Heights University Hospital

All Charges

Charge

Type

Setting

Price

MESH PROLENE 12 X 12 23000PML

Facility

$592.65

Service Code	HCPCS C1781
Hospital Charge Code	270611263
Hospital Revenue Code	278
Min. Negotiated Rate	$88.90
Max. Negotiated Rate	$143.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$118.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.42
Rate for Payer: Qualcare PPO/HMO/WC	$88.90

MESH PROLENE 3 HRN 230000PHSM

Facility

$2,148.82

Service Code	HCPCS C1781
Hospital Charge Code	270612392
Hospital Revenue Code	278
Min. Negotiated Rate	$322.32
Max. Negotiated Rate	$1,074.41
Rate for Payer: Aetna Commercial	$644.65
Rate for Payer: Aetna Medicare Advantage	$644.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$547.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$547.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$429.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$547.95
Rate for Payer: Cigna Commercial	$1,074.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$520.01
Rate for Payer: Qualcare PPO/HMO/WC	$322.32

MESH PROLENE 3 HRN 230000PHSM

Facility

$2,148.82

Service Code	HCPCS C1781
Hospital Charge Code	270612392
Hospital Revenue Code	278
Min. Negotiated Rate	$322.32
Max. Negotiated Rate	$520.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$429.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$520.01
Rate for Payer: Qualcare PPO/HMO/WC	$322.32

MESH PROLENE 3x6

Facility

$604.91

Service Code	HCPCS C1781
Hospital Charge Code	270652755
Hospital Revenue Code	278
Min. Negotiated Rate	$90.74
Max. Negotiated Rate	$146.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.39
Rate for Payer: Qualcare PPO/HMO/WC	$90.74

MESH PROLENE 3x6

Facility

$604.91

Service Code	HCPCS C1781
Hospital Charge Code	270652755
Hospital Revenue Code	278
Min. Negotiated Rate	$90.74
Max. Negotiated Rate	$302.45
Rate for Payer: Aetna Commercial	$181.47
Rate for Payer: Aetna Medicare Advantage	$181.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.25
Rate for Payer: Cigna Commercial	$302.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.39
Rate for Payer: Qualcare PPO/HMO/WC	$90.74

MESH PROLENE 6 IN X 6 IN

Facility

$271.31

Service Code	HCPCS C1781
Hospital Charge Code	270665964
Hospital Revenue Code	278
Min. Negotiated Rate	$40.70
Max. Negotiated Rate	$65.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.66
Rate for Payer: Qualcare PPO/HMO/WC	$40.70

MESH PROLENE 6 IN X 6 IN

Facility

$271.31

Service Code	HCPCS C1781
Hospital Charge Code	270665964
Hospital Revenue Code	278
Min. Negotiated Rate	$40.70
Max. Negotiated Rate	$135.66
Rate for Payer: Aetna Commercial	$81.39
Rate for Payer: Aetna Medicare Advantage	$81.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.18
Rate for Payer: Cigna Commercial	$135.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.66
Rate for Payer: Qualcare PPO/HMO/WC	$40.70

MESH PROLENE EXTENDED 6

Facility

$1,448.78

Service Code	HCPCS C1781
Hospital Charge Code	270651826
Hospital Revenue Code	278
Min. Negotiated Rate	$217.32
Max. Negotiated Rate	$350.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$289.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.60
Rate for Payer: Qualcare PPO/HMO/WC	$217.32

MESH PROLENE EXTENDED 6

Facility

$1,448.78

Service Code	HCPCS C1781
Hospital Charge Code	270651826
Hospital Revenue Code	278
Min. Negotiated Rate	$217.32
Max. Negotiated Rate	$724.39
Rate for Payer: Aetna Commercial	$434.63
Rate for Payer: Aetna Medicare Advantage	$434.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$369.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$369.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$289.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$369.44
Rate for Payer: Cigna Commercial	$724.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.60
Rate for Payer: Qualcare PPO/HMO/WC	$217.32

MESH PROLENE HERNIA SYSTEM LG

Facility

$2,198.46

Service Code	HCPCS C1781
Hospital Charge Code	270659431
Hospital Revenue Code	278
Min. Negotiated Rate	$329.77
Max. Negotiated Rate	$532.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$439.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.03
Rate for Payer: Qualcare PPO/HMO/WC	$329.77

MESH PROLENE HERNIA SYSTEM LG

Facility

$2,198.46

Service Code	HCPCS C1781
Hospital Charge Code	270659431
Hospital Revenue Code	278
Min. Negotiated Rate	$329.77
Max. Negotiated Rate	$1,099.23
Rate for Payer: Aetna Commercial	$659.54
Rate for Payer: Aetna Medicare Advantage	$659.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$560.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$560.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$439.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$560.61
Rate for Payer: Cigna Commercial	$1,099.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.03
Rate for Payer: Qualcare PPO/HMO/WC	$329.77

MESH PROLITE 1010303-05

Facility

$585.90

Service Code	HCPCS C1781
Hospital Charge Code	270661162
Hospital Revenue Code	278
Min. Negotiated Rate	$87.89
Max. Negotiated Rate	$141.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.79
Rate for Payer: Qualcare PPO/HMO/WC	$87.89

MESH PROLITE 1010303-05

Facility

$585.90

Service Code	HCPCS C1781
Hospital Charge Code	270661162
Hospital Revenue Code	278
Min. Negotiated Rate	$87.89
Max. Negotiated Rate	$292.95
Rate for Payer: Aetna Commercial	$175.77
Rate for Payer: Aetna Medicare Advantage	$175.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.40
Rate for Payer: Cigna Commercial	$292.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.79
Rate for Payer: Qualcare PPO/HMO/WC	$87.89

MESH PROLOOP LARGE 30902

Facility

$1,244.60

Service Code	HCPCS C1781
Hospital Charge Code	270651871
Hospital Revenue Code	278
Min. Negotiated Rate	$186.69
Max. Negotiated Rate	$301.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.19
Rate for Payer: Qualcare PPO/HMO/WC	$186.69

MESH PROLOOP LARGE 30902

Facility

$1,244.60

Service Code	HCPCS C1781
Hospital Charge Code	270651871
Hospital Revenue Code	278
Min. Negotiated Rate	$186.69
Max. Negotiated Rate	$622.30
Rate for Payer: Aetna Commercial	$373.38
Rate for Payer: Aetna Medicare Advantage	$373.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$317.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$317.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$317.37
Rate for Payer: Cigna Commercial	$622.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.19
Rate for Payer: Qualcare PPO/HMO/WC	$186.69

MESH PROLOOP LARGE POLYPROPYLE

Facility

$615.90

Service Code	HCPCS C1780
Hospital Charge Code	270653355
Hospital Revenue Code	278
Min. Negotiated Rate	$92.39
Max. Negotiated Rate	$149.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.05
Rate for Payer: Qualcare PPO/HMO/WC	$92.39

MESH PROLOOP LARGE POLYPROPYLE

Facility

$615.90

Service Code	HCPCS C1780
Hospital Charge Code	270653355
Hospital Revenue Code	278
Min. Negotiated Rate	$92.39
Max. Negotiated Rate	$307.95
Rate for Payer: Aetna Commercial	$184.77
Rate for Payer: Aetna Medicare Advantage	$184.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.05
Rate for Payer: Cigna Commercial	$307.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.05
Rate for Payer: Qualcare PPO/HMO/WC	$92.39

MESH PROLOOP PLUG LG. 2/BOX

Facility

$673.75

Service Code	HCPCS C1781
Hospital Charge Code	270653907
Hospital Revenue Code	278
Min. Negotiated Rate	$101.06
Max. Negotiated Rate	$336.88
Rate for Payer: Aetna Commercial	$202.12
Rate for Payer: Aetna Medicare Advantage	$202.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.81
Rate for Payer: Cigna Commercial	$336.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.05
Rate for Payer: Qualcare PPO/HMO/WC	$101.06

MESH PROLOOP PLUG LG. 2/BOX

Facility

$673.75

Service Code	HCPCS C1781
Hospital Charge Code	270653907
Hospital Revenue Code	278
Min. Negotiated Rate	$101.06
Max. Negotiated Rate	$163.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.05
Rate for Payer: Qualcare PPO/HMO/WC	$101.06

MESH PROLOOP PLUG XL

Facility

$1,333.80

Service Code	HCPCS C1781
Hospital Charge Code	270655388
Hospital Revenue Code	278
Min. Negotiated Rate	$200.07
Max. Negotiated Rate	$666.90
Rate for Payer: Aetna Commercial	$400.14
Rate for Payer: Aetna Medicare Advantage	$400.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$340.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$340.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$266.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$340.12
Rate for Payer: Cigna Commercial	$666.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$322.78
Rate for Payer: Qualcare PPO/HMO/WC	$200.07

MESH PROLOOP PLUG XL

Facility

$1,333.80

Service Code	HCPCS C1781
Hospital Charge Code	270655388
Hospital Revenue Code	278
Min. Negotiated Rate	$200.07
Max. Negotiated Rate	$322.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$266.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$322.78
Rate for Payer: Qualcare PPO/HMO/WC	$200.07

MESH PROLOOP PLUG X-LG 2/BOX

Facility

$722.75

Service Code	HCPCS C1781
Hospital Charge Code	270654230
Hospital Revenue Code	278
Min. Negotiated Rate	$108.41
Max. Negotiated Rate	$174.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.91
Rate for Payer: Qualcare PPO/HMO/WC	$108.41

MESH PROLOOP PLUG X-LG 2/BOX

Facility

$722.75

Service Code	HCPCS C1781
Hospital Charge Code	270654230
Hospital Revenue Code	278
Min. Negotiated Rate	$108.41
Max. Negotiated Rate	$361.38
Rate for Payer: Aetna Commercial	$216.82
Rate for Payer: Aetna Medicare Advantage	$216.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.30
Rate for Payer: Cigna Commercial	$361.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.91
Rate for Payer: Qualcare PPO/HMO/WC	$108.41

MESH PROLOOP X-LG 30903

Facility

$666.90

Hospital Charge Code	270660258
Hospital Revenue Code	272
Min. Negotiated Rate	$86.70
Max. Negotiated Rate	$333.45
Rate for Payer: Aetna Commercial	$200.07
Rate for Payer: Aetna Medicare Advantage	$200.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.06
Rate for Payer: Cigna Commercial	$333.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.70
Rate for Payer: Oxford Commercial	$333.45
Rate for Payer: Qualcare PPO/HMO/WC	$100.03
Rate for Payer: UnitedHealthcare Commercial	$333.45

MESH PROLOOP X-LG 30903

Facility

$666.90

Hospital Charge Code	270660258
Hospital Revenue Code	272
Min. Negotiated Rate	$100.03
Max. Negotiated Rate	$100.03
Rate for Payer: Qualcare PPO/HMO/WC	$100.03

Know your out-of-pocket cost for care.

All Charges