|
HC AR SCREW LO PRO 3.5X14
|
Facility
IP
|
$700.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608061
|
|
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 3.5X14
|
Facility
OP
|
$700.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608061
|
|
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
|
|
|
HC AR SCREW LO PRO 3.5X16
|
Facility
IP
|
$700.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608062
|
|
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 3.5X16
|
Facility
OP
|
$700.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608062
|
|
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
|
|
|
HC AR SCREW LO PRO 3.5X20
|
Facility
IP
|
$700.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608194
|
|
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 3.5X20
|
Facility
OP
|
$700.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608194
|
|
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
|
|
|
HC AR SCREW LO PRO 3.5X22
|
Facility
OP
|
$700.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608063
|
|
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
|
|
|
HC AR SCREW LO PRO 3.5X22
|
Facility
IP
|
$700.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608063
|
|
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 4X32
|
Facility
OP
|
$1,375.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608156
|
|
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 LO PRO 4X32
|
Facility
IP
|
$1,375.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608156
|
|
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 LO PRO 4X34
|
Facility
IP
|
$1,375.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608157
|
|
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 LO PRO 4X34
|
Facility
OP
|
$1,375.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608157
|
|
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 MICRO COMP 11MM
|
Facility
IP
|
$1,925.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602510
|
|
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 SCREW MICRO COMP 11MM
|
Facility
OP
|
$1,925.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602510
|
|
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 SCREW TENDONESIS 6.25X15
|
Facility
IP
|
$2,227.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603448
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,670.62 |
| Max. Negotiated Rate |
$2,071.58 |
| Rate for Payer: Aetna Commercial |
$1,924.56
|
| Rate for Payer: Cash Price |
$1,381.05
|
| Rate for Payer: Cigna All Commercial |
$1,922.33
|
| Rate for Payer: CORVEL All Commercial |
$2,071.58
|
| Rate for Payer: Coventry All Commercial |
$1,960.20
|
| Rate for Payer: Encore All Commercial |
$2,050.41
|
| Rate for Payer: Frontpath All Commercial |
$2,049.30
|
| Rate for Payer: Humana ChoiceCare |
$1,923.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,004.75
|
| Rate for Payer: PHCS All Commercial |
$1,670.62
|
| Rate for Payer: PHP All Commercial |
$1,689.34
|
| Rate for Payer: Sagamore Health Network All Products |
$1,719.63
|
| Rate for Payer: Signature Care EPO |
$1,848.82
|
| Rate for Payer: Signature Care PPO |
$1,960.20
|
| Rate for Payer: United Healthcare Commercial |
$1,755.27
|
|
|
HC AR SCREW TENDONESIS 6.25X15
|
Facility
OP
|
$2,227.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603448
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,071.58 |
| Rate for Payer: Aetna Commercial |
$1,880.01
|
| Rate for Payer: Aetna Medicare |
$735.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$735.08
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,279.25
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,392.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$845.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$808.58
|
| Rate for Payer: Cash Price |
$1,381.05
|
| Rate for Payer: Cash Price |
$1,381.05
|
| Rate for Payer: Centivo All Commercial |
$1,136.02
|
| Rate for Payer: Cigna All Commercial |
$1,922.33
|
| Rate for Payer: CORVEL All Commercial |
$2,071.58
|
| Rate for Payer: Coventry All Commercial |
$1,960.20
|
| Rate for Payer: Encore All Commercial |
$2,050.41
|
| Rate for Payer: Frontpath All Commercial |
$2,049.30
|
| Rate for Payer: Humana ChoiceCare |
$1,923.89
|
| Rate for Payer: Humana Medicare |
$1,136.02
|
| Rate for Payer: Lucent All Commercial |
$1,136.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,004.75
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,670.62
|
| Rate for Payer: PHP All Commercial |
$1,689.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$868.72
|
| Rate for Payer: Sagamore Health Network All Products |
$1,719.63
|
| Rate for Payer: Signature Care EPO |
$1,848.82
|
| Rate for Payer: Signature Care PPO |
$1,960.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,893.38
|
| Rate for Payer: United Healthcare Commercial |
$1,755.27
|
| Rate for Payer: United Healthcare Medicare |
$735.08
|
|
|
HC AR SCREW TENODESIS 3X8
|
Facility
OP
|
$2,227.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603249
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,071.58 |
| Rate for Payer: Aetna Commercial |
$1,880.01
|
| Rate for Payer: Aetna Medicare |
$735.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$735.08
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,279.25
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,392.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$845.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$808.58
|
| Rate for Payer: Cash Price |
$1,381.05
|
| Rate for Payer: Cash Price |
$1,381.05
|
| Rate for Payer: Centivo All Commercial |
$1,136.02
|
| Rate for Payer: Cigna All Commercial |
$1,922.33
|
| Rate for Payer: CORVEL All Commercial |
$2,071.58
|
| Rate for Payer: Coventry All Commercial |
$1,960.20
|
| Rate for Payer: Encore All Commercial |
$2,050.41
|
| Rate for Payer: Frontpath All Commercial |
$2,049.30
|
| Rate for Payer: Humana ChoiceCare |
$1,923.89
|
| Rate for Payer: Humana Medicare |
$1,136.02
|
| Rate for Payer: Lucent All Commercial |
$1,136.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,004.75
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,670.62
|
| Rate for Payer: PHP All Commercial |
$1,689.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$868.72
|
| Rate for Payer: Sagamore Health Network All Products |
$1,719.63
|
| Rate for Payer: Signature Care EPO |
$1,848.82
|
| Rate for Payer: Signature Care PPO |
$1,960.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,893.38
|
| Rate for Payer: United Healthcare Commercial |
$1,755.27
|
| Rate for Payer: United Healthcare Medicare |
$735.08
|
|
|
HC AR SCREW TENODESIS 3X8
|
Facility
IP
|
$2,227.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603249
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,670.62 |
| Max. Negotiated Rate |
$2,071.58 |
| Rate for Payer: Aetna Commercial |
$1,924.56
|
| Rate for Payer: Cash Price |
$1,381.05
|
| Rate for Payer: Cigna All Commercial |
$1,922.33
|
| Rate for Payer: CORVEL All Commercial |
$2,071.58
|
| Rate for Payer: Coventry All Commercial |
$1,960.20
|
| Rate for Payer: Encore All Commercial |
$2,050.41
|
| Rate for Payer: Frontpath All Commercial |
$2,049.30
|
| Rate for Payer: Humana ChoiceCare |
$1,923.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,004.75
|
| Rate for Payer: PHCS All Commercial |
$1,670.62
|
| Rate for Payer: PHP All Commercial |
$1,689.34
|
| Rate for Payer: Sagamore Health Network All Products |
$1,719.63
|
| Rate for Payer: Signature Care EPO |
$1,848.82
|
| Rate for Payer: Signature Care PPO |
$1,960.20
|
| Rate for Payer: United Healthcare Commercial |
$1,755.27
|
|
|
HC AR SCREW TENODESIS 8X12
|
Facility
IP
|
$1,732.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607774
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,299.38 |
| Max. Negotiated Rate |
$1,611.22 |
| Rate for Payer: Aetna Commercial |
$1,496.88
|
| Rate for Payer: Cash Price |
$1,074.15
|
| Rate for Payer: Cigna All Commercial |
$1,495.15
|
| Rate for Payer: CORVEL All Commercial |
$1,611.22
|
| Rate for Payer: Coventry All Commercial |
$1,524.60
|
| Rate for Payer: Encore All Commercial |
$1,594.77
|
| Rate for Payer: Frontpath All Commercial |
$1,593.90
|
| Rate for Payer: Humana ChoiceCare |
$1,496.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,559.25
|
| Rate for Payer: PHCS All Commercial |
$1,299.38
|
| Rate for Payer: PHP All Commercial |
$1,313.93
|
| Rate for Payer: Sagamore Health Network All Products |
$1,337.49
|
| Rate for Payer: Signature Care EPO |
$1,437.98
|
| Rate for Payer: Signature Care PPO |
$1,524.60
|
| Rate for Payer: United Healthcare Commercial |
$1,365.21
|
|
|
HC AR SCREW TENODESIS 8X12
|
Facility
OP
|
$1,732.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607774
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,611.22 |
| Rate for Payer: Aetna Commercial |
$1,462.23
|
| Rate for Payer: Aetna Medicare |
$571.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$571.72
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$994.97
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,082.99
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$657.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$628.90
|
| Rate for Payer: Cash Price |
$1,074.15
|
| Rate for Payer: Cash Price |
$1,074.15
|
| Rate for Payer: Centivo All Commercial |
$883.58
|
| Rate for Payer: Cigna All Commercial |
$1,495.15
|
| Rate for Payer: CORVEL All Commercial |
$1,611.22
|
| Rate for Payer: Coventry All Commercial |
$1,524.60
|
| Rate for Payer: Encore All Commercial |
$1,594.77
|
| Rate for Payer: Frontpath All Commercial |
$1,593.90
|
| Rate for Payer: Humana ChoiceCare |
$1,496.36
|
| Rate for Payer: Humana Medicare |
$883.58
|
| Rate for Payer: Lucent All Commercial |
$883.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,559.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,299.38
|
| Rate for Payer: PHP All Commercial |
$1,313.93
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$675.68
|
| Rate for Payer: Sagamore Health Network All Products |
$1,337.49
|
| Rate for Payer: Signature Care EPO |
$1,437.98
|
| Rate for Payer: Signature Care PPO |
$1,524.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,472.62
|
| Rate for Payer: United Healthcare Commercial |
$1,365.21
|
| Rate for Payer: United Healthcare Medicare |
$571.72
|
|
|
HC AR SCREW VAL KRE 3X14
|
Facility
IP
|
$2,460.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608064
|
|
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 VAL KRE 3X14
|
Facility
OP
|
$2,460.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608064
|
|
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 VAL KRE 3X20
|
Facility
OP
|
$2,460.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608065
|
|
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 VAL KRE 3X20
|
Facility
IP
|
$2,460.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608065
|
|
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 VAL KRE 3X22
|
Facility
IP
|
$2,460.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608066
|
|
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
|
|
