|
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
|
|
|
HC AR DRILL BIT 3.5 35
|
Facility
OP
|
$924.00
|
|
| Hospital Charge Code |
41608057
|
|
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 BIT 3.5 35
|
Facility
IP
|
$924.00
|
|
| Hospital Charge Code |
41608057
|
|
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 4.0 CANN
|
Facility
IP
|
$1,072.50
|
|
| Hospital Charge Code |
41604944
|
|
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 4.0 CANN
|
Facility
OP
|
$1,072.50
|
|
| Hospital Charge Code |
41604944
|
|
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 4.5 CANN
|
Facility
IP
|
$1,072.50
|
|
| Hospital Charge Code |
41607711
|
|
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 4.5 CANN
|
Facility
OP
|
$1,072.50
|
|
| Hospital Charge Code |
41607711
|
|
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 MICRO PROFILE
|
Facility
IP
|
$825.00
|
|
| Hospital Charge Code |
41602508
|
|
Hospital Revenue Code
|
272
|
| 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 DRILL BIT MICRO PROFILE
|
Facility
OP
|
$825.00
|
|
| Hospital Charge Code |
41602508
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| 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 |
$121.68
|
| 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 |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| 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 DRILL BIT SWIVELOCK 4.75
|
Facility
IP
|
$2,062.50
|
|
| Hospital Charge Code |
41607963
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,546.88 |
| Max. Negotiated Rate |
$1,918.12 |
| Rate for Payer: Aetna Commercial |
$1,782.00
|
| Rate for Payer: Cash Price |
$1,278.75
|
| Rate for Payer: Cigna All Commercial |
$1,779.94
|
| Rate for Payer: CORVEL All Commercial |
$1,918.12
|
| Rate for Payer: Coventry All Commercial |
$1,815.00
|
| Rate for Payer: Encore All Commercial |
$1,898.53
|
| Rate for Payer: Frontpath All Commercial |
$1,897.50
|
| Rate for Payer: Humana ChoiceCare |
$1,781.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,856.25
|
| Rate for Payer: PHCS All Commercial |
$1,546.88
|
| Rate for Payer: PHP All Commercial |
$1,564.20
|
| Rate for Payer: Sagamore Health Network All Products |
$1,592.25
|
| Rate for Payer: Signature Care EPO |
$1,711.88
|
| Rate for Payer: Signature Care PPO |
$1,815.00
|
| Rate for Payer: United Healthcare Commercial |
$1,625.25
|
|
|
HC AR DRILL BIT SWIVELOCK 4.75
|
Facility
OP
|
$2,062.50
|
|
| Hospital Charge Code |
41607963
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,918.12 |
| Rate for Payer: Aetna Commercial |
$1,740.75
|
| Rate for Payer: Aetna Medicare |
$680.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$680.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,184.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,289.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$782.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$748.69
|
| Rate for Payer: Cash Price |
$1,278.75
|
| Rate for Payer: Cash Price |
$1,278.75
|
| Rate for Payer: Centivo All Commercial |
$1,051.88
|
| Rate for Payer: Cigna All Commercial |
$1,779.94
|
| Rate for Payer: CORVEL All Commercial |
$1,918.12
|
| Rate for Payer: Coventry All Commercial |
$1,815.00
|
| Rate for Payer: Encore All Commercial |
$1,898.53
|
| Rate for Payer: Frontpath All Commercial |
$1,897.50
|
| Rate for Payer: Humana ChoiceCare |
$1,781.38
|
| Rate for Payer: Humana Medicare |
$1,051.88
|
| Rate for Payer: Lucent All Commercial |
$1,051.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,856.25
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,546.88
|
| Rate for Payer: PHP All Commercial |
$1,564.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$804.38
|
| Rate for Payer: Sagamore Health Network All Products |
$1,592.25
|
| Rate for Payer: Signature Care EPO |
$1,711.88
|
| Rate for Payer: Signature Care PPO |
$1,815.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,753.12
|
| Rate for Payer: United Healthcare Commercial |
$1,625.25
|
| Rate for Payer: United Healthcare Medicare |
$680.62
|
|
|
HC AR DRILL FLIPCUTTER III
|
Facility
OP
|
$2,282.50
|
|
| Hospital Charge Code |
41606236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$2,122.72 |
| Rate for Payer: Aetna Commercial |
$1,926.43
|
| Rate for Payer: Aetna Medicare |
$753.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$753.22
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,310.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,426.79
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$866.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$828.55
|
| Rate for Payer: Cash Price |
$1,415.15
|
| Rate for Payer: Cash Price |
$1,415.15
|
| Rate for Payer: Centivo All Commercial |
$1,164.08
|
| Rate for Payer: Cigna All Commercial |
$1,969.80
|
| Rate for Payer: CORVEL All Commercial |
$2,122.72
|
| Rate for Payer: Coventry All Commercial |
$2,008.60
|
| Rate for Payer: Encore All Commercial |
$2,101.04
|
| Rate for Payer: Frontpath All Commercial |
$2,099.90
|
| Rate for Payer: Humana ChoiceCare |
$1,971.40
|
| Rate for Payer: Humana Medicare |
$1,164.08
|
| Rate for Payer: Lucent All Commercial |
$1,164.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,054.25
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,711.88
|
| Rate for Payer: PHP All Commercial |
$1,731.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$890.18
|
| Rate for Payer: Sagamore Health Network All Products |
$1,762.09
|
| Rate for Payer: Signature Care EPO |
$1,894.48
|
| Rate for Payer: Signature Care PPO |
$2,008.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,940.12
|
| Rate for Payer: United Healthcare Commercial |
$1,798.61
|
| Rate for Payer: United Healthcare Medicare |
$753.22
|
|
|
HC AR DRILL FLIPCUTTER III
|
Facility
IP
|
$2,282.50
|
|
| Hospital Charge Code |
41606236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,711.88 |
| Max. Negotiated Rate |
$2,122.72 |
| Rate for Payer: Aetna Commercial |
$1,972.08
|
| Rate for Payer: Cash Price |
$1,415.15
|
| Rate for Payer: Cigna All Commercial |
$1,969.80
|
| Rate for Payer: CORVEL All Commercial |
$2,122.72
|
| Rate for Payer: Coventry All Commercial |
$2,008.60
|
| Rate for Payer: Encore All Commercial |
$2,101.04
|
| Rate for Payer: Frontpath All Commercial |
$2,099.90
|
| Rate for Payer: Humana ChoiceCare |
$1,971.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,054.25
|
| Rate for Payer: PHCS All Commercial |
$1,711.88
|
| Rate for Payer: PHP All Commercial |
$1,731.05
|
| Rate for Payer: Sagamore Health Network All Products |
$1,762.09
|
| Rate for Payer: Signature Care EPO |
$1,894.48
|
| Rate for Payer: Signature Care PPO |
$2,008.60
|
| Rate for Payer: United Healthcare Commercial |
$1,798.61
|
|
|
HC AR DRILL GUIDE
|
Facility
IP
|
$1,250.00
|
|
| Hospital Charge Code |
41606534
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$937.50 |
| Max. Negotiated Rate |
$1,162.50 |
| Rate for Payer: Aetna Commercial |
$1,080.00
|
| Rate for Payer: Cash Price |
$775.00
|
| Rate for Payer: Cigna All Commercial |
$1,078.75
|
| Rate for Payer: CORVEL All Commercial |
$1,162.50
|
| Rate for Payer: Coventry All Commercial |
$1,100.00
|
| Rate for Payer: Encore All Commercial |
$1,150.62
|
| Rate for Payer: Frontpath All Commercial |
$1,150.00
|
| Rate for Payer: Humana ChoiceCare |
$1,079.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,125.00
|
| Rate for Payer: PHCS All Commercial |
$937.50
|
| Rate for Payer: PHP All Commercial |
$948.00
|
| Rate for Payer: Sagamore Health Network All Products |
$965.00
|
| Rate for Payer: Signature Care EPO |
$1,037.50
|
| Rate for Payer: Signature Care PPO |
$1,100.00
|
| Rate for Payer: United Healthcare Commercial |
$985.00
|
|
|
HC AR DRILL GUIDE
|
Facility
OP
|
$1,250.00
|
|
| Hospital Charge Code |
41606534
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,162.50 |
| Rate for Payer: Aetna Commercial |
$1,055.00
|
| Rate for Payer: Aetna Medicare |
$412.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$412.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$717.88
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$781.38
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$474.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$453.75
|
| Rate for Payer: Cash Price |
$775.00
|
| Rate for Payer: Cash Price |
$775.00
|
| Rate for Payer: Centivo All Commercial |
$637.50
|
| Rate for Payer: Cigna All Commercial |
$1,078.75
|
| Rate for Payer: CORVEL All Commercial |
$1,162.50
|
| Rate for Payer: Coventry All Commercial |
$1,100.00
|
| Rate for Payer: Encore All Commercial |
$1,150.62
|
| Rate for Payer: Frontpath All Commercial |
$1,150.00
|
| Rate for Payer: Humana ChoiceCare |
$1,079.62
|
| Rate for Payer: Humana Medicare |
$637.50
|
| Rate for Payer: Lucent All Commercial |
$637.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,125.00
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$937.50
|
| Rate for Payer: PHP All Commercial |
$948.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$487.50
|
| Rate for Payer: Sagamore Health Network All Products |
$965.00
|
| Rate for Payer: Signature Care EPO |
$1,037.50
|
| Rate for Payer: Signature Care PPO |
$1,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,062.50
|
| Rate for Payer: United Healthcare Commercial |
$985.00
|
| Rate for Payer: United Healthcare Medicare |
$412.50
|
|
|
HC AR DRILL GUIDE 3.9 CORKSCREW
|
Facility
OP
|
$2,475.00
|
|
| Hospital Charge Code |
41607407
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$2,301.75 |
| Rate for Payer: Aetna Commercial |
$2,088.90
|
| Rate for Payer: Aetna Medicare |
$816.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$816.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,421.39
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,547.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$939.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$898.42
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Centivo All Commercial |
$1,262.25
|
| Rate for Payer: Cigna All Commercial |
$2,135.92
|
| Rate for Payer: CORVEL All Commercial |
$2,301.75
|
| Rate for Payer: Coventry All Commercial |
$2,178.00
|
| Rate for Payer: Encore All Commercial |
$2,278.24
|
| Rate for Payer: Frontpath All Commercial |
$2,277.00
|
| Rate for Payer: Humana ChoiceCare |
$2,137.66
|
| Rate for Payer: Humana Medicare |
$1,262.25
|
| Rate for Payer: Lucent All Commercial |
$1,262.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,227.50
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,856.25
|
| Rate for Payer: PHP All Commercial |
$1,877.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$965.25
|
| Rate for Payer: Sagamore Health Network All Products |
$1,910.70
|
| Rate for Payer: Signature Care EPO |
$2,054.25
|
| Rate for Payer: Signature Care PPO |
$2,178.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,103.75
|
| Rate for Payer: United Healthcare Commercial |
$1,950.30
|
| Rate for Payer: United Healthcare Medicare |
$816.75
|
|
|
HC AR DRILL GUIDE 3.9 CORKSCREW
|
Facility
IP
|
$2,475.00
|
|
| Hospital Charge Code |
41607407
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,856.25 |
| Max. Negotiated Rate |
$2,301.75 |
| Rate for Payer: Aetna Commercial |
$2,138.40
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Cigna All Commercial |
$2,135.92
|
| Rate for Payer: CORVEL All Commercial |
$2,301.75
|
| Rate for Payer: Coventry All Commercial |
$2,178.00
|
| Rate for Payer: Encore All Commercial |
$2,278.24
|
| Rate for Payer: Frontpath All Commercial |
$2,277.00
|
| Rate for Payer: Humana ChoiceCare |
$2,137.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,227.50
|
| Rate for Payer: PHCS All Commercial |
$1,856.25
|
| Rate for Payer: PHP All Commercial |
$1,877.04
|
| Rate for Payer: Sagamore Health Network All Products |
$1,910.70
|
| Rate for Payer: Signature Care EPO |
$2,054.25
|
| Rate for Payer: Signature Care PPO |
$2,178.00
|
| Rate for Payer: United Healthcare Commercial |
$1,950.30
|
|
|
HC AR DRILL PIN 2.4
|
Facility
OP
|
$246.40
|
|
| Hospital Charge Code |
41606544
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$81.31 |
| Max. Negotiated Rate |
$229.15 |
| Rate for Payer: Aetna Commercial |
$207.96
|
| Rate for Payer: Aetna Medicare |
$81.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$81.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$141.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$154.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$93.51
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$89.44
|
| Rate for Payer: Cash Price |
$152.77
|
| Rate for Payer: Cash Price |
$152.77
|
| Rate for Payer: Centivo All Commercial |
$125.66
|
| Rate for Payer: Cigna All Commercial |
$212.64
|
| Rate for Payer: CORVEL All Commercial |
$229.15
|
| Rate for Payer: Coventry All Commercial |
$216.83
|
| Rate for Payer: Encore All Commercial |
$226.81
|
| Rate for Payer: Frontpath All Commercial |
$226.69
|
| Rate for Payer: Humana ChoiceCare |
$212.82
|
| Rate for Payer: Humana Medicare |
$125.66
|
| Rate for Payer: Lucent All Commercial |
$125.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$221.76
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$184.80
|
| Rate for Payer: PHP All Commercial |
$186.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$96.10
|
| Rate for Payer: Sagamore Health Network All Products |
$190.22
|
| Rate for Payer: Signature Care EPO |
$204.51
|
| Rate for Payer: Signature Care PPO |
$216.83
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$209.44
|
| Rate for Payer: United Healthcare Commercial |
$194.16
|
| Rate for Payer: United Healthcare Medicare |
$81.31
|
|
|
HC AR DRILL PIN 2.4
|
Facility
IP
|
$246.40
|
|
| Hospital Charge Code |
41606544
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$184.80 |
| Max. Negotiated Rate |
$229.15 |
| Rate for Payer: Aetna Commercial |
$212.89
|
| Rate for Payer: Cash Price |
$152.77
|
| Rate for Payer: Cigna All Commercial |
$212.64
|
| Rate for Payer: CORVEL All Commercial |
$229.15
|
| Rate for Payer: Coventry All Commercial |
$216.83
|
| Rate for Payer: Encore All Commercial |
$226.81
|
| Rate for Payer: Frontpath All Commercial |
$226.69
|
| Rate for Payer: Humana ChoiceCare |
$212.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$221.76
|
| Rate for Payer: PHCS All Commercial |
$184.80
|
| Rate for Payer: PHP All Commercial |
$186.87
|
| Rate for Payer: Sagamore Health Network All Products |
$190.22
|
| Rate for Payer: Signature Care EPO |
$204.51
|
| Rate for Payer: Signature Care PPO |
$216.83
|
| Rate for Payer: United Healthcare Commercial |
$194.16
|
|
|
HC AR DRILL PIN 3.5
|
Facility
IP
|
$646.80
|
|
| Hospital Charge Code |
41606233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$485.10 |
| Max. Negotiated Rate |
$601.52 |
| Rate for Payer: Aetna Commercial |
$558.84
|
| Rate for Payer: Cash Price |
$401.02
|
| Rate for Payer: Cigna All Commercial |
$558.19
|
| Rate for Payer: CORVEL All Commercial |
$601.52
|
| Rate for Payer: Coventry All Commercial |
$569.18
|
| Rate for Payer: Encore All Commercial |
$595.38
|
| Rate for Payer: Frontpath All Commercial |
$595.06
|
| Rate for Payer: Humana ChoiceCare |
$558.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$582.12
|
| Rate for Payer: PHCS All Commercial |
$485.10
|
| Rate for Payer: PHP All Commercial |
$490.53
|
| Rate for Payer: Sagamore Health Network All Products |
$499.33
|
| Rate for Payer: Signature Care EPO |
$536.84
|
| Rate for Payer: Signature Care PPO |
$569.18
|
| Rate for Payer: United Healthcare Commercial |
$509.68
|
|
|
HC AR DRILL PIN 3.5
|
Facility
OP
|
$646.80
|
|
| Hospital Charge Code |
41606233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$601.52 |
| Rate for Payer: Aetna Commercial |
$545.90
|
| Rate for Payer: Aetna Medicare |
$213.44
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$213.44
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$371.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$404.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$245.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$234.79
|
| Rate for Payer: Cash Price |
$401.02
|
| Rate for Payer: Cash Price |
$401.02
|
| Rate for Payer: Centivo All Commercial |
$329.87
|
| Rate for Payer: Cigna All Commercial |
$558.19
|
| Rate for Payer: CORVEL All Commercial |
$601.52
|
| Rate for Payer: Coventry All Commercial |
$569.18
|
| Rate for Payer: Encore All Commercial |
$595.38
|
| Rate for Payer: Frontpath All Commercial |
$595.06
|
| Rate for Payer: Humana ChoiceCare |
$558.64
|
| Rate for Payer: Humana Medicare |
$329.87
|
| Rate for Payer: Lucent All Commercial |
$329.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$582.12
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$485.10
|
| Rate for Payer: PHP All Commercial |
$490.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$252.25
|
| Rate for Payer: Sagamore Health Network All Products |
$499.33
|
| Rate for Payer: Signature Care EPO |
$536.84
|
| Rate for Payer: Signature Care PPO |
$569.18
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$549.78
|
| Rate for Payer: United Healthcare Commercial |
$509.68
|
| Rate for Payer: United Healthcare Medicare |
$213.44
|
|
|
HC AR DRILL PIN 4MM
|
Facility
OP
|
$962.50
|
|
| Hospital Charge Code |
41605848
|
|
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
|
|
|
HC AR DRILL PIN 4MM
|
Facility
IP
|
$962.50
|
|
| Hospital Charge Code |
41605848
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$721.88 |
| Max. Negotiated Rate |
$895.12 |
| Rate for Payer: Aetna Commercial |
$831.60
|
| Rate for Payer: Cash Price |
$596.75
|
| 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: Lutheran Preferred All Commercial |
$866.25
|
| Rate for Payer: PHCS All Commercial |
$721.88
|
| Rate for Payer: PHP All Commercial |
$729.96
|
| 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: United Healthcare Commercial |
$758.45
|
|
|
HC AR DX SWIVELOCK SL 3.5X8.5
|
Facility
OP
|
$2,337.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602621
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,173.88 |
| Rate for Payer: Aetna Commercial |
$1,972.85
|
| Rate for Payer: Aetna Medicare |
$771.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$771.38
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,342.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,461.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$887.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$848.51
|
| Rate for Payer: Cash Price |
$1,449.25
|
| Rate for Payer: Cash Price |
$1,449.25
|
| Rate for Payer: Centivo All Commercial |
$1,192.12
|
| Rate for Payer: Cigna All Commercial |
$2,017.26
|
| Rate for Payer: CORVEL All Commercial |
$2,173.88
|
| Rate for Payer: Coventry All Commercial |
$2,057.00
|
| Rate for Payer: Encore All Commercial |
$2,151.67
|
| Rate for Payer: Frontpath All Commercial |
$2,150.50
|
| Rate for Payer: Humana ChoiceCare |
$2,018.90
|
| Rate for Payer: Humana Medicare |
$1,192.12
|
| Rate for Payer: Lucent All Commercial |
$1,192.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,103.75
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,753.12
|
| Rate for Payer: PHP All Commercial |
$1,772.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$911.62
|
| Rate for Payer: Sagamore Health Network All Products |
$1,804.55
|
| Rate for Payer: Signature Care EPO |
$1,940.12
|
| Rate for Payer: Signature Care PPO |
$2,057.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,986.88
|
| Rate for Payer: United Healthcare Commercial |
$1,841.95
|
| Rate for Payer: United Healthcare Medicare |
$771.38
|
|
|
HC AR DX SWIVELOCK SL 3.5X8.5
|
Facility
IP
|
$2,337.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602621
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,753.12 |
| Max. Negotiated Rate |
$2,173.88 |
| Rate for Payer: Aetna Commercial |
$2,019.60
|
| Rate for Payer: Cash Price |
$1,449.25
|
| Rate for Payer: Cigna All Commercial |
$2,017.26
|
| Rate for Payer: CORVEL All Commercial |
$2,173.88
|
| Rate for Payer: Coventry All Commercial |
$2,057.00
|
| Rate for Payer: Encore All Commercial |
$2,151.67
|
| Rate for Payer: Frontpath All Commercial |
$2,150.50
|
| Rate for Payer: Humana ChoiceCare |
$2,018.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,103.75
|
| Rate for Payer: PHCS All Commercial |
$1,753.12
|
| Rate for Payer: PHP All Commercial |
$1,772.76
|
| Rate for Payer: Sagamore Health Network All Products |
$1,804.55
|
| Rate for Payer: Signature Care EPO |
$1,940.12
|
| Rate for Payer: Signature Care PPO |
$2,057.00
|
| Rate for Payer: United Healthcare Commercial |
$1,841.95
|
|
