Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LENS IO CHIRON CIIVB 26.0

Facility

$1,659.25

Hospital Charge Code	270602104
Hospital Revenue Code	276
Min. Negotiated Rate	$39.99
Max. Negotiated Rate	$829.62
Rate for Payer: Aetna Commercial	$630.51
Rate for Payer: Aetna Medicare Advantage	$497.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$423.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$423.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$423.11
Rate for Payer: Cigna Commercial	$829.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$365.04
Rate for Payer: Qualcare PPO/HMO/WC	$248.89
Rate for Payer: UnitedHealthcare Community & State	$39.99
Rate for Payer: Wellpoint Medicaid Managed Care	$43.97

LENS IO CHIRON CIIVB 26.5

Facility

$1,659.25

Hospital Charge Code	270602105
Hospital Revenue Code	276
Min. Negotiated Rate	$39.99
Max. Negotiated Rate	$829.62
Rate for Payer: Aetna Commercial	$630.51
Rate for Payer: Aetna Medicare Advantage	$497.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$423.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$423.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$423.11
Rate for Payer: Cigna Commercial	$829.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$365.04
Rate for Payer: Qualcare PPO/HMO/WC	$248.89
Rate for Payer: UnitedHealthcare Community & State	$39.99
Rate for Payer: Wellpoint Medicaid Managed Care	$43.97

LENS IO CHIRON CIIVB 26.5

Facility

$1,659.25

Hospital Charge Code	270602105
Hospital Revenue Code	276
Min. Negotiated Rate	$248.89
Max. Negotiated Rate	$401.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$365.04
Rate for Payer: Qualcare PPO/HMO/WC	$248.89

LENS IO CHIRON CIIVB 27.0

Facility

$1,659.25

Hospital Charge Code	270602106
Hospital Revenue Code	276
Min. Negotiated Rate	$39.99
Max. Negotiated Rate	$829.62
Rate for Payer: Aetna Commercial	$630.51
Rate for Payer: Aetna Medicare Advantage	$497.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$423.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$423.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$423.11
Rate for Payer: Cigna Commercial	$829.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$365.04
Rate for Payer: Qualcare PPO/HMO/WC	$248.89
Rate for Payer: UnitedHealthcare Community & State	$39.99
Rate for Payer: Wellpoint Medicaid Managed Care	$43.97

LENS IO CHIRON CIIVB 27.0

Facility

$1,659.25

Hospital Charge Code	270602106
Hospital Revenue Code	276
Min. Negotiated Rate	$248.89
Max. Negotiated Rate	$401.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$365.04
Rate for Payer: Qualcare PPO/HMO/WC	$248.89

LENS IO CHIRON CIIVB 27.5

Facility

$1,659.25

Hospital Charge Code	270602107
Hospital Revenue Code	276
Min. Negotiated Rate	$248.89
Max. Negotiated Rate	$401.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$365.04
Rate for Payer: Qualcare PPO/HMO/WC	$248.89

LENS IO CHIRON CIIVB 27.5

Facility

$1,659.25

Hospital Charge Code	270602107
Hospital Revenue Code	276
Min. Negotiated Rate	$39.99
Max. Negotiated Rate	$829.62
Rate for Payer: Aetna Commercial	$630.51
Rate for Payer: Aetna Medicare Advantage	$497.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$423.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$423.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$423.11
Rate for Payer: Cigna Commercial	$829.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$365.04
Rate for Payer: Qualcare PPO/HMO/WC	$248.89
Rate for Payer: UnitedHealthcare Community & State	$39.99
Rate for Payer: Wellpoint Medicaid Managed Care	$43.97

LENS IO CHIRON CIIVB 28.0

Facility

$1,659.25

Hospital Charge Code	270602108
Hospital Revenue Code	276
Min. Negotiated Rate	$248.89
Max. Negotiated Rate	$401.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$365.04
Rate for Payer: Qualcare PPO/HMO/WC	$248.89

LENS IO CHIRON CIIVB 28.0

Facility

$1,659.25

Hospital Charge Code	270602108
Hospital Revenue Code	276
Min. Negotiated Rate	$39.99
Max. Negotiated Rate	$829.62
Rate for Payer: Aetna Commercial	$630.51
Rate for Payer: Aetna Medicare Advantage	$497.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$423.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$423.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$423.11
Rate for Payer: Cigna Commercial	$829.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$365.04
Rate for Payer: Qualcare PPO/HMO/WC	$248.89
Rate for Payer: UnitedHealthcare Community & State	$39.99
Rate for Payer: Wellpoint Medicaid Managed Care	$43.97

LENS IO CHIRON LI61U 20.0

Facility

$589.65

Hospital Charge Code	270624443
Hospital Revenue Code	276
Min. Negotiated Rate	$88.45
Max. Negotiated Rate	$142.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$129.72
Rate for Payer: Qualcare PPO/HMO/WC	$88.45

LENS IO CHIRON LI61U 20.0

Facility

$589.65

Hospital Charge Code	270624443
Hospital Revenue Code	276
Min. Negotiated Rate	$14.21
Max. Negotiated Rate	$294.82
Rate for Payer: Aetna Commercial	$224.07
Rate for Payer: Aetna Medicare Advantage	$176.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$150.36
Rate for Payer: Cigna Commercial	$294.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$129.72
Rate for Payer: Qualcare PPO/HMO/WC	$88.45
Rate for Payer: UnitedHealthcare Community & State	$14.21
Rate for Payer: Wellpoint Medicaid Managed Care	$15.63

LENS IO CHIRON P574UV 13.2

Facility

$472.00

Hospital Charge Code	270623452
Hospital Revenue Code	276
Min. Negotiated Rate	$70.80
Max. Negotiated Rate	$114.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$103.84
Rate for Payer: Qualcare PPO/HMO/WC	$70.80

LENS IO CHIRON P574UV 13.2

Facility

$472.00

Hospital Charge Code	270623452
Hospital Revenue Code	276
Min. Negotiated Rate	$11.38
Max. Negotiated Rate	$236.00
Rate for Payer: Aetna Commercial	$179.36
Rate for Payer: Aetna Medicare Advantage	$141.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.36
Rate for Payer: Cigna Commercial	$236.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$103.84
Rate for Payer: Qualcare PPO/HMO/WC	$70.80
Rate for Payer: UnitedHealthcare Community & State	$11.38
Rate for Payer: Wellpoint Medicaid Managed Care	$12.51

LENS IO FOLDABLE AA4204VF 17.5

Facility

$550.00

Hospital Charge Code	270639839
Hospital Revenue Code	276
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

LENS IO FOLDABLE AA4204VF 17.5

Facility

$550.00

Hospital Charge Code	270639839
Hospital Revenue Code	276
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

LENS IO IOLAB 2129S 10.0

Facility

$959.25

Hospital Charge Code	270610083
Hospital Revenue Code	276
Min. Negotiated Rate	$23.12
Max. Negotiated Rate	$479.62
Rate for Payer: Aetna Commercial	$364.51
Rate for Payer: Aetna Medicare Advantage	$287.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$244.61
Rate for Payer: Cigna Commercial	$479.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.03
Rate for Payer: Qualcare PPO/HMO/WC	$143.89
Rate for Payer: UnitedHealthcare Community & State	$23.12
Rate for Payer: Wellpoint Medicaid Managed Care	$25.42

LENS IO IOLAB 2129S 10.0

Facility

$959.25

Hospital Charge Code	270610083
Hospital Revenue Code	276
Min. Negotiated Rate	$143.89
Max. Negotiated Rate	$232.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.03
Rate for Payer: Qualcare PPO/HMO/WC	$143.89

LENS IO IOLAB 2129S 16.5

Facility

$959.25

Hospital Charge Code	270602112
Hospital Revenue Code	276
Min. Negotiated Rate	$23.12
Max. Negotiated Rate	$479.62
Rate for Payer: Aetna Commercial	$364.51
Rate for Payer: Aetna Medicare Advantage	$287.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$244.61
Rate for Payer: Cigna Commercial	$479.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.03
Rate for Payer: Qualcare PPO/HMO/WC	$143.89
Rate for Payer: UnitedHealthcare Community & State	$23.12
Rate for Payer: Wellpoint Medicaid Managed Care	$25.42

LENS IO IOLAB 2129S 16.5

Facility

$959.25

Hospital Charge Code	270602112
Hospital Revenue Code	276
Min. Negotiated Rate	$143.89
Max. Negotiated Rate	$232.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.03
Rate for Payer: Qualcare PPO/HMO/WC	$143.89

LENS IO IOLAB 2129S 17.0

Facility

$959.25

Hospital Charge Code	270602113
Hospital Revenue Code	276
Min. Negotiated Rate	$143.89
Max. Negotiated Rate	$232.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.03
Rate for Payer: Qualcare PPO/HMO/WC	$143.89

LENS IO IOLAB 2129S 17.0

Facility

$959.25

Hospital Charge Code	270602113
Hospital Revenue Code	276
Min. Negotiated Rate	$23.12
Max. Negotiated Rate	$479.62
Rate for Payer: Aetna Commercial	$364.51
Rate for Payer: Aetna Medicare Advantage	$287.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$244.61
Rate for Payer: Cigna Commercial	$479.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.03
Rate for Payer: Qualcare PPO/HMO/WC	$143.89
Rate for Payer: UnitedHealthcare Community & State	$23.12
Rate for Payer: Wellpoint Medicaid Managed Care	$25.42

LENS IO IOLAB 2129S 17.5

Facility

$959.25

Hospital Charge Code	270602114
Hospital Revenue Code	276
Min. Negotiated Rate	$143.89
Max. Negotiated Rate	$232.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.03
Rate for Payer: Qualcare PPO/HMO/WC	$143.89

LENS IO IOLAB 2129S 17.5

Facility

$959.25

Hospital Charge Code	270602114
Hospital Revenue Code	276
Min. Negotiated Rate	$23.12
Max. Negotiated Rate	$479.62
Rate for Payer: Aetna Commercial	$364.51
Rate for Payer: Aetna Medicare Advantage	$287.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$244.61
Rate for Payer: Cigna Commercial	$479.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.03
Rate for Payer: Qualcare PPO/HMO/WC	$143.89
Rate for Payer: UnitedHealthcare Community & State	$23.12
Rate for Payer: Wellpoint Medicaid Managed Care	$25.42

LENS IO IOLAB 2129S 18.0

Facility

$959.25

Hospital Charge Code	270602115
Hospital Revenue Code	276
Min. Negotiated Rate	$23.12
Max. Negotiated Rate	$479.62
Rate for Payer: Aetna Commercial	$364.51
Rate for Payer: Aetna Medicare Advantage	$287.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$244.61
Rate for Payer: Cigna Commercial	$479.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.03
Rate for Payer: Qualcare PPO/HMO/WC	$143.89
Rate for Payer: UnitedHealthcare Community & State	$23.12
Rate for Payer: Wellpoint Medicaid Managed Care	$25.42

LENS IO IOLAB 2129S 18.0

Facility

$959.25

Hospital Charge Code	270602115
Hospital Revenue Code	276
Min. Negotiated Rate	$143.89
Max. Negotiated Rate	$232.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.03
Rate for Payer: Qualcare PPO/HMO/WC	$143.89

Know your out-of-pocket cost for care.

All Charges