Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LENS IO ALCON LX10BD 24.0

Facility

$2,267.25

Hospital Charge Code	270602195
Hospital Revenue Code	276
Min. Negotiated Rate	$54.64
Max. Negotiated Rate	$1,133.62
Rate for Payer: Aetna Commercial	$861.55
Rate for Payer: Aetna Medicare Advantage	$680.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$578.15
Rate for Payer: Cigna Commercial	$1,133.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$498.80
Rate for Payer: Qualcare PPO/HMO/WC	$340.09
Rate for Payer: UnitedHealthcare Community & State	$54.64
Rate for Payer: Wellpoint Medicaid Managed Care	$60.08

LENS IO ALCON LX10BD 25.0

Facility

$2,267.25

Hospital Charge Code	270607720
Hospital Revenue Code	276
Min. Negotiated Rate	$54.64
Max. Negotiated Rate	$1,133.62
Rate for Payer: Aetna Commercial	$861.55
Rate for Payer: Aetna Medicare Advantage	$680.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$578.15
Rate for Payer: Cigna Commercial	$1,133.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$498.80
Rate for Payer: Qualcare PPO/HMO/WC	$340.09
Rate for Payer: UnitedHealthcare Community & State	$54.64
Rate for Payer: Wellpoint Medicaid Managed Care	$60.08

LENS IO ALCON LX10BD 25.0

Facility

$2,267.25

Hospital Charge Code	270607720
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$548.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$498.80
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

LENS IO ALCON LX10BD 26.0

Facility

$2,994.45

Hospital Charge Code	270602196
Hospital Revenue Code	276
Min. Negotiated Rate	$72.17
Max. Negotiated Rate	$1,497.22
Rate for Payer: Aetna Commercial	$1,137.89
Rate for Payer: Aetna Medicare Advantage	$898.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$763.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$763.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$763.58
Rate for Payer: Cigna Commercial	$1,497.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$724.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$658.78
Rate for Payer: Qualcare PPO/HMO/WC	$449.17
Rate for Payer: UnitedHealthcare Community & State	$72.17
Rate for Payer: Wellpoint Medicaid Managed Care	$79.35

LENS IO ALCON LX10BD 26.0

Facility

$2,994.45

Hospital Charge Code	270602196
Hospital Revenue Code	276
Min. Negotiated Rate	$449.17
Max. Negotiated Rate	$724.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$724.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$658.78
Rate for Payer: Qualcare PPO/HMO/WC	$449.17

LENS IO ALCON LX10BD 27.0

Facility

$2,082.45

Hospital Charge Code	270602197
Hospital Revenue Code	276
Min. Negotiated Rate	$50.19
Max. Negotiated Rate	$1,041.22
Rate for Payer: Aetna Commercial	$791.33
Rate for Payer: Aetna Medicare Advantage	$624.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$531.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$531.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$531.02
Rate for Payer: Cigna Commercial	$1,041.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$503.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$458.14
Rate for Payer: Qualcare PPO/HMO/WC	$312.37
Rate for Payer: UnitedHealthcare Community & State	$50.19
Rate for Payer: Wellpoint Medicaid Managed Care	$55.18

LENS IO ALCON LX10BD 27.0

Facility

$2,082.45

Hospital Charge Code	270602197
Hospital Revenue Code	276
Min. Negotiated Rate	$312.37
Max. Negotiated Rate	$503.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$503.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$458.14
Rate for Payer: Qualcare PPO/HMO/WC	$312.37

LENS IO ALCON MC60CM 4.0

Facility

$1,521.65

Hospital Charge Code	270612881
Hospital Revenue Code	276
Min. Negotiated Rate	$36.67
Max. Negotiated Rate	$760.83
Rate for Payer: Aetna Commercial	$578.23
Rate for Payer: Aetna Medicare Advantage	$456.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$388.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$388.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$388.02
Rate for Payer: Cigna Commercial	$760.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$334.76
Rate for Payer: Qualcare PPO/HMO/WC	$228.25
Rate for Payer: UnitedHealthcare Community & State	$36.67
Rate for Payer: Wellpoint Medicaid Managed Care	$40.32

LENS IO ALCON MC60CM 4.0

Facility

$1,521.65

Hospital Charge Code	270612881
Hospital Revenue Code	276
Min. Negotiated Rate	$228.25
Max. Negotiated Rate	$368.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$334.76
Rate for Payer: Qualcare PPO/HMO/WC	$228.25

LENS IO ALCON MC71CM 10.0

Facility

$2,267.25

Hospital Charge Code	270602262
Hospital Revenue Code	276
Min. Negotiated Rate	$54.64
Max. Negotiated Rate	$1,133.62
Rate for Payer: Aetna Commercial	$861.55
Rate for Payer: Aetna Medicare Advantage	$680.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$578.15
Rate for Payer: Cigna Commercial	$1,133.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$498.80
Rate for Payer: Qualcare PPO/HMO/WC	$340.09
Rate for Payer: UnitedHealthcare Community & State	$54.64
Rate for Payer: Wellpoint Medicaid Managed Care	$60.08

LENS IO ALCON MC71CM 10.0

Facility

$2,267.25

Hospital Charge Code	270602262
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$548.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$498.80
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

LENS IO ALCON MC71CM 10.5

Facility

$2,267.25

Hospital Charge Code	270606281
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$548.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$498.80
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

LENS IO ALCON MC71CM 10.5

Facility

$2,267.25

Hospital Charge Code	270606281
Hospital Revenue Code	276
Min. Negotiated Rate	$54.64
Max. Negotiated Rate	$1,133.62
Rate for Payer: Aetna Commercial	$861.55
Rate for Payer: Aetna Medicare Advantage	$680.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$578.15
Rate for Payer: Cigna Commercial	$1,133.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$498.80
Rate for Payer: Qualcare PPO/HMO/WC	$340.09
Rate for Payer: UnitedHealthcare Community & State	$54.64
Rate for Payer: Wellpoint Medicaid Managed Care	$60.08

LENS IO ALCON MC71CM 11.0

Facility

$2,267.25

Hospital Charge Code	270606278
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$548.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$498.80
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

LENS IO ALCON MC71CM 11.0

Facility

$2,267.25

Hospital Charge Code	270602263
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$548.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$498.80
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

LENS IO ALCON MC71CM 11.0

Facility

$2,267.25

Hospital Charge Code	270606278
Hospital Revenue Code	276
Min. Negotiated Rate	$54.64
Max. Negotiated Rate	$1,133.62
Rate for Payer: Aetna Commercial	$861.55
Rate for Payer: Aetna Medicare Advantage	$680.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$578.15
Rate for Payer: Cigna Commercial	$1,133.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$498.80
Rate for Payer: Qualcare PPO/HMO/WC	$340.09
Rate for Payer: UnitedHealthcare Community & State	$54.64
Rate for Payer: Wellpoint Medicaid Managed Care	$60.08

LENS IO ALCON MC71CM 11.0

Facility

$2,267.25

Hospital Charge Code	270602263
Hospital Revenue Code	276
Min. Negotiated Rate	$54.64
Max. Negotiated Rate	$1,133.62
Rate for Payer: Aetna Commercial	$861.55
Rate for Payer: Aetna Medicare Advantage	$680.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$578.15
Rate for Payer: Cigna Commercial	$1,133.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$498.80
Rate for Payer: Qualcare PPO/HMO/WC	$340.09
Rate for Payer: UnitedHealthcare Community & State	$54.64
Rate for Payer: Wellpoint Medicaid Managed Care	$60.08

LENS IO ALCON MC71CM 12.0

Facility

$2,267.25

Hospital Charge Code	270607587
Hospital Revenue Code	276
Min. Negotiated Rate	$54.64
Max. Negotiated Rate	$1,133.62
Rate for Payer: Aetna Commercial	$861.55
Rate for Payer: Aetna Medicare Advantage	$680.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$578.15
Rate for Payer: Cigna Commercial	$1,133.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$498.80
Rate for Payer: Qualcare PPO/HMO/WC	$340.09
Rate for Payer: UnitedHealthcare Community & State	$54.64
Rate for Payer: Wellpoint Medicaid Managed Care	$60.08

LENS IO ALCON MC71CM 12.0

Facility

$2,267.25

Hospital Charge Code	270607587
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$548.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$498.80
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

LENS IO ALCON MC71CM 13.0

Facility

$2,619.25

Hospital Charge Code	270602264
Hospital Revenue Code	276
Min. Negotiated Rate	$63.12
Max. Negotiated Rate	$1,309.62
Rate for Payer: Aetna Commercial	$995.32
Rate for Payer: Aetna Medicare Advantage	$785.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$667.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$667.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$667.91
Rate for Payer: Cigna Commercial	$1,309.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$633.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$576.24
Rate for Payer: Qualcare PPO/HMO/WC	$392.89
Rate for Payer: UnitedHealthcare Community & State	$63.12
Rate for Payer: Wellpoint Medicaid Managed Care	$69.41

LENS IO ALCON MC71CM 13.0

Facility

$2,619.25

Hospital Charge Code	270602264
Hospital Revenue Code	276
Min. Negotiated Rate	$392.89
Max. Negotiated Rate	$633.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$633.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$576.24
Rate for Payer: Qualcare PPO/HMO/WC	$392.89

LENS IO ALCON MC71CM 14.0

Facility

$2,267.25

Hospital Charge Code	270602265
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$548.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$498.80
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

LENS IO ALCON MC71CM 14.0

Facility

$2,267.25

Hospital Charge Code	270602265
Hospital Revenue Code	276
Min. Negotiated Rate	$54.64
Max. Negotiated Rate	$1,133.62
Rate for Payer: Aetna Commercial	$861.55
Rate for Payer: Aetna Medicare Advantage	$680.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$578.15
Rate for Payer: Cigna Commercial	$1,133.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$498.80
Rate for Payer: Qualcare PPO/HMO/WC	$340.09
Rate for Payer: UnitedHealthcare Community & State	$54.64
Rate for Payer: Wellpoint Medicaid Managed Care	$60.08

LENS IO ALCON MC71CM 15.0

Facility

$2,267.25

Hospital Charge Code	270602266
Hospital Revenue Code	276
Min. Negotiated Rate	$54.64
Max. Negotiated Rate	$1,133.62
Rate for Payer: Aetna Commercial	$861.55
Rate for Payer: Aetna Medicare Advantage	$680.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$578.15
Rate for Payer: Cigna Commercial	$1,133.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$498.80
Rate for Payer: Qualcare PPO/HMO/WC	$340.09
Rate for Payer: UnitedHealthcare Community & State	$54.64
Rate for Payer: Wellpoint Medicaid Managed Care	$60.08

LENS IO ALCON MC71CM 15.0

Facility

$2,267.25

Hospital Charge Code	270602266
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$548.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$498.80
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

Know your out-of-pocket cost for care.

All Charges