|
HC AR DIST KIT SWIVELOCK 4.75
|
Facility
OP
|
$2,079.00
|
|
| Hospital Charge Code |
41607962
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,933.47 |
| Rate for Payer: Aetna Commercial |
$1,754.68
|
| Rate for Payer: Aetna Medicare |
$686.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$686.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,193.97
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,299.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$788.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$754.68
|
| Rate for Payer: Cash Price |
$1,288.98
|
| Rate for Payer: Cash Price |
$1,288.98
|
| Rate for Payer: Centivo All Commercial |
$1,060.29
|
| Rate for Payer: Cigna All Commercial |
$1,794.18
|
| Rate for Payer: CORVEL All Commercial |
$1,933.47
|
| Rate for Payer: Coventry All Commercial |
$1,829.52
|
| Rate for Payer: Encore All Commercial |
$1,913.72
|
| Rate for Payer: Frontpath All Commercial |
$1,912.68
|
| Rate for Payer: Humana ChoiceCare |
$1,795.63
|
| Rate for Payer: Humana Medicare |
$1,060.29
|
| Rate for Payer: Lucent All Commercial |
$1,060.29
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,871.10
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,559.25
|
| Rate for Payer: PHP All Commercial |
$1,576.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$810.81
|
| Rate for Payer: Sagamore Health Network All Products |
$1,604.99
|
| Rate for Payer: Signature Care EPO |
$1,725.57
|
| Rate for Payer: Signature Care PPO |
$1,829.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,767.15
|
| Rate for Payer: United Healthcare Commercial |
$1,638.25
|
| Rate for Payer: United Healthcare Medicare |
$686.07
|
|
|
HC AR DIST KIT SWIVELOCK 4.75
|
Facility
IP
|
$2,079.00
|
|
| Hospital Charge Code |
41607962
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,559.25 |
| Max. Negotiated Rate |
$1,933.47 |
| Rate for Payer: Aetna Commercial |
$1,796.26
|
| Rate for Payer: Cash Price |
$1,288.98
|
| Rate for Payer: Cigna All Commercial |
$1,794.18
|
| Rate for Payer: CORVEL All Commercial |
$1,933.47
|
| Rate for Payer: Coventry All Commercial |
$1,829.52
|
| Rate for Payer: Encore All Commercial |
$1,913.72
|
| Rate for Payer: Frontpath All Commercial |
$1,912.68
|
| Rate for Payer: Humana ChoiceCare |
$1,795.63
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,871.10
|
| Rate for Payer: PHCS All Commercial |
$1,559.25
|
| Rate for Payer: PHP All Commercial |
$1,576.71
|
| Rate for Payer: Sagamore Health Network All Products |
$1,604.99
|
| Rate for Payer: Signature Care EPO |
$1,725.57
|
| Rate for Payer: Signature Care PPO |
$1,829.52
|
| Rate for Payer: United Healthcare Commercial |
$1,638.25
|
|
|
HC AR DOG BONE BUTTON
|
Facility
IP
|
$1,925.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607786
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,443.75 |
| Max. Negotiated Rate |
$1,790.25 |
| Rate for Payer: Aetna Commercial |
$1,663.20
|
| Rate for Payer: Cash Price |
$1,193.50
|
| Rate for Payer: Cigna All Commercial |
$1,661.28
|
| Rate for Payer: CORVEL All Commercial |
$1,790.25
|
| Rate for Payer: Coventry All Commercial |
$1,694.00
|
| Rate for Payer: Encore All Commercial |
$1,771.96
|
| Rate for Payer: Frontpath All Commercial |
$1,771.00
|
| Rate for Payer: Humana ChoiceCare |
$1,662.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,732.50
|
| Rate for Payer: PHCS All Commercial |
$1,443.75
|
| Rate for Payer: PHP All Commercial |
$1,459.92
|
| Rate for Payer: Sagamore Health Network All Products |
$1,486.10
|
| Rate for Payer: Signature Care EPO |
$1,597.75
|
| Rate for Payer: Signature Care PPO |
$1,694.00
|
| Rate for Payer: United Healthcare Commercial |
$1,516.90
|
|
|
HC AR DOG BONE BUTTON
|
Facility
OP
|
$1,925.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607786
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,790.25 |
| Rate for Payer: Aetna Commercial |
$1,624.70
|
| Rate for Payer: Aetna Medicare |
$635.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$635.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,105.53
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,203.32
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$730.54
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$698.78
|
| Rate for Payer: Cash Price |
$1,193.50
|
| Rate for Payer: Cash Price |
$1,193.50
|
| Rate for Payer: Centivo All Commercial |
$981.75
|
| Rate for Payer: Cigna All Commercial |
$1,661.28
|
| Rate for Payer: CORVEL All Commercial |
$1,790.25
|
| Rate for Payer: Coventry All Commercial |
$1,694.00
|
| Rate for Payer: Encore All Commercial |
$1,771.96
|
| Rate for Payer: Frontpath All Commercial |
$1,771.00
|
| Rate for Payer: Humana ChoiceCare |
$1,662.62
|
| Rate for Payer: Humana Medicare |
$981.75
|
| Rate for Payer: Lucent All Commercial |
$981.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,732.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,443.75
|
| Rate for Payer: PHP All Commercial |
$1,459.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$750.75
|
| Rate for Payer: Sagamore Health Network All Products |
$1,486.10
|
| Rate for Payer: Signature Care EPO |
$1,597.75
|
| Rate for Payer: Signature Care PPO |
$1,694.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,636.25
|
| Rate for Payer: United Healthcare Commercial |
$1,516.90
|
| Rate for Payer: United Healthcare Medicare |
$635.25
|
|
|
HC AR DRILL 8 CANN
|
Facility
IP
|
$1,625.00
|
|
| Hospital Charge Code |
41608076
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,218.75 |
| Max. Negotiated Rate |
$1,511.25 |
| Rate for Payer: Aetna Commercial |
$1,404.00
|
| Rate for Payer: Cash Price |
$1,007.50
|
| Rate for Payer: Cigna All Commercial |
$1,402.38
|
| Rate for Payer: CORVEL All Commercial |
$1,511.25
|
| Rate for Payer: Coventry All Commercial |
$1,430.00
|
| Rate for Payer: Encore All Commercial |
$1,495.81
|
| Rate for Payer: Frontpath All Commercial |
$1,495.00
|
| Rate for Payer: Humana ChoiceCare |
$1,403.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,462.50
|
| Rate for Payer: PHCS All Commercial |
$1,218.75
|
| Rate for Payer: PHP All Commercial |
$1,232.40
|
| Rate for Payer: Sagamore Health Network All Products |
$1,254.50
|
| Rate for Payer: Signature Care EPO |
$1,348.75
|
| Rate for Payer: Signature Care PPO |
$1,430.00
|
| Rate for Payer: United Healthcare Commercial |
$1,280.50
|
|
|
HC AR DRILL 8 CANN
|
Facility
OP
|
$1,625.00
|
|
| Hospital Charge Code |
41608076
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,511.25 |
| Rate for Payer: Aetna Commercial |
$1,371.50
|
| Rate for Payer: Aetna Medicare |
$536.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$536.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$933.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,015.79
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$616.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$589.88
|
| Rate for Payer: Cash Price |
$1,007.50
|
| Rate for Payer: Cash Price |
$1,007.50
|
| Rate for Payer: Centivo All Commercial |
$828.75
|
| Rate for Payer: Cigna All Commercial |
$1,402.38
|
| Rate for Payer: CORVEL All Commercial |
$1,511.25
|
| Rate for Payer: Coventry All Commercial |
$1,430.00
|
| Rate for Payer: Encore All Commercial |
$1,495.81
|
| Rate for Payer: Frontpath All Commercial |
$1,495.00
|
| Rate for Payer: Humana ChoiceCare |
$1,403.51
|
| Rate for Payer: Humana Medicare |
$828.75
|
| Rate for Payer: Lucent All Commercial |
$828.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,462.50
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,218.75
|
| Rate for Payer: PHP All Commercial |
$1,232.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$633.75
|
| Rate for Payer: Sagamore Health Network All Products |
$1,254.50
|
| Rate for Payer: Signature Care EPO |
$1,348.75
|
| Rate for Payer: Signature Care PPO |
$1,430.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,381.25
|
| Rate for Payer: United Healthcare Commercial |
$1,280.50
|
| Rate for Payer: United Healthcare Medicare |
$536.25
|
|
|
HC AR DRILL 9 CANN
|
Facility
OP
|
$924.00
|
|
| Hospital Charge Code |
41605858
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$859.32 |
| Rate for Payer: Aetna Commercial |
$779.86
|
| Rate for Payer: Aetna Medicare |
$304.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$304.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$530.65
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$577.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$350.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$335.41
|
| Rate for Payer: Cash Price |
$572.88
|
| Rate for Payer: Cash Price |
$572.88
|
| Rate for Payer: Centivo All Commercial |
$471.24
|
| Rate for Payer: Cigna All Commercial |
$797.41
|
| Rate for Payer: CORVEL All Commercial |
$859.32
|
| Rate for Payer: Coventry All Commercial |
$813.12
|
| Rate for Payer: Encore All Commercial |
$850.54
|
| Rate for Payer: Frontpath All Commercial |
$850.08
|
| Rate for Payer: Humana ChoiceCare |
$798.06
|
| Rate for Payer: Humana Medicare |
$471.24
|
| Rate for Payer: Lucent All Commercial |
$471.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$831.60
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$693.00
|
| Rate for Payer: PHP All Commercial |
$700.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$360.36
|
| Rate for Payer: Sagamore Health Network All Products |
$713.33
|
| Rate for Payer: Signature Care EPO |
$766.92
|
| Rate for Payer: Signature Care PPO |
$813.12
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$785.40
|
| Rate for Payer: United Healthcare Commercial |
$728.11
|
| Rate for Payer: United Healthcare Medicare |
$304.92
|
|
|
HC AR DRILL 9 CANN
|
Facility
IP
|
$924.00
|
|
| Hospital Charge Code |
41605858
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$693.00 |
| Max. Negotiated Rate |
$859.32 |
| Rate for Payer: Aetna Commercial |
$798.34
|
| Rate for Payer: Cash Price |
$572.88
|
| Rate for Payer: Cigna All Commercial |
$797.41
|
| Rate for Payer: CORVEL All Commercial |
$859.32
|
| Rate for Payer: Coventry All Commercial |
$813.12
|
| Rate for Payer: Encore All Commercial |
$850.54
|
| Rate for Payer: Frontpath All Commercial |
$850.08
|
| Rate for Payer: Humana ChoiceCare |
$798.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$831.60
|
| Rate for Payer: PHCS All Commercial |
$693.00
|
| Rate for Payer: PHP All Commercial |
$700.76
|
| Rate for Payer: Sagamore Health Network All Products |
$713.33
|
| Rate for Payer: Signature Care EPO |
$766.92
|
| Rate for Payer: Signature Care PPO |
$813.12
|
| Rate for Payer: United Healthcare Commercial |
$728.11
|
|
|
HC AR DRILL BIT 2.0
|
Facility
IP
|
$2,295.00
|
|
| Hospital Charge Code |
41608349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,721.25 |
| Max. Negotiated Rate |
$2,134.35 |
| Rate for Payer: Aetna Commercial |
$1,982.88
|
| Rate for Payer: Cash Price |
$1,422.90
|
| Rate for Payer: Cigna All Commercial |
$1,980.58
|
| Rate for Payer: CORVEL All Commercial |
$2,134.35
|
| Rate for Payer: Coventry All Commercial |
$2,019.60
|
| Rate for Payer: Encore All Commercial |
$2,112.55
|
| Rate for Payer: Frontpath All Commercial |
$2,111.40
|
| Rate for Payer: Humana ChoiceCare |
$1,982.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,065.50
|
| Rate for Payer: PHCS All Commercial |
$1,721.25
|
| Rate for Payer: PHP All Commercial |
$1,740.53
|
| Rate for Payer: Sagamore Health Network All Products |
$1,771.74
|
| Rate for Payer: Signature Care EPO |
$1,904.85
|
| Rate for Payer: Signature Care PPO |
$2,019.60
|
| Rate for Payer: United Healthcare Commercial |
$1,808.46
|
|
|
HC AR DRILL BIT 2.0
|
Facility
OP
|
$2,295.00
|
|
| Hospital Charge Code |
41608349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$2,134.35 |
| Rate for Payer: Aetna Commercial |
$1,936.98
|
| Rate for Payer: Aetna Medicare |
$757.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$757.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,318.02
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,434.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$870.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$833.08
|
| Rate for Payer: Cash Price |
$1,422.90
|
| Rate for Payer: Cash Price |
$1,422.90
|
| Rate for Payer: Centivo All Commercial |
$1,170.45
|
| Rate for Payer: Cigna All Commercial |
$1,980.58
|
| Rate for Payer: CORVEL All Commercial |
$2,134.35
|
| Rate for Payer: Coventry All Commercial |
$2,019.60
|
| Rate for Payer: Encore All Commercial |
$2,112.55
|
| Rate for Payer: Frontpath All Commercial |
$2,111.40
|
| Rate for Payer: Humana ChoiceCare |
$1,982.19
|
| Rate for Payer: Humana Medicare |
$1,170.45
|
| Rate for Payer: Lucent All Commercial |
$1,170.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,065.50
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,721.25
|
| Rate for Payer: PHP All Commercial |
$1,740.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$895.05
|
| Rate for Payer: Sagamore Health Network All Products |
$1,771.74
|
| Rate for Payer: Signature Care EPO |
$1,904.85
|
| Rate for Payer: Signature Care PPO |
$2,019.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,950.75
|
| Rate for Payer: United Healthcare Commercial |
$1,808.46
|
| Rate for Payer: United Healthcare Medicare |
$757.35
|
|
|
HC AR DRILL BIT 2.0 CALI
|
Facility
IP
|
$795.00
|
|
| Hospital Charge Code |
41608059
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$596.25 |
| Max. Negotiated Rate |
$739.35 |
| Rate for Payer: Aetna Commercial |
$686.88
|
| Rate for Payer: Cash Price |
$492.90
|
| Rate for Payer: Cigna All Commercial |
$686.08
|
| Rate for Payer: CORVEL All Commercial |
$739.35
|
| Rate for Payer: Coventry All Commercial |
$699.60
|
| Rate for Payer: Encore All Commercial |
$731.80
|
| Rate for Payer: Frontpath All Commercial |
$731.40
|
| Rate for Payer: Humana ChoiceCare |
$686.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$715.50
|
| Rate for Payer: PHCS All Commercial |
$596.25
|
| Rate for Payer: PHP All Commercial |
$602.93
|
| Rate for Payer: Sagamore Health Network All Products |
$613.74
|
| Rate for Payer: Signature Care EPO |
$659.85
|
| Rate for Payer: Signature Care PPO |
$699.60
|
| Rate for Payer: United Healthcare Commercial |
$626.46
|
|
|
HC AR DRILL BIT 2.0 CALI
|
Facility
OP
|
$795.00
|
|
| Hospital Charge Code |
41608059
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$739.35 |
| Rate for Payer: Aetna Commercial |
$670.98
|
| Rate for Payer: Aetna Medicare |
$262.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$262.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$456.57
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$496.95
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$301.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$288.58
|
| Rate for Payer: Cash Price |
$492.90
|
| Rate for Payer: Cash Price |
$492.90
|
| Rate for Payer: Centivo All Commercial |
$405.45
|
| Rate for Payer: Cigna All Commercial |
$686.08
|
| Rate for Payer: CORVEL All Commercial |
$739.35
|
| Rate for Payer: Coventry All Commercial |
$699.60
|
| Rate for Payer: Encore All Commercial |
$731.80
|
| Rate for Payer: Frontpath All Commercial |
$731.40
|
| Rate for Payer: Humana ChoiceCare |
$686.64
|
| Rate for Payer: Humana Medicare |
$405.45
|
| Rate for Payer: Lucent All Commercial |
$405.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$715.50
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$596.25
|
| Rate for Payer: PHP All Commercial |
$602.93
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$310.05
|
| Rate for Payer: Sagamore Health Network All Products |
$613.74
|
| Rate for Payer: Signature Care EPO |
$659.85
|
| Rate for Payer: Signature Care PPO |
$699.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$675.75
|
| Rate for Payer: United Healthcare Commercial |
$626.46
|
| Rate for Payer: United Healthcare Medicare |
$262.35
|
|
|
HC AR DRILL BIT 2.0 CALI LONG
|
Facility
OP
|
$920.00
|
|
| Hospital Charge Code |
41608323
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$855.60 |
| Rate for Payer: Aetna Commercial |
$776.48
|
| Rate for Payer: Aetna Medicare |
$303.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$303.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$528.36
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$575.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$349.14
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$333.96
|
| Rate for Payer: Cash Price |
$570.40
|
| Rate for Payer: Cash Price |
$570.40
|
| Rate for Payer: Centivo All Commercial |
$469.20
|
| Rate for Payer: Cigna All Commercial |
$793.96
|
| Rate for Payer: CORVEL All Commercial |
$855.60
|
| Rate for Payer: Coventry All Commercial |
$809.60
|
| Rate for Payer: Encore All Commercial |
$846.86
|
| Rate for Payer: Frontpath All Commercial |
$846.40
|
| Rate for Payer: Humana ChoiceCare |
$794.60
|
| Rate for Payer: Humana Medicare |
$469.20
|
| Rate for Payer: Lucent All Commercial |
$469.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$828.00
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$690.00
|
| Rate for Payer: PHP All Commercial |
$697.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$358.80
|
| Rate for Payer: Sagamore Health Network All Products |
$710.24
|
| Rate for Payer: Signature Care EPO |
$763.60
|
| Rate for Payer: Signature Care PPO |
$809.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$782.00
|
| Rate for Payer: United Healthcare Commercial |
$724.96
|
| Rate for Payer: United Healthcare Medicare |
$303.60
|
|
|
HC AR DRILL BIT 2.0 CALI LONG
|
Facility
IP
|
$920.00
|
|
| Hospital Charge Code |
41608323
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$690.00 |
| Max. Negotiated Rate |
$855.60 |
| Rate for Payer: Aetna Commercial |
$794.88
|
| Rate for Payer: Cash Price |
$570.40
|
| Rate for Payer: Cigna All Commercial |
$793.96
|
| Rate for Payer: CORVEL All Commercial |
$855.60
|
| Rate for Payer: Coventry All Commercial |
$809.60
|
| Rate for Payer: Encore All Commercial |
$846.86
|
| Rate for Payer: Frontpath All Commercial |
$846.40
|
| Rate for Payer: Humana ChoiceCare |
$794.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$828.00
|
| Rate for Payer: PHCS All Commercial |
$690.00
|
| Rate for Payer: PHP All Commercial |
$697.73
|
| Rate for Payer: Sagamore Health Network All Products |
$710.24
|
| Rate for Payer: Signature Care EPO |
$763.60
|
| Rate for Payer: Signature Care PPO |
$809.60
|
| Rate for Payer: United Healthcare Commercial |
$724.96
|
|
|
HC AR DRILL BIT 2.0 CANN
|
Facility
IP
|
$1,072.50
|
|
| Hospital Charge Code |
41602507
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$804.38 |
| Max. Negotiated Rate |
$997.42 |
| Rate for Payer: Aetna Commercial |
$926.64
|
| Rate for Payer: Cash Price |
$664.95
|
| Rate for Payer: Cigna All Commercial |
$925.57
|
| Rate for Payer: CORVEL All Commercial |
$997.42
|
| Rate for Payer: Coventry All Commercial |
$943.80
|
| Rate for Payer: Encore All Commercial |
$987.24
|
| Rate for Payer: Frontpath All Commercial |
$986.70
|
| Rate for Payer: Humana ChoiceCare |
$926.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$965.25
|
| Rate for Payer: PHCS All Commercial |
$804.38
|
| Rate for Payer: PHP All Commercial |
$813.38
|
| Rate for Payer: Sagamore Health Network All Products |
$827.97
|
| Rate for Payer: Signature Care EPO |
$890.18
|
| Rate for Payer: Signature Care PPO |
$943.80
|
| Rate for Payer: United Healthcare Commercial |
$845.13
|
|
|
HC AR DRILL BIT 2.0 CANN
|
Facility
OP
|
$1,072.50
|
|
| Hospital Charge Code |
41602507
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$997.42 |
| Rate for Payer: Aetna Commercial |
$905.19
|
| Rate for Payer: Aetna Medicare |
$353.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$353.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$615.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$670.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$407.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$389.32
|
| Rate for Payer: Cash Price |
$664.95
|
| Rate for Payer: Cash Price |
$664.95
|
| Rate for Payer: Centivo All Commercial |
$546.98
|
| Rate for Payer: Cigna All Commercial |
$925.57
|
| Rate for Payer: CORVEL All Commercial |
$997.42
|
| Rate for Payer: Coventry All Commercial |
$943.80
|
| Rate for Payer: Encore All Commercial |
$987.24
|
| Rate for Payer: Frontpath All Commercial |
$986.70
|
| Rate for Payer: Humana ChoiceCare |
$926.32
|
| Rate for Payer: Humana Medicare |
$546.98
|
| Rate for Payer: Lucent All Commercial |
$546.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$965.25
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$804.38
|
| Rate for Payer: PHP All Commercial |
$813.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$418.28
|
| Rate for Payer: Sagamore Health Network All Products |
$827.97
|
| Rate for Payer: Signature Care EPO |
$890.18
|
| Rate for Payer: Signature Care PPO |
$943.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$911.62
|
| Rate for Payer: United Healthcare Commercial |
$845.13
|
| Rate for Payer: United Healthcare Medicare |
$353.92
|
|
|
HC AR DRILL BIT 20MM CANN
|
Facility
OP
|
$770.00
|
|
| Hospital Charge Code |
41605892
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$716.10 |
| Rate for Payer: Aetna Commercial |
$649.88
|
| Rate for Payer: Aetna Medicare |
$254.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$254.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$442.21
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$481.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$292.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$279.51
|
| Rate for Payer: Cash Price |
$477.40
|
| Rate for Payer: Cash Price |
$477.40
|
| Rate for Payer: Centivo All Commercial |
$392.70
|
| Rate for Payer: Cigna All Commercial |
$664.51
|
| Rate for Payer: CORVEL All Commercial |
$716.10
|
| Rate for Payer: Coventry All Commercial |
$677.60
|
| Rate for Payer: Encore All Commercial |
$708.78
|
| Rate for Payer: Frontpath All Commercial |
$708.40
|
| Rate for Payer: Humana ChoiceCare |
$665.05
|
| Rate for Payer: Humana Medicare |
$392.70
|
| Rate for Payer: Lucent All Commercial |
$392.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$693.00
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$577.50
|
| Rate for Payer: PHP All Commercial |
$583.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$300.30
|
| Rate for Payer: Sagamore Health Network All Products |
$594.44
|
| Rate for Payer: Signature Care EPO |
$639.10
|
| Rate for Payer: Signature Care PPO |
$677.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$654.50
|
| Rate for Payer: United Healthcare Commercial |
$606.76
|
| Rate for Payer: United Healthcare Medicare |
$254.10
|
|
|
HC AR DRILL BIT 20MM CANN
|
Facility
IP
|
$770.00
|
|
| Hospital Charge Code |
41605892
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$577.50 |
| Max. Negotiated Rate |
$716.10 |
| Rate for Payer: Aetna Commercial |
$665.28
|
| Rate for Payer: Cash Price |
$477.40
|
| Rate for Payer: Cigna All Commercial |
$664.51
|
| Rate for Payer: CORVEL All Commercial |
$716.10
|
| Rate for Payer: Coventry All Commercial |
$677.60
|
| Rate for Payer: Encore All Commercial |
$708.78
|
| Rate for Payer: Frontpath All Commercial |
$708.40
|
| Rate for Payer: Humana ChoiceCare |
$665.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$693.00
|
| Rate for Payer: PHCS All Commercial |
$577.50
|
| Rate for Payer: PHP All Commercial |
$583.97
|
| Rate for Payer: Sagamore Health Network All Products |
$594.44
|
| Rate for Payer: Signature Care EPO |
$639.10
|
| Rate for Payer: Signature Care PPO |
$677.60
|
| Rate for Payer: United Healthcare Commercial |
$606.76
|
|
|
HC AR DRILL BIT 2.5 30
|
Facility
OP
|
$994.00
|
|
| Hospital Charge Code |
41608058
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$924.42 |
| Rate for Payer: Aetna Commercial |
$838.94
|
| Rate for Payer: Aetna Medicare |
$328.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$328.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$570.85
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$621.35
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$377.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$360.82
|
| Rate for Payer: Cash Price |
$616.28
|
| Rate for Payer: Cash Price |
$616.28
|
| Rate for Payer: Centivo All Commercial |
$506.94
|
| Rate for Payer: Cigna All Commercial |
$857.82
|
| Rate for Payer: CORVEL All Commercial |
$924.42
|
| Rate for Payer: Coventry All Commercial |
$874.72
|
| Rate for Payer: Encore All Commercial |
$914.98
|
| Rate for Payer: Frontpath All Commercial |
$914.48
|
| Rate for Payer: Humana ChoiceCare |
$858.52
|
| Rate for Payer: Humana Medicare |
$506.94
|
| Rate for Payer: Lucent All Commercial |
$506.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$894.60
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$745.50
|
| Rate for Payer: PHP All Commercial |
$753.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$387.66
|
| Rate for Payer: Sagamore Health Network All Products |
$767.37
|
| Rate for Payer: Signature Care EPO |
$825.02
|
| Rate for Payer: Signature Care PPO |
$874.72
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$844.90
|
| Rate for Payer: United Healthcare Commercial |
$783.27
|
| Rate for Payer: United Healthcare Medicare |
$328.02
|
|
|
HC AR DRILL BIT 2.5 30
|
Facility
IP
|
$994.00
|
|
| Hospital Charge Code |
41608058
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$745.50 |
| Max. Negotiated Rate |
$924.42 |
| Rate for Payer: Aetna Commercial |
$858.82
|
| Rate for Payer: Cash Price |
$616.28
|
| Rate for Payer: Cigna All Commercial |
$857.82
|
| Rate for Payer: CORVEL All Commercial |
$924.42
|
| Rate for Payer: Coventry All Commercial |
$874.72
|
| Rate for Payer: Encore All Commercial |
$914.98
|
| Rate for Payer: Frontpath All Commercial |
$914.48
|
| Rate for Payer: Humana ChoiceCare |
$858.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$894.60
|
| Rate for Payer: PHCS All Commercial |
$745.50
|
| Rate for Payer: PHP All Commercial |
$753.85
|
| Rate for Payer: Sagamore Health Network All Products |
$767.37
|
| Rate for Payer: Signature Care EPO |
$825.02
|
| Rate for Payer: Signature Care PPO |
$874.72
|
| Rate for Payer: United Healthcare Commercial |
$783.27
|
|
|
HC AR DRILL BIT 2.5 CALI
|
Facility
IP
|
$994.00
|
|
| Hospital Charge Code |
41608335
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$745.50 |
| Max. Negotiated Rate |
$924.42 |
| Rate for Payer: Aetna Commercial |
$858.82
|
| Rate for Payer: Cash Price |
$616.28
|
| Rate for Payer: Cigna All Commercial |
$857.82
|
| Rate for Payer: CORVEL All Commercial |
$924.42
|
| Rate for Payer: Coventry All Commercial |
$874.72
|
| Rate for Payer: Encore All Commercial |
$914.98
|
| Rate for Payer: Frontpath All Commercial |
$914.48
|
| Rate for Payer: Humana ChoiceCare |
$858.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$894.60
|
| Rate for Payer: PHCS All Commercial |
$745.50
|
| Rate for Payer: PHP All Commercial |
$753.85
|
| Rate for Payer: Sagamore Health Network All Products |
$767.37
|
| Rate for Payer: Signature Care EPO |
$825.02
|
| Rate for Payer: Signature Care PPO |
$874.72
|
| Rate for Payer: United Healthcare Commercial |
$783.27
|
|
|
HC AR DRILL BIT 2.5 CALI
|
Facility
OP
|
$994.00
|
|
| Hospital Charge Code |
41608335
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$924.42 |
| Rate for Payer: Aetna Commercial |
$838.94
|
| Rate for Payer: Aetna Medicare |
$328.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$328.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$570.85
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$621.35
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$377.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$360.82
|
| Rate for Payer: Cash Price |
$616.28
|
| Rate for Payer: Cash Price |
$616.28
|
| Rate for Payer: Centivo All Commercial |
$506.94
|
| Rate for Payer: Cigna All Commercial |
$857.82
|
| Rate for Payer: CORVEL All Commercial |
$924.42
|
| Rate for Payer: Coventry All Commercial |
$874.72
|
| Rate for Payer: Encore All Commercial |
$914.98
|
| Rate for Payer: Frontpath All Commercial |
$914.48
|
| Rate for Payer: Humana ChoiceCare |
$858.52
|
| Rate for Payer: Humana Medicare |
$506.94
|
| Rate for Payer: Lucent All Commercial |
$506.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$894.60
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$745.50
|
| Rate for Payer: PHP All Commercial |
$753.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$387.66
|
| Rate for Payer: Sagamore Health Network All Products |
$767.37
|
| Rate for Payer: Signature Care EPO |
$825.02
|
| Rate for Payer: Signature Care PPO |
$874.72
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$844.90
|
| Rate for Payer: United Healthcare Commercial |
$783.27
|
| Rate for Payer: United Healthcare Medicare |
$328.02
|
|
|
HC AR DRILL BIT 2.6 CANN
|
Facility
IP
|
$1,460.00
|
|
| Hospital Charge Code |
41608219
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,095.00 |
| Max. Negotiated Rate |
$1,357.80 |
| Rate for Payer: Aetna Commercial |
$1,261.44
|
| Rate for Payer: Cash Price |
$905.20
|
| Rate for Payer: Cigna All Commercial |
$1,259.98
|
| Rate for Payer: CORVEL All Commercial |
$1,357.80
|
| Rate for Payer: Coventry All Commercial |
$1,284.80
|
| Rate for Payer: Encore All Commercial |
$1,343.93
|
| Rate for Payer: Frontpath All Commercial |
$1,343.20
|
| Rate for Payer: Humana ChoiceCare |
$1,261.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,314.00
|
| Rate for Payer: PHCS All Commercial |
$1,095.00
|
| Rate for Payer: PHP All Commercial |
$1,107.26
|
| Rate for Payer: Sagamore Health Network All Products |
$1,127.12
|
| Rate for Payer: Signature Care EPO |
$1,211.80
|
| Rate for Payer: Signature Care PPO |
$1,284.80
|
| Rate for Payer: United Healthcare Commercial |
$1,150.48
|
|
|
HC AR DRILL BIT 2.6 CANN
|
Facility
OP
|
$1,460.00
|
|
| Hospital Charge Code |
41608219
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,357.80 |
| Rate for Payer: Aetna Commercial |
$1,232.24
|
| Rate for Payer: Aetna Medicare |
$481.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$481.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$838.48
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$912.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$554.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$529.98
|
| Rate for Payer: Cash Price |
$905.20
|
| Rate for Payer: Cash Price |
$905.20
|
| Rate for Payer: Centivo All Commercial |
$744.60
|
| Rate for Payer: Cigna All Commercial |
$1,259.98
|
| Rate for Payer: CORVEL All Commercial |
$1,357.80
|
| Rate for Payer: Coventry All Commercial |
$1,284.80
|
| Rate for Payer: Encore All Commercial |
$1,343.93
|
| Rate for Payer: Frontpath All Commercial |
$1,343.20
|
| Rate for Payer: Humana ChoiceCare |
$1,261.00
|
| Rate for Payer: Humana Medicare |
$744.60
|
| Rate for Payer: Lucent All Commercial |
$744.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,314.00
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,095.00
|
| Rate for Payer: PHP All Commercial |
$1,107.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$569.40
|
| Rate for Payer: Sagamore Health Network All Products |
$1,127.12
|
| Rate for Payer: Signature Care EPO |
$1,211.80
|
| Rate for Payer: Signature Care PPO |
$1,284.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,241.00
|
| Rate for Payer: United Healthcare Commercial |
$1,150.48
|
| Rate for Payer: United Healthcare Medicare |
$481.80
|
|
|
HC AR DRILL BIT 3.0 CANN
|
Facility
OP
|
$962.50
|
|
| Hospital Charge Code |
41607710
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$895.12 |
| Rate for Payer: Aetna Commercial |
$812.35
|
| Rate for Payer: Aetna Medicare |
$317.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$317.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$552.76
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$601.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$365.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$349.39
|
| Rate for Payer: Cash Price |
$596.75
|
| Rate for Payer: Cash Price |
$596.75
|
| Rate for Payer: Centivo All Commercial |
$490.88
|
| Rate for Payer: Cigna All Commercial |
$830.64
|
| Rate for Payer: CORVEL All Commercial |
$895.12
|
| Rate for Payer: Coventry All Commercial |
$847.00
|
| Rate for Payer: Encore All Commercial |
$885.98
|
| Rate for Payer: Frontpath All Commercial |
$885.50
|
| Rate for Payer: Humana ChoiceCare |
$831.31
|
| Rate for Payer: Humana Medicare |
$490.88
|
| Rate for Payer: Lucent All Commercial |
$490.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$866.25
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$721.88
|
| Rate for Payer: PHP All Commercial |
$729.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$375.38
|
| Rate for Payer: Sagamore Health Network All Products |
$743.05
|
| Rate for Payer: Signature Care EPO |
$798.88
|
| Rate for Payer: Signature Care PPO |
$847.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$818.12
|
| Rate for Payer: United Healthcare Commercial |
$758.45
|
| Rate for Payer: United Healthcare Medicare |
$317.62
|
|
