Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LENS IO IOLAB 2192S 14.0

Facility

$959.25

Hospital Charge Code	270602109
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 2192S 15.0

Facility

$959.25

Hospital Charge Code	270602110
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 2192S 15.0

Facility

$959.25

Hospital Charge Code	270602110
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 2192S 15.5

Facility

$959.25

Hospital Charge Code	270602111
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 2192S 15.5

Facility

$959.25

Hospital Charge Code	270602111
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 2192S 16.0

Facility

$959.25

Hospital Charge Code	270602005
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 2192S 16.0

Facility

$959.25

Hospital Charge Code	270602005
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 2192S 22.5

Facility

$959.25

Hospital Charge Code	270602124
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 2192S 22.5

Facility

$959.25

Hospital Charge Code	270602124
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 L122UV 09.0

Facility

$472.85

Hospital Charge Code	270621823
Hospital Revenue Code	276
Min. Negotiated Rate	$11.40
Max. Negotiated Rate	$236.43
Rate for Payer: Aetna Commercial	$179.68
Rate for Payer: Aetna Medicare Advantage	$141.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.58
Rate for Payer: Cigna Commercial	$236.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.03
Rate for Payer: Qualcare PPO/HMO/WC	$70.93
Rate for Payer: UnitedHealthcare Community & State	$11.40
Rate for Payer: Wellpoint Medicaid Managed Care	$12.53

LENS IO L122UV 09.0

Facility

$472.85

Hospital Charge Code	270621823
Hospital Revenue Code	276
Min. Negotiated Rate	$70.93
Max. Negotiated Rate	$114.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.03
Rate for Payer: Qualcare PPO/HMO/WC	$70.93

LENS IOL CHIRON 68UV 21.0

Facility

$445.65

Hospital Charge Code	270623887
Hospital Revenue Code	276
Min. Negotiated Rate	$66.85
Max. Negotiated Rate	$107.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$98.04
Rate for Payer: Qualcare PPO/HMO/WC	$66.85

LENS IOL CHIRON 68UV 21.0

Facility

$445.65

Hospital Charge Code	270623887
Hospital Revenue Code	276
Min. Negotiated Rate	$10.74
Max. Negotiated Rate	$222.82
Rate for Payer: Aetna Commercial	$169.35
Rate for Payer: Aetna Medicare Advantage	$133.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.64
Rate for Payer: Cigna Commercial	$222.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$98.04
Rate for Payer: Qualcare PPO/HMO/WC	$66.85
Rate for Payer: UnitedHealthcare Community & State	$10.74
Rate for Payer: Wellpoint Medicaid Managed Care	$11.81

LENS IOL MA60AC 10.0

Facility

$720.40

Hospital Charge Code	270669805
Hospital Revenue Code	276
Min. Negotiated Rate	$108.06
Max. Negotiated Rate	$174.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.49
Rate for Payer: Qualcare PPO/HMO/WC	$108.06

LENS IOL MA60AC 10.0

Facility

$720.40

Hospital Charge Code	270669805
Hospital Revenue Code	276
Min. Negotiated Rate	$17.36
Max. Negotiated Rate	$360.20
Rate for Payer: Aetna Commercial	$273.75
Rate for Payer: Aetna Medicare Advantage	$216.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.70
Rate for Payer: Cigna Commercial	$360.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.49
Rate for Payer: Qualcare PPO/HMO/WC	$108.06
Rate for Payer: UnitedHealthcare Community & State	$17.36
Rate for Payer: Wellpoint Medicaid Managed Care	$19.09

LENS IOL MA60AC 15.5

Facility

$720.40

Hospital Charge Code	270669804
Hospital Revenue Code	276
Min. Negotiated Rate	$17.36
Max. Negotiated Rate	$360.20
Rate for Payer: Aetna Commercial	$273.75
Rate for Payer: Aetna Medicare Advantage	$216.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.70
Rate for Payer: Cigna Commercial	$360.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.49
Rate for Payer: Qualcare PPO/HMO/WC	$108.06
Rate for Payer: UnitedHealthcare Community & State	$17.36
Rate for Payer: Wellpoint Medicaid Managed Care	$19.09

LENS IOL MA60AC 15.5

Facility

$720.40

Hospital Charge Code	270669804
Hospital Revenue Code	276
Min. Negotiated Rate	$108.06
Max. Negotiated Rate	$174.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.49
Rate for Payer: Qualcare PPO/HMO/WC	$108.06

LENS IOL MA60AC 20.5

Facility

$720.40

Hospital Charge Code	270669803
Hospital Revenue Code	276
Min. Negotiated Rate	$17.36
Max. Negotiated Rate	$360.20
Rate for Payer: Aetna Commercial	$273.75
Rate for Payer: Aetna Medicare Advantage	$216.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.70
Rate for Payer: Cigna Commercial	$360.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.49
Rate for Payer: Qualcare PPO/HMO/WC	$108.06
Rate for Payer: UnitedHealthcare Community & State	$17.36
Rate for Payer: Wellpoint Medicaid Managed Care	$19.09

LENS IOL MA60AC 20.5

Facility

$720.40

Hospital Charge Code	270669803
Hospital Revenue Code	276
Min. Negotiated Rate	$108.06
Max. Negotiated Rate	$174.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.49
Rate for Payer: Qualcare PPO/HMO/WC	$108.06

LENS IOL MA60AC 6.0

Facility

$720.40

Hospital Charge Code	270669800
Hospital Revenue Code	276
Min. Negotiated Rate	$108.06
Max. Negotiated Rate	$174.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.49
Rate for Payer: Qualcare PPO/HMO/WC	$108.06

LENS IOL MA60AC 6.0

Facility

$720.40

Hospital Charge Code	270669800
Hospital Revenue Code	276
Min. Negotiated Rate	$17.36
Max. Negotiated Rate	$360.20
Rate for Payer: Aetna Commercial	$273.75
Rate for Payer: Aetna Medicare Advantage	$216.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.70
Rate for Payer: Cigna Commercial	$360.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.49
Rate for Payer: Qualcare PPO/HMO/WC	$108.06
Rate for Payer: UnitedHealthcare Community & State	$17.36
Rate for Payer: Wellpoint Medicaid Managed Care	$19.09

LENS IOL MA60AC 6.5

Facility

$720.40

Hospital Charge Code	270669801
Hospital Revenue Code	276
Min. Negotiated Rate	$108.06
Max. Negotiated Rate	$174.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.49
Rate for Payer: Qualcare PPO/HMO/WC	$108.06

LENS IOL MA60AC 6.5

Facility

$720.40

Hospital Charge Code	270669801
Hospital Revenue Code	276
Min. Negotiated Rate	$17.36
Max. Negotiated Rate	$360.20
Rate for Payer: Aetna Commercial	$273.75
Rate for Payer: Aetna Medicare Advantage	$216.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.70
Rate for Payer: Cigna Commercial	$360.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.49
Rate for Payer: Qualcare PPO/HMO/WC	$108.06
Rate for Payer: UnitedHealthcare Community & State	$17.36
Rate for Payer: Wellpoint Medicaid Managed Care	$19.09

LENS IOL MA60AC 8.5

Facility

$720.40

Hospital Charge Code	270669802
Hospital Revenue Code	276
Min. Negotiated Rate	$17.36
Max. Negotiated Rate	$360.20
Rate for Payer: Aetna Commercial	$273.75
Rate for Payer: Aetna Medicare Advantage	$216.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.70
Rate for Payer: Cigna Commercial	$360.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.49
Rate for Payer: Qualcare PPO/HMO/WC	$108.06
Rate for Payer: UnitedHealthcare Community & State	$17.36
Rate for Payer: Wellpoint Medicaid Managed Care	$19.09

LENS IOL MA60AC 8.5

Facility

$720.40

Hospital Charge Code	270669802
Hospital Revenue Code	276
Min. Negotiated Rate	$108.06
Max. Negotiated Rate	$174.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.49
Rate for Payer: Qualcare PPO/HMO/WC	$108.06

Know your out-of-pocket cost for care.

All Charges