Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LENS IO ALCON MTA5UO 14.0

Facility

$2,267.25

Hospital Charge Code	270602790
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 MTA5UO 14.5

Facility

$2,267.25

Hospital Charge Code	270602798
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 MTA5UO 14.5

Facility

$2,267.25

Hospital Charge Code	270602798
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 MTA5UO 15.5

Facility

$2,267.25

Hospital Charge Code	270602791
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 MTA5UO 15.5

Facility

$2,267.25

Hospital Charge Code	270602791
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 MTA5UO 16.0

Facility

$1,572.00

Hospital Charge Code	270602799
Hospital Revenue Code	276
Min. Negotiated Rate	$37.89
Max. Negotiated Rate	$786.00
Rate for Payer: Aetna Commercial	$597.36
Rate for Payer: Aetna Medicare Advantage	$471.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$400.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$400.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$400.86
Rate for Payer: Cigna Commercial	$786.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$345.84
Rate for Payer: Qualcare PPO/HMO/WC	$235.80
Rate for Payer: UnitedHealthcare Community & State	$37.89
Rate for Payer: Wellpoint Medicaid Managed Care	$41.66

LENS IO ALCON MTA5UO 16.0

Facility

$1,572.00

Hospital Charge Code	270602799
Hospital Revenue Code	276
Min. Negotiated Rate	$235.80
Max. Negotiated Rate	$380.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$345.84
Rate for Payer: Qualcare PPO/HMO/WC	$235.80

LENS IO ALCON MTA5UO 16.5

Facility

$1,572.00

Hospital Charge Code	270602792
Hospital Revenue Code	276
Min. Negotiated Rate	$37.89
Max. Negotiated Rate	$786.00
Rate for Payer: Aetna Commercial	$597.36
Rate for Payer: Aetna Medicare Advantage	$471.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$400.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$400.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$400.86
Rate for Payer: Cigna Commercial	$786.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$345.84
Rate for Payer: Qualcare PPO/HMO/WC	$235.80
Rate for Payer: UnitedHealthcare Community & State	$37.89
Rate for Payer: Wellpoint Medicaid Managed Care	$41.66

LENS IO ALCON MTA5UO 16.5

Facility

$1,572.00

Hospital Charge Code	270602792
Hospital Revenue Code	276
Min. Negotiated Rate	$235.80
Max. Negotiated Rate	$380.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$345.84
Rate for Payer: Qualcare PPO/HMO/WC	$235.80

LENS IO ALCON MTA5UO 17.0

Facility

$2,267.25

Hospital Charge Code	270602800
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 MTA5UO 17.0

Facility

$2,267.25

Hospital Charge Code	270602800
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 MTA5UO 17.5

Facility

$2,267.25

Hospital Charge Code	270602801
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 MTA5UO 17.5

Facility

$2,267.25

Hospital Charge Code	270602801
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 MTA5UO 18.0

Facility

$2,267.25

Hospital Charge Code	270602802
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 MTA5UO 18.0

Facility

$2,267.25

Hospital Charge Code	270602802
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 MTA5UO 18.5

Facility

$2,267.25

Hospital Charge Code	270602803
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 MTA5UO 18.5

Facility

$2,267.25

Hospital Charge Code	270602803
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 MTA5UO 19.0

Facility

$1,149.65

Hospital Charge Code	270602804
Hospital Revenue Code	276
Min. Negotiated Rate	$172.45
Max. Negotiated Rate	$278.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$252.92
Rate for Payer: Qualcare PPO/HMO/WC	$172.45

LENS IO ALCON MTA5UO 19.0

Facility

$1,149.65

Hospital Charge Code	270602804
Hospital Revenue Code	276
Min. Negotiated Rate	$27.71
Max. Negotiated Rate	$574.83
Rate for Payer: Aetna Commercial	$436.87
Rate for Payer: Aetna Medicare Advantage	$344.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.16
Rate for Payer: Cigna Commercial	$574.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$252.92
Rate for Payer: Qualcare PPO/HMO/WC	$172.45
Rate for Payer: UnitedHealthcare Community & State	$27.71
Rate for Payer: Wellpoint Medicaid Managed Care	$30.47

LENS IO ALCON MTA5UO 19.5

Facility

$1,572.00

Hospital Charge Code	270602805
Hospital Revenue Code	276
Min. Negotiated Rate	$37.89
Max. Negotiated Rate	$786.00
Rate for Payer: Aetna Commercial	$597.36
Rate for Payer: Aetna Medicare Advantage	$471.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$400.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$400.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$400.86
Rate for Payer: Cigna Commercial	$786.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$345.84
Rate for Payer: Qualcare PPO/HMO/WC	$235.80
Rate for Payer: UnitedHealthcare Community & State	$37.89
Rate for Payer: Wellpoint Medicaid Managed Care	$41.66

LENS IO ALCON MTA5UO 19.5

Facility

$1,572.00

Hospital Charge Code	270602805
Hospital Revenue Code	276
Min. Negotiated Rate	$235.80
Max. Negotiated Rate	$380.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$345.84
Rate for Payer: Qualcare PPO/HMO/WC	$235.80

LENS IO ALCON MTA5UO 20.0

Facility

$2,267.25

Hospital Charge Code	270602806
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 MTA5UO 20.0

Facility

$2,267.25

Hospital Charge Code	270602806
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 MTA5UO 20.5

Facility

$1,572.00

Hospital Charge Code	270602807
Hospital Revenue Code	276
Min. Negotiated Rate	$37.89
Max. Negotiated Rate	$786.00
Rate for Payer: Aetna Commercial	$597.36
Rate for Payer: Aetna Medicare Advantage	$471.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$400.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$400.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$400.86
Rate for Payer: Cigna Commercial	$786.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$345.84
Rate for Payer: Qualcare PPO/HMO/WC	$235.80
Rate for Payer: UnitedHealthcare Community & State	$37.89
Rate for Payer: Wellpoint Medicaid Managed Care	$41.66

LENS IO ALCON MTA5UO 20.5

Facility

$1,572.00

Hospital Charge Code	270602807
Hospital Revenue Code	276
Min. Negotiated Rate	$235.80
Max. Negotiated Rate	$380.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$345.84
Rate for Payer: Qualcare PPO/HMO/WC	$235.80

Know your out-of-pocket cost for care.

All Charges