Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LENS INTRAOCCULAR 17.0 DIOPTER

Facility

$750.00

Service Code	HCPCS V2632
Hospital Charge Code	270653315
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 INTRAOCCULAR 17.0 DIOPTER

Facility

$750.00

Service Code	HCPCS V2632
Hospital Charge Code	270653315
Hospital Revenue Code	276
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
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
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

LENS INTRAOCCULAR+17.0 DIOPTER

Facility

$887.00

Service Code	HCPCS V2632
Hospital Charge Code	270650887
Hospital Revenue Code	276
Min. Negotiated Rate	$133.05
Max. Negotiated Rate	$214.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.65
Rate for Payer: Qualcare PPO/HMO/WC	$133.05

LENS INTRAOCCULAR+17.0 DIOPTER

Facility

$887.00

Service Code	HCPCS V2632
Hospital Charge Code	270650887
Hospital Revenue Code	276
Min. Negotiated Rate	$25.19
Max. Negotiated Rate	$443.50
Rate for Payer: Aetna Commercial	$337.06
Rate for Payer: Aetna Medicare Advantage	$266.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.19
Rate for Payer: Cigna Commercial	$443.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.65
Rate for Payer: Qualcare PPO/HMO/WC	$133.05
Rate for Payer: UnitedHealthcare Community & State	$28.03
Rate for Payer: Wellpoint Medicaid Managed Care	$25.19

LENS INTRAOCCULAR 17.5 DIOPTER

Facility

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270653332
Hospital Revenue Code	276
Min. Negotiated Rate	$46.10
Max. Negotiated Rate	$811.62
Rate for Payer: Aetna Commercial	$616.84
Rate for Payer: Aetna Medicare Advantage	$486.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$413.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$413.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$413.93
Rate for Payer: Cigna Commercial	$811.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.83
Rate for Payer: Qualcare PPO/HMO/WC	$243.49
Rate for Payer: UnitedHealthcare Community & State	$51.29
Rate for Payer: Wellpoint Medicaid Managed Care	$46.10

LENS INTRAOCCULAR 17.5 DIOPTER

Facility

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270653332
Hospital Revenue Code	276
Min. Negotiated Rate	$243.49
Max. Negotiated Rate	$392.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.83
Rate for Payer: Qualcare PPO/HMO/WC	$243.49

LENS INTRAOCCULAR+17.5 DIOPTER

Facility

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270653281
Hospital Revenue Code	276
Min. Negotiated Rate	$108.06
Max. Negotiated Rate	$174.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: Qualcare PPO/HMO/WC	$108.06

LENS INTRAOCCULAR+17.5 DIOPTER

Facility

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270653281
Hospital Revenue Code	276
Min. Negotiated Rate	$20.46
Max. Negotiated Rate	$360.20
Rate for Payer: Aetna Commercial	$273.75
Rate for Payer: Aetna Medicare Advantage	$216.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.70
Rate for Payer: Cigna Commercial	$360.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: Qualcare PPO/HMO/WC	$108.06
Rate for Payer: UnitedHealthcare Community & State	$22.76
Rate for Payer: Wellpoint Medicaid Managed Care	$20.46

LENS INTRAOCCULAR17.5 DIOPTER

Facility

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270650651
Hospital Revenue Code	276
Min. Negotiated Rate	$20.46
Max. Negotiated Rate	$360.20
Rate for Payer: Aetna Commercial	$273.75
Rate for Payer: Aetna Medicare Advantage	$216.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.70
Rate for Payer: Cigna Commercial	$360.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: Qualcare PPO/HMO/WC	$108.06
Rate for Payer: UnitedHealthcare Community & State	$22.76
Rate for Payer: Wellpoint Medicaid Managed Care	$20.46

LENS INTRAOCCULAR17.5 DIOPTER

Facility

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270650651
Hospital Revenue Code	276
Min. Negotiated Rate	$108.06
Max. Negotiated Rate	$174.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: Qualcare PPO/HMO/WC	$108.06

LENS INTRAOCCULAR+18.0 DIOPTER

Facility

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270653275
Hospital Revenue Code	276
Min. Negotiated Rate	$20.46
Max. Negotiated Rate	$360.20
Rate for Payer: Aetna Commercial	$273.75
Rate for Payer: Aetna Medicare Advantage	$216.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.70
Rate for Payer: Cigna Commercial	$360.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: Qualcare PPO/HMO/WC	$108.06
Rate for Payer: UnitedHealthcare Community & State	$22.76
Rate for Payer: Wellpoint Medicaid Managed Care	$20.46

LENS INTRAOCCULAR+18.0 DIOPTER

Facility

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270653275
Hospital Revenue Code	276
Min. Negotiated Rate	$108.06
Max. Negotiated Rate	$174.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: Qualcare PPO/HMO/WC	$108.06

LENS INTRAOCCULAR 18.5 DIOPTER

Facility

$720.00

Service Code	HCPCS V2632
Hospital Charge Code	270686558
Hospital Revenue Code	276
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$174.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

LENS INTRAOCCULAR 18.5 DIOPTER

Facility

$720.40

Hospital Charge Code	270655341
Hospital Revenue Code	276
Min. Negotiated Rate	$108.06
Max. Negotiated Rate	$174.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: Qualcare PPO/HMO/WC	$108.06

LENS INTRAOCCULAR 18.5 DIOPTER

Facility

$720.40

Hospital Charge Code	270655341
Hospital Revenue Code	276
Min. Negotiated Rate	$20.46
Max. Negotiated Rate	$360.20
Rate for Payer: Aetna Commercial	$273.75
Rate for Payer: Aetna Medicare Advantage	$216.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.70
Rate for Payer: Cigna Commercial	$360.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: Qualcare PPO/HMO/WC	$108.06
Rate for Payer: UnitedHealthcare Community & State	$22.76
Rate for Payer: Wellpoint Medicaid Managed Care	$20.46

LENS INTRAOCCULAR 18.5 DIOPTER

Facility

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270653317
Hospital Revenue Code	276
Min. Negotiated Rate	$46.10
Max. Negotiated Rate	$811.62
Rate for Payer: Aetna Commercial	$616.84
Rate for Payer: Aetna Medicare Advantage	$486.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$413.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$413.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$413.93
Rate for Payer: Cigna Commercial	$811.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.83
Rate for Payer: Qualcare PPO/HMO/WC	$243.49
Rate for Payer: UnitedHealthcare Community & State	$51.29
Rate for Payer: Wellpoint Medicaid Managed Care	$46.10

LENS INTRAOCCULAR 18.5 DIOPTER

Facility

$720.00

Service Code	HCPCS V2632
Hospital Charge Code	270686558
Hospital Revenue Code	276
Min. Negotiated Rate	$20.45
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$273.60
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: Qualcare PPO/HMO/WC	$108.00
Rate for Payer: UnitedHealthcare Community & State	$22.75
Rate for Payer: Wellpoint Medicaid Managed Care	$20.45

LENS INTRAOCCULAR 18.5 DIOPTER

Facility

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270653317
Hospital Revenue Code	276
Min. Negotiated Rate	$243.49
Max. Negotiated Rate	$392.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.83
Rate for Payer: Qualcare PPO/HMO/WC	$243.49

LENS INTRAOCCULAR+18.5 DIOPTER

Facility

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270653282
Hospital Revenue Code	276
Min. Negotiated Rate	$108.06
Max. Negotiated Rate	$174.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: Qualcare PPO/HMO/WC	$108.06

LENS INTRAOCCULAR+18.5 DIOPTER

Facility

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270653282
Hospital Revenue Code	276
Min. Negotiated Rate	$20.46
Max. Negotiated Rate	$360.20
Rate for Payer: Aetna Commercial	$273.75
Rate for Payer: Aetna Medicare Advantage	$216.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.70
Rate for Payer: Cigna Commercial	$360.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: Qualcare PPO/HMO/WC	$108.06
Rate for Payer: UnitedHealthcare Community & State	$22.76
Rate for Payer: Wellpoint Medicaid Managed Care	$20.46

LENS INTRAOCCULAR 19.0 DIO

Facility

$1,748.70

Service Code	HCPCS V2632
Hospital Charge Code	270653318
Hospital Revenue Code	276
Min. Negotiated Rate	$49.66
Max. Negotiated Rate	$874.35
Rate for Payer: Aetna Commercial	$664.51
Rate for Payer: Aetna Medicare Advantage	$524.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$445.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$445.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$445.92
Rate for Payer: Cigna Commercial	$874.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.19
Rate for Payer: Qualcare PPO/HMO/WC	$262.31
Rate for Payer: UnitedHealthcare Community & State	$55.26
Rate for Payer: Wellpoint Medicaid Managed Care	$49.66

LENS INTRAOCCULAR 19.0 DIO

Facility

$1,748.70

Service Code	HCPCS V2632
Hospital Charge Code	270653318
Hospital Revenue Code	276
Min. Negotiated Rate	$262.31
Max. Negotiated Rate	$423.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.19
Rate for Payer: Qualcare PPO/HMO/WC	$262.31

LENS INTRAOCCULAR 19.5 DIO

Facility

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270653319
Hospital Revenue Code	276
Min. Negotiated Rate	$243.49
Max. Negotiated Rate	$392.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.83
Rate for Payer: Qualcare PPO/HMO/WC	$243.49

LENS INTRAOCCULAR 19.5 DIO

Facility

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270653319
Hospital Revenue Code	276
Min. Negotiated Rate	$46.10
Max. Negotiated Rate	$811.62
Rate for Payer: Aetna Commercial	$616.84
Rate for Payer: Aetna Medicare Advantage	$486.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$413.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$413.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$413.93
Rate for Payer: Cigna Commercial	$811.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.83
Rate for Payer: Qualcare PPO/HMO/WC	$243.49
Rate for Payer: UnitedHealthcare Community & State	$51.29
Rate for Payer: Wellpoint Medicaid Managed Care	$46.10

LENS INTRAOCCULAR+19.5 DIOPTER

Facility

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270650860
Hospital Revenue Code	276
Min. Negotiated Rate	$20.46
Max. Negotiated Rate	$360.20
Rate for Payer: Aetna Commercial	$273.75
Rate for Payer: Aetna Medicare Advantage	$216.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.70
Rate for Payer: Cigna Commercial	$360.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.34
Rate for Payer: Qualcare PPO/HMO/WC	$108.06
Rate for Payer: UnitedHealthcare Community & State	$22.76
Rate for Payer: Wellpoint Medicaid Managed Care	$20.46

Know your out-of-pocket cost for care.

All Charges