Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

LENS INTRAOCCULAR 22.5 DIOPTER

Facility

IP

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270660635
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 22.5 DIOPTER

Facility

OP

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270661238
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 22.5 DIOPTER

Facility

IP

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270653312
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 23.0 DIOPTER

Facility

IP

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270653325
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 23.0 DIOPTER

Facility

OP

$670.00

Service Code	HCPCS V2632
Hospital Charge Code	270661734
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 23.0 DIOPTER

Facility

OP

$425.00

Hospital Charge Code	270653255
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 23.0 DIOPTER

Facility

IP

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270653246
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 23.0 DIOPTER

Facility

IP

$670.00

Service Code	HCPCS V2632
Hospital Charge Code	270661734
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 23.0 DIOPTER

Facility

IP

$425.00

Hospital Charge Code	270653255
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 23.0 DIOPTER

Facility

OP

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270653246
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 23.0 DIOPTER

Facility

OP

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270653325
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 +23.5DIOPTER

Facility

OP

$887.00

Hospital Charge Code	270653234
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 +23.5DIOPTER

Facility

IP

$887.00

Hospital Charge Code	270653234
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 23.5 DIOPTER

Facility

IP

$750.00

Hospital Charge Code	270653327
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: Qualcare PPO/HMO/WC	$112.50

LENS INTRAOCCULAR 23.5 DIOPTER

Facility

OP

$750.00

Hospital Charge Code	270653327
Hospital Revenue Code	276
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$225.00
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: Qualcare PPO/HMO/WC	$112.50

LENS INTRAOCCULAR 23.5 DIOPTER

Facility

IP

$720.40

Hospital Charge Code	270650623
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 23.5 DIOPTER

Facility

OP

$720.40

Hospital Charge Code	270650623
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 23.5 DIOPTER

Facility

OP

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270664944
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 23.5 DIOPTER

Facility

IP

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270664944
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+23.5 DIOPTER

Facility

IP

$1,548.25

Service Code	HCPCS V2632
Hospital Charge Code	270650867
Hospital Revenue Code	276
Min. Negotiated Rate	$232.24
Max. Negotiated Rate	$374.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$374.68
Rate for Payer: Qualcare PPO/HMO/WC	$232.24

LENS INTRAOCCULAR+23.5 DIOPTER

Facility

OP

$1,548.25

Service Code	HCPCS V2632
Hospital Charge Code	270650867
Hospital Revenue Code	276
Min. Negotiated Rate	$87.44
Max. Negotiated Rate	$464.48
Rate for Payer: Aetna Commercial	$464.48
Rate for Payer: Aetna Medicare Advantage	$464.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.80
Rate for Payer: Cigna Commercial	$145.73
Rate for Payer: Cigna Medicare Advantage	$87.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$374.68
Rate for Payer: Qualcare PPO/HMO/WC	$232.24

LENS INTRAOCCULAR 24.0

Facility

OP

$300.00

Hospital Charge Code	270655316
Hospital Revenue Code	276
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$90.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

LENS INTRAOCCULAR 24.0

Facility

IP

$300.00

Hospital Charge Code	270655316
Hospital Revenue Code	276
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

LENS INTRAOCCULAR +24.0DIOPTER

Facility

IP

$887.00

Hospital Charge Code	270653235
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 +24.0DIOPTER

Facility

OP

$887.00

Hospital Charge Code	270653235
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