Heights University Hospital

All Charges

Charge

Type

Setting

Price

MESH VENTRAL 4 X 6 ELLIPCE

Facility

$3,897.00

Service Code	HCPCS C1781
Hospital Charge Code	270690904
Hospital Revenue Code	278
Min. Negotiated Rate	$584.55
Max. Negotiated Rate	$1,948.50
Rate for Payer: Aetna Commercial	$1,169.10
Rate for Payer: Aetna Medicare Advantage	$1,169.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$993.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$993.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$779.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$993.74
Rate for Payer: Cigna Commercial	$1,948.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$943.07
Rate for Payer: Qualcare PPO/HMO/WC	$584.55

MESH VENTRAL 4 X 6 ELLIPCE

Facility

$3,897.00

Service Code	HCPCS C1781
Hospital Charge Code	270690904
Hospital Revenue Code	278
Min. Negotiated Rate	$584.55
Max. Negotiated Rate	$943.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$779.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$943.07
Rate for Payer: Qualcare PPO/HMO/WC	$584.55

MESH VENTRALEX ST PATCH LARGE

Facility

$7,832.00

Service Code	HCPCS C1781
Hospital Charge Code	270698961
Hospital Revenue Code	278
Min. Negotiated Rate	$1,174.80
Max. Negotiated Rate	$1,895.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,566.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,895.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,174.80

MESH VENTRALEX ST PATCH LARGE

Facility

$7,832.00

Service Code	HCPCS C1781
Hospital Charge Code	270698961
Hospital Revenue Code	278
Min. Negotiated Rate	$1,174.80
Max. Negotiated Rate	$3,916.00
Rate for Payer: Aetna Commercial	$2,349.60
Rate for Payer: Aetna Medicare Advantage	$2,349.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,997.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,997.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,566.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,997.16
Rate for Payer: Cigna Commercial	$3,916.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,895.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,174.80

MESH VENTRALEX ST PATCH MEDIUM

Facility

$7,034.50

Service Code	HCPCS C1781
Hospital Charge Code	270698958
Hospital Revenue Code	278
Min. Negotiated Rate	$1,055.17
Max. Negotiated Rate	$1,702.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,406.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,702.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,055.17

MESH VENTRALEX ST PATCH MEDIUM

Facility

$7,034.50

Service Code	HCPCS C1781
Hospital Charge Code	270698958
Hospital Revenue Code	278
Min. Negotiated Rate	$1,055.17
Max. Negotiated Rate	$3,517.25
Rate for Payer: Aetna Commercial	$2,110.35
Rate for Payer: Aetna Medicare Advantage	$2,110.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,793.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,793.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,406.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,793.80
Rate for Payer: Cigna Commercial	$3,517.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,702.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,055.17

MESH VENTRALEX ST PATCH SMALL

Facility

$5,868.65

Service Code	HCPCS C1781
Hospital Charge Code	270698963
Hospital Revenue Code	278
Min. Negotiated Rate	$880.30
Max. Negotiated Rate	$1,420.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,173.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,420.21
Rate for Payer: Qualcare PPO/HMO/WC	$880.30

MESH VENTRALEX ST PATCH SMALL

Facility

$5,868.65

Service Code	HCPCS C1781
Hospital Charge Code	270698963
Hospital Revenue Code	278
Min. Negotiated Rate	$880.30
Max. Negotiated Rate	$2,934.32
Rate for Payer: Aetna Commercial	$1,760.60
Rate for Payer: Aetna Medicare Advantage	$1,760.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,496.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,496.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,173.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,496.51
Rate for Payer: Cigna Commercial	$2,934.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,420.21
Rate for Payer: Qualcare PPO/HMO/WC	$880.30

MESH VENTRALIGHT 10 X 13 ELLIP

Facility

$14,140.50

Service Code	HCPCS C1781
Hospital Charge Code	270690902
Hospital Revenue Code	278
Min. Negotiated Rate	$2,121.07
Max. Negotiated Rate	$7,070.25
Rate for Payer: Aetna Commercial	$4,242.15
Rate for Payer: Aetna Medicare Advantage	$4,242.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,605.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,605.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,828.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,605.83
Rate for Payer: Cigna Commercial	$7,070.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,422.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,121.07

MESH VENTRALIGHT 10 X 13 ELLIP

Facility

$14,140.50

Service Code	HCPCS C1781
Hospital Charge Code	270690902
Hospital Revenue Code	278
Min. Negotiated Rate	$2,121.07
Max. Negotiated Rate	$3,422.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,828.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,422.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,121.07

MESH VENTRALIGHT 6 X 10 OVAL

Facility

$8,371.50

Service Code	HCPCS C1781
Hospital Charge Code	270690905
Hospital Revenue Code	278
Min. Negotiated Rate	$1,255.72
Max. Negotiated Rate	$4,185.75
Rate for Payer: Aetna Commercial	$2,511.45
Rate for Payer: Aetna Medicare Advantage	$2,511.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,134.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,134.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,674.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,134.73
Rate for Payer: Cigna Commercial	$4,185.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,025.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,255.72

MESH VENTRALIGHT 6 X 10 OVAL

Facility

$8,371.50

Service Code	HCPCS C1781
Hospital Charge Code	270690905
Hospital Revenue Code	278
Min. Negotiated Rate	$1,255.72
Max. Negotiated Rate	$2,025.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,674.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,025.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,255.72

MESH VENTRALIGHT RECG 12 X 14

Facility

$14,905.00

Service Code	HCPCS C1781
Hospital Charge Code	270690903
Hospital Revenue Code	278
Min. Negotiated Rate	$2,235.75
Max. Negotiated Rate	$3,607.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,981.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,607.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,235.75

MESH VENTRALIGHT RECG 12 X 14

Facility

$14,905.00

Service Code	HCPCS C1781
Hospital Charge Code	270690903
Hospital Revenue Code	278
Min. Negotiated Rate	$2,235.75
Max. Negotiated Rate	$7,452.50
Rate for Payer: Aetna Commercial	$4,471.50
Rate for Payer: Aetna Medicare Advantage	$4,471.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,800.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,800.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,981.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,800.78
Rate for Payer: Cigna Commercial	$7,452.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,607.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,235.75

MESH VENTRAL PHASIX 10X12IN

Facility

$72,185.00

Service Code	HCPCS C1781
Hospital Charge Code	270698769
Hospital Revenue Code	278
Min. Negotiated Rate	$10,827.75
Max. Negotiated Rate	$17,468.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14,437.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17,468.77
Rate for Payer: Qualcare PPO/HMO/WC	$10,827.75

MESH VENTRAL PHASIX 10X12IN

Facility

$72,185.00

Service Code	HCPCS C1781
Hospital Charge Code	270698769
Hospital Revenue Code	278
Min. Negotiated Rate	$10,827.75
Max. Negotiated Rate	$36,092.50
Rate for Payer: Aetna Commercial	$21,655.50
Rate for Payer: Aetna Medicare Advantage	$21,655.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18,407.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18,407.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14,437.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18,407.17
Rate for Payer: Cigna Commercial	$36,092.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17,468.77
Rate for Payer: Qualcare PPO/HMO/WC	$10,827.75

MESH VENTRIO 10.8x13.7 XL OVAL

Facility

$13,307.60

Hospital Charge Code	270647199
Hospital Revenue Code	278
Min. Negotiated Rate	$1,996.14
Max. Negotiated Rate	$3,220.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,661.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,220.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,996.14

MESH VENTRIO 10.8x13.7 XL OVAL

Facility

$13,307.60

Hospital Charge Code	270647199
Hospital Revenue Code	278
Min. Negotiated Rate	$1,996.14
Max. Negotiated Rate	$6,653.80
Rate for Payer: Aetna Commercial	$3,992.28
Rate for Payer: Aetna Medicare Advantage	$3,992.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,393.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,393.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,661.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,393.44
Rate for Payer: Cigna Commercial	$6,653.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,220.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,996.14

MESH VENTRIO 8.7 x 10

Facility

$9,775.00

Service Code	HCPCS C1781
Hospital Charge Code	270663620
Hospital Revenue Code	278
Min. Negotiated Rate	$1,466.25
Max. Negotiated Rate	$4,887.50
Rate for Payer: Aetna Commercial	$2,932.50
Rate for Payer: Aetna Medicare Advantage	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,492.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,492.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,955.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,492.62
Rate for Payer: Cigna Commercial	$4,887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,365.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,466.25

MESH VENTRIO 8.7 x 10

Facility

$9,775.00

Service Code	HCPCS C1781
Hospital Charge Code	270663620
Hospital Revenue Code	278
Min. Negotiated Rate	$1,466.25
Max. Negotiated Rate	$2,365.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,955.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,365.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,466.25

MESH VENTRIO OVAL LG 5.4x7.0

Facility

$6,400.00

Service Code	HCPCS C1781
Hospital Charge Code	270647197
Hospital Revenue Code	278
Min. Negotiated Rate	$960.00
Max. Negotiated Rate	$3,200.00
Rate for Payer: Aetna Commercial	$1,920.00
Rate for Payer: Aetna Medicare Advantage	$1,920.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,632.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,632.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,632.00
Rate for Payer: Cigna Commercial	$3,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,548.80
Rate for Payer: Qualcare PPO/HMO/WC	$960.00

MESH VENTRIO OVAL LG 5.4x7.0

Facility

$6,400.00

Service Code	HCPCS C1781
Hospital Charge Code	270647197
Hospital Revenue Code	278
Min. Negotiated Rate	$960.00
Max. Negotiated Rate	$1,548.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,548.80
Rate for Payer: Qualcare PPO/HMO/WC	$960.00

MESH VENTRIO OVAL MED 4.3x5.5

Facility

$5,050.00

Service Code	HCPCS C1781
Hospital Charge Code	270647196
Hospital Revenue Code	278
Min. Negotiated Rate	$757.50
Max. Negotiated Rate	$2,525.00
Rate for Payer: Aetna Commercial	$1,515.00
Rate for Payer: Aetna Medicare Advantage	$1,515.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,287.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,287.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,287.75
Rate for Payer: Cigna Commercial	$2,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,222.10
Rate for Payer: Qualcare PPO/HMO/WC	$757.50

MESH VENTRIO OVAL MED 4.3x5.5

Facility

$5,050.00

Service Code	HCPCS C1781
Hospital Charge Code	270647196
Hospital Revenue Code	278
Min. Negotiated Rate	$757.50
Max. Negotiated Rate	$1,222.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,010.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,222.10
Rate for Payer: Qualcare PPO/HMO/WC	$757.50

MESH VENTRIO OVAL SM 3.1x4.7

Facility

$3,253.50

Service Code	HCPCS C1781
Hospital Charge Code	270647195
Hospital Revenue Code	278
Min. Negotiated Rate	$488.02
Max. Negotiated Rate	$1,626.75
Rate for Payer: Aetna Commercial	$976.05
Rate for Payer: Aetna Medicare Advantage	$976.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$829.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$829.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$829.64
Rate for Payer: Cigna Commercial	$1,626.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$787.35
Rate for Payer: Qualcare PPO/HMO/WC	$488.02

Know your out-of-pocket cost for care.

All Charges