Heights University Hospital

All Charges

Charge

Type

Setting

Price

LENS INTRAOCULAR SN60AT 20.0

Facility

$1,116.00

Hospital Charge Code	270630319
Hospital Revenue Code	276
Min. Negotiated Rate	$167.40
Max. Negotiated Rate	$270.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.07
Rate for Payer: Qualcare PPO/HMO/WC	$167.40

LENS INTRAOCULAR SN60AT 20.0

Facility

$1,116.00

Hospital Charge Code	270631139
Hospital Revenue Code	276
Min. Negotiated Rate	$167.40
Max. Negotiated Rate	$558.00
Rate for Payer: Aetna Commercial	$334.80
Rate for Payer: Aetna Medicare Advantage	$334.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$284.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$284.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$284.58
Rate for Payer: Cigna Commercial	$558.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.07
Rate for Payer: Qualcare PPO/HMO/WC	$167.40

LENS INTRAOCULAR SN60AT 20.0

Facility

$892.85

Hospital Charge Code	270631319
Hospital Revenue Code	276
Min. Negotiated Rate	$133.93
Max. Negotiated Rate	$216.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.07
Rate for Payer: Qualcare PPO/HMO/WC	$133.93

LENS INTRAOCULAR SN60AT 20.5

Facility

$1,116.00

Hospital Charge Code	270630320
Hospital Revenue Code	276
Min. Negotiated Rate	$167.40
Max. Negotiated Rate	$558.00
Rate for Payer: Aetna Commercial	$334.80
Rate for Payer: Aetna Medicare Advantage	$334.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$284.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$284.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$284.58
Rate for Payer: Cigna Commercial	$558.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.07
Rate for Payer: Qualcare PPO/HMO/WC	$167.40

LENS INTRAOCULAR SN60AT 20.5

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631320
Hospital Revenue Code	276
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

LENS INTRAOCULAR SN60AT 20.5

Facility

$1,116.00

Hospital Charge Code	270630320
Hospital Revenue Code	276
Min. Negotiated Rate	$167.40
Max. Negotiated Rate	$270.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.07
Rate for Payer: Qualcare PPO/HMO/WC	$167.40

LENS INTRAOCULAR SN60AT 20.5

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631320
Hospital Revenue Code	276
Min. Negotiated Rate	$87.44
Max. Negotiated Rate	$270.00
Rate for Payer: Aetna Commercial	$270.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$145.73
Rate for Payer: Cigna Medicare Advantage	$87.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

LENS INTRAOCULAR SN60AT 21.0

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631622
Hospital Revenue Code	276
Min. Negotiated Rate	$87.44
Max. Negotiated Rate	$270.00
Rate for Payer: Aetna Commercial	$270.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$145.73
Rate for Payer: Cigna Medicare Advantage	$87.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

LENS INTRAOCULAR SN60AT 21.0

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631622
Hospital Revenue Code	276
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

LENS INTRAOCULAR SN60AT 21.5

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631550
Hospital Revenue Code	276
Min. Negotiated Rate	$87.44
Max. Negotiated Rate	$270.00
Rate for Payer: Aetna Commercial	$270.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$145.73
Rate for Payer: Cigna Medicare Advantage	$87.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

LENS INTRAOCULAR SN60AT 21.5

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631550
Hospital Revenue Code	276
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

LENS INTRAOCULAR SN60AT 22.0

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631551
Hospital Revenue Code	276
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

LENS INTRAOCULAR SN60AT 22.0

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631551
Hospital Revenue Code	276
Min. Negotiated Rate	$87.44
Max. Negotiated Rate	$270.00
Rate for Payer: Aetna Commercial	$270.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$145.73
Rate for Payer: Cigna Medicare Advantage	$87.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

LENS INTRAOCULAR SN60AT 22.5

Facility

$892.85

Hospital Charge Code	270631224
Hospital Revenue Code	276
Min. Negotiated Rate	$133.93
Max. Negotiated Rate	$446.43
Rate for Payer: Aetna Commercial	$267.86
Rate for Payer: Aetna Medicare Advantage	$267.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.68
Rate for Payer: Cigna Commercial	$446.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.07
Rate for Payer: Qualcare PPO/HMO/WC	$133.93

LENS INTRAOCULAR SN60AT 22.5

Facility

$892.85

Hospital Charge Code	270631224
Hospital Revenue Code	276
Min. Negotiated Rate	$133.93
Max. Negotiated Rate	$216.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.07
Rate for Payer: Qualcare PPO/HMO/WC	$133.93

LENS INTRAOCULAR SN60AT 23.5

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631943
Hospital Revenue Code	276
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

LENS INTRAOCULAR SN60AT 23.5

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631943
Hospital Revenue Code	276
Min. Negotiated Rate	$87.44
Max. Negotiated Rate	$270.00
Rate for Payer: Aetna Commercial	$270.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$145.73
Rate for Payer: Cigna Medicare Advantage	$87.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

LENS INTRAOCULAR SN60AT 24.5

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631386
Hospital Revenue Code	276
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

LENS INTRAOCULAR SN60AT 24.5

Facility

$900.00

Service Code	HCPCS V2632
Hospital Charge Code	270631386
Hospital Revenue Code	276
Min. Negotiated Rate	$87.44
Max. Negotiated Rate	$270.00
Rate for Payer: Aetna Commercial	$270.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$145.73
Rate for Payer: Cigna Medicare Advantage	$87.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

LENS INTRAOCULAR SN60AT 25.0

Facility

$892.85

Hospital Charge Code	270631387
Hospital Revenue Code	276
Min. Negotiated Rate	$133.93
Max. Negotiated Rate	$446.43
Rate for Payer: Aetna Commercial	$267.86
Rate for Payer: Aetna Medicare Advantage	$267.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.68
Rate for Payer: Cigna Commercial	$446.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.07
Rate for Payer: Qualcare PPO/HMO/WC	$133.93

LENS INTRAOCULAR SN60AT 25.0

Facility

$892.85

Hospital Charge Code	270631387
Hospital Revenue Code	276
Min. Negotiated Rate	$133.93
Max. Negotiated Rate	$216.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.07
Rate for Payer: Qualcare PPO/HMO/WC	$133.93

LENS INTRAOCULAR SN60AT 26.0

Facility

$892.85

Hospital Charge Code	270631388
Hospital Revenue Code	276
Min. Negotiated Rate	$133.93
Max. Negotiated Rate	$216.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.07
Rate for Payer: Qualcare PPO/HMO/WC	$133.93

LENS INTRAOCULAR SN60AT 26.0

Facility

$892.85

Hospital Charge Code	270631388
Hospital Revenue Code	276
Min. Negotiated Rate	$133.93
Max. Negotiated Rate	$446.43
Rate for Payer: Aetna Commercial	$267.86
Rate for Payer: Aetna Medicare Advantage	$267.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.68
Rate for Payer: Cigna Commercial	$446.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.07
Rate for Payer: Qualcare PPO/HMO/WC	$133.93

LENS INTRAOCULAR SN60AT 6.0

Facility

$892.85

Hospital Charge Code	270633632
Hospital Revenue Code	276
Min. Negotiated Rate	$133.93
Max. Negotiated Rate	$446.43
Rate for Payer: Aetna Commercial	$267.86
Rate for Payer: Aetna Medicare Advantage	$267.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.68
Rate for Payer: Cigna Commercial	$446.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.07
Rate for Payer: Qualcare PPO/HMO/WC	$133.93

LENS INTRAOCULAR SN60AT 6.0

Facility

$892.85

Hospital Charge Code	270633632
Hospital Revenue Code	276
Min. Negotiated Rate	$133.93
Max. Negotiated Rate	$216.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.07
Rate for Payer: Qualcare PPO/HMO/WC	$133.93

Know your out-of-pocket cost for care.

All Charges