Heights University Hospital

All Charges

Charge

Type

Setting

Price

LENS IO ALCON LX10BD 19.0'

Facility

$2,267.25

Hospital Charge Code	270602129
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$548.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

LENS IO ALCON LX10BD 19.0'

Facility

$2,267.25

Hospital Charge Code	270602129
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$1,133.62
Rate for Payer: Aetna Commercial	$680.17
Rate for Payer: Aetna Medicare Advantage	$680.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$578.15
Rate for Payer: Cigna Commercial	$1,133.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

LENS IO ALCON LX10BD 19.5

Facility

$1,572.00

Hospital Charge Code	270602189
Hospital Revenue Code	276
Min. Negotiated Rate	$235.80
Max. Negotiated Rate	$786.00
Rate for Payer: Aetna Commercial	$471.60
Rate for Payer: Aetna Medicare Advantage	$471.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$400.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$400.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$400.86
Rate for Payer: Cigna Commercial	$786.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.42
Rate for Payer: Qualcare PPO/HMO/WC	$235.80

LENS IO ALCON LX10BD 19.5

Facility

$1,572.00

Hospital Charge Code	270602189
Hospital Revenue Code	276
Min. Negotiated Rate	$235.80
Max. Negotiated Rate	$380.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.42
Rate for Payer: Qualcare PPO/HMO/WC	$235.80

LENS IO ALCON LX10BD 20.0

Facility

$2,267.25

Hospital Charge Code	270602190
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$1,133.62
Rate for Payer: Aetna Commercial	$680.17
Rate for Payer: Aetna Medicare Advantage	$680.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$578.15
Rate for Payer: Cigna Commercial	$1,133.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

LENS IO ALCON LX10BD 20.0

Facility

$2,267.25

Hospital Charge Code	270602190
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$548.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

LENS IO ALCON LX10BD 20.5

Facility

$2,267.25

Hospital Charge Code	270602191
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$548.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

LENS IO ALCON LX10BD 20.5

Facility

$2,267.25

Hospital Charge Code	270602191
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$1,133.62
Rate for Payer: Aetna Commercial	$680.17
Rate for Payer: Aetna Medicare Advantage	$680.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$578.15
Rate for Payer: Cigna Commercial	$1,133.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

LENS IO ALCON LX10BD 21.0

Facility

$2,267.25

Hospital Charge Code	270602192
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$548.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

LENS IO ALCON LX10BD 21.0

Facility

$2,267.25

Hospital Charge Code	270602192
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$1,133.62
Rate for Payer: Aetna Commercial	$680.17
Rate for Payer: Aetna Medicare Advantage	$680.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$578.15
Rate for Payer: Cigna Commercial	$1,133.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

LENS IO ALCON LX10BD 21.5

Facility

$2,096.85

Hospital Charge Code	270609505
Hospital Revenue Code	276
Min. Negotiated Rate	$314.53
Max. Negotiated Rate	$1,048.42
Rate for Payer: Aetna Commercial	$629.05
Rate for Payer: Aetna Medicare Advantage	$629.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$534.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$534.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$534.70
Rate for Payer: Cigna Commercial	$1,048.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$507.44
Rate for Payer: Qualcare PPO/HMO/WC	$314.53

LENS IO ALCON LX10BD 21.5

Facility

$2,096.85

Hospital Charge Code	270609505
Hospital Revenue Code	276
Min. Negotiated Rate	$314.53
Max. Negotiated Rate	$507.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$507.44
Rate for Payer: Qualcare PPO/HMO/WC	$314.53

LENS IO ALCON LX10BD 22.0

Facility

$2,267.25

Hospital Charge Code	270602193
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$1,133.62
Rate for Payer: Aetna Commercial	$680.17
Rate for Payer: Aetna Medicare Advantage	$680.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$578.15
Rate for Payer: Cigna Commercial	$1,133.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

LENS IO ALCON LX10BD 22.0

Facility

$2,267.25

Hospital Charge Code	270602193
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$548.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

LENS IO ALCON LX10BD 23.0

Facility

$2,267.25

Hospital Charge Code	270607719
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$1,133.62
Rate for Payer: Aetna Commercial	$680.17
Rate for Payer: Aetna Medicare Advantage	$680.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$578.15
Rate for Payer: Cigna Commercial	$1,133.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

LENS IO ALCON LX10BD 23.0

Facility

$2,267.25

Hospital Charge Code	270607719
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$548.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

LENS IO ALCON LX10BD 23.5

Facility

$2,082.45

Hospital Charge Code	270602194
Hospital Revenue Code	276
Min. Negotiated Rate	$312.37
Max. Negotiated Rate	$503.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$503.95
Rate for Payer: Qualcare PPO/HMO/WC	$312.37

LENS IO ALCON LX10BD 23.5

Facility

$2,082.45

Hospital Charge Code	270602194
Hospital Revenue Code	276
Min. Negotiated Rate	$312.37
Max. Negotiated Rate	$1,041.22
Rate for Payer: Aetna Commercial	$624.74
Rate for Payer: Aetna Medicare Advantage	$624.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$531.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$531.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$531.02
Rate for Payer: Cigna Commercial	$1,041.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$503.95
Rate for Payer: Qualcare PPO/HMO/WC	$312.37

LENS IO ALCON LX10BD 24.0

Facility

$2,267.25

Hospital Charge Code	270602195
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$548.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

LENS IO ALCON LX10BD 24.0

Facility

$2,267.25

Hospital Charge Code	270602195
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$1,133.62
Rate for Payer: Aetna Commercial	$680.17
Rate for Payer: Aetna Medicare Advantage	$680.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$578.15
Rate for Payer: Cigna Commercial	$1,133.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

LENS IO ALCON LX10BD 25.0

Facility

$2,267.25

Hospital Charge Code	270607720
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$1,133.62
Rate for Payer: Aetna Commercial	$680.17
Rate for Payer: Aetna Medicare Advantage	$680.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$578.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$578.15
Rate for Payer: Cigna Commercial	$1,133.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

LENS IO ALCON LX10BD 25.0

Facility

$2,267.25

Hospital Charge Code	270607720
Hospital Revenue Code	276
Min. Negotiated Rate	$340.09
Max. Negotiated Rate	$548.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.67
Rate for Payer: Qualcare PPO/HMO/WC	$340.09

LENS IO ALCON LX10BD 26.0

Facility

$2,994.45

Hospital Charge Code	270602196
Hospital Revenue Code	276
Min. Negotiated Rate	$449.17
Max. Negotiated Rate	$1,497.22
Rate for Payer: Aetna Commercial	$898.34
Rate for Payer: Aetna Medicare Advantage	$898.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$763.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$763.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$763.58
Rate for Payer: Cigna Commercial	$1,497.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$724.66
Rate for Payer: Qualcare PPO/HMO/WC	$449.17

LENS IO ALCON LX10BD 26.0

Facility

$2,994.45

Hospital Charge Code	270602196
Hospital Revenue Code	276
Min. Negotiated Rate	$449.17
Max. Negotiated Rate	$724.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$724.66
Rate for Payer: Qualcare PPO/HMO/WC	$449.17

LENS IO ALCON LX10BD 27.0

Facility

$2,082.45

Hospital Charge Code	270602197
Hospital Revenue Code	276
Min. Negotiated Rate	$312.37
Max. Negotiated Rate	$1,041.22
Rate for Payer: Qualcare PPO/HMO/WC	$312.37
Rate for Payer: Aetna Commercial	$624.74
Rate for Payer: Aetna Medicare Advantage	$624.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$531.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$531.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$531.02
Rate for Payer: Cigna Commercial	$1,041.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$503.95

Know your out-of-pocket cost for care.

All Charges