Heights University Hospital

All Charges

Charge

Type

Setting

Price

MESH STEX ELIP 17x10CM

Facility

$2,371.40

Service Code	HCPCS C1781
Hospital Charge Code	270671732
Hospital Revenue Code	278
Min. Negotiated Rate	$355.71
Max. Negotiated Rate	$1,185.70
Rate for Payer: Aetna Commercial	$711.42
Rate for Payer: Aetna Medicare Advantage	$711.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$604.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$604.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$474.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$604.71
Rate for Payer: Cigna Commercial	$1,185.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$573.88
Rate for Payer: Qualcare PPO/HMO/WC	$355.71

MESH STEX ELIP 17x10CM

Facility

$2,371.40

Service Code	HCPCS C1781
Hospital Charge Code	270671732
Hospital Revenue Code	278
Min. Negotiated Rate	$355.71
Max. Negotiated Rate	$573.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$474.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$573.88
Rate for Payer: Qualcare PPO/HMO/WC	$355.71

MESH STEX ELIP 20x12CM

Facility

$9,435.20

Hospital Charge Code	270677505
Hospital Revenue Code	278
Min. Negotiated Rate	$1,415.28
Max. Negotiated Rate	$2,283.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,887.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,283.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,415.28

MESH STEX ELIP 20x12CM

Facility

$9,435.20

Hospital Charge Code	270677505
Hospital Revenue Code	278
Min. Negotiated Rate	$1,415.28
Max. Negotiated Rate	$4,717.60
Rate for Payer: Aetna Commercial	$2,830.56
Rate for Payer: Aetna Medicare Advantage	$2,830.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,405.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,405.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,887.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,405.98
Rate for Payer: Cigna Commercial	$4,717.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,283.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,415.28

MESH STEX ROUND 12CM

Facility

$2,901.45

Service Code	HCPCS C1781
Hospital Charge Code	270665531
Hospital Revenue Code	278
Min. Negotiated Rate	$435.22
Max. Negotiated Rate	$702.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$702.15
Rate for Payer: Qualcare PPO/HMO/WC	$435.22

MESH STEX ROUND 12CM

Facility

$2,901.45

Service Code	HCPCS C1781
Hospital Charge Code	270665531
Hospital Revenue Code	278
Min. Negotiated Rate	$435.22
Max. Negotiated Rate	$1,450.72
Rate for Payer: Aetna Commercial	$870.43
Rate for Payer: Aetna Medicare Advantage	$870.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$739.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$739.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$739.87
Rate for Payer: Cigna Commercial	$1,450.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$702.15
Rate for Payer: Qualcare PPO/HMO/WC	$435.22

MESH STEX ROUND 15CM

Facility

$3,761.60

Service Code	HCPCS C1781
Hospital Charge Code	270665532
Hospital Revenue Code	278
Min. Negotiated Rate	$564.24
Max. Negotiated Rate	$910.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$752.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$910.31
Rate for Payer: Qualcare PPO/HMO/WC	$564.24

MESH STEX ROUND 15CM

Facility

$3,761.60

Service Code	HCPCS C1781
Hospital Charge Code	270665532
Hospital Revenue Code	278
Min. Negotiated Rate	$564.24
Max. Negotiated Rate	$1,880.80
Rate for Payer: Aetna Commercial	$1,128.48
Rate for Payer: Aetna Medicare Advantage	$1,128.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$959.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$959.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$752.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$959.21
Rate for Payer: Cigna Commercial	$1,880.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$910.31
Rate for Payer: Qualcare PPO/HMO/WC	$564.24

MESH STEX ROUND 9CM

Facility

$2,115.65

Service Code	HCPCS C1781
Hospital Charge Code	270665530
Hospital Revenue Code	278
Min. Negotiated Rate	$317.35
Max. Negotiated Rate	$1,057.83
Rate for Payer: Aetna Commercial	$634.70
Rate for Payer: Aetna Medicare Advantage	$634.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$539.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$539.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$423.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$539.49
Rate for Payer: Cigna Commercial	$1,057.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$511.99
Rate for Payer: Qualcare PPO/HMO/WC	$317.35

MESH STEX ROUND 9CM

Facility

$2,115.65

Service Code	HCPCS C1781
Hospital Charge Code	270665530
Hospital Revenue Code	278
Min. Negotiated Rate	$317.35
Max. Negotiated Rate	$511.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$423.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$511.99
Rate for Payer: Qualcare PPO/HMO/WC	$317.35

MESH STEX SKIRT 15x10CM 6X4

Facility

$3,582.00

Service Code	HCPCS C1781
Hospital Charge Code	270679903
Hospital Revenue Code	278
Min. Negotiated Rate	$537.30
Max. Negotiated Rate	$866.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$716.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$866.84
Rate for Payer: Qualcare PPO/HMO/WC	$537.30

MESH STEX SKIRT 15x10CM 6X4

Facility

$3,582.00

Service Code	HCPCS C1781
Hospital Charge Code	270679903
Hospital Revenue Code	278
Min. Negotiated Rate	$537.30
Max. Negotiated Rate	$1,791.00
Rate for Payer: Aetna Commercial	$1,074.60
Rate for Payer: Aetna Medicare Advantage	$1,074.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$913.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$913.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$716.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$913.41
Rate for Payer: Cigna Commercial	$1,791.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$866.84
Rate for Payer: Qualcare PPO/HMO/WC	$537.30

MESH STRATTICE 10x16CM

Facility

$27,385.00

Service Code	HCPCS Q4130
Hospital Charge Code	270677283
Hospital Revenue Code	278
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$8,215.50
Rate for Payer: Aetna Commercial	$8,215.50
Rate for Payer: Aetna Medicare Advantage	$8,215.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,983.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,983.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,477.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,983.18
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,627.17
Rate for Payer: Qualcare PPO/HMO/WC	$4,107.75

MESH STRATTICE 10x16CM

Facility

$27,385.00

Service Code	HCPCS Q4130
Hospital Charge Code	270677283
Hospital Revenue Code	278
Min. Negotiated Rate	$4,107.75
Max. Negotiated Rate	$6,627.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,477.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,627.17
Rate for Payer: Qualcare PPO/HMO/WC	$4,107.75

MESH STRATTICE 16x20CM

Facility

$54,750.00

Service Code	HCPCS Q4130
Hospital Charge Code	270677096
Hospital Revenue Code	278
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$16,425.00
Rate for Payer: Aetna Commercial	$16,425.00
Rate for Payer: Aetna Medicare Advantage	$16,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,961.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,961.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,961.25
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,249.50
Rate for Payer: Qualcare PPO/HMO/WC	$8,212.50

MESH STRATTICE 16x20CM

Facility

$99,655.00

Hospital Charge Code	270677284
Hospital Revenue Code	636
Min. Negotiated Rate	$14,948.25
Max. Negotiated Rate	$49,827.50
Rate for Payer: Aetna Commercial	$29,896.50
Rate for Payer: Aetna Medicare Advantage	$29,896.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,412.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,412.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25,412.03
Rate for Payer: Cigna Commercial	$49,827.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24,116.51
Rate for Payer: Qualcare PPO/HMO/WC	$14,948.25

MESH STRATTICE 16x20CM

Facility

$54,750.00

Service Code	HCPCS Q4130
Hospital Charge Code	270677096
Hospital Revenue Code	278
Min. Negotiated Rate	$8,212.50
Max. Negotiated Rate	$13,249.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,249.50
Rate for Payer: Qualcare PPO/HMO/WC	$8,212.50

MESH STRATTICE 16x20CM

Facility

$99,655.00

Hospital Charge Code	270677284
Hospital Revenue Code	636
Min. Negotiated Rate	$14,948.25
Max. Negotiated Rate	$24,116.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24,116.51
Rate for Payer: Qualcare PPO/HMO/WC	$14,948.25

MESH STRATTICE 6x10CM

Facility

$10,815.00

Service Code	HCPCS C1781
Hospital Charge Code	270683760
Hospital Revenue Code	278
Min. Negotiated Rate	$1,622.25
Max. Negotiated Rate	$2,617.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,163.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,617.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,622.25

MESH STRATTICE 6x10CM

Facility

$10,815.00

Service Code	HCPCS C1781
Hospital Charge Code	270683760
Hospital Revenue Code	278
Min. Negotiated Rate	$1,622.25
Max. Negotiated Rate	$5,407.50
Rate for Payer: Aetna Commercial	$3,244.50
Rate for Payer: Aetna Medicare Advantage	$3,244.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,757.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,757.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,163.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,757.82
Rate for Payer: Cigna Commercial	$5,407.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,617.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,622.25

MESH STRATTICE 6X8CM

Facility

$8,100.00

Service Code	HCPCS Q4130
Hospital Charge Code	270676314
Hospital Revenue Code	278
Min. Negotiated Rate	$1,215.00
Max. Negotiated Rate	$1,960.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,620.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,960.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,215.00

MESH STRATTICE 6X8CM

Facility

$8,100.00

Service Code	HCPCS Q4130
Hospital Charge Code	270676314
Hospital Revenue Code	278
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$2,430.00
Rate for Payer: Aetna Commercial	$2,430.00
Rate for Payer: Aetna Medicare Advantage	$2,430.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,065.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,065.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,065.50
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,960.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,215.00

MESH STRATTICE 6X8CM/SQCMJW

Facility

$166.56

Hospital Charge Code	270676314W
Hospital Revenue Code	636
Min. Negotiated Rate	$24.98
Max. Negotiated Rate	$40.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.31
Rate for Payer: Qualcare PPO/HMO/WC	$24.98

MESH STRATTICE 6X8CM/SQCMJW

Facility

$166.56

Hospital Charge Code	270676314W
Hospital Revenue Code	636
Min. Negotiated Rate	$24.98
Max. Negotiated Rate	$83.28
Rate for Payer: Aetna Commercial	$49.97
Rate for Payer: Aetna Medicare Advantage	$49.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.47
Rate for Payer: Cigna Commercial	$83.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.31
Rate for Payer: Qualcare PPO/HMO/WC	$24.98

MESH SURGICAL MOTIMESH 7.5x15

Facility

$1.00

Hospital Charge Code	270644453
Hospital Revenue Code	278
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.50
Rate for Payer: Aetna Commercial	$0.30
Rate for Payer: Aetna Medicare Advantage	$0.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.26
Rate for Payer: Cigna Commercial	$0.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.24
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

Know your out-of-pocket cost for care.

All Charges