Heights University Hospital

All Charges

Charge

Type

Setting

Price

MESH 3D MID MED LT 3.1X5.3IN

Facility

$412.89

Service Code	HCPCS C1781
Hospital Charge Code	270695723
Hospital Revenue Code	278
Min. Negotiated Rate	$61.93
Max. Negotiated Rate	$206.44
Rate for Payer: Aetna Commercial	$123.87
Rate for Payer: Aetna Medicare Advantage	$123.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.29
Rate for Payer: Cigna Commercial	$206.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.92
Rate for Payer: Qualcare PPO/HMO/WC	$61.93

MESH 3D MID MED LT 3.1X5.3IN

Facility

$412.89

Service Code	HCPCS C1781
Hospital Charge Code	270695723
Hospital Revenue Code	278
Min. Negotiated Rate	$61.93
Max. Negotiated Rate	$99.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.92
Rate for Payer: Qualcare PPO/HMO/WC	$61.93

MESH 3D MID RIGHT XL

Facility

$2,285.00

Service Code	HCPCS C1781
Hospital Charge Code	270694710
Hospital Revenue Code	278
Min. Negotiated Rate	$342.75
Max. Negotiated Rate	$1,142.50
Rate for Payer: Aetna Commercial	$685.50
Rate for Payer: Aetna Medicare Advantage	$685.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$582.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$582.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$457.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$582.67
Rate for Payer: Cigna Commercial	$1,142.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.97
Rate for Payer: Qualcare PPO/HMO/WC	$342.75

MESH 3D MID RIGHT XL

Facility

$2,285.00

Service Code	HCPCS C1781
Hospital Charge Code	270694710
Hospital Revenue Code	278
Min. Negotiated Rate	$342.75
Max. Negotiated Rate	$552.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$457.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.97
Rate for Payer: Qualcare PPO/HMO/WC	$342.75

MESH 6.1x10.1 OVAL 0010219

Facility

$10,500.00

Service Code	HCPCS C1781
Hospital Charge Code	270647200
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

MESH 6.1x10.1 OVAL 0010219

Facility

$10,500.00

Service Code	HCPCS C1781
Hospital Charge Code	270647200
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,150.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

MESH APOG W/ INTERPRO 72404025

Facility

$6,975.00

Hospital Charge Code	270634315
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,687.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

MESH APOG W/ INTERPRO 72404025

Facility

$6,975.00

Hospital Charge Code	270634315
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,092.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

MESH BARD COMPOSIT 10X14

Facility

$9,625.00

Hospital Charge Code	270657719
Hospital Revenue Code	278
Min. Negotiated Rate	$1,443.75
Max. Negotiated Rate	$2,329.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,329.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,443.75

MESH BARD COMPOSIT 10X14

Facility

$9,625.00

Hospital Charge Code	270657719
Hospital Revenue Code	278
Min. Negotiated Rate	$1,443.75
Max. Negotiated Rate	$4,812.50
Rate for Payer: Aetna Commercial	$2,887.50
Rate for Payer: Aetna Medicare Advantage	$2,887.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,454.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,454.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,454.38
Rate for Payer: Cigna Commercial	$4,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,329.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,443.75

MESH BILAYER 4x5INTEGRA/SQCMJW

Facility

$952.50

Hospital Charge Code	270648773W
Hospital Revenue Code	636
Min. Negotiated Rate	$142.88
Max. Negotiated Rate	$230.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.50
Rate for Payer: Qualcare PPO/HMO/WC	$142.88

MESH BILAYER 4x5INTEGRA/SQCMJW

Facility

$952.50

Hospital Charge Code	270648773W
Hospital Revenue Code	636
Min. Negotiated Rate	$142.88
Max. Negotiated Rate	$476.25
Rate for Payer: Aetna Commercial	$285.75
Rate for Payer: Aetna Medicare Advantage	$285.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.89
Rate for Payer: Cigna Commercial	$476.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.50
Rate for Payer: Qualcare PPO/HMO/WC	$142.88

MESH BILAYER GRAFT 2x2IN

Facility

$9,555.00

Service Code	HCPCS Q4104
Hospital Charge Code	270648094
Hospital Revenue Code	278
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$2,866.50
Rate for Payer: Aetna Commercial	$2,866.50
Rate for Payer: Aetna Medicare Advantage	$2,866.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,436.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,436.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,911.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,436.53
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,312.31
Rate for Payer: Qualcare PPO/HMO/WC	$1,433.25

MESH BILAYER GRAFT 2x2IN

Facility

$9,555.00

Service Code	HCPCS Q4104
Hospital Charge Code	270648094
Hospital Revenue Code	278
Min. Negotiated Rate	$1,433.25
Max. Negotiated Rate	$2,312.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,911.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,312.31
Rate for Payer: Qualcare PPO/HMO/WC	$1,433.25

MESH BIO-A TISSU 8 CM X8 CM

Facility

$2,005.00

Service Code	HCPCS C1781
Hospital Charge Code	270683492
Hospital Revenue Code	278
Min. Negotiated Rate	$300.75
Max. Negotiated Rate	$485.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$401.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$485.21
Rate for Payer: Qualcare PPO/HMO/WC	$300.75

MESH BIO-A TISSU 8 CM X8 CM

Facility

$2,005.00

Service Code	HCPCS C1781
Hospital Charge Code	270683492
Hospital Revenue Code	278
Min. Negotiated Rate	$300.75
Max. Negotiated Rate	$1,002.50
Rate for Payer: Aetna Commercial	$601.50
Rate for Payer: Aetna Medicare Advantage	$601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$511.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$511.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$401.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$511.27
Rate for Payer: Cigna Commercial	$1,002.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$485.21
Rate for Payer: Qualcare PPO/HMO/WC	$300.75

MESH BIOD HERN PRESHAPE 7X10-U

Facility

$10,242.10

Service Code	HCPCS C1763
Hospital Charge Code	270692874
Hospital Revenue Code	278
Min. Negotiated Rate	$1,536.32
Max. Negotiated Rate	$5,121.05
Rate for Payer: Aetna Commercial	$3,072.63
Rate for Payer: Aetna Medicare Advantage	$3,072.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,611.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,611.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,048.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,611.74
Rate for Payer: Cigna Commercial	$5,121.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,478.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,536.32

MESH BIOD HERN PRESHAPE 7X10-U

Facility

$10,242.10

Service Code	HCPCS C1763
Hospital Charge Code	270692874
Hospital Revenue Code	278
Min. Negotiated Rate	$1,536.32
Max. Negotiated Rate	$2,478.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,048.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,478.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,536.32

MESH BIOD HIAT HERN STD 7X10ST

Facility

$10,242.10

Service Code	HCPCS C1763
Hospital Charge Code	270692875
Hospital Revenue Code	278
Min. Negotiated Rate	$1,536.32
Max. Negotiated Rate	$5,121.05
Rate for Payer: Aetna Commercial	$3,072.63
Rate for Payer: Aetna Medicare Advantage	$3,072.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,611.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,611.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,048.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,611.74
Rate for Payer: Cigna Commercial	$5,121.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,478.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,536.32

MESH BIOD HIAT HERN STD 7X10ST

Facility

$10,242.10

Service Code	HCPCS C1763
Hospital Charge Code	270692875
Hospital Revenue Code	278
Min. Negotiated Rate	$1,536.32
Max. Negotiated Rate	$2,478.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,048.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,478.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,536.32

MESH CIRCLE 6 IN VENTRALIGHT

Facility

$5,594.00

Service Code	HCPCS C1781
Hospital Charge Code	270690921
Hospital Revenue Code	278
Min. Negotiated Rate	$839.10
Max. Negotiated Rate	$1,353.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,118.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,353.75
Rate for Payer: Qualcare PPO/HMO/WC	$839.10

MESH CIRCLE 6 IN VENTRALIGHT

Facility

$5,594.00

Service Code	HCPCS C1781
Hospital Charge Code	270690921
Hospital Revenue Code	278
Min. Negotiated Rate	$839.10
Max. Negotiated Rate	$2,797.00
Rate for Payer: Aetna Commercial	$1,678.20
Rate for Payer: Aetna Medicare Advantage	$1,678.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,426.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,426.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,118.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,426.47
Rate for Payer: Cigna Commercial	$2,797.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,353.75
Rate for Payer: Qualcare PPO/HMO/WC	$839.10

MESH CIRCLE 8 IN VENTRALIGHT

Facility

$9,251.00

Service Code	HCPCS C1781
Hospital Charge Code	270690922
Hospital Revenue Code	278
Min. Negotiated Rate	$1,387.65
Max. Negotiated Rate	$2,238.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.65

MESH CIRCLE 8 IN VENTRALIGHT

Facility

$9,251.00

Service Code	HCPCS C1781
Hospital Charge Code	270690922
Hospital Revenue Code	278
Min. Negotiated Rate	$1,387.65
Max. Negotiated Rate	$4,625.50
Rate for Payer: Aetna Commercial	$2,775.30
Rate for Payer: Aetna Medicare Advantage	$2,775.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,359.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,359.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,359.01
Rate for Payer: Cigna Commercial	$4,625.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.65

MESH CMT DERMATRIX 72403671

Facility

$2,232.00

Hospital Charge Code	270628319
Hospital Revenue Code	278
Min. Negotiated Rate	$334.80
Max. Negotiated Rate	$540.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$446.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$540.14
Rate for Payer: Qualcare PPO/HMO/WC	$334.80

Know your out-of-pocket cost for care.

All Charges