Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

MESH SOFT 3X6

Facility

$1,016.25

Service Code	HCPCS C1781
Hospital Charge Code	270691536
Hospital Revenue Code	278
Min. Negotiated Rate	$152.44
Max. Negotiated Rate	$245.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.93
Rate for Payer: Qualcare PPO/HMO/WC	$152.44

MESH SOFT 4X6

Facility

$1,101.20

Service Code	HCPCS C1781
Hospital Charge Code	270691538
Hospital Revenue Code	278
Min. Negotiated Rate	$31.27
Max. Negotiated Rate	$550.60
Rate for Payer: Aetna Commercial	$418.46
Rate for Payer: Aetna Medicare Advantage	$330.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.81
Rate for Payer: Cigna Commercial	$550.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.49
Rate for Payer: Qualcare PPO/HMO/WC	$165.18
Rate for Payer: UnitedHealthcare Community & State	$34.80
Rate for Payer: Wellpoint Medicaid Managed Care	$31.27

MESH SOFT 4X6

Facility

$1,101.20

Service Code	HCPCS C1781
Hospital Charge Code	270691538
Hospital Revenue Code	278
Min. Negotiated Rate	$165.18
Max. Negotiated Rate	$266.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.49
Rate for Payer: Qualcare PPO/HMO/WC	$165.18

MESH SOFT 6X6

Facility

$1,242.00

Service Code	HCPCS C1781
Hospital Charge Code	270691537
Hospital Revenue Code	278
Min. Negotiated Rate	$35.27
Max. Negotiated Rate	$621.00
Rate for Payer: Aetna Commercial	$471.96
Rate for Payer: Aetna Medicare Advantage	$372.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.71
Rate for Payer: Cigna Commercial	$621.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.56
Rate for Payer: Qualcare PPO/HMO/WC	$186.30
Rate for Payer: UnitedHealthcare Community & State	$39.25
Rate for Payer: Wellpoint Medicaid Managed Care	$35.27

MESH SOFT 6X6

Facility

$1,242.00

Service Code	HCPCS C1781
Hospital Charge Code	270691537
Hospital Revenue Code	278
Min. Negotiated Rate	$186.30
Max. Negotiated Rate	$300.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.56
Rate for Payer: Qualcare PPO/HMO/WC	$186.30

MESH SOFT VENTRAL 12X12INCH

Facility

$2,394.00

Service Code	HCPCS C1781
Hospital Charge Code	270697073
Hospital Revenue Code	278
Min. Negotiated Rate	$67.99
Max. Negotiated Rate	$1,197.00
Rate for Payer: Aetna Commercial	$909.72
Rate for Payer: Aetna Medicare Advantage	$718.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$610.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$610.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$478.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$610.47
Rate for Payer: Cigna Commercial	$1,197.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$579.35
Rate for Payer: Qualcare PPO/HMO/WC	$359.10
Rate for Payer: UnitedHealthcare Community & State	$75.65
Rate for Payer: Wellpoint Medicaid Managed Care	$67.99

MESH SOFT VENTRAL 12X12INCH

Facility

$2,394.00

Service Code	HCPCS C1781
Hospital Charge Code	270697073
Hospital Revenue Code	278
Min. Negotiated Rate	$359.10
Max. Negotiated Rate	$579.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$478.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$579.35
Rate for Payer: Qualcare PPO/HMO/WC	$359.10

MESH STEX 15x10CM

Facility

$2,637.70

Service Code	HCPCS C1781
Hospital Charge Code	270665533
Hospital Revenue Code	278
Min. Negotiated Rate	$74.91
Max. Negotiated Rate	$1,318.85
Rate for Payer: Aetna Commercial	$1,002.33
Rate for Payer: Aetna Medicare Advantage	$791.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$672.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$672.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$527.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$672.61
Rate for Payer: Cigna Commercial	$1,318.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$638.32
Rate for Payer: Qualcare PPO/HMO/WC	$395.65
Rate for Payer: UnitedHealthcare Community & State	$83.35
Rate for Payer: Wellpoint Medicaid Managed Care	$74.91

MESH STEX 15x10CM

Facility

$2,637.70

Service Code	HCPCS C1781
Hospital Charge Code	270665533
Hospital Revenue Code	278
Min. Negotiated Rate	$395.65
Max. Negotiated Rate	$638.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$527.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$638.32
Rate for Payer: Qualcare PPO/HMO/WC	$395.65

MESH STEX 20x15CM

Facility

$4,231.35

Service Code	HCPCS C1781
Hospital Charge Code	270665534
Hospital Revenue Code	278
Min. Negotiated Rate	$634.70
Max. Negotiated Rate	$1,023.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$846.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,023.99
Rate for Payer: Qualcare PPO/HMO/WC	$634.70

MESH STEX 20x15CM

Facility

$4,231.35

Service Code	HCPCS C1781
Hospital Charge Code	270665534
Hospital Revenue Code	278
Min. Negotiated Rate	$120.17
Max. Negotiated Rate	$2,115.68
Rate for Payer: Aetna Commercial	$1,607.91
Rate for Payer: Aetna Medicare Advantage	$1,269.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,078.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,078.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$846.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,078.99
Rate for Payer: Cigna Commercial	$2,115.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,023.99
Rate for Payer: Qualcare PPO/HMO/WC	$634.70
Rate for Payer: UnitedHealthcare Community & State	$133.71
Rate for Payer: Wellpoint Medicaid Managed Care	$120.17

MESH STEX 25x20CM

Facility

$6,752.65

Service Code	HCPCS C1781
Hospital Charge Code	270667413
Hospital Revenue Code	278
Min. Negotiated Rate	$191.78
Max. Negotiated Rate	$3,376.32
Rate for Payer: Aetna Commercial	$2,566.01
Rate for Payer: Aetna Medicare Advantage	$2,025.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.93
Rate for Payer: Cigna Commercial	$3,376.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,634.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.90
Rate for Payer: UnitedHealthcare Community & State	$213.38
Rate for Payer: Wellpoint Medicaid Managed Care	$191.78

MESH STEX 25x20CM

Facility

$6,752.65

Service Code	HCPCS C1781
Hospital Charge Code	270667413
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.90
Max. Negotiated Rate	$1,634.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,634.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.90

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 17x10CM

Facility

$2,371.40

Service Code	HCPCS C1781
Hospital Charge Code	270671732
Hospital Revenue Code	278
Min. Negotiated Rate	$67.35
Max. Negotiated Rate	$1,185.70
Rate for Payer: Aetna Commercial	$901.13
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
Rate for Payer: UnitedHealthcare Community & State	$74.94
Rate for Payer: Wellpoint Medicaid Managed Care	$67.35

MESH STEX ELIP 20x12CM

Facility

$9,435.20

Hospital Charge Code	270677505
Hospital Revenue Code	278
Min. Negotiated Rate	$267.96
Max. Negotiated Rate	$4,717.60
Rate for Payer: Aetna Commercial	$3,585.38
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
Rate for Payer: UnitedHealthcare Community & State	$298.15
Rate for Payer: Wellpoint Medicaid Managed Care	$267.96

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 ROUND 12CM

Facility

$2,901.45

Service Code	HCPCS C1781
Hospital Charge Code	270665531
Hospital Revenue Code	278
Min. Negotiated Rate	$82.40
Max. Negotiated Rate	$1,450.72
Rate for Payer: Aetna Commercial	$1,102.55
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
Rate for Payer: UnitedHealthcare Community & State	$91.69
Rate for Payer: Wellpoint Medicaid Managed Care	$82.40

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 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	$106.83
Max. Negotiated Rate	$1,880.80
Rate for Payer: Aetna Commercial	$1,429.41
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
Rate for Payer: UnitedHealthcare Community & State	$118.87
Rate for Payer: Wellpoint Medicaid Managed Care	$106.83

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 ROUND 9CM

Facility

$2,115.65

Service Code	HCPCS C1781
Hospital Charge Code	270665530
Hospital Revenue Code	278
Min. Negotiated Rate	$60.08
Max. Negotiated Rate	$1,057.83
Rate for Payer: Aetna Commercial	$803.95
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
Rate for Payer: UnitedHealthcare Community & State	$66.85
Rate for Payer: Wellpoint Medicaid Managed Care	$60.08

MESH STEX SKIRT 15x10CM 6X4

Facility

$3,582.00

Service Code	HCPCS C1781
Hospital Charge Code	270679903
Hospital Revenue Code	278
Min. Negotiated Rate	$101.73
Max. Negotiated Rate	$1,791.00
Rate for Payer: Aetna Commercial	$1,361.16
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
Rate for Payer: UnitedHealthcare Community & State	$113.19
Rate for Payer: Wellpoint Medicaid Managed Care	$101.73

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

Know your out-of-pocket cost for care.

All Charges