|
HC AR DBL COMP SCREW 3.5X40 CANN
|
Facility
OP
|
$269.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603366
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.94 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$227.46
|
| Rate for Payer: Aetna Medicare |
$88.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$88.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$154.77
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$168.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$102.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$97.83
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Centivo All Commercial |
$137.44
|
| Rate for Payer: Cigna All Commercial |
$232.58
|
| Rate for Payer: CORVEL All Commercial |
$250.64
|
| Rate for Payer: Coventry All Commercial |
$237.16
|
| Rate for Payer: Encore All Commercial |
$248.07
|
| Rate for Payer: Frontpath All Commercial |
$247.94
|
| Rate for Payer: Humana ChoiceCare |
$232.77
|
| Rate for Payer: Humana Medicare |
$137.44
|
| Rate for Payer: Lucent All Commercial |
$137.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$242.55
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$202.12
|
| Rate for Payer: PHP All Commercial |
$204.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$105.10
|
| Rate for Payer: Sagamore Health Network All Products |
$208.05
|
| Rate for Payer: Signature Care EPO |
$223.68
|
| Rate for Payer: Signature Care PPO |
$237.16
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$229.08
|
| Rate for Payer: United Healthcare Commercial |
$212.37
|
| Rate for Payer: United Healthcare Medicare |
$88.94
|
|
|
HC AR DBL COMP SCREW 3.5X40 CANN
|
Facility
IP
|
$269.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603366
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$202.12 |
| Max. Negotiated Rate |
$250.64 |
| Rate for Payer: Aetna Commercial |
$232.85
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Cigna All Commercial |
$232.58
|
| Rate for Payer: CORVEL All Commercial |
$250.64
|
| Rate for Payer: Coventry All Commercial |
$237.16
|
| Rate for Payer: Encore All Commercial |
$248.07
|
| Rate for Payer: Frontpath All Commercial |
$247.94
|
| Rate for Payer: Humana ChoiceCare |
$232.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$242.55
|
| Rate for Payer: PHCS All Commercial |
$202.12
|
| Rate for Payer: PHP All Commercial |
$204.39
|
| Rate for Payer: Sagamore Health Network All Products |
$208.05
|
| Rate for Payer: Signature Care EPO |
$223.68
|
| Rate for Payer: Signature Care PPO |
$237.16
|
| Rate for Payer: United Healthcare Commercial |
$212.37
|
|
|
HC AR DBL COMP SCREW 3.5X40 CORT
|
Facility
IP
|
$269.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603344
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$202.12 |
| Max. Negotiated Rate |
$250.64 |
| Rate for Payer: Aetna Commercial |
$232.85
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Cigna All Commercial |
$232.58
|
| Rate for Payer: CORVEL All Commercial |
$250.64
|
| Rate for Payer: Coventry All Commercial |
$237.16
|
| Rate for Payer: Encore All Commercial |
$248.07
|
| Rate for Payer: Frontpath All Commercial |
$247.94
|
| Rate for Payer: Humana ChoiceCare |
$232.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$242.55
|
| Rate for Payer: PHCS All Commercial |
$202.12
|
| Rate for Payer: PHP All Commercial |
$204.39
|
| Rate for Payer: Sagamore Health Network All Products |
$208.05
|
| Rate for Payer: Signature Care EPO |
$223.68
|
| Rate for Payer: Signature Care PPO |
$237.16
|
| Rate for Payer: United Healthcare Commercial |
$212.37
|
|
|
HC AR DBL COMP SCREW 3.5X40 CORT
|
Facility
OP
|
$269.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603344
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.94 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$227.46
|
| Rate for Payer: Aetna Medicare |
$88.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$88.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$154.77
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$168.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$102.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$97.83
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Centivo All Commercial |
$137.44
|
| Rate for Payer: Cigna All Commercial |
$232.58
|
| Rate for Payer: CORVEL All Commercial |
$250.64
|
| Rate for Payer: Coventry All Commercial |
$237.16
|
| Rate for Payer: Encore All Commercial |
$248.07
|
| Rate for Payer: Frontpath All Commercial |
$247.94
|
| Rate for Payer: Humana ChoiceCare |
$232.77
|
| Rate for Payer: Humana Medicare |
$137.44
|
| Rate for Payer: Lucent All Commercial |
$137.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$242.55
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$202.12
|
| Rate for Payer: PHP All Commercial |
$204.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$105.10
|
| Rate for Payer: Sagamore Health Network All Products |
$208.05
|
| Rate for Payer: Signature Care EPO |
$223.68
|
| Rate for Payer: Signature Care PPO |
$237.16
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$229.08
|
| Rate for Payer: United Healthcare Commercial |
$212.37
|
| Rate for Payer: United Healthcare Medicare |
$88.94
|
|
|
HC AR DBL COMP SCREW 3.5X40 LOCK
|
Facility
IP
|
$825.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603323
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$618.75 |
| Max. Negotiated Rate |
$767.25 |
| Rate for Payer: Aetna Commercial |
$712.80
|
| Rate for Payer: Cash Price |
$511.50
|
| Rate for Payer: Cigna All Commercial |
$711.98
|
| Rate for Payer: CORVEL All Commercial |
$767.25
|
| Rate for Payer: Coventry All Commercial |
$726.00
|
| Rate for Payer: Encore All Commercial |
$759.41
|
| Rate for Payer: Frontpath All Commercial |
$759.00
|
| Rate for Payer: Humana ChoiceCare |
$712.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$742.50
|
| Rate for Payer: PHCS All Commercial |
$618.75
|
| Rate for Payer: PHP All Commercial |
$625.68
|
| Rate for Payer: Sagamore Health Network All Products |
$636.90
|
| Rate for Payer: Signature Care EPO |
$684.75
|
| Rate for Payer: Signature Care PPO |
$726.00
|
| Rate for Payer: United Healthcare Commercial |
$650.10
|
|
|
HC AR DBL COMP SCREW 3.5X40 LOCK
|
Facility
OP
|
$825.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603323
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$272.25 |
| Max. Negotiated Rate |
$767.25 |
| Rate for Payer: Aetna Commercial |
$696.30
|
| Rate for Payer: Aetna Medicare |
$272.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$272.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$473.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$515.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$313.09
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$299.48
|
| Rate for Payer: Cash Price |
$511.50
|
| Rate for Payer: Cash Price |
$511.50
|
| Rate for Payer: Centivo All Commercial |
$420.75
|
| Rate for Payer: Cigna All Commercial |
$711.98
|
| Rate for Payer: CORVEL All Commercial |
$767.25
|
| Rate for Payer: Coventry All Commercial |
$726.00
|
| Rate for Payer: Encore All Commercial |
$759.41
|
| Rate for Payer: Frontpath All Commercial |
$759.00
|
| Rate for Payer: Humana ChoiceCare |
$712.55
|
| Rate for Payer: Humana Medicare |
$420.75
|
| Rate for Payer: Lucent All Commercial |
$420.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$742.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$618.75
|
| Rate for Payer: PHP All Commercial |
$625.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$321.75
|
| Rate for Payer: Sagamore Health Network All Products |
$636.90
|
| Rate for Payer: Signature Care EPO |
$684.75
|
| Rate for Payer: Signature Care PPO |
$726.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$701.25
|
| Rate for Payer: United Healthcare Commercial |
$650.10
|
| Rate for Payer: United Healthcare Medicare |
$272.25
|
|
|
HC AR DBL COMP SCREW 3.5X42 CANN
|
Facility
IP
|
$269.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603367
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$202.12 |
| Max. Negotiated Rate |
$250.64 |
| Rate for Payer: Aetna Commercial |
$232.85
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Cigna All Commercial |
$232.58
|
| Rate for Payer: CORVEL All Commercial |
$250.64
|
| Rate for Payer: Coventry All Commercial |
$237.16
|
| Rate for Payer: Encore All Commercial |
$248.07
|
| Rate for Payer: Frontpath All Commercial |
$247.94
|
| Rate for Payer: Humana ChoiceCare |
$232.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$242.55
|
| Rate for Payer: PHCS All Commercial |
$202.12
|
| Rate for Payer: PHP All Commercial |
$204.39
|
| Rate for Payer: Sagamore Health Network All Products |
$208.05
|
| Rate for Payer: Signature Care EPO |
$223.68
|
| Rate for Payer: Signature Care PPO |
$237.16
|
| Rate for Payer: United Healthcare Commercial |
$212.37
|
|
|
HC AR DBL COMP SCREW 3.5X42 CANN
|
Facility
OP
|
$269.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603367
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.94 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$227.46
|
| Rate for Payer: Aetna Medicare |
$88.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$88.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$154.77
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$168.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$102.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$97.83
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Centivo All Commercial |
$137.44
|
| Rate for Payer: Cigna All Commercial |
$232.58
|
| Rate for Payer: CORVEL All Commercial |
$250.64
|
| Rate for Payer: Coventry All Commercial |
$237.16
|
| Rate for Payer: Encore All Commercial |
$248.07
|
| Rate for Payer: Frontpath All Commercial |
$247.94
|
| Rate for Payer: Humana ChoiceCare |
$232.77
|
| Rate for Payer: Humana Medicare |
$137.44
|
| Rate for Payer: Lucent All Commercial |
$137.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$242.55
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$202.12
|
| Rate for Payer: PHP All Commercial |
$204.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$105.10
|
| Rate for Payer: Sagamore Health Network All Products |
$208.05
|
| Rate for Payer: Signature Care EPO |
$223.68
|
| Rate for Payer: Signature Care PPO |
$237.16
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$229.08
|
| Rate for Payer: United Healthcare Commercial |
$212.37
|
| Rate for Payer: United Healthcare Medicare |
$88.94
|
|
|
HC AR DBL COMP SCREW 3.5X42 CORT
|
Facility
IP
|
$269.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603345
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$202.12 |
| Max. Negotiated Rate |
$250.64 |
| Rate for Payer: Aetna Commercial |
$232.85
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Cigna All Commercial |
$232.58
|
| Rate for Payer: CORVEL All Commercial |
$250.64
|
| Rate for Payer: Coventry All Commercial |
$237.16
|
| Rate for Payer: Encore All Commercial |
$248.07
|
| Rate for Payer: Frontpath All Commercial |
$247.94
|
| Rate for Payer: Humana ChoiceCare |
$232.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$242.55
|
| Rate for Payer: PHCS All Commercial |
$202.12
|
| Rate for Payer: PHP All Commercial |
$204.39
|
| Rate for Payer: Sagamore Health Network All Products |
$208.05
|
| Rate for Payer: Signature Care EPO |
$223.68
|
| Rate for Payer: Signature Care PPO |
$237.16
|
| Rate for Payer: United Healthcare Commercial |
$212.37
|
|
|
HC AR DBL COMP SCREW 3.5X42 CORT
|
Facility
OP
|
$269.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603345
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.94 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$227.46
|
| Rate for Payer: Aetna Medicare |
$88.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$88.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$154.77
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$168.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$102.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$97.83
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Centivo All Commercial |
$137.44
|
| Rate for Payer: Cigna All Commercial |
$232.58
|
| Rate for Payer: CORVEL All Commercial |
$250.64
|
| Rate for Payer: Coventry All Commercial |
$237.16
|
| Rate for Payer: Encore All Commercial |
$248.07
|
| Rate for Payer: Frontpath All Commercial |
$247.94
|
| Rate for Payer: Humana ChoiceCare |
$232.77
|
| Rate for Payer: Humana Medicare |
$137.44
|
| Rate for Payer: Lucent All Commercial |
$137.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$242.55
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$202.12
|
| Rate for Payer: PHP All Commercial |
$204.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$105.10
|
| Rate for Payer: Sagamore Health Network All Products |
$208.05
|
| Rate for Payer: Signature Care EPO |
$223.68
|
| Rate for Payer: Signature Care PPO |
$237.16
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$229.08
|
| Rate for Payer: United Healthcare Commercial |
$212.37
|
| Rate for Payer: United Healthcare Medicare |
$88.94
|
|
|
HC AR DBL COMP SCREW 3.5X42 LOCK
|
Facility
IP
|
$825.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603324
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$618.75 |
| Max. Negotiated Rate |
$767.25 |
| Rate for Payer: Aetna Commercial |
$712.80
|
| Rate for Payer: Cash Price |
$511.50
|
| Rate for Payer: Cigna All Commercial |
$711.98
|
| Rate for Payer: CORVEL All Commercial |
$767.25
|
| Rate for Payer: Coventry All Commercial |
$726.00
|
| Rate for Payer: Encore All Commercial |
$759.41
|
| Rate for Payer: Frontpath All Commercial |
$759.00
|
| Rate for Payer: Humana ChoiceCare |
$712.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$742.50
|
| Rate for Payer: PHCS All Commercial |
$618.75
|
| Rate for Payer: PHP All Commercial |
$625.68
|
| Rate for Payer: Sagamore Health Network All Products |
$636.90
|
| Rate for Payer: Signature Care EPO |
$684.75
|
| Rate for Payer: Signature Care PPO |
$726.00
|
| Rate for Payer: United Healthcare Commercial |
$650.10
|
|
|
HC AR DBL COMP SCREW 3.5X42 LOCK
|
Facility
OP
|
$825.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603324
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$272.25 |
| Max. Negotiated Rate |
$767.25 |
| Rate for Payer: Aetna Commercial |
$696.30
|
| Rate for Payer: Aetna Medicare |
$272.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$272.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$473.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$515.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$313.09
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$299.48
|
| Rate for Payer: Cash Price |
$511.50
|
| Rate for Payer: Cash Price |
$511.50
|
| Rate for Payer: Centivo All Commercial |
$420.75
|
| Rate for Payer: Cigna All Commercial |
$711.98
|
| Rate for Payer: CORVEL All Commercial |
$767.25
|
| Rate for Payer: Coventry All Commercial |
$726.00
|
| Rate for Payer: Encore All Commercial |
$759.41
|
| Rate for Payer: Frontpath All Commercial |
$759.00
|
| Rate for Payer: Humana ChoiceCare |
$712.55
|
| Rate for Payer: Humana Medicare |
$420.75
|
| Rate for Payer: Lucent All Commercial |
$420.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$742.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$618.75
|
| Rate for Payer: PHP All Commercial |
$625.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$321.75
|
| Rate for Payer: Sagamore Health Network All Products |
$636.90
|
| Rate for Payer: Signature Care EPO |
$684.75
|
| Rate for Payer: Signature Care PPO |
$726.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$701.25
|
| Rate for Payer: United Healthcare Commercial |
$650.10
|
| Rate for Payer: United Healthcare Medicare |
$272.25
|
|
|
HC AR DBL COMP SCREW 3.5X44 CANN
|
Facility
IP
|
$269.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603368
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$202.12 |
| Max. Negotiated Rate |
$250.64 |
| Rate for Payer: Aetna Commercial |
$232.85
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Cigna All Commercial |
$232.58
|
| Rate for Payer: CORVEL All Commercial |
$250.64
|
| Rate for Payer: Coventry All Commercial |
$237.16
|
| Rate for Payer: Encore All Commercial |
$248.07
|
| Rate for Payer: Frontpath All Commercial |
$247.94
|
| Rate for Payer: Humana ChoiceCare |
$232.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$242.55
|
| Rate for Payer: PHCS All Commercial |
$202.12
|
| Rate for Payer: PHP All Commercial |
$204.39
|
| Rate for Payer: Sagamore Health Network All Products |
$208.05
|
| Rate for Payer: Signature Care EPO |
$223.68
|
| Rate for Payer: Signature Care PPO |
$237.16
|
| Rate for Payer: United Healthcare Commercial |
$212.37
|
|
|
HC AR DBL COMP SCREW 3.5X44 CANN
|
Facility
OP
|
$269.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603368
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.94 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$227.46
|
| Rate for Payer: Aetna Medicare |
$88.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$88.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$154.77
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$168.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$102.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$97.83
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Centivo All Commercial |
$137.44
|
| Rate for Payer: Cigna All Commercial |
$232.58
|
| Rate for Payer: CORVEL All Commercial |
$250.64
|
| Rate for Payer: Coventry All Commercial |
$237.16
|
| Rate for Payer: Encore All Commercial |
$248.07
|
| Rate for Payer: Frontpath All Commercial |
$247.94
|
| Rate for Payer: Humana ChoiceCare |
$232.77
|
| Rate for Payer: Humana Medicare |
$137.44
|
| Rate for Payer: Lucent All Commercial |
$137.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$242.55
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$202.12
|
| Rate for Payer: PHP All Commercial |
$204.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$105.10
|
| Rate for Payer: Sagamore Health Network All Products |
$208.05
|
| Rate for Payer: Signature Care EPO |
$223.68
|
| Rate for Payer: Signature Care PPO |
$237.16
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$229.08
|
| Rate for Payer: United Healthcare Commercial |
$212.37
|
| Rate for Payer: United Healthcare Medicare |
$88.94
|
|
|
HC AR DBL COMP SCREW 3.5X44 CORT
|
Facility
IP
|
$269.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603346
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$202.12 |
| Max. Negotiated Rate |
$250.64 |
| Rate for Payer: Aetna Commercial |
$232.85
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Cigna All Commercial |
$232.58
|
| Rate for Payer: CORVEL All Commercial |
$250.64
|
| Rate for Payer: Coventry All Commercial |
$237.16
|
| Rate for Payer: Encore All Commercial |
$248.07
|
| Rate for Payer: Frontpath All Commercial |
$247.94
|
| Rate for Payer: Humana ChoiceCare |
$232.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$242.55
|
| Rate for Payer: PHCS All Commercial |
$202.12
|
| Rate for Payer: PHP All Commercial |
$204.39
|
| Rate for Payer: Sagamore Health Network All Products |
$208.05
|
| Rate for Payer: Signature Care EPO |
$223.68
|
| Rate for Payer: Signature Care PPO |
$237.16
|
| Rate for Payer: United Healthcare Commercial |
$212.37
|
|
|
HC AR DBL COMP SCREW 3.5X44 CORT
|
Facility
OP
|
$269.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603346
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.94 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$227.46
|
| Rate for Payer: Aetna Medicare |
$88.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$88.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$154.77
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$168.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$102.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$97.83
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Centivo All Commercial |
$137.44
|
| Rate for Payer: Cigna All Commercial |
$232.58
|
| Rate for Payer: CORVEL All Commercial |
$250.64
|
| Rate for Payer: Coventry All Commercial |
$237.16
|
| Rate for Payer: Encore All Commercial |
$248.07
|
| Rate for Payer: Frontpath All Commercial |
$247.94
|
| Rate for Payer: Humana ChoiceCare |
$232.77
|
| Rate for Payer: Humana Medicare |
$137.44
|
| Rate for Payer: Lucent All Commercial |
$137.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$242.55
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$202.12
|
| Rate for Payer: PHP All Commercial |
$204.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$105.10
|
| Rate for Payer: Sagamore Health Network All Products |
$208.05
|
| Rate for Payer: Signature Care EPO |
$223.68
|
| Rate for Payer: Signature Care PPO |
$237.16
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$229.08
|
| Rate for Payer: United Healthcare Commercial |
$212.37
|
| Rate for Payer: United Healthcare Medicare |
$88.94
|
|
|
HC AR DBL COMP SCREW 3.5X44 LOCK
|
Facility
IP
|
$825.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603325
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$618.75 |
| Max. Negotiated Rate |
$767.25 |
| Rate for Payer: Aetna Commercial |
$712.80
|
| Rate for Payer: Cash Price |
$511.50
|
| Rate for Payer: Cigna All Commercial |
$711.98
|
| Rate for Payer: CORVEL All Commercial |
$767.25
|
| Rate for Payer: Coventry All Commercial |
$726.00
|
| Rate for Payer: Encore All Commercial |
$759.41
|
| Rate for Payer: Frontpath All Commercial |
$759.00
|
| Rate for Payer: Humana ChoiceCare |
$712.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$742.50
|
| Rate for Payer: PHCS All Commercial |
$618.75
|
| Rate for Payer: PHP All Commercial |
$625.68
|
| Rate for Payer: Sagamore Health Network All Products |
$636.90
|
| Rate for Payer: Signature Care EPO |
$684.75
|
| Rate for Payer: Signature Care PPO |
$726.00
|
| Rate for Payer: United Healthcare Commercial |
$650.10
|
|
|
HC AR DBL COMP SCREW 3.5X44 LOCK
|
Facility
OP
|
$825.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603325
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$272.25 |
| Max. Negotiated Rate |
$767.25 |
| Rate for Payer: Aetna Commercial |
$696.30
|
| Rate for Payer: Aetna Medicare |
$272.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$272.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$473.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$515.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$313.09
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$299.48
|
| Rate for Payer: Cash Price |
$511.50
|
| Rate for Payer: Cash Price |
$511.50
|
| Rate for Payer: Centivo All Commercial |
$420.75
|
| Rate for Payer: Cigna All Commercial |
$711.98
|
| Rate for Payer: CORVEL All Commercial |
$767.25
|
| Rate for Payer: Coventry All Commercial |
$726.00
|
| Rate for Payer: Encore All Commercial |
$759.41
|
| Rate for Payer: Frontpath All Commercial |
$759.00
|
| Rate for Payer: Humana ChoiceCare |
$712.55
|
| Rate for Payer: Humana Medicare |
$420.75
|
| Rate for Payer: Lucent All Commercial |
$420.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$742.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$618.75
|
| Rate for Payer: PHP All Commercial |
$625.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$321.75
|
| Rate for Payer: Sagamore Health Network All Products |
$636.90
|
| Rate for Payer: Signature Care EPO |
$684.75
|
| Rate for Payer: Signature Care PPO |
$726.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$701.25
|
| Rate for Payer: United Healthcare Commercial |
$650.10
|
| Rate for Payer: United Healthcare Medicare |
$272.25
|
|
|
HC AR DBL COMP SCREW 3.5X46 CANN
|
Facility
IP
|
$269.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603369
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$202.12 |
| Max. Negotiated Rate |
$250.64 |
| Rate for Payer: Aetna Commercial |
$232.85
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Cigna All Commercial |
$232.58
|
| Rate for Payer: CORVEL All Commercial |
$250.64
|
| Rate for Payer: Coventry All Commercial |
$237.16
|
| Rate for Payer: Encore All Commercial |
$248.07
|
| Rate for Payer: Frontpath All Commercial |
$247.94
|
| Rate for Payer: Humana ChoiceCare |
$232.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$242.55
|
| Rate for Payer: PHCS All Commercial |
$202.12
|
| Rate for Payer: PHP All Commercial |
$204.39
|
| Rate for Payer: Sagamore Health Network All Products |
$208.05
|
| Rate for Payer: Signature Care EPO |
$223.68
|
| Rate for Payer: Signature Care PPO |
$237.16
|
| Rate for Payer: United Healthcare Commercial |
$212.37
|
|
|
HC AR DBL COMP SCREW 3.5X46 CANN
|
Facility
OP
|
$269.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603369
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.94 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$227.46
|
| Rate for Payer: Aetna Medicare |
$88.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$88.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$154.77
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$168.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$102.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$97.83
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Centivo All Commercial |
$137.44
|
| Rate for Payer: Cigna All Commercial |
$232.58
|
| Rate for Payer: CORVEL All Commercial |
$250.64
|
| Rate for Payer: Coventry All Commercial |
$237.16
|
| Rate for Payer: Encore All Commercial |
$248.07
|
| Rate for Payer: Frontpath All Commercial |
$247.94
|
| Rate for Payer: Humana ChoiceCare |
$232.77
|
| Rate for Payer: Humana Medicare |
$137.44
|
| Rate for Payer: Lucent All Commercial |
$137.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$242.55
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$202.12
|
| Rate for Payer: PHP All Commercial |
$204.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$105.10
|
| Rate for Payer: Sagamore Health Network All Products |
$208.05
|
| Rate for Payer: Signature Care EPO |
$223.68
|
| Rate for Payer: Signature Care PPO |
$237.16
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$229.08
|
| Rate for Payer: United Healthcare Commercial |
$212.37
|
| Rate for Payer: United Healthcare Medicare |
$88.94
|
|
|
HC AR DBL COMP SCREW 3.5X46 CORT
|
Facility
OP
|
$269.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603347
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.94 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$227.46
|
| Rate for Payer: Aetna Medicare |
$88.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$88.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$154.77
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$168.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$102.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$97.83
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Centivo All Commercial |
$137.44
|
| Rate for Payer: Cigna All Commercial |
$232.58
|
| Rate for Payer: CORVEL All Commercial |
$250.64
|
| Rate for Payer: Coventry All Commercial |
$237.16
|
| Rate for Payer: Encore All Commercial |
$248.07
|
| Rate for Payer: Frontpath All Commercial |
$247.94
|
| Rate for Payer: Humana ChoiceCare |
$232.77
|
| Rate for Payer: Humana Medicare |
$137.44
|
| Rate for Payer: Lucent All Commercial |
$137.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$242.55
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$202.12
|
| Rate for Payer: PHP All Commercial |
$204.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$105.10
|
| Rate for Payer: Sagamore Health Network All Products |
$208.05
|
| Rate for Payer: Signature Care EPO |
$223.68
|
| Rate for Payer: Signature Care PPO |
$237.16
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$229.08
|
| Rate for Payer: United Healthcare Commercial |
$212.37
|
| Rate for Payer: United Healthcare Medicare |
$88.94
|
|
|
HC AR DBL COMP SCREW 3.5X46 CORT
|
Facility
IP
|
$269.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603347
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$202.12 |
| Max. Negotiated Rate |
$250.64 |
| Rate for Payer: Aetna Commercial |
$232.85
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Cigna All Commercial |
$232.58
|
| Rate for Payer: CORVEL All Commercial |
$250.64
|
| Rate for Payer: Coventry All Commercial |
$237.16
|
| Rate for Payer: Encore All Commercial |
$248.07
|
| Rate for Payer: Frontpath All Commercial |
$247.94
|
| Rate for Payer: Humana ChoiceCare |
$232.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$242.55
|
| Rate for Payer: PHCS All Commercial |
$202.12
|
| Rate for Payer: PHP All Commercial |
$204.39
|
| Rate for Payer: Sagamore Health Network All Products |
$208.05
|
| Rate for Payer: Signature Care EPO |
$223.68
|
| Rate for Payer: Signature Care PPO |
$237.16
|
| Rate for Payer: United Healthcare Commercial |
$212.37
|
|
|
HC AR DBL COMP SCREW 3.5X46 LOCK
|
Facility
OP
|
$825.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603326
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$272.25 |
| Max. Negotiated Rate |
$767.25 |
| Rate for Payer: Aetna Commercial |
$696.30
|
| Rate for Payer: Aetna Medicare |
$272.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$272.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$473.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$515.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$313.09
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$299.48
|
| Rate for Payer: Cash Price |
$511.50
|
| Rate for Payer: Cash Price |
$511.50
|
| Rate for Payer: Centivo All Commercial |
$420.75
|
| Rate for Payer: Cigna All Commercial |
$711.98
|
| Rate for Payer: CORVEL All Commercial |
$767.25
|
| Rate for Payer: Coventry All Commercial |
$726.00
|
| Rate for Payer: Encore All Commercial |
$759.41
|
| Rate for Payer: Frontpath All Commercial |
$759.00
|
| Rate for Payer: Humana ChoiceCare |
$712.55
|
| Rate for Payer: Humana Medicare |
$420.75
|
| Rate for Payer: Lucent All Commercial |
$420.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$742.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$618.75
|
| Rate for Payer: PHP All Commercial |
$625.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$321.75
|
| Rate for Payer: Sagamore Health Network All Products |
$636.90
|
| Rate for Payer: Signature Care EPO |
$684.75
|
| Rate for Payer: Signature Care PPO |
$726.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$701.25
|
| Rate for Payer: United Healthcare Commercial |
$650.10
|
| Rate for Payer: United Healthcare Medicare |
$272.25
|
|
|
HC AR DBL COMP SCREW 3.5X46 LOCK
|
Facility
IP
|
$825.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603326
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$618.75 |
| Max. Negotiated Rate |
$767.25 |
| Rate for Payer: Aetna Commercial |
$712.80
|
| Rate for Payer: Cash Price |
$511.50
|
| Rate for Payer: Cigna All Commercial |
$711.98
|
| Rate for Payer: CORVEL All Commercial |
$767.25
|
| Rate for Payer: Coventry All Commercial |
$726.00
|
| Rate for Payer: Encore All Commercial |
$759.41
|
| Rate for Payer: Frontpath All Commercial |
$759.00
|
| Rate for Payer: Humana ChoiceCare |
$712.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$742.50
|
| Rate for Payer: PHCS All Commercial |
$618.75
|
| Rate for Payer: PHP All Commercial |
$625.68
|
| Rate for Payer: Sagamore Health Network All Products |
$636.90
|
| Rate for Payer: Signature Care EPO |
$684.75
|
| Rate for Payer: Signature Care PPO |
$726.00
|
| Rate for Payer: United Healthcare Commercial |
$650.10
|
|
|
HC AR DBL COMP SCREW 3.5X48 CANN
|
Facility
IP
|
$269.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603370
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$202.12 |
| Max. Negotiated Rate |
$250.64 |
| Rate for Payer: Aetna Commercial |
$232.85
|
| Rate for Payer: Cash Price |
$167.09
|
| Rate for Payer: Cigna All Commercial |
$232.58
|
| Rate for Payer: CORVEL All Commercial |
$250.64
|
| Rate for Payer: Coventry All Commercial |
$237.16
|
| Rate for Payer: Encore All Commercial |
$248.07
|
| Rate for Payer: Frontpath All Commercial |
$247.94
|
| Rate for Payer: Humana ChoiceCare |
$232.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$242.55
|
| Rate for Payer: PHCS All Commercial |
$202.12
|
| Rate for Payer: PHP All Commercial |
$204.39
|
| Rate for Payer: Sagamore Health Network All Products |
$208.05
|
| Rate for Payer: Signature Care EPO |
$223.68
|
| Rate for Payer: Signature Care PPO |
$237.16
|
| Rate for Payer: United Healthcare Commercial |
$212.37
|
|
