Heights University Hospital

All Charges

Charge

Type

Setting

Price

MESH MALLEABLE L/PRO 100x100MM

Facility

$13,430.00

Hospital Charge Code	270660972
Hospital Revenue Code	278
Min. Negotiated Rate	$2,014.50
Max. Negotiated Rate	$3,250.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,686.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,250.06
Rate for Payer: Qualcare PPO/HMO/WC	$2,014.50

MESH MARLEX **********

Facility

$655.00

Hospital Charge Code	1601251
Hospital Revenue Code	272
Min. Negotiated Rate	$85.15
Max. Negotiated Rate	$327.50
Rate for Payer: Aetna Commercial	$196.50
Rate for Payer: Aetna Medicare Advantage	$196.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.03
Rate for Payer: Cigna Commercial	$327.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.15
Rate for Payer: Oxford Commercial	$327.50
Rate for Payer: Qualcare PPO/HMO/WC	$98.25
Rate for Payer: UnitedHealthcare Commercial	$327.50

MESH MARLEX **********

Facility

$655.00

Hospital Charge Code	1601251
Hospital Revenue Code	272
Min. Negotiated Rate	$98.25
Max. Negotiated Rate	$98.25
Rate for Payer: Qualcare PPO/HMO/WC	$98.25

MESH MARLEX 10 X 14 011266

Facility

$1,956.00

Hospital Charge Code	270061030
Hospital Revenue Code	278
Min. Negotiated Rate	$293.40
Max. Negotiated Rate	$978.00
Rate for Payer: Aetna Commercial	$586.80
Rate for Payer: Aetna Medicare Advantage	$586.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$498.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$498.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$391.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$498.78
Rate for Payer: Cigna Commercial	$978.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$473.35
Rate for Payer: Qualcare PPO/HMO/WC	$293.40

MESH MARLEX 10 X 14 011266

Facility

$1,956.00

Hospital Charge Code	270061030
Hospital Revenue Code	278
Min. Negotiated Rate	$293.40
Max. Negotiated Rate	$473.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$391.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$473.35
Rate for Payer: Qualcare PPO/HMO/WC	$293.40

MESH MARLEX 10x14 0112660

Facility

$697.50

Service Code	HCPCS C1781
Hospital Charge Code	270626940
Hospital Revenue Code	278
Min. Negotiated Rate	$104.62
Max. Negotiated Rate	$348.75
Rate for Payer: Aetna Commercial	$209.25
Rate for Payer: Aetna Medicare Advantage	$209.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.86
Rate for Payer: Cigna Commercial	$348.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.79
Rate for Payer: Qualcare PPO/HMO/WC	$104.62

MESH MARLEX 10x14 0112660

Facility

$697.50

Service Code	HCPCS C1781
Hospital Charge Code	270626940
Hospital Revenue Code	278
Min. Negotiated Rate	$104.62
Max. Negotiated Rate	$168.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.79
Rate for Payer: Qualcare PPO/HMO/WC	$104.62

MESH MARLEX 3 X 6 *******

Facility

$449.00

Hospital Charge Code	1605617
Hospital Revenue Code	272
Min. Negotiated Rate	$67.35
Max. Negotiated Rate	$67.35
Rate for Payer: Qualcare PPO/HMO/WC	$67.35

MESH MARLEX 3 X 6 *******

Facility

$449.00

Hospital Charge Code	1605617
Hospital Revenue Code	272
Min. Negotiated Rate	$58.37
Max. Negotiated Rate	$224.50
Rate for Payer: Aetna Commercial	$134.70
Rate for Payer: Aetna Medicare Advantage	$134.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.50
Rate for Payer: Cigna Commercial	$224.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.37
Rate for Payer: Oxford Commercial	$224.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.35
Rate for Payer: UnitedHealthcare Commercial	$224.50

MESH MARLEX 6 X 6 *******

Facility

$548.00

Hospital Charge Code	1605609
Hospital Revenue Code	272
Min. Negotiated Rate	$82.20
Max. Negotiated Rate	$82.20
Rate for Payer: Qualcare PPO/HMO/WC	$82.20

MESH MARLEX 6 X 6 *******

Facility

$548.00

Hospital Charge Code	1605609
Hospital Revenue Code	272
Min. Negotiated Rate	$71.24
Max. Negotiated Rate	$274.00
Rate for Payer: Aetna Commercial	$164.40
Rate for Payer: Aetna Medicare Advantage	$164.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.74
Rate for Payer: Cigna Commercial	$274.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.24
Rate for Payer: Oxford Commercial	$274.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.20
Rate for Payer: UnitedHealthcare Commercial	$274.00

MESH MARLEX 6 X 6 011272

Facility

$828.85

Service Code	HCPCS C1781
Hospital Charge Code	270600418
Hospital Revenue Code	278
Min. Negotiated Rate	$124.33
Max. Negotiated Rate	$200.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.58
Rate for Payer: Qualcare PPO/HMO/WC	$124.33

MESH MARLEX 6 X 6 011272

Facility

$828.85

Service Code	HCPCS C1781
Hospital Charge Code	270600418
Hospital Revenue Code	278
Min. Negotiated Rate	$124.33
Max. Negotiated Rate	$414.43
Rate for Payer: Aetna Commercial	$248.66
Rate for Payer: Aetna Medicare Advantage	$248.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.36
Rate for Payer: Cigna Commercial	$414.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.58
Rate for Payer: Qualcare PPO/HMO/WC	$124.33

MESH MARLEX PLUG PERFIX LARGE

Facility

$1,293.50

Hospital Charge Code	270654347
Hospital Revenue Code	278
Min. Negotiated Rate	$194.03
Max. Negotiated Rate	$313.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$258.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.03
Rate for Payer: Qualcare PPO/HMO/WC	$194.03

MESH MARLEX PLUG PERFIX LARGE

Facility

$1,293.50

Hospital Charge Code	270654347
Hospital Revenue Code	278
Min. Negotiated Rate	$194.03
Max. Negotiated Rate	$646.75
Rate for Payer: Aetna Commercial	$388.05
Rate for Payer: Aetna Medicare Advantage	$388.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$329.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$329.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$258.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$329.84
Rate for Payer: Cigna Commercial	$646.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.03
Rate for Payer: Qualcare PPO/HMO/WC	$194.03

MESH MARLEX PLUG PERFIX SMALL

Facility

$2,535.50

Service Code	HCPCS C1781
Hospital Charge Code	270657712
Hospital Revenue Code	278
Min. Negotiated Rate	$380.32
Max. Negotiated Rate	$613.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$507.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$613.59
Rate for Payer: Qualcare PPO/HMO/WC	$380.32

MESH MARLEX PLUG PERFIX SMALL

Facility

$2,535.50

Service Code	HCPCS C1781
Hospital Charge Code	270657712
Hospital Revenue Code	278
Min. Negotiated Rate	$380.32
Max. Negotiated Rate	$1,267.75
Rate for Payer: Aetna Commercial	$760.65
Rate for Payer: Aetna Medicare Advantage	$760.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$646.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$646.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$507.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$646.55
Rate for Payer: Cigna Commercial	$1,267.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$613.59
Rate for Payer: Qualcare PPO/HMO/WC	$380.32

MESH MARLEX PLUG XL

Facility

$1,698.50

Service Code	HCPCS C1781
Hospital Charge Code	270653977
Hospital Revenue Code	278
Min. Negotiated Rate	$254.78
Max. Negotiated Rate	$849.25
Rate for Payer: Aetna Commercial	$509.55
Rate for Payer: Aetna Medicare Advantage	$509.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$433.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$433.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$339.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$433.12
Rate for Payer: Cigna Commercial	$849.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.04
Rate for Payer: Qualcare PPO/HMO/WC	$254.78

MESH MARLEX PLUG XL

Facility

$1,698.50

Service Code	HCPCS C1781
Hospital Charge Code	270653977
Hospital Revenue Code	278
Min. Negotiated Rate	$254.78
Max. Negotiated Rate	$411.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$339.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.04
Rate for Payer: Qualcare PPO/HMO/WC	$254.78

MESH MAX 3D LEFT 10.8CM X 16CM

Facility

$1,169.05

Hospital Charge Code	270657165
Hospital Revenue Code	278
Min. Negotiated Rate	$175.36
Max. Negotiated Rate	$282.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$233.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$282.91
Rate for Payer: Qualcare PPO/HMO/WC	$175.36

MESH MAX 3D LEFT 10.8CM X 16CM

Facility

$1,169.05

Hospital Charge Code	270657165
Hospital Revenue Code	278
Min. Negotiated Rate	$175.36
Max. Negotiated Rate	$584.52
Rate for Payer: Aetna Commercial	$350.71
Rate for Payer: Aetna Medicare Advantage	$350.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$298.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$298.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$233.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$298.11
Rate for Payer: Cigna Commercial	$584.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$282.91
Rate for Payer: Qualcare PPO/HMO/WC	$175.36

MESH OVAL ULTRA PRO LARGE

Facility

$995.00

Hospital Charge Code	270701545
Hospital Revenue Code	278
Min. Negotiated Rate	$149.25
Max. Negotiated Rate	$497.50
Rate for Payer: Aetna Commercial	$298.50
Rate for Payer: Aetna Medicare Advantage	$298.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.72
Rate for Payer: Cigna Commercial	$497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.79
Rate for Payer: Qualcare PPO/HMO/WC	$149.25

MESH OVAL ULTRA PRO LARGE

Facility

$995.00

Hospital Charge Code	270701545
Hospital Revenue Code	278
Min. Negotiated Rate	$149.25
Max. Negotiated Rate	$240.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.79
Rate for Payer: Qualcare PPO/HMO/WC	$149.25

MESH PARIATIX SKIRT 6 X 4

Facility

$3,192.50

Service Code	HCPCS C1781
Hospital Charge Code	270679896
Hospital Revenue Code	278
Min. Negotiated Rate	$478.88
Max. Negotiated Rate	$772.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$638.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$772.59
Rate for Payer: Qualcare PPO/HMO/WC	$478.88

MESH PARIATIX SKIRT 6 X 4

Facility

$3,192.50

Service Code	HCPCS C1781
Hospital Charge Code	270679896
Hospital Revenue Code	278
Min. Negotiated Rate	$478.88
Max. Negotiated Rate	$1,596.25
Rate for Payer: Aetna Commercial	$957.75
Rate for Payer: Aetna Medicare Advantage	$957.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$814.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$814.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$638.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$814.09
Rate for Payer: Cigna Commercial	$1,596.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$772.59
Rate for Payer: Qualcare PPO/HMO/WC	$478.88

Know your out-of-pocket cost for care.

All Charges