Heights University Hospital

All Charges

Charge

Type

Setting

Price

LENS IO ALCON MTA5UO 16.0

Facility

$1,572.00

Hospital Charge Code	270602799
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 MTA5UO 16.5

Facility

$1,572.00

Hospital Charge Code	270602792
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 MTA5UO 16.5

Facility

$1,572.00

Hospital Charge Code	270602792
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 MTA5UO 17.0

Facility

$2,267.25

Hospital Charge Code	270602800
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 MTA5UO 17.0

Facility

$2,267.25

Hospital Charge Code	270602800
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 MTA5UO 17.5

Facility

$2,267.25

Hospital Charge Code	270602801
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 MTA5UO 17.5

Facility

$2,267.25

Hospital Charge Code	270602801
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 MTA5UO 18.0

Facility

$2,267.25

Hospital Charge Code	270602802
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 MTA5UO 18.0

Facility

$2,267.25

Hospital Charge Code	270602802
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 MTA5UO 18.5

Facility

$2,267.25

Hospital Charge Code	270602803
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 MTA5UO 18.5

Facility

$2,267.25

Hospital Charge Code	270602803
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 MTA5UO 19.0

Facility

$1,149.65

Hospital Charge Code	270602804
Hospital Revenue Code	276
Min. Negotiated Rate	$172.45
Max. Negotiated Rate	$278.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.22
Rate for Payer: Qualcare PPO/HMO/WC	$172.45

LENS IO ALCON MTA5UO 19.0

Facility

$1,149.65

Hospital Charge Code	270602804
Hospital Revenue Code	276
Min. Negotiated Rate	$172.45
Max. Negotiated Rate	$574.83
Rate for Payer: Aetna Commercial	$344.89
Rate for Payer: Aetna Medicare Advantage	$344.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.16
Rate for Payer: Cigna Commercial	$574.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.22
Rate for Payer: Qualcare PPO/HMO/WC	$172.45

LENS IO ALCON MTA5UO 19.5

Facility

$1,572.00

Hospital Charge Code	270602805
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 MTA5UO 19.5

Facility

$1,572.00

Hospital Charge Code	270602805
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 MTA5UO 20.0

Facility

$2,267.25

Hospital Charge Code	270602806
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 MTA5UO 20.0

Facility

$2,267.25

Hospital Charge Code	270602806
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 MTA5UO 20.5

Facility

$1,572.00

Hospital Charge Code	270602807
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 MTA5UO 20.5

Facility

$1,572.00

Hospital Charge Code	270602807
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 MTA5UO 21.5

Facility

$1,572.00

Hospital Charge Code	270602808
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 MTA5UO 21.5

Facility

$1,572.00

Hospital Charge Code	270602808
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 MTA5UO 22.0

Facility

$2,267.25

Hospital Charge Code	270602603
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 MTA5UO 22.0

Facility

$2,267.25

Hospital Charge Code	270602603
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 MTA5UO 22.5

Facility

$1,572.00

Hospital Charge Code	270602809
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 MTA5UO 22.5

Facility

$1,572.00

Hospital Charge Code	270602809
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