Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LENS INTRAOCULAR 26 5 DIOPTER

Facility

$745.00

Service Code	HCPCS V2632
Hospital Charge Code	270695623
Hospital Revenue Code	276
Min. Negotiated Rate	$21.16
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$283.10
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Community & State	$23.54
Rate for Payer: Wellpoint Medicaid Managed Care	$21.16

LENS INTRAOCULAR 26.5 DIPOLTER

Facility

$745.00

Service Code	HCPCS V2632
Hospital Charge Code	270678584
Hospital Revenue Code	276
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$180.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

LENS INTRAOCULAR 26.5 DIPOLTER

Facility

$745.00

Service Code	HCPCS V2632
Hospital Charge Code	270678584
Hospital Revenue Code	276
Min. Negotiated Rate	$21.16
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$283.10
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Community & State	$23.54
Rate for Payer: Wellpoint Medicaid Managed Care	$21.16

LENS INTRAOCULAR 27.0 DIOPTER

Facility

$745.00

Service Code	HCPCS V2632
Hospital Charge Code	270695624
Hospital Revenue Code	276
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$180.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

LENS INTRAOCULAR 27.0 DIOPTER

Facility

$670.00

Service Code	HCPCS V2632
Hospital Charge Code	270653274
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 INTRAOCULAR 27.0 DIOPTER

Facility

$745.00

Service Code	HCPCS V2632
Hospital Charge Code	270695624
Hospital Revenue Code	276
Min. Negotiated Rate	$21.16
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$283.10
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Community & State	$23.54
Rate for Payer: Wellpoint Medicaid Managed Care	$21.16

LENS INTRAOCULAR 27.0 DIOPTER

Facility

$670.00

Service Code	HCPCS V2632
Hospital Charge Code	270653274
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 INTRAOCULAR 27.5 DIOPTER

Facility

$745.00

Service Code	HCPCS V2632
Hospital Charge Code	270695625
Hospital Revenue Code	276
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$180.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

LENS INTRAOCULAR 27.5 DIOPTER

Facility

$745.00

Service Code	HCPCS V2632
Hospital Charge Code	270695625
Hospital Revenue Code	276
Min. Negotiated Rate	$21.16
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$283.10
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Community & State	$23.54
Rate for Payer: Wellpoint Medicaid Managed Care	$21.16

LENS INTRAOCULAR 28.0 DIOPTER

Facility

$750.00

Service Code	HCPCS V2632
Hospital Charge Code	270653308
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 INTRAOCULAR 28.0 DIOPTER

Facility

$745.00

Service Code	HCPCS V2632
Hospital Charge Code	270695626
Hospital Revenue Code	276
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$180.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

LENS INTRAOCULAR 28.0 DIOPTER

Facility

$750.00

Service Code	HCPCS V2632
Hospital Charge Code	270653308
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 INTRAOCULAR 28.0 DIOPTER

Facility

$745.00

Service Code	HCPCS V2632
Hospital Charge Code	270695626
Hospital Revenue Code	276
Min. Negotiated Rate	$21.16
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$283.10
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Community & State	$23.54
Rate for Payer: Wellpoint Medicaid Managed Care	$21.16

LENS INTRAOCULAR 28.5 DIOPTER

Facility

$745.00

Service Code	HCPCS V2632
Hospital Charge Code	270695627
Hospital Revenue Code	276
Min. Negotiated Rate	$21.16
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$283.10
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Community & State	$23.54
Rate for Payer: Wellpoint Medicaid Managed Care	$21.16

LENS INTRAOCULAR 28.5 DIOPTER

Facility

$745.00

Service Code	HCPCS V2632
Hospital Charge Code	270695627
Hospital Revenue Code	276
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$180.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

LENS INTRAOCULAR 28.5 DIOPTER

Facility

$745.00

Service Code	HCPCS V2632
Hospital Charge Code	270662312
Hospital Revenue Code	276
Min. Negotiated Rate	$21.16
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$283.10
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Community & State	$23.54
Rate for Payer: Wellpoint Medicaid Managed Care	$21.16

LENS INTRAOCULAR 28.5 DIOPTER

Facility

$745.00

Service Code	HCPCS V2632
Hospital Charge Code	270662312
Hospital Revenue Code	276
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$180.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

LENS INTRAOCULAR 29.0 DIOPTER

Facility

$745.00

Service Code	HCPCS V2632
Hospital Charge Code	270695628
Hospital Revenue Code	276
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$180.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

LENS INTRAOCULAR 29.0 DIOPTER

Facility

$745.00

Service Code	HCPCS V2632
Hospital Charge Code	270695628
Hospital Revenue Code	276
Min. Negotiated Rate	$21.16
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$283.10
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Community & State	$23.54
Rate for Payer: Wellpoint Medicaid Managed Care	$21.16

LENS INTRAOCULAR 29.5 DIOPTER

Facility

$745.00

Service Code	HCPCS V2632
Hospital Charge Code	270695629
Hospital Revenue Code	276
Min. Negotiated Rate	$21.16
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$283.10
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Community & State	$23.54
Rate for Payer: Wellpoint Medicaid Managed Care	$21.16

LENS INTRAOCULAR 29.5 DIOPTER

Facility

$745.00

Service Code	HCPCS V2632
Hospital Charge Code	270695629
Hospital Revenue Code	276
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$180.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

LENS INTRAOCULAR 30.0 DIOPTER

Facility

$745.00

Service Code	HCPCS V2632
Hospital Charge Code	270695630
Hospital Revenue Code	276
Min. Negotiated Rate	$21.16
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$283.10
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Community & State	$23.54
Rate for Payer: Wellpoint Medicaid Managed Care	$21.16

LENS INTRAOCULAR 30.0 DIOPTER

Facility

$745.00

Service Code	HCPCS V2632
Hospital Charge Code	270695630
Hospital Revenue Code	276
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$180.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

LENS INTRAOCULAR 5.0

Facility

$425.00

Hospital Charge Code	270602609
Hospital Revenue Code	276
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$102.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

LENS INTRAOCULAR 5.0

Facility

$425.00

Hospital Charge Code	270602609
Hospital Revenue Code	276
Min. Negotiated Rate	$12.07
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Community & State	$13.43
Rate for Payer: Wellpoint Medicaid Managed Care	$12.07

Know your out-of-pocket cost for care.

All Charges