Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LENS IO ALCON MZ30BD 22.0

Facility

$1,572.00

Hospital Charge Code	270602216
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 MZ30BD 22.0

Facility

$1,572.00

Hospital Charge Code	270602216
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 MZ30BD 23.0

Facility

$1,572.00

Hospital Charge Code	270602206
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 MZ30BD 23.0

Facility

$1,572.00

Hospital Charge Code	270602206
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 MZ30BD 23.5

Facility

$1,572.00

Hospital Charge Code	270602207
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 MZ30BD 23.5

Facility

$1,572.00

Hospital Charge Code	270602207
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 MZ30BD 24.0

Facility

$1,572.00

Hospital Charge Code	270602217
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 MZ30BD 24.0

Facility

$1,572.00

Hospital Charge Code	270602217
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 MZ30BD 24.5

Facility

$1,572.00

Hospital Charge Code	270602219
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 MZ30BD 24.5

Facility

$1,572.00

Hospital Charge Code	270602219
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 MZ30BD 26.5

Facility

$1,572.00

Hospital Charge Code	270602208
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 MZ30BD 26.5

Facility

$1,572.00

Hospital Charge Code	270602208
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 MZ30BD 27.0

Facility

$1,572.00

Hospital Charge Code	270602221
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 MZ30BD 27.0

Facility

$1,572.00

Hospital Charge Code	270602221
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 MZ60BD 21.5

Facility

$1,572.00

Hospital Charge Code	270606968
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 MZ60BD 21.5

Facility

$1,572.00

Hospital Charge Code	270606968
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 SK61CM 12.0

Facility

$1,521.65

Hospital Charge Code	270610082
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 SK61CM 12.0

Facility

$1,521.65

Hospital Charge Code	270610082
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 SK61CM 16.5

Facility

$1,521.65

Hospital Charge Code	270602179
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 SK61CM 16.5

Facility

$1,521.65

Hospital Charge Code	270602179
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 SK61CM 17.5

Facility

$750.00

Hospital Charge Code	270620136
Hospital Revenue Code	276
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

LENS IO ALCON SK61CM 17.5

Facility

$750.00

Hospital Charge Code	270620136
Hospital Revenue Code	276
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

LENS IO ALCON SK61CM 18.5

Facility

$1,521.65

Hospital Charge Code	270602180
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 SK61CM 18.5

Facility

$1,521.65

Hospital Charge Code	270602180
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 SK61CM 19.0

Facility

$1,521.65

Hospital Charge Code	270602181
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

Know your out-of-pocket cost for care.

All Charges