Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 16.0

Facility

$1,659.25

Hospital Charge Code	270602013
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 16.0

Facility

$1,659.25

Hospital Charge Code	270602013
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 16.5

Facility

$1,659.25

Hospital Charge Code	270602014
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 16.5

Facility

$1,659.25

Hospital Charge Code	270602014
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 17.0

Facility

$1,659.25

Hospital Charge Code	270602015
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 17.0

Facility

$1,659.25

Hospital Charge Code	270602015
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 17.5

Facility

$1,659.25

Hospital Charge Code	270602016
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 17.5

Facility

$1,659.25

Hospital Charge Code	270602016
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 17.5*****

Facility

$600.00

Service Code	HCPCS C1780
Hospital Charge Code	27060216
Hospital Revenue Code	276
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

LENS IO CHIRON CIIVB 17.5*****

Facility

$600.00

Service Code	HCPCS C1780
Hospital Charge Code	27060216
Hospital Revenue Code	276
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$180.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

LENS IO CHIRON CIIVB 18.0

Facility

$1,659.25

Hospital Charge Code	270602018
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 18.0

Facility

$1,659.25

Hospital Charge Code	270602018
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 18.5

Facility

$1,659.25

Hospital Charge Code	270602020
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 18.5

Facility

$1,659.25

Hospital Charge Code	270602020
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 19.0

Facility

$1,659.25

Hospital Charge Code	270602094
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 19.0

Facility

$1,659.25

Hospital Charge Code	270602094
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 19.5

Facility

$1,659.25

Hospital Charge Code	270602095
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 19.5

Facility

$1,659.25

Hospital Charge Code	270602095
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 20.0

Facility

$1,659.25

Hospital Charge Code	270602096
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 20.0

Facility

$1,659.25

Hospital Charge Code	270602096
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 20.5

Facility

$1,659.25

Hospital Charge Code	270602097
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 20.5

Facility

$1,659.25

Hospital Charge Code	270602097
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 21.0

Facility

$1,659.25

Hospital Charge Code	270602098
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 21.0

Facility

$1,659.25

Hospital Charge Code	270602098
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

Know your out-of-pocket cost for care.

All Charges