Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

LENS INTRAOCCULAR 24.0 DIOPTER

Facility

IP

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270653328
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+24.0 DIOPTER

Facility

IP

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270650869
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+24.0 DIOPTER

Facility

OP

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270650869
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 INTRAOCCULAR24.5 DIO FOLD

Facility

IP

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270650644
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 INTRAOCCULAR24.5 DIO FOLD

Facility

OP

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270650644
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 24.5 DIOPTER

Facility

IP

$1,548.25

Service Code	HCPCS V2632
Hospital Charge Code	270661735
Hospital Revenue Code	276
Min. Negotiated Rate	$232.24
Max. Negotiated Rate	$374.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$374.68
Rate for Payer: Qualcare PPO/HMO/WC	$232.24

LENS INTRAOCCULAR 24.5 DIOPTER

Facility

IP

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270653302
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 24.5 DIOPTER

Facility

IP

$720.40

Hospital Charge Code	661735
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 24.5 DIOPTER

Facility

OP

$720.40

Hospital Charge Code	661735
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 24.5 DIOPTER

Facility

OP

$1,548.25

Service Code	HCPCS V2632
Hospital Charge Code	270661735
Hospital Revenue Code	276
Min. Negotiated Rate	$43.97
Max. Negotiated Rate	$774.12
Rate for Payer: Aetna Commercial	$588.34
Rate for Payer: Aetna Medicare Advantage	$464.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.80
Rate for Payer: Cigna Commercial	$774.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$374.68
Rate for Payer: Qualcare PPO/HMO/WC	$232.24
Rate for Payer: UnitedHealthcare Community & State	$48.92
Rate for Payer: Wellpoint Medicaid Managed Care	$43.97

LENS INTRAOCCULAR 24.5 DIOPTER

Facility

OP

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270653302
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 25.0 DIOPTER

Facility

IP

$1,748.70

Service Code	HCPCS V2632
Hospital Charge Code	270653306
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 25.0 DIOPTER

Facility

OP

$1,748.70

Service Code	HCPCS V2632
Hospital Charge Code	270653306
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 25.0 DIOPTER

Facility

IP

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270661736
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 25.0 DIOPTER

Facility

OP

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270661736
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+25.5 DIOPTER

Facility

IP

$670.00

Service Code	HCPCS V2632
Hospital Charge Code	270650875
Hospital Revenue Code	276
Min. Negotiated Rate	$100.50
Max. Negotiated Rate	$162.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.50

LENS INTRAOCCULAR+25.5 DIOPTER

Facility

OP

$670.00

Service Code	HCPCS V2632
Hospital Charge Code	270650875
Hospital Revenue Code	276
Min. Negotiated Rate	$19.03
Max. Negotiated Rate	$335.00
Rate for Payer: Aetna Commercial	$254.60
Rate for Payer: Aetna Medicare Advantage	$201.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.85
Rate for Payer: Cigna Commercial	$335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.50
Rate for Payer: UnitedHealthcare Community & State	$21.17
Rate for Payer: Wellpoint Medicaid Managed Care	$19.03

LENS INTRAOCCULAR 26.0 DIOPTER

Facility

IP

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270653307
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 26.0 DIOPTER

Facility

OP

$1,623.25

Service Code	HCPCS V2632
Hospital Charge Code	270653307
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+26.0 DIOPTER

Facility

IP

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270653277
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+26.0 DIOPTER

Facility

OP

$720.40

Service Code	HCPCS V2632
Hospital Charge Code	270653277
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 26.5 DIOPTER

Facility

OP

$750.00

Service Code	HCPCS V2632
Hospital Charge Code	270653329
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 26.5 DIOPTER

Facility

IP

$750.00

Service Code	HCPCS V2632
Hospital Charge Code	270653329
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 28.00

Facility

IP

$720.40

Hospital Charge Code	270670027
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 28.00

Facility

OP

$720.40

Hospital Charge Code	270670027
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