Heights University Hospital

All Charges

Charge

Type

Setting

Price

LENS IO CHIRON 8191B 18.0

Facility

$690.45

Hospital Charge Code	270621256
Hospital Revenue Code	276
Min. Negotiated Rate	$103.57
Max. Negotiated Rate	$167.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.09
Rate for Payer: Qualcare PPO/HMO/WC	$103.57

LENS IO CHIRON 8191B 18.0

Facility

$690.45

Hospital Charge Code	270621256
Hospital Revenue Code	276
Min. Negotiated Rate	$103.57
Max. Negotiated Rate	$345.23
Rate for Payer: Aetna Commercial	$207.13
Rate for Payer: Aetna Medicare Advantage	$207.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$176.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$176.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$176.06
Rate for Payer: Cigna Commercial	$345.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.09
Rate for Payer: Qualcare PPO/HMO/WC	$103.57

LENS IO CHIRON 8191B 19.0

Facility

$445.65

Hospital Charge Code	270624731
Hospital Revenue Code	276
Min. Negotiated Rate	$66.85
Max. Negotiated Rate	$107.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.85
Rate for Payer: Qualcare PPO/HMO/WC	$66.85

LENS IO CHIRON 8191B 19.0

Facility

$445.65

Hospital Charge Code	270624731
Hospital Revenue Code	276
Min. Negotiated Rate	$66.85
Max. Negotiated Rate	$222.82
Rate for Payer: Aetna Commercial	$133.69
Rate for Payer: Aetna Medicare Advantage	$133.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.64
Rate for Payer: Cigna Commercial	$222.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.85
Rate for Payer: Qualcare PPO/HMO/WC	$66.85

LENS IO CHIRON 8191B 21.0

Facility

$690.45

Hospital Charge Code	270621257
Hospital Revenue Code	276
Min. Negotiated Rate	$103.57
Max. Negotiated Rate	$345.23
Rate for Payer: Aetna Commercial	$207.13
Rate for Payer: Aetna Medicare Advantage	$207.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$176.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$176.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$176.06
Rate for Payer: Cigna Commercial	$345.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.09
Rate for Payer: Qualcare PPO/HMO/WC	$103.57

LENS IO CHIRON 8191B 21.0

Facility

$690.45

Hospital Charge Code	270621257
Hospital Revenue Code	276
Min. Negotiated Rate	$103.57
Max. Negotiated Rate	$167.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.09
Rate for Payer: Qualcare PPO/HMO/WC	$103.57

LENS IO CHIRON 8191B 22.0

Facility

$690.45

Hospital Charge Code	270621594
Hospital Revenue Code	276
Min. Negotiated Rate	$103.57
Max. Negotiated Rate	$167.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.09
Rate for Payer: Qualcare PPO/HMO/WC	$103.57

LENS IO CHIRON 8191B 22.0

Facility

$690.45

Hospital Charge Code	270621594
Hospital Revenue Code	276
Min. Negotiated Rate	$103.57
Max. Negotiated Rate	$345.23
Rate for Payer: Aetna Commercial	$207.13
Rate for Payer: Aetna Medicare Advantage	$207.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$176.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$176.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$176.06
Rate for Payer: Cigna Commercial	$345.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.09
Rate for Payer: Qualcare PPO/HMO/WC	$103.57

LENS IO CHIRON 8191B 22.5

Facility

$690.45

Hospital Charge Code	270621595
Hospital Revenue Code	276
Min. Negotiated Rate	$103.57
Max. Negotiated Rate	$167.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.09
Rate for Payer: Qualcare PPO/HMO/WC	$103.57

LENS IO CHIRON 8191B 22.5

Facility

$690.45

Hospital Charge Code	270621595
Hospital Revenue Code	276
Min. Negotiated Rate	$103.57
Max. Negotiated Rate	$345.23
Rate for Payer: Aetna Commercial	$207.13
Rate for Payer: Aetna Medicare Advantage	$207.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$176.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$176.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$176.06
Rate for Payer: Cigna Commercial	$345.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.09
Rate for Payer: Qualcare PPO/HMO/WC	$103.57

LENS IO CHIRON 8191B 23.0

Facility

$472.85

Hospital Charge Code	270621886
Hospital Revenue Code	276
Min. Negotiated Rate	$70.93
Max. Negotiated Rate	$236.43
Rate for Payer: Aetna Commercial	$141.85
Rate for Payer: Aetna Medicare Advantage	$141.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.58
Rate for Payer: Cigna Commercial	$236.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.43
Rate for Payer: Qualcare PPO/HMO/WC	$70.93

LENS IO CHIRON 8191B 23.0

Facility

$472.85

Hospital Charge Code	270621886
Hospital Revenue Code	276
Min. Negotiated Rate	$70.93
Max. Negotiated Rate	$114.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.43
Rate for Payer: Qualcare PPO/HMO/WC	$70.93

LENS IO CHIRON 8191B 24.0

Facility

$690.45

Hospital Charge Code	270621596
Hospital Revenue Code	276
Min. Negotiated Rate	$103.57
Max. Negotiated Rate	$167.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.09
Rate for Payer: Qualcare PPO/HMO/WC	$103.57

LENS IO CHIRON 8191B 24.0

Facility

$690.45

Hospital Charge Code	270621596
Hospital Revenue Code	276
Min. Negotiated Rate	$103.57
Max. Negotiated Rate	$345.23
Rate for Payer: Aetna Commercial	$207.13
Rate for Payer: Aetna Medicare Advantage	$207.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$176.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$176.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$176.06
Rate for Payer: Cigna Commercial	$345.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.09
Rate for Payer: Qualcare PPO/HMO/WC	$103.57

LENS IO CHIRON 8191B 24.5D

Facility

$472.85

Hospital Charge Code	270621821
Hospital Revenue Code	276
Min. Negotiated Rate	$70.93
Max. Negotiated Rate	$114.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.43
Rate for Payer: Qualcare PPO/HMO/WC	$70.93

LENS IO CHIRON 8191B 24.5D

Facility

$472.85

Hospital Charge Code	270621821
Hospital Revenue Code	276
Min. Negotiated Rate	$70.93
Max. Negotiated Rate	$236.43
Rate for Payer: Aetna Commercial	$141.85
Rate for Payer: Aetna Medicare Advantage	$141.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.58
Rate for Payer: Cigna Commercial	$236.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.43
Rate for Payer: Qualcare PPO/HMO/WC	$70.93

LENS IO CHIRON 8191B 27.0D

Facility

$472.85

Hospital Charge Code	270622552
Hospital Revenue Code	276
Min. Negotiated Rate	$70.93
Max. Negotiated Rate	$236.43
Rate for Payer: Aetna Commercial	$141.85
Rate for Payer: Aetna Medicare Advantage	$141.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.58
Rate for Payer: Cigna Commercial	$236.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.43
Rate for Payer: Qualcare PPO/HMO/WC	$70.93

LENS IO CHIRON 8191B 27.0D

Facility

$472.85

Hospital Charge Code	270622552
Hospital Revenue Code	276
Min. Negotiated Rate	$70.93
Max. Negotiated Rate	$114.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.43
Rate for Payer: Qualcare PPO/HMO/WC	$70.93

LENS IO CHIRON CIIVB 14.0

Facility

$1,659.25

Hospital Charge Code	270602009
Hospital Revenue Code	276
Min. Negotiated Rate	$248.89
Max. Negotiated Rate	$829.62
Rate for Payer: Aetna Commercial	$497.77
Rate for Payer: Aetna Medicare Advantage	$497.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$423.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$423.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$423.11
Rate for Payer: Cigna Commercial	$829.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.54
Rate for Payer: Qualcare PPO/HMO/WC	$248.89

LENS IO CHIRON CIIVB 14.0

Facility

$1,659.25

Hospital Charge Code	270602009
Hospital Revenue Code	276
Min. Negotiated Rate	$248.89
Max. Negotiated Rate	$401.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.54
Rate for Payer: Qualcare PPO/HMO/WC	$248.89

LENS IO CHIRON CIIVB 14.5

Facility

$1,659.25

Hospital Charge Code	270602010
Hospital Revenue Code	276
Min. Negotiated Rate	$248.89
Max. Negotiated Rate	$401.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.54
Rate for Payer: Qualcare PPO/HMO/WC	$248.89

LENS IO CHIRON CIIVB 14.5

Facility

$1,659.25

Hospital Charge Code	270602010
Hospital Revenue Code	276
Min. Negotiated Rate	$248.89
Max. Negotiated Rate	$829.62
Rate for Payer: Aetna Commercial	$497.77
Rate for Payer: Aetna Medicare Advantage	$497.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$423.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$423.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$423.11
Rate for Payer: Cigna Commercial	$829.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.54
Rate for Payer: Qualcare PPO/HMO/WC	$248.89

LENS IO CHIRON CIIVB 15.0

Facility

$1,659.25

Hospital Charge Code	270602011
Hospital Revenue Code	276
Min. Negotiated Rate	$248.89
Max. Negotiated Rate	$401.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.54
Rate for Payer: Qualcare PPO/HMO/WC	$248.89

LENS IO CHIRON CIIVB 15.0

Facility

$1,659.25

Hospital Charge Code	270602011
Hospital Revenue Code	276
Min. Negotiated Rate	$248.89
Max. Negotiated Rate	$829.62
Rate for Payer: Aetna Commercial	$497.77
Rate for Payer: Aetna Medicare Advantage	$497.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$423.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$423.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$423.11
Rate for Payer: Cigna Commercial	$829.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.54
Rate for Payer: Qualcare PPO/HMO/WC	$248.89

LENS IO CHIRON CIIVB 15.5

Facility

$1,659.25

Hospital Charge Code	270602012
Hospital Revenue Code	276
Min. Negotiated Rate	$248.89
Max. Negotiated Rate	$829.62
Rate for Payer: Aetna Commercial	$497.77
Rate for Payer: Aetna Medicare Advantage	$497.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$423.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$423.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$423.11
Rate for Payer: Cigna Commercial	$829.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.54
Rate for Payer: Qualcare PPO/HMO/WC	$248.89

Know your out-of-pocket cost for care.

All Charges