Heights University Hospital

All Charges

Charge

Type

Setting

Price

MESH CMT DERMATRIX 72403671

Facility

$2,232.00

Hospital Charge Code	270628319
Hospital Revenue Code	278
Min. Negotiated Rate	$334.80
Max. Negotiated Rate	$1,116.00
Rate for Payer: Aetna Commercial	$669.60
Rate for Payer: Aetna Medicare Advantage	$669.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$569.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$569.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$446.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$569.16
Rate for Payer: Cigna Commercial	$1,116.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$540.14
Rate for Payer: Qualcare PPO/HMO/WC	$334.80

MESH COMP KUG XL 10X13 0010207

Facility

$10,733.65

Hospital Charge Code	270630865
Hospital Revenue Code	278
Min. Negotiated Rate	$1,610.05
Max. Negotiated Rate	$2,597.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,146.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,597.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,610.05

MESH COMP KUG XL 10X13 0010207

Facility

$10,733.65

Hospital Charge Code	270630865
Hospital Revenue Code	278
Min. Negotiated Rate	$1,610.05
Max. Negotiated Rate	$5,366.82
Rate for Payer: Aetna Commercial	$3,220.09
Rate for Payer: Aetna Medicare Advantage	$3,220.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,737.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,737.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,146.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,737.08
Rate for Payer: Cigna Commercial	$5,366.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,597.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,610.05

MESH COMPOSIX 3 X 6 0113360

Facility

$2,068.85

Hospital Charge Code	270609157
Hospital Revenue Code	278
Min. Negotiated Rate	$310.33
Max. Negotiated Rate	$1,034.42
Rate for Payer: Aetna Commercial	$620.65
Rate for Payer: Aetna Medicare Advantage	$620.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$527.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$527.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$413.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$527.56
Rate for Payer: Cigna Commercial	$1,034.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$500.66
Rate for Payer: Qualcare PPO/HMO/WC	$310.33

MESH COMPOSIX 3 X 6 0113360

Facility

$2,068.85

Hospital Charge Code	270609157
Hospital Revenue Code	278
Min. Negotiated Rate	$310.33
Max. Negotiated Rate	$500.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$413.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$500.66
Rate for Payer: Qualcare PPO/HMO/WC	$310.33

MESH COMPOSIX 4x6 ELLIPTICAL

Facility

$2,511.50

Service Code	HCPCS C1781
Hospital Charge Code	270644629
Hospital Revenue Code	278
Min. Negotiated Rate	$376.73
Max. Negotiated Rate	$1,255.75
Rate for Payer: Aetna Commercial	$753.45
Rate for Payer: Aetna Medicare Advantage	$753.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$640.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$640.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$502.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$640.43
Rate for Payer: Cigna Commercial	$1,255.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$607.78
Rate for Payer: Qualcare PPO/HMO/WC	$376.73

MESH COMPOSIX 4x6 ELLIPTICAL

Facility

$2,511.50

Service Code	HCPCS C1781
Hospital Charge Code	270644629
Hospital Revenue Code	278
Min. Negotiated Rate	$376.73
Max. Negotiated Rate	$607.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$502.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$607.78
Rate for Payer: Qualcare PPO/HMO/WC	$376.73

MESH COMPOSIX 4 X 8 0113480

Facility

$3,218.45

Hospital Charge Code	270614252
Hospital Revenue Code	278
Min. Negotiated Rate	$482.77
Max. Negotiated Rate	$1,609.22
Rate for Payer: Aetna Commercial	$965.53
Rate for Payer: Aetna Medicare Advantage	$965.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$820.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$820.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$820.70
Rate for Payer: Cigna Commercial	$1,609.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.86
Rate for Payer: Qualcare PPO/HMO/WC	$482.77

MESH COMPOSIX 4 X 8 0113480

Facility

$3,218.45

Hospital Charge Code	270614252
Hospital Revenue Code	278
Min. Negotiated Rate	$482.77
Max. Negotiated Rate	$778.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.86
Rate for Payer: Qualcare PPO/HMO/WC	$482.77

MESH COMPOSIX 6 X 8 0113680

Facility

$3,936.35

Hospital Charge Code	270608983
Hospital Revenue Code	278
Min. Negotiated Rate	$590.45
Max. Negotiated Rate	$952.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.60
Rate for Payer: Qualcare PPO/HMO/WC	$590.45

MESH COMPOSIX 6 X 8 0113680

Facility

$3,936.35

Hospital Charge Code	270608983
Hospital Revenue Code	278
Min. Negotiated Rate	$590.45
Max. Negotiated Rate	$1,968.17
Rate for Payer: Aetna Commercial	$1,180.90
Rate for Payer: Aetna Medicare Advantage	$1,180.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,003.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,003.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,003.77
Rate for Payer: Cigna Commercial	$1,968.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.60
Rate for Payer: Qualcare PPO/HMO/WC	$590.45

MESH COMPOSIX 8 X 10 0113810

Facility

$7,638.75

Hospital Charge Code	270611937
Hospital Revenue Code	278
Min. Negotiated Rate	$1,145.81
Max. Negotiated Rate	$1,848.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,527.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,848.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,145.81

MESH COMPOSIX 8 X 10 0113810

Facility

$7,638.75

Hospital Charge Code	270611937
Hospital Revenue Code	278
Min. Negotiated Rate	$1,145.81
Max. Negotiated Rate	$3,819.38
Rate for Payer: Aetna Commercial	$2,291.62
Rate for Payer: Aetna Medicare Advantage	$2,291.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,947.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,947.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,527.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,947.88
Rate for Payer: Cigna Commercial	$3,819.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,848.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,145.81

MESH COMPOSIX KUGEL 0010209

Facility

$8,184.00

Hospital Charge Code	270630866
Hospital Revenue Code	278
Min. Negotiated Rate	$1,227.60
Max. Negotiated Rate	$1,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,636.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,227.60

MESH COMPOSIX KUGEL 0010209

Facility

$8,184.00

Hospital Charge Code	270630866
Hospital Revenue Code	278
Min. Negotiated Rate	$1,227.60
Max. Negotiated Rate	$4,092.00
Rate for Payer: Aetna Commercial	$2,455.20
Rate for Payer: Aetna Medicare Advantage	$2,455.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,086.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,086.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,636.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,086.92
Rate for Payer: Cigna Commercial	$4,092.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,227.60

MESH COMPOSIX LP ELLIPSE 6x8

Facility

$5,288.00

Service Code	HCPCS C1781
Hospital Charge Code	270643867
Hospital Revenue Code	278
Min. Negotiated Rate	$793.20
Max. Negotiated Rate	$1,279.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,057.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,279.70
Rate for Payer: Qualcare PPO/HMO/WC	$793.20

MESH COMPOSIX LP ELLIPSE 6x8

Facility

$5,288.00

Service Code	HCPCS C1781
Hospital Charge Code	270643867
Hospital Revenue Code	278
Min. Negotiated Rate	$793.20
Max. Negotiated Rate	$2,644.00
Rate for Payer: Aetna Commercial	$1,586.40
Rate for Payer: Aetna Medicare Advantage	$1,586.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,348.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,348.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,057.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,348.44
Rate for Payer: Cigna Commercial	$2,644.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,279.70
Rate for Payer: Qualcare PPO/HMO/WC	$793.20

MESH COMPOSIX PS 6.2x8.2

Facility

$6,825.55

Service Code	HCPCS C1781
Hospital Charge Code	270647905
Hospital Revenue Code	278
Min. Negotiated Rate	$1,023.83
Max. Negotiated Rate	$1,651.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,365.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,651.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.83

MESH COMPOSIX PS 6.2x8.2

Facility

$6,825.55

Service Code	HCPCS C1781
Hospital Charge Code	270647905
Hospital Revenue Code	278
Min. Negotiated Rate	$1,023.83
Max. Negotiated Rate	$3,412.78
Rate for Payer: Aetna Commercial	$2,047.66
Rate for Payer: Aetna Medicare Advantage	$2,047.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,740.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,740.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,365.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,740.52
Rate for Payer: Cigna Commercial	$3,412.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,651.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.83

MESH COMPOSIX PS 8.2x10.2

Facility

$10,719.40

Hospital Charge Code	270647920
Hospital Revenue Code	278
Min. Negotiated Rate	$1,607.91
Max. Negotiated Rate	$5,359.70
Rate for Payer: Aetna Commercial	$3,215.82
Rate for Payer: Aetna Medicare Advantage	$3,215.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,733.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,733.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,143.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,733.45
Rate for Payer: Cigna Commercial	$5,359.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,594.09
Rate for Payer: Qualcare PPO/HMO/WC	$1,607.91

MESH COMPOSIX PS 8.2x10.2

Facility

$10,719.40

Hospital Charge Code	270647920
Hospital Revenue Code	278
Min. Negotiated Rate	$1,607.91
Max. Negotiated Rate	$2,594.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,143.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,594.09
Rate for Payer: Qualcare PPO/HMO/WC	$1,607.91

MESH C-QUAR 8X12

Facility

$5,577.50

Hospital Charge Code	270647407
Hospital Revenue Code	278
Min. Negotiated Rate	$836.62
Max. Negotiated Rate	$2,788.75
Rate for Payer: Aetna Commercial	$1,673.25
Rate for Payer: Aetna Medicare Advantage	$1,673.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,422.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,422.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,115.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,422.26
Rate for Payer: Cigna Commercial	$2,788.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,349.76
Rate for Payer: Qualcare PPO/HMO/WC	$836.62

MESH C-QUAR 8X12

Facility

$5,577.50

Hospital Charge Code	270647407
Hospital Revenue Code	278
Min. Negotiated Rate	$836.62
Max. Negotiated Rate	$1,349.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,115.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,349.76
Rate for Payer: Qualcare PPO/HMO/WC	$836.62

MESH C-QUR 3X6

Facility

$1,324.05

Service Code	HCPCS C1781
Hospital Charge Code	270657915
Hospital Revenue Code	278
Min. Negotiated Rate	$198.61
Max. Negotiated Rate	$320.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.42
Rate for Payer: Qualcare PPO/HMO/WC	$198.61

MESH C-QUR 3X6

Facility

$1,324.05

Service Code	HCPCS C1781
Hospital Charge Code	270657915
Hospital Revenue Code	278
Min. Negotiated Rate	$198.61
Max. Negotiated Rate	$662.02
Rate for Payer: Aetna Commercial	$397.21
Rate for Payer: Aetna Medicare Advantage	$397.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.63
Rate for Payer: Cigna Commercial	$662.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.42
Rate for Payer: Qualcare PPO/HMO/WC	$198.61

Know your out-of-pocket cost for care.

All Charges