|
HC AR SCREW 4X44 CANN
|
Facility
IP
|
$1,375.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608173
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,031.25 |
| Max. Negotiated Rate |
$1,278.75 |
| Rate for Payer: Aetna Commercial |
$1,188.00
|
| Rate for Payer: Cash Price |
$852.50
|
| Rate for Payer: Cigna All Commercial |
$1,186.62
|
| Rate for Payer: CORVEL All Commercial |
$1,278.75
|
| Rate for Payer: Coventry All Commercial |
$1,210.00
|
| Rate for Payer: Encore All Commercial |
$1,265.69
|
| Rate for Payer: Frontpath All Commercial |
$1,265.00
|
| Rate for Payer: Humana ChoiceCare |
$1,187.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,237.50
|
| Rate for Payer: PHCS All Commercial |
$1,031.25
|
| Rate for Payer: PHP All Commercial |
$1,042.80
|
| Rate for Payer: Sagamore Health Network All Products |
$1,061.50
|
| Rate for Payer: Signature Care EPO |
$1,141.25
|
| Rate for Payer: Signature Care PPO |
$1,210.00
|
| Rate for Payer: United Healthcare Commercial |
$1,083.50
|
|
|
HC AR SCREW 4X50 CANN
|
Facility
IP
|
$1,375.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608217
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,031.25 |
| Max. Negotiated Rate |
$1,278.75 |
| Rate for Payer: Aetna Commercial |
$1,188.00
|
| Rate for Payer: Cash Price |
$852.50
|
| Rate for Payer: Cigna All Commercial |
$1,186.62
|
| Rate for Payer: CORVEL All Commercial |
$1,278.75
|
| Rate for Payer: Coventry All Commercial |
$1,210.00
|
| Rate for Payer: Encore All Commercial |
$1,265.69
|
| Rate for Payer: Frontpath All Commercial |
$1,265.00
|
| Rate for Payer: Humana ChoiceCare |
$1,187.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,237.50
|
| Rate for Payer: PHCS All Commercial |
$1,031.25
|
| Rate for Payer: PHP All Commercial |
$1,042.80
|
| Rate for Payer: Sagamore Health Network All Products |
$1,061.50
|
| Rate for Payer: Signature Care EPO |
$1,141.25
|
| Rate for Payer: Signature Care PPO |
$1,210.00
|
| Rate for Payer: United Healthcare Commercial |
$1,083.50
|
|
|
HC AR SCREW 4X50 CANN
|
Facility
OP
|
$1,375.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608217
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$453.75 |
| Max. Negotiated Rate |
$1,278.75 |
| Rate for Payer: Aetna Commercial |
$1,160.50
|
| Rate for Payer: Aetna Medicare |
$453.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$453.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$789.66
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$859.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$521.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$499.12
|
| Rate for Payer: Cash Price |
$852.50
|
| Rate for Payer: Cash Price |
$852.50
|
| Rate for Payer: Centivo All Commercial |
$701.25
|
| Rate for Payer: Cigna All Commercial |
$1,186.62
|
| Rate for Payer: CORVEL All Commercial |
$1,278.75
|
| Rate for Payer: Coventry All Commercial |
$1,210.00
|
| Rate for Payer: Encore All Commercial |
$1,265.69
|
| Rate for Payer: Frontpath All Commercial |
$1,265.00
|
| Rate for Payer: Humana ChoiceCare |
$1,187.59
|
| Rate for Payer: Humana Medicare |
$701.25
|
| Rate for Payer: Lucent All Commercial |
$701.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,237.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,031.25
|
| Rate for Payer: PHP All Commercial |
$1,042.80
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$536.25
|
| Rate for Payer: Sagamore Health Network All Products |
$1,061.50
|
| Rate for Payer: Signature Care EPO |
$1,141.25
|
| Rate for Payer: Signature Care PPO |
$1,210.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,168.75
|
| Rate for Payer: United Healthcare Commercial |
$1,083.50
|
| Rate for Payer: United Healthcare Medicare |
$453.75
|
|
|
HC AR SCREW 6.7X85 CANN
|
Facility
IP
|
$1,375.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604945
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,031.25 |
| Max. Negotiated Rate |
$1,278.75 |
| Rate for Payer: Aetna Commercial |
$1,188.00
|
| Rate for Payer: Cash Price |
$852.50
|
| Rate for Payer: Cigna All Commercial |
$1,186.62
|
| Rate for Payer: CORVEL All Commercial |
$1,278.75
|
| Rate for Payer: Coventry All Commercial |
$1,210.00
|
| Rate for Payer: Encore All Commercial |
$1,265.69
|
| Rate for Payer: Frontpath All Commercial |
$1,265.00
|
| Rate for Payer: Humana ChoiceCare |
$1,187.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,237.50
|
| Rate for Payer: PHCS All Commercial |
$1,031.25
|
| Rate for Payer: PHP All Commercial |
$1,042.80
|
| Rate for Payer: Sagamore Health Network All Products |
$1,061.50
|
| Rate for Payer: Signature Care EPO |
$1,141.25
|
| Rate for Payer: Signature Care PPO |
$1,210.00
|
| Rate for Payer: United Healthcare Commercial |
$1,083.50
|
|
|
HC AR SCREW 6.7X85 CANN
|
Facility
OP
|
$1,375.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604945
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$453.75 |
| Max. Negotiated Rate |
$1,278.75 |
| Rate for Payer: Aetna Commercial |
$1,160.50
|
| Rate for Payer: Aetna Medicare |
$453.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$453.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$789.66
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$859.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$521.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$499.12
|
| Rate for Payer: Cash Price |
$852.50
|
| Rate for Payer: Cash Price |
$852.50
|
| Rate for Payer: Centivo All Commercial |
$701.25
|
| Rate for Payer: Cigna All Commercial |
$1,186.62
|
| Rate for Payer: CORVEL All Commercial |
$1,278.75
|
| Rate for Payer: Coventry All Commercial |
$1,210.00
|
| Rate for Payer: Encore All Commercial |
$1,265.69
|
| Rate for Payer: Frontpath All Commercial |
$1,265.00
|
| Rate for Payer: Humana ChoiceCare |
$1,187.59
|
| Rate for Payer: Humana Medicare |
$701.25
|
| Rate for Payer: Lucent All Commercial |
$701.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,237.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,031.25
|
| Rate for Payer: PHP All Commercial |
$1,042.80
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$536.25
|
| Rate for Payer: Sagamore Health Network All Products |
$1,061.50
|
| Rate for Payer: Signature Care EPO |
$1,141.25
|
| Rate for Payer: Signature Care PPO |
$1,210.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,168.75
|
| Rate for Payer: United Healthcare Commercial |
$1,083.50
|
| Rate for Payer: United Healthcare Medicare |
$453.75
|
|
|
HC AR SCREW 6X23 INT
|
Facility
OP
|
$1,680.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,562.40 |
| Rate for Payer: Aetna Commercial |
$1,417.92
|
| Rate for Payer: Aetna Medicare |
$554.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$554.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$964.82
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,050.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$637.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$609.84
|
| Rate for Payer: Cash Price |
$1,041.60
|
| Rate for Payer: Cash Price |
$1,041.60
|
| Rate for Payer: Centivo All Commercial |
$856.80
|
| Rate for Payer: Cigna All Commercial |
$1,449.84
|
| Rate for Payer: CORVEL All Commercial |
$1,562.40
|
| Rate for Payer: Coventry All Commercial |
$1,478.40
|
| Rate for Payer: Encore All Commercial |
$1,546.44
|
| Rate for Payer: Frontpath All Commercial |
$1,545.60
|
| Rate for Payer: Humana ChoiceCare |
$1,451.02
|
| Rate for Payer: Humana Medicare |
$856.80
|
| Rate for Payer: Lucent All Commercial |
$856.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,512.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,260.00
|
| Rate for Payer: PHP All Commercial |
$1,274.11
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$655.20
|
| Rate for Payer: Sagamore Health Network All Products |
$1,296.96
|
| Rate for Payer: Signature Care EPO |
$1,394.40
|
| Rate for Payer: Signature Care PPO |
$1,478.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,428.00
|
| Rate for Payer: United Healthcare Commercial |
$1,323.84
|
| Rate for Payer: United Healthcare Medicare |
$554.40
|
|
|
HC AR SCREW 6X23 INT
|
Facility
IP
|
$1,680.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,260.00 |
| Max. Negotiated Rate |
$1,562.40 |
| Rate for Payer: Aetna Commercial |
$1,451.52
|
| Rate for Payer: Cash Price |
$1,041.60
|
| Rate for Payer: Cigna All Commercial |
$1,449.84
|
| Rate for Payer: CORVEL All Commercial |
$1,562.40
|
| Rate for Payer: Coventry All Commercial |
$1,478.40
|
| Rate for Payer: Encore All Commercial |
$1,546.44
|
| Rate for Payer: Frontpath All Commercial |
$1,545.60
|
| Rate for Payer: Humana ChoiceCare |
$1,451.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,512.00
|
| Rate for Payer: PHCS All Commercial |
$1,260.00
|
| Rate for Payer: PHP All Commercial |
$1,274.11
|
| Rate for Payer: Sagamore Health Network All Products |
$1,296.96
|
| Rate for Payer: Signature Care EPO |
$1,394.40
|
| Rate for Payer: Signature Care PPO |
$1,478.40
|
| Rate for Payer: United Healthcare Commercial |
$1,323.84
|
|
|
HC AR SCREW 7X20 INT
|
Facility
IP
|
$2,460.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608110
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,845.00 |
| Max. Negotiated Rate |
$2,287.80 |
| Rate for Payer: Aetna Commercial |
$2,125.44
|
| Rate for Payer: Cash Price |
$1,525.20
|
| Rate for Payer: Cigna All Commercial |
$2,122.98
|
| Rate for Payer: CORVEL All Commercial |
$2,287.80
|
| Rate for Payer: Coventry All Commercial |
$2,164.80
|
| Rate for Payer: Encore All Commercial |
$2,264.43
|
| Rate for Payer: Frontpath All Commercial |
$2,263.20
|
| Rate for Payer: Humana ChoiceCare |
$2,124.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,214.00
|
| Rate for Payer: PHCS All Commercial |
$1,845.00
|
| Rate for Payer: PHP All Commercial |
$1,865.66
|
| Rate for Payer: Sagamore Health Network All Products |
$1,899.12
|
| Rate for Payer: Signature Care EPO |
$2,041.80
|
| Rate for Payer: Signature Care PPO |
$2,164.80
|
| Rate for Payer: United Healthcare Commercial |
$1,938.48
|
|
|
HC AR SCREW 7X20 INT
|
Facility
OP
|
$2,460.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608110
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,287.80 |
| Rate for Payer: Aetna Commercial |
$2,076.24
|
| Rate for Payer: Aetna Medicare |
$811.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$811.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,412.78
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,537.75
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$933.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$892.98
|
| Rate for Payer: Cash Price |
$1,525.20
|
| Rate for Payer: Cash Price |
$1,525.20
|
| Rate for Payer: Centivo All Commercial |
$1,254.60
|
| Rate for Payer: Cigna All Commercial |
$2,122.98
|
| Rate for Payer: CORVEL All Commercial |
$2,287.80
|
| Rate for Payer: Coventry All Commercial |
$2,164.80
|
| Rate for Payer: Encore All Commercial |
$2,264.43
|
| Rate for Payer: Frontpath All Commercial |
$2,263.20
|
| Rate for Payer: Humana ChoiceCare |
$2,124.70
|
| Rate for Payer: Humana Medicare |
$1,254.60
|
| Rate for Payer: Lucent All Commercial |
$1,254.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,214.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,845.00
|
| Rate for Payer: PHP All Commercial |
$1,865.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$959.40
|
| Rate for Payer: Sagamore Health Network All Products |
$1,899.12
|
| Rate for Payer: Signature Care EPO |
$2,041.80
|
| Rate for Payer: Signature Care PPO |
$2,164.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,091.00
|
| Rate for Payer: United Healthcare Commercial |
$1,938.48
|
| Rate for Payer: United Healthcare Medicare |
$811.80
|
|
|
HC AR SCREW 8X20 INT
|
Facility
OP
|
$1,622.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606981
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,508.92 |
| Rate for Payer: Aetna Commercial |
$1,369.39
|
| Rate for Payer: Aetna Medicare |
$535.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$535.42
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$931.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,014.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$615.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$588.97
|
| Rate for Payer: Cash Price |
$1,005.95
|
| Rate for Payer: Cash Price |
$1,005.95
|
| Rate for Payer: Centivo All Commercial |
$827.48
|
| Rate for Payer: Cigna All Commercial |
$1,400.22
|
| Rate for Payer: CORVEL All Commercial |
$1,508.92
|
| Rate for Payer: Coventry All Commercial |
$1,427.80
|
| Rate for Payer: Encore All Commercial |
$1,493.51
|
| Rate for Payer: Frontpath All Commercial |
$1,492.70
|
| Rate for Payer: Humana ChoiceCare |
$1,401.35
|
| Rate for Payer: Humana Medicare |
$827.48
|
| Rate for Payer: Lucent All Commercial |
$827.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,460.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,216.88
|
| Rate for Payer: PHP All Commercial |
$1,230.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$632.78
|
| Rate for Payer: Sagamore Health Network All Products |
$1,252.57
|
| Rate for Payer: Signature Care EPO |
$1,346.68
|
| Rate for Payer: Signature Care PPO |
$1,427.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,379.12
|
| Rate for Payer: United Healthcare Commercial |
$1,278.53
|
| Rate for Payer: United Healthcare Medicare |
$535.42
|
|
|
HC AR SCREW 8X20 INT
|
Facility
IP
|
$1,622.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606981
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,216.88 |
| Max. Negotiated Rate |
$1,508.92 |
| Rate for Payer: Aetna Commercial |
$1,401.84
|
| Rate for Payer: Cash Price |
$1,005.95
|
| Rate for Payer: Cigna All Commercial |
$1,400.22
|
| Rate for Payer: CORVEL All Commercial |
$1,508.92
|
| Rate for Payer: Coventry All Commercial |
$1,427.80
|
| Rate for Payer: Encore All Commercial |
$1,493.51
|
| Rate for Payer: Frontpath All Commercial |
$1,492.70
|
| Rate for Payer: Humana ChoiceCare |
$1,401.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,460.25
|
| Rate for Payer: PHCS All Commercial |
$1,216.88
|
| Rate for Payer: PHP All Commercial |
$1,230.50
|
| Rate for Payer: Sagamore Health Network All Products |
$1,252.57
|
| Rate for Payer: Signature Care EPO |
$1,346.68
|
| Rate for Payer: Signature Care PPO |
$1,427.80
|
| Rate for Payer: United Healthcare Commercial |
$1,278.53
|
|
|
HC AR SCREW 8X23
|
Facility
OP
|
$1,375.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606365
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$453.75 |
| Max. Negotiated Rate |
$1,278.75 |
| Rate for Payer: Aetna Commercial |
$1,160.50
|
| Rate for Payer: Aetna Medicare |
$453.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$453.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$789.66
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$859.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$521.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$499.12
|
| Rate for Payer: Cash Price |
$852.50
|
| Rate for Payer: Cash Price |
$852.50
|
| Rate for Payer: Centivo All Commercial |
$701.25
|
| Rate for Payer: Cigna All Commercial |
$1,186.62
|
| Rate for Payer: CORVEL All Commercial |
$1,278.75
|
| Rate for Payer: Coventry All Commercial |
$1,210.00
|
| Rate for Payer: Encore All Commercial |
$1,265.69
|
| Rate for Payer: Frontpath All Commercial |
$1,265.00
|
| Rate for Payer: Humana ChoiceCare |
$1,187.59
|
| Rate for Payer: Humana Medicare |
$701.25
|
| Rate for Payer: Lucent All Commercial |
$701.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,237.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,031.25
|
| Rate for Payer: PHP All Commercial |
$1,042.80
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$536.25
|
| Rate for Payer: Sagamore Health Network All Products |
$1,061.50
|
| Rate for Payer: Signature Care EPO |
$1,141.25
|
| Rate for Payer: Signature Care PPO |
$1,210.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,168.75
|
| Rate for Payer: United Healthcare Commercial |
$1,083.50
|
| Rate for Payer: United Healthcare Medicare |
$453.75
|
|
|
HC AR SCREW 8X23
|
Facility
IP
|
$1,375.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606365
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,031.25 |
| Max. Negotiated Rate |
$1,278.75 |
| Rate for Payer: Aetna Commercial |
$1,188.00
|
| Rate for Payer: Cash Price |
$852.50
|
| Rate for Payer: Cigna All Commercial |
$1,186.62
|
| Rate for Payer: CORVEL All Commercial |
$1,278.75
|
| Rate for Payer: Coventry All Commercial |
$1,210.00
|
| Rate for Payer: Encore All Commercial |
$1,265.69
|
| Rate for Payer: Frontpath All Commercial |
$1,265.00
|
| Rate for Payer: Humana ChoiceCare |
$1,187.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,237.50
|
| Rate for Payer: PHCS All Commercial |
$1,031.25
|
| Rate for Payer: PHP All Commercial |
$1,042.80
|
| Rate for Payer: Sagamore Health Network All Products |
$1,061.50
|
| Rate for Payer: Signature Care EPO |
$1,141.25
|
| Rate for Payer: Signature Care PPO |
$1,210.00
|
| Rate for Payer: United Healthcare Commercial |
$1,083.50
|
|
|
HC AR SCREW 8X23 INT
|
Facility
IP
|
$1,375.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607747
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,031.25 |
| Max. Negotiated Rate |
$1,278.75 |
| Rate for Payer: Aetna Commercial |
$1,188.00
|
| Rate for Payer: Cash Price |
$852.50
|
| Rate for Payer: Cigna All Commercial |
$1,186.62
|
| Rate for Payer: CORVEL All Commercial |
$1,278.75
|
| Rate for Payer: Coventry All Commercial |
$1,210.00
|
| Rate for Payer: Encore All Commercial |
$1,265.69
|
| Rate for Payer: Frontpath All Commercial |
$1,265.00
|
| Rate for Payer: Humana ChoiceCare |
$1,187.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,237.50
|
| Rate for Payer: PHCS All Commercial |
$1,031.25
|
| Rate for Payer: PHP All Commercial |
$1,042.80
|
| Rate for Payer: Sagamore Health Network All Products |
$1,061.50
|
| Rate for Payer: Signature Care EPO |
$1,141.25
|
| Rate for Payer: Signature Care PPO |
$1,210.00
|
| Rate for Payer: United Healthcare Commercial |
$1,083.50
|
|
|
HC AR SCREW 8X23 INT
|
Facility
OP
|
$1,375.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607747
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$453.75 |
| Max. Negotiated Rate |
$1,278.75 |
| Rate for Payer: Aetna Commercial |
$1,160.50
|
| Rate for Payer: Aetna Medicare |
$453.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$453.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$789.66
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$859.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$521.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$499.12
|
| Rate for Payer: Cash Price |
$852.50
|
| Rate for Payer: Cash Price |
$852.50
|
| Rate for Payer: Centivo All Commercial |
$701.25
|
| Rate for Payer: Cigna All Commercial |
$1,186.62
|
| Rate for Payer: CORVEL All Commercial |
$1,278.75
|
| Rate for Payer: Coventry All Commercial |
$1,210.00
|
| Rate for Payer: Encore All Commercial |
$1,265.69
|
| Rate for Payer: Frontpath All Commercial |
$1,265.00
|
| Rate for Payer: Humana ChoiceCare |
$1,187.59
|
| Rate for Payer: Humana Medicare |
$701.25
|
| Rate for Payer: Lucent All Commercial |
$701.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,237.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,031.25
|
| Rate for Payer: PHP All Commercial |
$1,042.80
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$536.25
|
| Rate for Payer: Sagamore Health Network All Products |
$1,061.50
|
| Rate for Payer: Signature Care EPO |
$1,141.25
|
| Rate for Payer: Signature Care PPO |
$1,210.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,168.75
|
| Rate for Payer: United Healthcare Commercial |
$1,083.50
|
| Rate for Payer: United Healthcare Medicare |
$453.75
|
|
|
HC AR SCREW 8X28 DELTA
|
Facility
OP
|
$1,375.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607705
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$453.75 |
| Max. Negotiated Rate |
$1,278.75 |
| Rate for Payer: Aetna Commercial |
$1,160.50
|
| Rate for Payer: Aetna Medicare |
$453.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$453.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$789.66
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$859.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$521.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$499.12
|
| Rate for Payer: Cash Price |
$852.50
|
| Rate for Payer: Cash Price |
$852.50
|
| Rate for Payer: Centivo All Commercial |
$701.25
|
| Rate for Payer: Cigna All Commercial |
$1,186.62
|
| Rate for Payer: CORVEL All Commercial |
$1,278.75
|
| Rate for Payer: Coventry All Commercial |
$1,210.00
|
| Rate for Payer: Encore All Commercial |
$1,265.69
|
| Rate for Payer: Frontpath All Commercial |
$1,265.00
|
| Rate for Payer: Humana ChoiceCare |
$1,187.59
|
| Rate for Payer: Humana Medicare |
$701.25
|
| Rate for Payer: Lucent All Commercial |
$701.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,237.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,031.25
|
| Rate for Payer: PHP All Commercial |
$1,042.80
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$536.25
|
| Rate for Payer: Sagamore Health Network All Products |
$1,061.50
|
| Rate for Payer: Signature Care EPO |
$1,141.25
|
| Rate for Payer: Signature Care PPO |
$1,210.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,168.75
|
| Rate for Payer: United Healthcare Commercial |
$1,083.50
|
| Rate for Payer: United Healthcare Medicare |
$453.75
|
|
|
HC AR SCREW 8X28 DELTA
|
Facility
IP
|
$1,375.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607705
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,031.25 |
| Max. Negotiated Rate |
$1,278.75 |
| Rate for Payer: Aetna Commercial |
$1,188.00
|
| Rate for Payer: Cash Price |
$852.50
|
| Rate for Payer: Cigna All Commercial |
$1,186.62
|
| Rate for Payer: CORVEL All Commercial |
$1,278.75
|
| Rate for Payer: Coventry All Commercial |
$1,210.00
|
| Rate for Payer: Encore All Commercial |
$1,265.69
|
| Rate for Payer: Frontpath All Commercial |
$1,265.00
|
| Rate for Payer: Humana ChoiceCare |
$1,187.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,237.50
|
| Rate for Payer: PHCS All Commercial |
$1,031.25
|
| Rate for Payer: PHP All Commercial |
$1,042.80
|
| Rate for Payer: Sagamore Health Network All Products |
$1,061.50
|
| Rate for Payer: Signature Care EPO |
$1,141.25
|
| Rate for Payer: Signature Care PPO |
$1,210.00
|
| Rate for Payer: United Healthcare Commercial |
$1,083.50
|
|
|
HC AR SCREW 8X30 INT
|
Facility
OP
|
$1,622.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606982
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,508.92 |
| Rate for Payer: Aetna Commercial |
$1,369.39
|
| Rate for Payer: Aetna Medicare |
$535.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$535.42
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$931.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,014.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$615.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$588.97
|
| Rate for Payer: Cash Price |
$1,005.95
|
| Rate for Payer: Cash Price |
$1,005.95
|
| Rate for Payer: Centivo All Commercial |
$827.48
|
| Rate for Payer: Cigna All Commercial |
$1,400.22
|
| Rate for Payer: CORVEL All Commercial |
$1,508.92
|
| Rate for Payer: Coventry All Commercial |
$1,427.80
|
| Rate for Payer: Encore All Commercial |
$1,493.51
|
| Rate for Payer: Frontpath All Commercial |
$1,492.70
|
| Rate for Payer: Humana ChoiceCare |
$1,401.35
|
| Rate for Payer: Humana Medicare |
$827.48
|
| Rate for Payer: Lucent All Commercial |
$827.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,460.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,216.88
|
| Rate for Payer: PHP All Commercial |
$1,230.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$632.78
|
| Rate for Payer: Sagamore Health Network All Products |
$1,252.57
|
| Rate for Payer: Signature Care EPO |
$1,346.68
|
| Rate for Payer: Signature Care PPO |
$1,427.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,379.12
|
| Rate for Payer: United Healthcare Commercial |
$1,278.53
|
| Rate for Payer: United Healthcare Medicare |
$535.42
|
|
|
HC AR SCREW 8X30 INT
|
Facility
IP
|
$1,622.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606982
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,216.88 |
| Max. Negotiated Rate |
$1,508.92 |
| Rate for Payer: Aetna Commercial |
$1,401.84
|
| Rate for Payer: Cash Price |
$1,005.95
|
| Rate for Payer: Cigna All Commercial |
$1,400.22
|
| Rate for Payer: CORVEL All Commercial |
$1,508.92
|
| Rate for Payer: Coventry All Commercial |
$1,427.80
|
| Rate for Payer: Encore All Commercial |
$1,493.51
|
| Rate for Payer: Frontpath All Commercial |
$1,492.70
|
| Rate for Payer: Humana ChoiceCare |
$1,401.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,460.25
|
| Rate for Payer: PHCS All Commercial |
$1,216.88
|
| Rate for Payer: PHP All Commercial |
$1,230.50
|
| Rate for Payer: Sagamore Health Network All Products |
$1,252.57
|
| Rate for Payer: Signature Care EPO |
$1,346.68
|
| Rate for Payer: Signature Care PPO |
$1,427.80
|
| Rate for Payer: United Healthcare Commercial |
$1,278.53
|
|
|
HC AR SCREW 9X20 INT
|
Facility
OP
|
$1,622.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607097
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,508.92 |
| Rate for Payer: Aetna Commercial |
$1,369.39
|
| Rate for Payer: Aetna Medicare |
$535.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$535.42
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$931.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,014.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$615.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$588.97
|
| Rate for Payer: Cash Price |
$1,005.95
|
| Rate for Payer: Cash Price |
$1,005.95
|
| Rate for Payer: Centivo All Commercial |
$827.48
|
| Rate for Payer: Cigna All Commercial |
$1,400.22
|
| Rate for Payer: CORVEL All Commercial |
$1,508.92
|
| Rate for Payer: Coventry All Commercial |
$1,427.80
|
| Rate for Payer: Encore All Commercial |
$1,493.51
|
| Rate for Payer: Frontpath All Commercial |
$1,492.70
|
| Rate for Payer: Humana ChoiceCare |
$1,401.35
|
| Rate for Payer: Humana Medicare |
$827.48
|
| Rate for Payer: Lucent All Commercial |
$827.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,460.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,216.88
|
| Rate for Payer: PHP All Commercial |
$1,230.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$632.78
|
| Rate for Payer: Sagamore Health Network All Products |
$1,252.57
|
| Rate for Payer: Signature Care EPO |
$1,346.68
|
| Rate for Payer: Signature Care PPO |
$1,427.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,379.12
|
| Rate for Payer: United Healthcare Commercial |
$1,278.53
|
| Rate for Payer: United Healthcare Medicare |
$535.42
|
|
|
HC AR SCREW 9X20 INT
|
Facility
IP
|
$1,622.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607097
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,216.88 |
| Max. Negotiated Rate |
$1,508.92 |
| Rate for Payer: Aetna Commercial |
$1,401.84
|
| Rate for Payer: Cash Price |
$1,005.95
|
| Rate for Payer: Cigna All Commercial |
$1,400.22
|
| Rate for Payer: CORVEL All Commercial |
$1,508.92
|
| Rate for Payer: Coventry All Commercial |
$1,427.80
|
| Rate for Payer: Encore All Commercial |
$1,493.51
|
| Rate for Payer: Frontpath All Commercial |
$1,492.70
|
| Rate for Payer: Humana ChoiceCare |
$1,401.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,460.25
|
| Rate for Payer: PHCS All Commercial |
$1,216.88
|
| Rate for Payer: PHP All Commercial |
$1,230.50
|
| Rate for Payer: Sagamore Health Network All Products |
$1,252.57
|
| Rate for Payer: Signature Care EPO |
$1,346.68
|
| Rate for Payer: Signature Care PPO |
$1,427.80
|
| Rate for Payer: United Healthcare Commercial |
$1,278.53
|
|
|
HC AR SCREW COMP
|
Facility
IP
|
$2,172.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605889
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,629.38 |
| Max. Negotiated Rate |
$2,020.42 |
| Rate for Payer: Aetna Commercial |
$1,877.04
|
| Rate for Payer: Cash Price |
$1,346.95
|
| Rate for Payer: Cigna All Commercial |
$1,874.87
|
| Rate for Payer: CORVEL All Commercial |
$2,020.42
|
| Rate for Payer: Coventry All Commercial |
$1,911.80
|
| Rate for Payer: Encore All Commercial |
$1,999.79
|
| Rate for Payer: Frontpath All Commercial |
$1,998.70
|
| Rate for Payer: Humana ChoiceCare |
$1,876.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,955.25
|
| Rate for Payer: PHCS All Commercial |
$1,629.38
|
| Rate for Payer: PHP All Commercial |
$1,647.62
|
| Rate for Payer: Sagamore Health Network All Products |
$1,677.17
|
| Rate for Payer: Signature Care EPO |
$1,803.18
|
| Rate for Payer: Signature Care PPO |
$1,911.80
|
| Rate for Payer: United Healthcare Commercial |
$1,711.93
|
|
|
HC AR SCREW COMP
|
Facility
OP
|
$2,172.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605889
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,020.42 |
| Rate for Payer: Aetna Commercial |
$1,833.59
|
| Rate for Payer: Aetna Medicare |
$716.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$716.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,247.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,358.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$824.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$788.62
|
| Rate for Payer: Cash Price |
$1,346.95
|
| Rate for Payer: Cash Price |
$1,346.95
|
| Rate for Payer: Centivo All Commercial |
$1,107.98
|
| Rate for Payer: Cigna All Commercial |
$1,874.87
|
| Rate for Payer: CORVEL All Commercial |
$2,020.42
|
| Rate for Payer: Coventry All Commercial |
$1,911.80
|
| Rate for Payer: Encore All Commercial |
$1,999.79
|
| Rate for Payer: Frontpath All Commercial |
$1,998.70
|
| Rate for Payer: Humana ChoiceCare |
$1,876.39
|
| Rate for Payer: Humana Medicare |
$1,107.98
|
| Rate for Payer: Lucent All Commercial |
$1,107.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,955.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,629.38
|
| Rate for Payer: PHP All Commercial |
$1,647.62
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$847.28
|
| Rate for Payer: Sagamore Health Network All Products |
$1,677.17
|
| Rate for Payer: Signature Care EPO |
$1,803.18
|
| Rate for Payer: Signature Care PPO |
$1,911.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,846.62
|
| Rate for Payer: United Healthcare Commercial |
$1,711.93
|
| Rate for Payer: United Healthcare Medicare |
$716.92
|
|
|
HC AR SCREW LO PRO 3.5X12
|
Facility
IP
|
$700.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608328
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$525.00 |
| Max. Negotiated Rate |
$651.00 |
| Rate for Payer: Aetna Commercial |
$604.80
|
| Rate for Payer: Cash Price |
$434.00
|
| Rate for Payer: Cigna All Commercial |
$604.10
|
| Rate for Payer: CORVEL All Commercial |
$651.00
|
| Rate for Payer: Coventry All Commercial |
$616.00
|
| Rate for Payer: Encore All Commercial |
$644.35
|
| Rate for Payer: Frontpath All Commercial |
$644.00
|
| Rate for Payer: Humana ChoiceCare |
$604.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$630.00
|
| Rate for Payer: PHCS All Commercial |
$525.00
|
| Rate for Payer: PHP All Commercial |
$530.88
|
| Rate for Payer: Sagamore Health Network All Products |
$540.40
|
| Rate for Payer: Signature Care EPO |
$581.00
|
| Rate for Payer: Signature Care PPO |
$616.00
|
| Rate for Payer: United Healthcare Commercial |
$551.60
|
|
|
HC AR SCREW LO PRO 3.5X12
|
Facility
OP
|
$700.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608328
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$231.00 |
| Max. Negotiated Rate |
$651.00 |
| Rate for Payer: Aetna Commercial |
$590.80
|
| Rate for Payer: Aetna Medicare |
$231.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$231.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$402.01
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$437.57
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$265.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$254.10
|
| Rate for Payer: Cash Price |
$434.00
|
| Rate for Payer: Cash Price |
$434.00
|
| Rate for Payer: Centivo All Commercial |
$357.00
|
| Rate for Payer: Cigna All Commercial |
$604.10
|
| Rate for Payer: CORVEL All Commercial |
$651.00
|
| Rate for Payer: Coventry All Commercial |
$616.00
|
| Rate for Payer: Encore All Commercial |
$644.35
|
| Rate for Payer: Frontpath All Commercial |
$644.00
|
| Rate for Payer: Humana ChoiceCare |
$604.59
|
| Rate for Payer: Humana Medicare |
$357.00
|
| Rate for Payer: Lucent All Commercial |
$357.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$630.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$525.00
|
| Rate for Payer: PHP All Commercial |
$530.88
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$273.00
|
| Rate for Payer: Sagamore Health Network All Products |
$540.40
|
| Rate for Payer: Signature Care EPO |
$581.00
|
| Rate for Payer: Signature Care PPO |
$616.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$595.00
|
| Rate for Payer: United Healthcare Commercial |
$551.60
|
| Rate for Payer: United Healthcare Medicare |
$231.00
|
|
