Heights University Hospital

All Charges

Charge

Type

Setting

Price

LENS IO ALCON MTA2UO 15.5

Facility

$2,267.25

Hospital Charge Code	270602350
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 MTA2UO 15.5

Facility

$2,267.25

Hospital Charge Code	270602350
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 MTA2UO 16.0

Facility

$2,267.25

Hospital Charge Code	270602351
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 MTA2UO 16.0

Facility

$2,267.25

Hospital Charge Code	270602351
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 MTA2UO 16.5

Facility

$1,572.00

Hospital Charge Code	270602353
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 MTA2UO 16.5

Facility

$2,267.25

Hospital Charge Code	270602352
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 MTA2UO 16.5

Facility

$1,572.00

Hospital Charge Code	270602353
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 MTA2UO 16.5

Facility

$2,267.25

Hospital Charge Code	270602352
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 MTA2UO 17.0

Facility

$750.00

Hospital Charge Code	270602359
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 IO ALCON MTA2UO 17.0

Facility

$750.00

Hospital Charge Code	270602359
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 IO ALCON MTA2UO 17.5

Facility

$2,267.25

Hospital Charge Code	270602361
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 MTA2UO 17.5

Facility

$2,267.25

Hospital Charge Code	270602361
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 MTA2UO 18.0

Facility

$2,267.25

Hospital Charge Code	270602362
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 MTA2UO 18.0

Facility

$2,267.25

Hospital Charge Code	270602362
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 MTA2UO 18.5

Facility

$2,267.25

Hospital Charge Code	270602363
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 MTA2UO 18.5

Facility

$2,267.25

Hospital Charge Code	270602363
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 MTA2UO 19.0

Facility

$2,267.25

Hospital Charge Code	270602364
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 MTA2UO 19.0

Facility

$2,267.25

Hospital Charge Code	270602364
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 MTA2UO 19.5

Facility

$2,267.25

Hospital Charge Code	270602365
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 MTA2UO 19.5

Facility

$2,267.25

Hospital Charge Code	270602365
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 MTA2UO 20.0

Facility

$2,267.25

Hospital Charge Code	270602366
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 MTA2UO 20.0

Facility

$2,267.25

Hospital Charge Code	270602366
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 MTA2UO 20.5

Facility

$2,267.25

Hospital Charge Code	270602367
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 MTA2UO 20.5

Facility

$2,267.25

Hospital Charge Code	270602367
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 MTA2UO 21.0

Facility

$1,572.00

Hospital Charge Code	270602368
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

Know your out-of-pocket cost for care.

All Charges