Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LENS INTRAOCULAR SN60AT 17.5

Facility

$892.85

Hospital Charge Code	270631942
Hospital Revenue Code	276
Min. Negotiated Rate	$21.52
Max. Negotiated Rate	$446.43
Rate for Payer: Aetna Commercial	$339.28
Rate for Payer: Aetna Medicare Advantage	$267.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.68
Rate for Payer: Cigna Commercial	$446.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$196.43
Rate for Payer: Qualcare PPO/HMO/WC	$133.93
Rate for Payer: UnitedHealthcare Community & State	$21.52
Rate for Payer: Wellpoint Medicaid Managed Care	$23.66

LENS INTRAOCULAR SN60AT 19.5

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631621
Hospital Revenue Code	276
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

LENS INTRAOCULAR SN60AT 19.5

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631621
Hospital Revenue Code	276
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

LENS INTRAOCULAR SN60AT 20.0

Facility

$1,116.00

Hospital Charge Code	270631139
Hospital Revenue Code	276
Min. Negotiated Rate	$167.40
Max. Negotiated Rate	$270.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$245.52
Rate for Payer: Qualcare PPO/HMO/WC	$167.40

LENS INTRAOCULAR SN60AT 20.0

Facility

$1,116.00

Hospital Charge Code	270630319
Hospital Revenue Code	276
Min. Negotiated Rate	$167.40
Max. Negotiated Rate	$270.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$245.52
Rate for Payer: Qualcare PPO/HMO/WC	$167.40

LENS INTRAOCULAR SN60AT 20.0

Facility

$1,116.00

Hospital Charge Code	270630319
Hospital Revenue Code	276
Min. Negotiated Rate	$26.90
Max. Negotiated Rate	$558.00
Rate for Payer: Aetna Commercial	$424.08
Rate for Payer: Aetna Medicare Advantage	$334.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$284.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$284.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$284.58
Rate for Payer: Cigna Commercial	$558.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$245.52
Rate for Payer: Qualcare PPO/HMO/WC	$167.40
Rate for Payer: UnitedHealthcare Community & State	$26.90
Rate for Payer: Wellpoint Medicaid Managed Care	$29.57

LENS INTRAOCULAR SN60AT 20.0

Facility

$892.85

Hospital Charge Code	270631319
Hospital Revenue Code	276
Min. Negotiated Rate	$21.52
Max. Negotiated Rate	$446.43
Rate for Payer: Aetna Commercial	$339.28
Rate for Payer: Aetna Medicare Advantage	$267.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.68
Rate for Payer: Cigna Commercial	$446.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$196.43
Rate for Payer: Qualcare PPO/HMO/WC	$133.93
Rate for Payer: UnitedHealthcare Community & State	$21.52
Rate for Payer: Wellpoint Medicaid Managed Care	$23.66

LENS INTRAOCULAR SN60AT 20.0

Facility

$1,116.00

Hospital Charge Code	270631139
Hospital Revenue Code	276
Min. Negotiated Rate	$26.90
Max. Negotiated Rate	$558.00
Rate for Payer: Aetna Commercial	$424.08
Rate for Payer: Aetna Medicare Advantage	$334.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$284.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$284.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$284.58
Rate for Payer: Cigna Commercial	$558.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$245.52
Rate for Payer: Qualcare PPO/HMO/WC	$167.40
Rate for Payer: UnitedHealthcare Community & State	$26.90
Rate for Payer: Wellpoint Medicaid Managed Care	$29.57

LENS INTRAOCULAR SN60AT 20.0

Facility

$892.85

Hospital Charge Code	270631319
Hospital Revenue Code	276
Min. Negotiated Rate	$133.93
Max. Negotiated Rate	$216.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$196.43
Rate for Payer: Qualcare PPO/HMO/WC	$133.93

LENS INTRAOCULAR SN60AT 20.5

Facility

$1,116.00

Hospital Charge Code	270630320
Hospital Revenue Code	276
Min. Negotiated Rate	$167.40
Max. Negotiated Rate	$270.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$245.52
Rate for Payer: Qualcare PPO/HMO/WC	$167.40

LENS INTRAOCULAR SN60AT 20.5

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631320
Hospital Revenue Code	276
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

LENS INTRAOCULAR SN60AT 20.5

Facility

$1,116.00

Hospital Charge Code	270630320
Hospital Revenue Code	276
Min. Negotiated Rate	$26.90
Max. Negotiated Rate	$558.00
Rate for Payer: Aetna Commercial	$424.08
Rate for Payer: Aetna Medicare Advantage	$334.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$284.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$284.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$284.58
Rate for Payer: Cigna Commercial	$558.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$245.52
Rate for Payer: Qualcare PPO/HMO/WC	$167.40
Rate for Payer: UnitedHealthcare Community & State	$26.90
Rate for Payer: Wellpoint Medicaid Managed Care	$29.57

LENS INTRAOCULAR SN60AT 20.5

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631320
Hospital Revenue Code	276
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

LENS INTRAOCULAR SN60AT 21.0

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631622
Hospital Revenue Code	276
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

LENS INTRAOCULAR SN60AT 21.0

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631622
Hospital Revenue Code	276
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

LENS INTRAOCULAR SN60AT 21.5

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631550
Hospital Revenue Code	276
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

LENS INTRAOCULAR SN60AT 21.5

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631550
Hospital Revenue Code	276
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

LENS INTRAOCULAR SN60AT 22.0

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631551
Hospital Revenue Code	276
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

LENS INTRAOCULAR SN60AT 22.0

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631551
Hospital Revenue Code	276
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

LENS INTRAOCULAR SN60AT 22.5

Facility

$892.85

Hospital Charge Code	270631224
Hospital Revenue Code	276
Min. Negotiated Rate	$21.52
Max. Negotiated Rate	$446.43
Rate for Payer: Aetna Commercial	$339.28
Rate for Payer: Aetna Medicare Advantage	$267.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.68
Rate for Payer: Cigna Commercial	$446.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$196.43
Rate for Payer: Qualcare PPO/HMO/WC	$133.93
Rate for Payer: UnitedHealthcare Community & State	$21.52
Rate for Payer: Wellpoint Medicaid Managed Care	$23.66

LENS INTRAOCULAR SN60AT 22.5

Facility

$892.85

Hospital Charge Code	270631224
Hospital Revenue Code	276
Min. Negotiated Rate	$133.93
Max. Negotiated Rate	$216.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$196.43
Rate for Payer: Qualcare PPO/HMO/WC	$133.93

LENS INTRAOCULAR SN60AT 23.5

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631943
Hospital Revenue Code	276
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

LENS INTRAOCULAR SN60AT 23.5

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631943
Hospital Revenue Code	276
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

LENS INTRAOCULAR SN60AT 24.5

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631386
Hospital Revenue Code	276
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

LENS INTRAOCULAR SN60AT 24.5

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631386
Hospital Revenue Code	276
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

Know your out-of-pocket cost for care.

All Charges