Heights University Hospital

All Charges

Charge

Type

Setting

Price

LENS IO ALCON MZ30BD 24.0

Facility

$1,572.00

Hospital Charge Code	270602217
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 MZ30BD 24.0

Facility

$1,572.00

Hospital Charge Code	270602217
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 MZ30BD 24.5

Facility

$1,572.00

Hospital Charge Code	270602219
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 MZ30BD 24.5

Facility

$1,572.00

Hospital Charge Code	270602219
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 MZ30BD 26.5

Facility

$1,572.00

Hospital Charge Code	270602208
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 MZ30BD 26.5

Facility

$1,572.00

Hospital Charge Code	270602208
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 MZ30BD 27.0

Facility

$1,572.00

Hospital Charge Code	270602221
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 MZ30BD 27.0

Facility

$1,572.00

Hospital Charge Code	270602221
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 MZ60BD 21.5

Facility

$1,572.00

Hospital Charge Code	270606968
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 MZ60BD 21.5

Facility

$1,572.00

Hospital Charge Code	270606968
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 SK61CM 12.0

Facility

$1,521.65

Hospital Charge Code	270610082
Hospital Revenue Code	276
Min. Negotiated Rate	$228.25
Max. Negotiated Rate	$368.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.24
Rate for Payer: Qualcare PPO/HMO/WC	$228.25

LENS IO ALCON SK61CM 12.0

Facility

$1,521.65

Hospital Charge Code	270610082
Hospital Revenue Code	276
Min. Negotiated Rate	$228.25
Max. Negotiated Rate	$760.83
Rate for Payer: Aetna Commercial	$456.50
Rate for Payer: Aetna Medicare Advantage	$456.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$388.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$388.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$388.02
Rate for Payer: Cigna Commercial	$760.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.24
Rate for Payer: Qualcare PPO/HMO/WC	$228.25

LENS IO ALCON SK61CM 16.5

Facility

$1,521.65

Hospital Charge Code	270602179
Hospital Revenue Code	276
Min. Negotiated Rate	$228.25
Max. Negotiated Rate	$760.83
Rate for Payer: Aetna Commercial	$456.50
Rate for Payer: Aetna Medicare Advantage	$456.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$388.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$388.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$388.02
Rate for Payer: Cigna Commercial	$760.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.24
Rate for Payer: Qualcare PPO/HMO/WC	$228.25

LENS IO ALCON SK61CM 16.5

Facility

$1,521.65

Hospital Charge Code	270602179
Hospital Revenue Code	276
Min. Negotiated Rate	$228.25
Max. Negotiated Rate	$368.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.24
Rate for Payer: Qualcare PPO/HMO/WC	$228.25

LENS IO ALCON SK61CM 17.5

Facility

$750.00

Hospital Charge Code	270620136
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 SK61CM 17.5

Facility

$750.00

Hospital Charge Code	270620136
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 SK61CM 18.5

Facility

$1,521.65

Hospital Charge Code	270602180
Hospital Revenue Code	276
Min. Negotiated Rate	$228.25
Max. Negotiated Rate	$760.83
Rate for Payer: Aetna Commercial	$456.50
Rate for Payer: Aetna Medicare Advantage	$456.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$388.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$388.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$388.02
Rate for Payer: Cigna Commercial	$760.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.24
Rate for Payer: Qualcare PPO/HMO/WC	$228.25

LENS IO ALCON SK61CM 18.5

Facility

$1,521.65

Hospital Charge Code	270602180
Hospital Revenue Code	276
Min. Negotiated Rate	$228.25
Max. Negotiated Rate	$368.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.24
Rate for Payer: Qualcare PPO/HMO/WC	$228.25

LENS IO ALCON SK61CM 19.0

Facility

$1,521.65

Hospital Charge Code	270602181
Hospital Revenue Code	276
Min. Negotiated Rate	$228.25
Max. Negotiated Rate	$368.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.24
Rate for Payer: Qualcare PPO/HMO/WC	$228.25

LENS IO ALCON SK61CM 19.0

Facility

$1,521.65

Hospital Charge Code	270602181
Hospital Revenue Code	276
Min. Negotiated Rate	$228.25
Max. Negotiated Rate	$760.83
Rate for Payer: Aetna Commercial	$456.50
Rate for Payer: Aetna Medicare Advantage	$456.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$388.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$388.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$388.02
Rate for Payer: Cigna Commercial	$760.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.24
Rate for Payer: Qualcare PPO/HMO/WC	$228.25

LENS IO ALCON SK61CM 20.0

Facility

$786.45

Hospital Charge Code	270615649
Hospital Revenue Code	276
Min. Negotiated Rate	$117.97
Max. Negotiated Rate	$190.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$190.32
Rate for Payer: Qualcare PPO/HMO/WC	$117.97

LENS IO ALCON SK61CM 20.0

Facility

$786.45

Hospital Charge Code	270615649
Hospital Revenue Code	276
Min. Negotiated Rate	$117.97
Max. Negotiated Rate	$393.23
Rate for Payer: Aetna Commercial	$235.94
Rate for Payer: Aetna Medicare Advantage	$235.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.54
Rate for Payer: Cigna Commercial	$393.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$190.32
Rate for Payer: Qualcare PPO/HMO/WC	$117.97

LENS IO ALCON SK61CM 20.5

Facility

$750.00

Hospital Charge Code	270602183
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 SK61CM 20.5

Facility

$750.00

Hospital Charge Code	270602183
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 SK61CM 21.0

Facility

$1,521.65

Hospital Charge Code	270602182
Hospital Revenue Code	276
Min. Negotiated Rate	$228.25
Max. Negotiated Rate	$760.83
Rate for Payer: Aetna Commercial	$456.50
Rate for Payer: Aetna Medicare Advantage	$456.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$388.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$388.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$388.02
Rate for Payer: Cigna Commercial	$760.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.24
Rate for Payer: Qualcare PPO/HMO/WC	$228.25

Know your out-of-pocket cost for care.

All Charges