Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

LENS INTRAOCCULAR 18.5 DIOPTER

Facility

IP

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270653317
Hospital Revenue Code	276
Min. Negotiated Rate	$243.49
Max. Negotiated Rate	$392.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.83
Rate for Payer: Qualcare PPO/HMO/WC	$243.49

LENS INTRAOCCULAR 18.5 DIOPTER

Facility

IP

$720.00

Service Code	HCPCS V2632
Hospital Charge Code	270686558
Hospital Revenue Code	276
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$174.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

LENS INTRAOCCULAR 18.5 DIOPTER

Facility

IP

$720.40

Hospital Charge Code	270655341
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: Qualcare PPO/HMO/WC	$108.06

LENS INTRAOCCULAR 18.5 DIOPTER

Facility

IP

$720.40

Hospital Charge Code	270655362
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: Qualcare PPO/HMO/WC	$108.06

LENS INTRAOCCULAR 18.5 DIOPTER

Facility

OP

$720.40

Hospital Charge Code	270655341
Hospital Revenue Code	276
Min. Negotiated Rate	$108.06
Max. Negotiated Rate	$360.20
Rate for Payer: Aetna Commercial	$216.12
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: Qualcare PPO/HMO/WC	$108.06

LENS INTRAOCCULAR 18.5 DIOPTER

Facility

OP

$720.40

Hospital Charge Code	270655362
Hospital Revenue Code	276
Min. Negotiated Rate	$108.06
Max. Negotiated Rate	$360.20
Rate for Payer: Aetna Commercial	$216.12
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: Qualcare PPO/HMO/WC	$108.06

LENS INTRAOCCULAR+18.5 DIOPTER

Facility

IP

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270653282
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: Qualcare PPO/HMO/WC	$108.06

LENS INTRAOCCULAR+18.5 DIOPTER

Facility

OP

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270653282
Hospital Revenue Code	276
Min. Negotiated Rate	$87.44
Max. Negotiated Rate	$216.12
Rate for Payer: Aetna Commercial	$216.12
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	$145.73
Rate for Payer: Cigna Medicare Advantage	$87.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: Qualcare PPO/HMO/WC	$108.06

LENS INTRAOCCULAR 19.0 DIO

Facility

OP

$1,748.70

Service Code	HCPCS V2632
Hospital Charge Code	270653318
Hospital Revenue Code	276
Min. Negotiated Rate	$87.44
Max. Negotiated Rate	$524.61
Rate for Payer: Aetna Commercial	$524.61
Rate for Payer: Aetna Medicare Advantage	$524.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$445.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$445.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$445.92
Rate for Payer: Cigna Commercial	$145.73
Rate for Payer: Cigna Medicare Advantage	$87.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.19
Rate for Payer: Qualcare PPO/HMO/WC	$262.31

LENS INTRAOCCULAR 19.0 DIO

Facility

IP

$1,748.70

Service Code	HCPCS V2632
Hospital Charge Code	270653318
Hospital Revenue Code	276
Min. Negotiated Rate	$262.31
Max. Negotiated Rate	$423.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.19
Rate for Payer: Qualcare PPO/HMO/WC	$262.31

LENS INTRAOCCULAR 19.0 DIPOTER

Facility

OP

$425.00

Hospital Charge Code	270653271
Hospital Revenue Code	276
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

LENS INTRAOCCULAR 19.0 DIPOTER

Facility

IP

$425.00

Hospital Charge Code	270653271
Hospital Revenue Code	276
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$102.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

LENS INTRAOCCULAR 19.5 DIO

Facility

OP

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270653319
Hospital Revenue Code	276
Min. Negotiated Rate	$87.44
Max. Negotiated Rate	$486.98
Rate for Payer: Aetna Commercial	$486.98
Rate for Payer: Aetna Medicare Advantage	$486.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$413.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$413.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$413.93
Rate for Payer: Cigna Commercial	$145.73
Rate for Payer: Cigna Medicare Advantage	$87.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.83
Rate for Payer: Qualcare PPO/HMO/WC	$243.49

LENS INTRAOCCULAR 19.5 DIO

Facility

IP

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270653319
Hospital Revenue Code	276
Min. Negotiated Rate	$243.49
Max. Negotiated Rate	$392.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.83
Rate for Payer: Qualcare PPO/HMO/WC	$243.49

LENS INTRAOCCULAR+19.5 DIOPTER

Facility

IP

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270650860
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: Qualcare PPO/HMO/WC	$108.06

LENS INTRAOCCULAR+19.5 DIOPTER

Facility

OP

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270650860
Hospital Revenue Code	276
Min. Negotiated Rate	$87.44
Max. Negotiated Rate	$216.12
Rate for Payer: Aetna Commercial	$216.12
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	$145.73
Rate for Payer: Cigna Medicare Advantage	$87.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: Qualcare PPO/HMO/WC	$108.06

LENS INTRAOCCULAR +20.0 DIOPTE

Facility

IP

$887.00

Hospital Charge Code	270653232
Hospital Revenue Code	276
Min. Negotiated Rate	$133.05
Max. Negotiated Rate	$214.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.65
Rate for Payer: Qualcare PPO/HMO/WC	$133.05

LENS INTRAOCCULAR +20.0 DIOPTE

Facility

OP

$670.00

Service Code	HCPCS V2632
Hospital Charge Code	270650861
Hospital Revenue Code	276
Min. Negotiated Rate	$87.44
Max. Negotiated Rate	$201.00
Rate for Payer: Aetna Commercial	$201.00
Rate for Payer: Aetna Medicare Advantage	$201.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.85
Rate for Payer: Cigna Commercial	$145.73
Rate for Payer: Cigna Medicare Advantage	$87.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.50

LENS INTRAOCCULAR +20.0 DIOPTE

Facility

IP

$670.00

Service Code	HCPCS V2632
Hospital Charge Code	270650861
Hospital Revenue Code	276
Min. Negotiated Rate	$100.50
Max. Negotiated Rate	$162.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.50

LENS INTRAOCCULAR +20.0 DIOPTE

Facility

OP

$887.00

Hospital Charge Code	270653232
Hospital Revenue Code	276
Min. Negotiated Rate	$133.05
Max. Negotiated Rate	$443.50
Rate for Payer: Aetna Commercial	$266.10
Rate for Payer: Aetna Medicare Advantage	$266.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.19
Rate for Payer: Cigna Commercial	$443.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.65
Rate for Payer: Qualcare PPO/HMO/WC	$133.05

LENS INTRAOCCULAR 20.0 DIOPTER

Facility

OP

$425.00

Hospital Charge Code	270653270
Hospital Revenue Code	276
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

LENS INTRAOCCULAR 20.0 DIOPTER

Facility

IP

$425.00

Hospital Charge Code	270653270
Hospital Revenue Code	276
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$102.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

LENS INTRAOCCULAR +20.5

Facility

OP

$720.00

Hospital Charge Code	270668386
Hospital Revenue Code	276
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$216.00
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

LENS INTRAOCCULAR +20.5

Facility

IP

$720.00

Hospital Charge Code	270668386
Hospital Revenue Code	276
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$174.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

LENS INTRAOCCULAR 20.5 DIOPTER

Facility

OP

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270660120
Hospital Revenue Code	276
Min. Negotiated Rate	$87.44
Max. Negotiated Rate	$216.12
Rate for Payer: Aetna Commercial	$216.12
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	$145.73
Rate for Payer: Cigna Medicare Advantage	$87.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: Qualcare PPO/HMO/WC	$108.06