedHealthcare Community & State	$39.12
Rate for Payer: Wellpoint Medicaid Managed Care	$43.02

LENS INTRAOCCULAR+22.0 DIOPTER

Facility

IP

$670.00

Service Code	HCPCS V2632
Hospital Charge Code	270650865
Hospital Revenue Code	276
Min. Negotiated Rate	$100.50
Max. Negotiated Rate	$162.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.40
Rate for Payer: Qualcare PPO/HMO/WC	$100.50

LENS INTRAOCCULAR+22.0 DIOPTER

Facility

IP

$887.00

Hospital Charge Code	270655291
Hospital Revenue Code	276
Min. Negotiated Rate	$133.05
Max. Negotiated Rate	$214.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$195.14
Rate for Payer: Qualcare PPO/HMO/WC	$133.05

LENS INTRAOCCULAR+22.0 DIOPTER

Facility

OP

$887.00

Hospital Charge Code	270655291
Hospital Revenue Code	276
Min. Negotiated Rate	$21.38
Max. Negotiated Rate	$443.50
Rate for Payer: Aetna Commercial	$337.06
Rate for Payer: Aetna Medicare Advantage	$266.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.19
Rate for Payer: Cigna Commercial	$443.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$195.14
Rate for Payer: Qualcare PPO/HMO/WC	$133.05
Rate for Payer: UnitedHealthcare Community & State	$21.38
Rate for Payer: Wellpoint Medicaid Managed Care	$23.51

LENS INTRAOCCULAR+22.0 DIOPTER

Facility

OP

$670.00

Service Code	HCPCS V2632
Hospital Charge Code	270650865
Hospital Revenue Code	276
Min. Negotiated Rate	$16.15
Max. Negotiated Rate	$335.00
Rate for Payer: Aetna Commercial	$254.60
Rate for Payer: Aetna Medicare Advantage	$201.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.85
Rate for Payer: Cigna Commercial	$335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.40
Rate for Payer: Qualcare PPO/HMO/WC	$100.50
Rate for Payer: UnitedHealthcare Community & State	$16.15
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

LENS INTRAOCCULAR +22.0DIOPTER

Facility

OP

$720.40

Hospital Charge Code	270650624
Hospital Revenue Code	276
Min. Negotiated Rate	$17.36
Max. Negotiated Rate	$360.20
Rate for Payer: Aetna Commercial	$273.75
Rate for Payer: Aetna Medicare Advantage	$216.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.70
Rate for Payer: Cigna Commercial	$360.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.49
Rate for Payer: Qualcare PPO/HMO/WC	$108.06
Rate for Payer: UnitedHealthcare Community & State	$17.36
Rate for Payer: Wellpoint Medicaid Managed Care	$19.09

LENS INTRAOCCULAR +22.0DIOPTER

Facility

IP

$720.40

Hospital Charge Code	270650624
Hospital Revenue Code	276
Min. Negotiated Rate	$108.06
Max. Negotiated Rate	$174.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.49
Rate for Payer: Qualcare PPO/HMO/WC	$108.06

LENS INTRAOCCULAR+22.5

Facility

OP

$670.00

Service Code	HCPCS V2632
Hospital Charge Code	270650866
Hospital Revenue Code	276
Min. Negotiated Rate	$16.15
Max. Negotiated Rate	$335.00
Rate for Payer: Aetna Commercial	$254.60
Rate for Payer: Aetna Medicare Advantage	$201.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.85
Rate for Payer: Cigna Commercial	$335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.40
Rate for Payer: Qualcare PPO/HMO/WC	$100.50
Rate for Payer: UnitedHealthcare Community & State	$16.15
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75