Heights University Hospital

All Charges

Charge

Type

Setting

Price

MESH PARIETEX 9cm ROUND

Facility

$1,571.90

Service Code	HCPCS C1781
Hospital Charge Code	270664234
Hospital Revenue Code	278
Min. Negotiated Rate	$235.78
Max. Negotiated Rate	$785.95
Rate for Payer: Aetna Commercial	$471.57
Rate for Payer: Aetna Medicare Advantage	$471.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$400.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$400.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$314.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$400.83
Rate for Payer: Cigna Commercial	$785.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.40
Rate for Payer: Qualcare PPO/HMO/WC	$235.78

MESH PARIETEX 9cm ROUND

Facility

$1,571.90

Service Code	HCPCS C1781
Hospital Charge Code	270664234
Hospital Revenue Code	278
Min. Negotiated Rate	$235.78
Max. Negotiated Rate	$380.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$314.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.40
Rate for Payer: Qualcare PPO/HMO/WC	$235.78

MESH PARIETEX RETANGLE 25X20CM

Facility

$12,810.00

Hospital Charge Code	270671349
Hospital Revenue Code	278
Min. Negotiated Rate	$1,921.50
Max. Negotiated Rate	$3,100.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,562.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,100.02
Rate for Payer: Qualcare PPO/HMO/WC	$1,921.50

MESH PARIETEX RETANGLE 25X20CM

Facility

$12,810.00

Hospital Charge Code	270671349
Hospital Revenue Code	278
Min. Negotiated Rate	$1,921.50
Max. Negotiated Rate	$6,405.00
Rate for Payer: Aetna Commercial	$3,843.00
Rate for Payer: Aetna Medicare Advantage	$3,843.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,266.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,266.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,562.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,266.55
Rate for Payer: Cigna Commercial	$6,405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,100.02
Rate for Payer: Qualcare PPO/HMO/WC	$1,921.50

MESH PARTIALCONTOUR

Facility

$25,272.00

Hospital Charge Code	270662168
Hospital Revenue Code	278
Min. Negotiated Rate	$3,790.80
Max. Negotiated Rate	$6,115.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,054.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,115.82
Rate for Payer: Qualcare PPO/HMO/WC	$3,790.80

MESH PARTIALCONTOUR

Facility

$25,272.00

Hospital Charge Code	270662168
Hospital Revenue Code	278
Min. Negotiated Rate	$3,790.80
Max. Negotiated Rate	$12,636.00
Rate for Payer: Aetna Commercial	$7,581.60
Rate for Payer: Aetna Medicare Advantage	$7,581.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,444.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,444.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,054.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,444.36
Rate for Payer: Cigna Commercial	$12,636.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,115.82
Rate for Payer: Qualcare PPO/HMO/WC	$3,790.80

MESH PELVIC SLING URETH SOLYX

Facility

$10,797.10

Service Code	HCPCS C1771
Hospital Charge Code	270695722
Hospital Revenue Code	278
Min. Negotiated Rate	$1,619.57
Max. Negotiated Rate	$2,612.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,159.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,612.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,619.57

MESH PELVIC SLING URETH SOLYX

Facility

$10,797.10

Service Code	HCPCS C1771
Hospital Charge Code	270695722
Hospital Revenue Code	278
Min. Negotiated Rate	$1,619.57
Max. Negotiated Rate	$5,398.55
Rate for Payer: Aetna Commercial	$3,239.13
Rate for Payer: Aetna Medicare Advantage	$3,239.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,753.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,753.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,159.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,753.26
Rate for Payer: Cigna Commercial	$5,398.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,612.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,619.57

MESH PELVITEX POLYPRO 486015

Facility

$1,934.45

Hospital Charge Code	270634048
Hospital Revenue Code	278
Min. Negotiated Rate	$290.17
Max. Negotiated Rate	$967.23
Rate for Payer: Aetna Commercial	$580.34
Rate for Payer: Aetna Medicare Advantage	$580.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$493.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$493.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$493.28
Rate for Payer: Cigna Commercial	$967.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$468.14
Rate for Payer: Qualcare PPO/HMO/WC	$290.17

MESH PELVITEX POLYPRO 486015

Facility

$1,934.45

Hospital Charge Code	270634048
Hospital Revenue Code	278
Min. Negotiated Rate	$290.17
Max. Negotiated Rate	$468.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$468.14
Rate for Payer: Qualcare PPO/HMO/WC	$290.17

MESH PERMACOL 10x15cm x 1.0mm

Facility

$17,294.00

Hospital Charge Code	2701663577
Hospital Revenue Code	278
Min. Negotiated Rate	$2,594.10
Max. Negotiated Rate	$4,185.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,458.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,185.15
Rate for Payer: Qualcare PPO/HMO/WC	$2,594.10

MESH PERMACOL 10x15cm x 1.0mm

Facility

$17,294.00

Hospital Charge Code	2701663577
Hospital Revenue Code	278
Min. Negotiated Rate	$2,594.10
Max. Negotiated Rate	$8,647.00
Rate for Payer: Aetna Commercial	$5,188.20
Rate for Payer: Aetna Medicare Advantage	$5,188.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,409.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,409.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,458.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,409.97
Rate for Payer: Cigna Commercial	$8,647.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,185.15
Rate for Payer: Qualcare PPO/HMO/WC	$2,594.10

MESH PERMACOL 10X15CMX1MM

Facility

$17,838.25

Service Code	HCPCS C1781
Hospital Charge Code	270663577
Hospital Revenue Code	278
Min. Negotiated Rate	$2,675.74
Max. Negotiated Rate	$8,919.12
Rate for Payer: Aetna Commercial	$5,351.48
Rate for Payer: Aetna Medicare Advantage	$5,351.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,548.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,548.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,567.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,548.75
Rate for Payer: Cigna Commercial	$8,919.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,316.86
Rate for Payer: Qualcare PPO/HMO/WC	$2,675.74

MESH PERMACOL 10X15CMX1MM

Facility

$17,838.25

Service Code	HCPCS C1781
Hospital Charge Code	270663577
Hospital Revenue Code	278
Min. Negotiated Rate	$2,675.74
Max. Negotiated Rate	$4,316.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,567.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,316.86
Rate for Payer: Qualcare PPO/HMO/WC	$2,675.74

MESH PERMACOL 10X15X1.5MM

Facility

$17,404.00

Hospital Charge Code	270677075
Hospital Revenue Code	278
Min. Negotiated Rate	$2,610.60
Max. Negotiated Rate	$8,702.00
Rate for Payer: Aetna Commercial	$5,221.20
Rate for Payer: Aetna Medicare Advantage	$5,221.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,438.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,438.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,480.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,438.02
Rate for Payer: Cigna Commercial	$8,702.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,211.77
Rate for Payer: Qualcare PPO/HMO/WC	$2,610.60

MESH PERMACOL 10X15X1.5MM

Facility

$17,404.00

Hospital Charge Code	270677075
Hospital Revenue Code	278
Min. Negotiated Rate	$2,610.60
Max. Negotiated Rate	$4,211.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,480.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,211.77
Rate for Payer: Qualcare PPO/HMO/WC	$2,610.60

MESH PERMACOL 20x30cm x 1.5mm

Facility

$61,236.25

Service Code	HCPCS C1781
Hospital Charge Code	270663578
Hospital Revenue Code	278
Min. Negotiated Rate	$9,185.44
Max. Negotiated Rate	$30,618.12
Rate for Payer: Aetna Commercial	$18,370.88
Rate for Payer: Aetna Medicare Advantage	$18,370.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,615.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,615.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12,247.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,615.24
Rate for Payer: Cigna Commercial	$30,618.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,819.17
Rate for Payer: Qualcare PPO/HMO/WC	$9,185.44

MESH PERMACOL 20x30cm x 1.5mm

Facility

$61,236.25

Service Code	HCPCS C1781
Hospital Charge Code	270663578
Hospital Revenue Code	278
Min. Negotiated Rate	$9,185.44
Max. Negotiated Rate	$14,819.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12,247.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,819.17
Rate for Payer: Qualcare PPO/HMO/WC	$9,185.44

MESH PEROG W/INTERPRO 72404046

Facility

$7,975.00

Hospital Charge Code	270634316
Hospital Revenue Code	278
Min. Negotiated Rate	$1,196.25
Max. Negotiated Rate	$3,987.50
Rate for Payer: Aetna Commercial	$2,392.50
Rate for Payer: Aetna Medicare Advantage	$2,392.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,033.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,033.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,033.62
Rate for Payer: Cigna Commercial	$3,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25

MESH PEROG W/INTERPRO 72404046

Facility

$7,975.00

Hospital Charge Code	270634316
Hospital Revenue Code	278
Min. Negotiated Rate	$1,196.25
Max. Negotiated Rate	$1,929.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25

MESH PHASIX 4 IN x 6 IN

Facility

$13,875.00

Service Code	HCPCS C1781
Hospital Charge Code	270681780
Hospital Revenue Code	278
Min. Negotiated Rate	$2,081.25
Max. Negotiated Rate	$6,937.50
Rate for Payer: Aetna Commercial	$4,162.50
Rate for Payer: Aetna Medicare Advantage	$4,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,538.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,538.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,538.12
Rate for Payer: Cigna Commercial	$6,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,357.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,081.25

MESH PHASIX 4 IN x 6 IN

Facility

$13,875.00

Service Code	HCPCS C1781
Hospital Charge Code	270681780
Hospital Revenue Code	278
Min. Negotiated Rate	$2,081.25
Max. Negotiated Rate	$3,357.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,357.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,081.25

MESH PHASIX 6X8 INCH

Facility

$28,875.00

Service Code	HCPCS C1781
Hospital Charge Code	270697136
Hospital Revenue Code	278
Min. Negotiated Rate	$4,331.25
Max. Negotiated Rate	$14,437.50
Rate for Payer: Aetna Commercial	$8,662.50
Rate for Payer: Aetna Medicare Advantage	$8,662.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,363.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,363.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,363.12
Rate for Payer: Cigna Commercial	$14,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,987.75
Rate for Payer: Qualcare PPO/HMO/WC	$4,331.25

MESH PHASIX 6X8 INCH

Facility

$28,875.00

Service Code	HCPCS C1781
Hospital Charge Code	270697136
Hospital Revenue Code	278
Min. Negotiated Rate	$4,331.25
Max. Negotiated Rate	$6,987.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,987.75
Rate for Payer: Qualcare PPO/HMO/WC	$4,331.25

MESH PHASIX ROUND 3IN 7.6CM

Facility

$7,324.00

Service Code	HCPCS C1781
Hospital Charge Code	270697134
Hospital Revenue Code	278
Min. Negotiated Rate	$1,098.60
Max. Negotiated Rate	$3,662.00
Rate for Payer: Aetna Commercial	$2,197.20
Rate for Payer: Aetna Medicare Advantage	$2,197.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,867.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,867.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,464.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,867.62
Rate for Payer: Cigna Commercial	$3,662.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,772.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,098.60

Know your out-of-pocket cost for care.

All Charges