|
HC ACU 2.0 QR SURGIBIT DRILL DM
|
Facility
IP
|
$556.00
|
|
| Hospital Charge Code |
41603278
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$344.72 |
| Max. Negotiated Rate |
$511.80 |
| Rate for Payer: Aetna Commercial |
$480.38
|
| Rate for Payer: Cigna All Products |
$479.83
|
| Rate for Payer: Coventry/First Health All Products |
$489.28
|
| Rate for Payer: Encore All Products |
$511.80
|
| Rate for Payer: Frontpath All Products |
$511.52
|
| Rate for Payer: Humana ChoiceCare |
$480.22
|
| Rate for Payer: Lutheran Preferred All Products |
$500.40
|
| Rate for Payer: PHCS/Multiplan All Products |
$417.00
|
| Rate for Payer: PHP All Products |
$421.67
|
| Rate for Payer: Sagamore All Products |
$429.23
|
| Rate for Payer: Self Pay/Cash Rate |
$344.72
|
| Rate for Payer: Signature Care EPO |
$461.48
|
| Rate for Payer: Signature Care PPO |
$489.28
|
| Rate for Payer: United Healthcare Commercial |
$438.13
|
|
|
HC ACU 2.0 QR SURGIBIT DRILL DM
|
Facility
OP
|
$556.00
|
|
| Hospital Charge Code |
41603278
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$183.48 |
| Max. Negotiated Rate |
$511.80 |
| Rate for Payer: Aetna Commercial |
$469.26
|
| Rate for Payer: Aetna Medicare |
$183.48
|
| Rate for Payer: Anthem Exchange |
$319.31
|
| Rate for Payer: Anthem Medicare |
$183.48
|
| Rate for Payer: Anthem PPO |
$319.31
|
| Rate for Payer: Anthem Traditional |
$347.56
|
| Rate for Payer: Caresource Just 4 Me |
$211.00
|
| Rate for Payer: Caresource Medicare |
$201.83
|
| Rate for Payer: Centivo/Paragon All Products |
$283.56
|
| Rate for Payer: Cigna All Products |
$479.83
|
| Rate for Payer: Coventry/First Health All Products |
$489.28
|
| Rate for Payer: Encore All Products |
$511.80
|
| Rate for Payer: Frontpath All Products |
$511.52
|
| Rate for Payer: Humana ChoiceCare |
$480.22
|
| Rate for Payer: Humana Medicare |
$283.56
|
| Rate for Payer: Lucent/Coldwater Veneers |
$283.56
|
| Rate for Payer: Lutheran Preferred All Products |
$500.40
|
| Rate for Payer: PHCS/Multiplan All Products |
$417.00
|
| Rate for Payer: PHP All Products |
$421.67
|
| Rate for Payer: Plain Church Group Ministry All Products |
$216.84
|
| Rate for Payer: Sagamore All Products |
$429.23
|
| Rate for Payer: Self Pay/Cash Rate |
$344.72
|
| Rate for Payer: Signature Care EPO |
$461.48
|
| Rate for Payer: Signature Care PPO |
$489.28
|
| Rate for Payer: Three Rivers Preferred All Products |
$472.60
|
| Rate for Payer: United Healthcare Commercial |
$438.13
|
| Rate for Payer: United Healthcare Medicare |
$183.48
|
|
|
HC ACU 20 TWIST-TRAK COMP SCREW
|
Facility
OP
|
$894.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602809
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$295.02 |
| Max. Negotiated Rate |
$822.93 |
| Rate for Payer: Aetna Commercial |
$754.54
|
| Rate for Payer: Aetna Medicare |
$295.02
|
| Rate for Payer: Anthem Exchange |
$513.42
|
| Rate for Payer: Anthem Medicare |
$295.02
|
| Rate for Payer: Anthem PPO |
$513.42
|
| Rate for Payer: Anthem Traditional |
$558.84
|
| Rate for Payer: Caresource Just 4 Me |
$339.27
|
| Rate for Payer: Caresource Medicare |
$324.52
|
| Rate for Payer: Centivo/Paragon All Products |
$455.94
|
| Rate for Payer: Cigna All Products |
$771.52
|
| Rate for Payer: Coventry/First Health All Products |
$786.72
|
| Rate for Payer: Encore All Products |
$822.93
|
| Rate for Payer: Frontpath All Products |
$822.48
|
| Rate for Payer: Humana ChoiceCare |
$772.15
|
| Rate for Payer: Humana Medicare |
$455.94
|
| Rate for Payer: Lucent/Coldwater Veneers |
$455.94
|
| Rate for Payer: Lutheran Preferred All Products |
$804.60
|
| Rate for Payer: PHCS/Multiplan All Products |
$670.50
|
| Rate for Payer: PHP All Products |
$678.01
|
| Rate for Payer: Plain Church Group Ministry All Products |
$348.66
|
| Rate for Payer: Sagamore All Products |
$690.17
|
| Rate for Payer: Self Pay/Cash Rate |
$554.28
|
| Rate for Payer: Signature Care EPO |
$742.02
|
| Rate for Payer: Signature Care PPO |
$786.72
|
| Rate for Payer: Three Rivers Preferred All Products |
$759.90
|
| Rate for Payer: United Healthcare Commercial |
$704.47
|
| Rate for Payer: United Healthcare Medicare |
$295.02
|
|
|
HC ACU 20 TWIST-TRAK COMP SCREW
|
Facility
IP
|
$894.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602809
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$554.28 |
| Max. Negotiated Rate |
$822.93 |
| Rate for Payer: Aetna Commercial |
$772.42
|
| Rate for Payer: Cigna All Products |
$771.52
|
| Rate for Payer: Coventry/First Health All Products |
$786.72
|
| Rate for Payer: Encore All Products |
$822.93
|
| Rate for Payer: Frontpath All Products |
$822.48
|
| Rate for Payer: Humana ChoiceCare |
$772.15
|
| Rate for Payer: Lutheran Preferred All Products |
$804.60
|
| Rate for Payer: PHCS/Multiplan All Products |
$670.50
|
| Rate for Payer: PHP All Products |
$678.01
|
| Rate for Payer: Sagamore All Products |
$690.17
|
| Rate for Payer: Self Pay/Cash Rate |
$554.28
|
| Rate for Payer: Signature Care EPO |
$742.02
|
| Rate for Payer: Signature Care PPO |
$786.72
|
| Rate for Payer: United Healthcare Commercial |
$704.47
|
|
|
HC ACU 2.0 X 6" ST GUIDE WIRE
|
Facility
IP
|
$75.60
|
|
| Hospital Charge Code |
41602812
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.87 |
| Max. Negotiated Rate |
$69.59 |
| Rate for Payer: Aetna Commercial |
$65.32
|
| Rate for Payer: Cigna All Products |
$65.24
|
| Rate for Payer: Coventry/First Health All Products |
$66.53
|
| Rate for Payer: Encore All Products |
$69.59
|
| Rate for Payer: Frontpath All Products |
$69.55
|
| Rate for Payer: Humana ChoiceCare |
$65.30
|
| Rate for Payer: Lutheran Preferred All Products |
$68.04
|
| Rate for Payer: PHCS/Multiplan All Products |
$56.70
|
| Rate for Payer: PHP All Products |
$57.34
|
| Rate for Payer: Sagamore All Products |
$58.36
|
| Rate for Payer: Self Pay/Cash Rate |
$46.87
|
| Rate for Payer: Signature Care EPO |
$62.75
|
| Rate for Payer: Signature Care PPO |
$66.53
|
| Rate for Payer: United Healthcare Commercial |
$59.57
|
|
|
HC ACU 2.0 X 6" ST GUIDE WIRE
|
Facility
OP
|
$75.60
|
|
| Hospital Charge Code |
41602812
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.95 |
| Max. Negotiated Rate |
$69.59 |
| Rate for Payer: Aetna Commercial |
$63.81
|
| Rate for Payer: Aetna Medicare |
$24.95
|
| Rate for Payer: Anthem Exchange |
$43.42
|
| Rate for Payer: Anthem Medicare |
$24.95
|
| Rate for Payer: Anthem PPO |
$43.42
|
| Rate for Payer: Anthem Traditional |
$47.26
|
| Rate for Payer: Caresource Just 4 Me |
$28.69
|
| Rate for Payer: Caresource Medicare |
$27.44
|
| Rate for Payer: Centivo/Paragon All Products |
$38.56
|
| Rate for Payer: Cigna All Products |
$65.24
|
| Rate for Payer: Coventry/First Health All Products |
$66.53
|
| Rate for Payer: Encore All Products |
$69.59
|
| Rate for Payer: Frontpath All Products |
$69.55
|
| Rate for Payer: Humana ChoiceCare |
$65.30
|
| Rate for Payer: Humana Medicare |
$38.56
|
| Rate for Payer: Lucent/Coldwater Veneers |
$38.56
|
| Rate for Payer: Lutheran Preferred All Products |
$68.04
|
| Rate for Payer: PHCS/Multiplan All Products |
$56.70
|
| Rate for Payer: PHP All Products |
$57.34
|
| Rate for Payer: Plain Church Group Ministry All Products |
$29.48
|
| Rate for Payer: Sagamore All Products |
$58.36
|
| Rate for Payer: Self Pay/Cash Rate |
$46.87
|
| Rate for Payer: Signature Care EPO |
$62.75
|
| Rate for Payer: Signature Care PPO |
$66.53
|
| Rate for Payer: Three Rivers Preferred All Products |
$64.26
|
| Rate for Payer: United Healthcare Commercial |
$59.57
|
| Rate for Payer: United Healthcare Medicare |
$24.95
|
|
|
HC ACU 2.3MM X 10MM HEX LAG SCREW
|
Facility
OP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603231
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$187.44 |
| Max. Negotiated Rate |
$522.84 |
| Rate for Payer: Aetna Commercial |
$479.39
|
| Rate for Payer: Aetna Medicare |
$187.44
|
| Rate for Payer: Anthem Exchange |
$326.20
|
| Rate for Payer: Anthem Medicare |
$187.44
|
| Rate for Payer: Anthem PPO |
$326.20
|
| Rate for Payer: Anthem Traditional |
$355.06
|
| Rate for Payer: Caresource Just 4 Me |
$215.56
|
| Rate for Payer: Caresource Medicare |
$206.18
|
| Rate for Payer: Centivo/Paragon All Products |
$289.68
|
| Rate for Payer: Cigna All Products |
$490.18
|
| Rate for Payer: Coventry/First Health All Products |
$499.84
|
| Rate for Payer: Encore All Products |
$522.84
|
| Rate for Payer: Frontpath All Products |
$522.56
|
| Rate for Payer: Humana ChoiceCare |
$490.58
|
| Rate for Payer: Humana Medicare |
$289.68
|
| Rate for Payer: Lucent/Coldwater Veneers |
$289.68
|
| Rate for Payer: Lutheran Preferred All Products |
$511.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$426.00
|
| Rate for Payer: PHP All Products |
$430.77
|
| Rate for Payer: Plain Church Group Ministry All Products |
$221.52
|
| Rate for Payer: Sagamore All Products |
$438.50
|
| Rate for Payer: Self Pay/Cash Rate |
$352.16
|
| Rate for Payer: Signature Care EPO |
$471.44
|
| Rate for Payer: Signature Care PPO |
$499.84
|
| Rate for Payer: Three Rivers Preferred All Products |
$482.80
|
| Rate for Payer: United Healthcare Commercial |
$447.58
|
| Rate for Payer: United Healthcare Medicare |
$187.44
|
|
|
HC ACU 2.3MM X 10MM HEX LAG SCREW
|
Facility
IP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603231
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$352.16 |
| Max. Negotiated Rate |
$522.84 |
| Rate for Payer: Aetna Commercial |
$490.75
|
| Rate for Payer: Cigna All Products |
$490.18
|
| Rate for Payer: Coventry/First Health All Products |
$499.84
|
| Rate for Payer: Encore All Products |
$522.84
|
| Rate for Payer: Frontpath All Products |
$522.56
|
| Rate for Payer: Humana ChoiceCare |
$490.58
|
| Rate for Payer: Lutheran Preferred All Products |
$511.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$426.00
|
| Rate for Payer: PHP All Products |
$430.77
|
| Rate for Payer: Sagamore All Products |
$438.50
|
| Rate for Payer: Self Pay/Cash Rate |
$352.16
|
| Rate for Payer: Signature Care EPO |
$471.44
|
| Rate for Payer: Signature Care PPO |
$499.84
|
| Rate for Payer: United Healthcare Commercial |
$447.58
|
|
|
HC ACU 2.3MM X 10MM HEX MLT SCREW
|
Facility
OP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603205
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$187.44 |
| Max. Negotiated Rate |
$522.84 |
| Rate for Payer: Aetna Commercial |
$479.39
|
| Rate for Payer: Aetna Medicare |
$187.44
|
| Rate for Payer: Anthem Exchange |
$326.20
|
| Rate for Payer: Anthem Medicare |
$187.44
|
| Rate for Payer: Anthem PPO |
$326.20
|
| Rate for Payer: Anthem Traditional |
$355.06
|
| Rate for Payer: Caresource Just 4 Me |
$215.56
|
| Rate for Payer: Caresource Medicare |
$206.18
|
| Rate for Payer: Centivo/Paragon All Products |
$289.68
|
| Rate for Payer: Cigna All Products |
$490.18
|
| Rate for Payer: Coventry/First Health All Products |
$499.84
|
| Rate for Payer: Encore All Products |
$522.84
|
| Rate for Payer: Frontpath All Products |
$522.56
|
| Rate for Payer: Humana ChoiceCare |
$490.58
|
| Rate for Payer: Humana Medicare |
$289.68
|
| Rate for Payer: Lucent/Coldwater Veneers |
$289.68
|
| Rate for Payer: Lutheran Preferred All Products |
$511.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$426.00
|
| Rate for Payer: PHP All Products |
$430.77
|
| Rate for Payer: Plain Church Group Ministry All Products |
$221.52
|
| Rate for Payer: Sagamore All Products |
$438.50
|
| Rate for Payer: Self Pay/Cash Rate |
$352.16
|
| Rate for Payer: Signature Care EPO |
$471.44
|
| Rate for Payer: Signature Care PPO |
$499.84
|
| Rate for Payer: Three Rivers Preferred All Products |
$482.80
|
| Rate for Payer: United Healthcare Commercial |
$447.58
|
| Rate for Payer: United Healthcare Medicare |
$187.44
|
|
|
HC ACU 2.3MM X 10MM HEX MLT SCREW
|
Facility
IP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603205
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$352.16 |
| Max. Negotiated Rate |
$522.84 |
| Rate for Payer: Aetna Commercial |
$490.75
|
| Rate for Payer: Cigna All Products |
$490.18
|
| Rate for Payer: Coventry/First Health All Products |
$499.84
|
| Rate for Payer: Encore All Products |
$522.84
|
| Rate for Payer: Frontpath All Products |
$522.56
|
| Rate for Payer: Humana ChoiceCare |
$490.58
|
| Rate for Payer: Lutheran Preferred All Products |
$511.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$426.00
|
| Rate for Payer: PHP All Products |
$430.77
|
| Rate for Payer: Sagamore All Products |
$438.50
|
| Rate for Payer: Self Pay/Cash Rate |
$352.16
|
| Rate for Payer: Signature Care EPO |
$471.44
|
| Rate for Payer: Signature Care PPO |
$499.84
|
| Rate for Payer: United Healthcare Commercial |
$447.58
|
|
|
HC ACU 2.3MM X 11MM HEX LAG SCREW
|
Facility
IP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603232
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$352.16 |
| Max. Negotiated Rate |
$522.84 |
| Rate for Payer: Aetna Commercial |
$490.75
|
| Rate for Payer: Cigna All Products |
$490.18
|
| Rate for Payer: Coventry/First Health All Products |
$499.84
|
| Rate for Payer: Encore All Products |
$522.84
|
| Rate for Payer: Frontpath All Products |
$522.56
|
| Rate for Payer: Humana ChoiceCare |
$490.58
|
| Rate for Payer: Lutheran Preferred All Products |
$511.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$426.00
|
| Rate for Payer: PHP All Products |
$430.77
|
| Rate for Payer: Sagamore All Products |
$438.50
|
| Rate for Payer: Self Pay/Cash Rate |
$352.16
|
| Rate for Payer: Signature Care EPO |
$471.44
|
| Rate for Payer: Signature Care PPO |
$499.84
|
| Rate for Payer: United Healthcare Commercial |
$447.58
|
|
|
HC ACU 2.3MM X 11MM HEX LAG SCREW
|
Facility
OP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603232
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$187.44 |
| Max. Negotiated Rate |
$522.84 |
| Rate for Payer: Aetna Commercial |
$479.39
|
| Rate for Payer: Aetna Medicare |
$187.44
|
| Rate for Payer: Anthem Exchange |
$326.20
|
| Rate for Payer: Anthem Medicare |
$187.44
|
| Rate for Payer: Anthem PPO |
$326.20
|
| Rate for Payer: Anthem Traditional |
$355.06
|
| Rate for Payer: Caresource Just 4 Me |
$215.56
|
| Rate for Payer: Caresource Medicare |
$206.18
|
| Rate for Payer: Centivo/Paragon All Products |
$289.68
|
| Rate for Payer: Cigna All Products |
$490.18
|
| Rate for Payer: Coventry/First Health All Products |
$499.84
|
| Rate for Payer: Encore All Products |
$522.84
|
| Rate for Payer: Frontpath All Products |
$522.56
|
| Rate for Payer: Humana ChoiceCare |
$490.58
|
| Rate for Payer: Humana Medicare |
$289.68
|
| Rate for Payer: Lucent/Coldwater Veneers |
$289.68
|
| Rate for Payer: Lutheran Preferred All Products |
$511.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$426.00
|
| Rate for Payer: PHP All Products |
$430.77
|
| Rate for Payer: Plain Church Group Ministry All Products |
$221.52
|
| Rate for Payer: Sagamore All Products |
$438.50
|
| Rate for Payer: Self Pay/Cash Rate |
$352.16
|
| Rate for Payer: Signature Care EPO |
$471.44
|
| Rate for Payer: Signature Care PPO |
$499.84
|
| Rate for Payer: Three Rivers Preferred All Products |
$482.80
|
| Rate for Payer: United Healthcare Commercial |
$447.58
|
| Rate for Payer: United Healthcare Medicare |
$187.44
|
|
|
HC ACU 2.3MM X 11MM HEX MLT SCREW
|
Facility
IP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603206
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$352.16 |
| Max. Negotiated Rate |
$522.84 |
| Rate for Payer: Aetna Commercial |
$490.75
|
| Rate for Payer: Cigna All Products |
$490.18
|
| Rate for Payer: Coventry/First Health All Products |
$499.84
|
| Rate for Payer: Encore All Products |
$522.84
|
| Rate for Payer: Frontpath All Products |
$522.56
|
| Rate for Payer: Humana ChoiceCare |
$490.58
|
| Rate for Payer: Lutheran Preferred All Products |
$511.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$426.00
|
| Rate for Payer: PHP All Products |
$430.77
|
| Rate for Payer: Sagamore All Products |
$438.50
|
| Rate for Payer: Self Pay/Cash Rate |
$352.16
|
| Rate for Payer: Signature Care EPO |
$471.44
|
| Rate for Payer: Signature Care PPO |
$499.84
|
| Rate for Payer: United Healthcare Commercial |
$447.58
|
|
|
HC ACU 2.3MM X 11MM HEX MLT SCREW
|
Facility
OP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603206
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$187.44 |
| Max. Negotiated Rate |
$522.84 |
| Rate for Payer: Aetna Commercial |
$479.39
|
| Rate for Payer: Aetna Medicare |
$187.44
|
| Rate for Payer: Anthem Exchange |
$326.20
|
| Rate for Payer: Anthem Medicare |
$187.44
|
| Rate for Payer: Anthem PPO |
$326.20
|
| Rate for Payer: Anthem Traditional |
$355.06
|
| Rate for Payer: Caresource Just 4 Me |
$215.56
|
| Rate for Payer: Caresource Medicare |
$206.18
|
| Rate for Payer: Centivo/Paragon All Products |
$289.68
|
| Rate for Payer: Cigna All Products |
$490.18
|
| Rate for Payer: Coventry/First Health All Products |
$499.84
|
| Rate for Payer: Encore All Products |
$522.84
|
| Rate for Payer: Frontpath All Products |
$522.56
|
| Rate for Payer: Humana ChoiceCare |
$490.58
|
| Rate for Payer: Humana Medicare |
$289.68
|
| Rate for Payer: Lucent/Coldwater Veneers |
$289.68
|
| Rate for Payer: Lutheran Preferred All Products |
$511.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$426.00
|
| Rate for Payer: PHP All Products |
$430.77
|
| Rate for Payer: Plain Church Group Ministry All Products |
$221.52
|
| Rate for Payer: Sagamore All Products |
$438.50
|
| Rate for Payer: Self Pay/Cash Rate |
$352.16
|
| Rate for Payer: Signature Care EPO |
$471.44
|
| Rate for Payer: Signature Care PPO |
$499.84
|
| Rate for Payer: Three Rivers Preferred All Products |
$482.80
|
| Rate for Payer: United Healthcare Commercial |
$447.58
|
| Rate for Payer: United Healthcare Medicare |
$187.44
|
|
|
HC ACU 2.3MM X 12MM HEX LAG SCREW
|
Facility
IP
|
$378.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603233
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$234.36 |
| Max. Negotiated Rate |
$347.95 |
| Rate for Payer: Aetna Commercial |
$326.59
|
| Rate for Payer: Cigna All Products |
$326.21
|
| Rate for Payer: Coventry/First Health All Products |
$332.64
|
| Rate for Payer: Encore All Products |
$347.95
|
| Rate for Payer: Frontpath All Products |
$347.76
|
| Rate for Payer: Humana ChoiceCare |
$326.48
|
| Rate for Payer: Lutheran Preferred All Products |
$340.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$283.50
|
| Rate for Payer: PHP All Products |
$286.68
|
| Rate for Payer: Sagamore All Products |
$291.82
|
| Rate for Payer: Self Pay/Cash Rate |
$234.36
|
| Rate for Payer: Signature Care EPO |
$313.74
|
| Rate for Payer: Signature Care PPO |
$332.64
|
| Rate for Payer: United Healthcare Commercial |
$297.86
|
|
|
HC ACU 2.3MM X 12MM HEX LAG SCREW
|
Facility
OP
|
$378.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603233
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$124.74 |
| Max. Negotiated Rate |
$347.95 |
| Rate for Payer: Aetna Commercial |
$319.03
|
| Rate for Payer: Aetna Medicare |
$124.74
|
| Rate for Payer: Anthem Exchange |
$217.09
|
| Rate for Payer: Anthem Medicare |
$124.74
|
| Rate for Payer: Anthem PPO |
$217.09
|
| Rate for Payer: Anthem Traditional |
$236.29
|
| Rate for Payer: Caresource Just 4 Me |
$143.45
|
| Rate for Payer: Caresource Medicare |
$137.21
|
| Rate for Payer: Centivo/Paragon All Products |
$192.78
|
| Rate for Payer: Cigna All Products |
$326.21
|
| Rate for Payer: Coventry/First Health All Products |
$332.64
|
| Rate for Payer: Encore All Products |
$347.95
|
| Rate for Payer: Frontpath All Products |
$347.76
|
| Rate for Payer: Humana ChoiceCare |
$326.48
|
| Rate for Payer: Humana Medicare |
$192.78
|
| Rate for Payer: Lucent/Coldwater Veneers |
$192.78
|
| Rate for Payer: Lutheran Preferred All Products |
$340.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$283.50
|
| Rate for Payer: PHP All Products |
$286.68
|
| Rate for Payer: Plain Church Group Ministry All Products |
$147.42
|
| Rate for Payer: Sagamore All Products |
$291.82
|
| Rate for Payer: Self Pay/Cash Rate |
$234.36
|
| Rate for Payer: Signature Care EPO |
$313.74
|
| Rate for Payer: Signature Care PPO |
$332.64
|
| Rate for Payer: Three Rivers Preferred All Products |
$321.30
|
| Rate for Payer: United Healthcare Commercial |
$297.86
|
| Rate for Payer: United Healthcare Medicare |
$124.74
|
|
|
HC ACU 2.3MM X 12MM HEX MLT SCREW
|
Facility
IP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603207
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$352.16 |
| Max. Negotiated Rate |
$522.84 |
| Rate for Payer: Aetna Commercial |
$490.75
|
| Rate for Payer: Cigna All Products |
$490.18
|
| Rate for Payer: Coventry/First Health All Products |
$499.84
|
| Rate for Payer: Encore All Products |
$522.84
|
| Rate for Payer: Frontpath All Products |
$522.56
|
| Rate for Payer: Humana ChoiceCare |
$490.58
|
| Rate for Payer: Lutheran Preferred All Products |
$511.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$426.00
|
| Rate for Payer: PHP All Products |
$430.77
|
| Rate for Payer: Sagamore All Products |
$438.50
|
| Rate for Payer: Self Pay/Cash Rate |
$352.16
|
| Rate for Payer: Signature Care EPO |
$471.44
|
| Rate for Payer: Signature Care PPO |
$499.84
|
| Rate for Payer: United Healthcare Commercial |
$447.58
|
|
|
HC ACU 2.3MM X 12MM HEX MLT SCREW
|
Facility
OP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603207
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$187.44 |
| Max. Negotiated Rate |
$522.84 |
| Rate for Payer: Signature Care PPO |
$499.84
|
| Rate for Payer: Aetna Commercial |
$479.39
|
| Rate for Payer: Aetna Medicare |
$187.44
|
| Rate for Payer: Anthem Exchange |
$326.20
|
| Rate for Payer: Anthem Medicare |
$187.44
|
| Rate for Payer: Anthem PPO |
$326.20
|
| Rate for Payer: Anthem Traditional |
$355.06
|
| Rate for Payer: Caresource Just 4 Me |
$215.56
|
| Rate for Payer: Caresource Medicare |
$206.18
|
| Rate for Payer: Centivo/Paragon All Products |
$289.68
|
| Rate for Payer: Cigna All Products |
$490.18
|
| Rate for Payer: Coventry/First Health All Products |
$499.84
|
| Rate for Payer: Encore All Products |
$522.84
|
| Rate for Payer: Frontpath All Products |
$522.56
|
| Rate for Payer: Humana ChoiceCare |
$490.58
|
| Rate for Payer: Humana Medicare |
$289.68
|
| Rate for Payer: Lucent/Coldwater Veneers |
$289.68
|
| Rate for Payer: Lutheran Preferred All Products |
$511.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$426.00
|
| Rate for Payer: PHP All Products |
$430.77
|
| Rate for Payer: Plain Church Group Ministry All Products |
$221.52
|
| Rate for Payer: Sagamore All Products |
$438.50
|
| Rate for Payer: Self Pay/Cash Rate |
$352.16
|
| Rate for Payer: Signature Care EPO |
$471.44
|
| Rate for Payer: Three Rivers Preferred All Products |
$482.80
|
| Rate for Payer: United Healthcare Commercial |
$447.58
|
| Rate for Payer: United Healthcare Medicare |
$187.44
|
|
|
HC ACU 2.3MM X 13MM HEX LAG SCREW
|
Facility
OP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603234
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$187.44 |
| Max. Negotiated Rate |
$522.84 |
| Rate for Payer: Aetna Commercial |
$479.39
|
| Rate for Payer: Aetna Medicare |
$187.44
|
| Rate for Payer: Anthem Exchange |
$326.20
|
| Rate for Payer: Anthem Medicare |
$187.44
|
| Rate for Payer: Anthem PPO |
$326.20
|
| Rate for Payer: Anthem Traditional |
$355.06
|
| Rate for Payer: Caresource Just 4 Me |
$215.56
|
| Rate for Payer: Caresource Medicare |
$206.18
|
| Rate for Payer: Centivo/Paragon All Products |
$289.68
|
| Rate for Payer: Cigna All Products |
$490.18
|
| Rate for Payer: Coventry/First Health All Products |
$499.84
|
| Rate for Payer: Encore All Products |
$522.84
|
| Rate for Payer: Frontpath All Products |
$522.56
|
| Rate for Payer: Humana ChoiceCare |
$490.58
|
| Rate for Payer: Humana Medicare |
$289.68
|
| Rate for Payer: Lucent/Coldwater Veneers |
$289.68
|
| Rate for Payer: Lutheran Preferred All Products |
$511.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$426.00
|
| Rate for Payer: PHP All Products |
$430.77
|
| Rate for Payer: Plain Church Group Ministry All Products |
$221.52
|
| Rate for Payer: Sagamore All Products |
$438.50
|
| Rate for Payer: Self Pay/Cash Rate |
$352.16
|
| Rate for Payer: Signature Care EPO |
$471.44
|
| Rate for Payer: Signature Care PPO |
$499.84
|
| Rate for Payer: Three Rivers Preferred All Products |
$482.80
|
| Rate for Payer: United Healthcare Commercial |
$447.58
|
| Rate for Payer: United Healthcare Medicare |
$187.44
|
|
|
HC ACU 2.3MM X 13MM HEX LAG SCREW
|
Facility
IP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603234
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$352.16 |
| Max. Negotiated Rate |
$522.84 |
| Rate for Payer: Aetna Commercial |
$490.75
|
| Rate for Payer: Cigna All Products |
$490.18
|
| Rate for Payer: Coventry/First Health All Products |
$499.84
|
| Rate for Payer: Encore All Products |
$522.84
|
| Rate for Payer: Frontpath All Products |
$522.56
|
| Rate for Payer: Humana ChoiceCare |
$490.58
|
| Rate for Payer: Lutheran Preferred All Products |
$511.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$426.00
|
| Rate for Payer: PHP All Products |
$430.77
|
| Rate for Payer: Sagamore All Products |
$438.50
|
| Rate for Payer: Self Pay/Cash Rate |
$352.16
|
| Rate for Payer: Signature Care EPO |
$471.44
|
| Rate for Payer: Signature Care PPO |
$499.84
|
| Rate for Payer: United Healthcare Commercial |
$447.58
|
|
|
HC ACU 2.3MM X 13MM HEX MLT SCREW
|
Facility
IP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603208
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$352.16 |
| Max. Negotiated Rate |
$522.84 |
| Rate for Payer: Aetna Commercial |
$490.75
|
| Rate for Payer: Cigna All Products |
$490.18
|
| Rate for Payer: Coventry/First Health All Products |
$499.84
|
| Rate for Payer: Encore All Products |
$522.84
|
| Rate for Payer: Frontpath All Products |
$522.56
|
| Rate for Payer: Humana ChoiceCare |
$490.58
|
| Rate for Payer: Lutheran Preferred All Products |
$511.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$426.00
|
| Rate for Payer: PHP All Products |
$430.77
|
| Rate for Payer: Sagamore All Products |
$438.50
|
| Rate for Payer: Self Pay/Cash Rate |
$352.16
|
| Rate for Payer: Signature Care EPO |
$471.44
|
| Rate for Payer: Signature Care PPO |
$499.84
|
| Rate for Payer: United Healthcare Commercial |
$447.58
|
|
|
HC ACU 2.3MM X 13MM HEX MLT SCREW
|
Facility
OP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603208
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$187.44 |
| Max. Negotiated Rate |
$522.84 |
| Rate for Payer: Aetna Commercial |
$479.39
|
| Rate for Payer: Aetna Medicare |
$187.44
|
| Rate for Payer: Anthem Exchange |
$326.20
|
| Rate for Payer: Anthem Medicare |
$187.44
|
| Rate for Payer: Anthem PPO |
$326.20
|
| Rate for Payer: Anthem Traditional |
$355.06
|
| Rate for Payer: Caresource Just 4 Me |
$215.56
|
| Rate for Payer: Caresource Medicare |
$206.18
|
| Rate for Payer: Centivo/Paragon All Products |
$289.68
|
| Rate for Payer: Cigna All Products |
$490.18
|
| Rate for Payer: Coventry/First Health All Products |
$499.84
|
| Rate for Payer: Encore All Products |
$522.84
|
| Rate for Payer: Frontpath All Products |
$522.56
|
| Rate for Payer: Humana ChoiceCare |
$490.58
|
| Rate for Payer: Humana Medicare |
$289.68
|
| Rate for Payer: Lucent/Coldwater Veneers |
$289.68
|
| Rate for Payer: Lutheran Preferred All Products |
$511.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$426.00
|
| Rate for Payer: PHP All Products |
$430.77
|
| Rate for Payer: Plain Church Group Ministry All Products |
$221.52
|
| Rate for Payer: Sagamore All Products |
$438.50
|
| Rate for Payer: Self Pay/Cash Rate |
$352.16
|
| Rate for Payer: Signature Care EPO |
$471.44
|
| Rate for Payer: Signature Care PPO |
$499.84
|
| Rate for Payer: Three Rivers Preferred All Products |
$482.80
|
| Rate for Payer: United Healthcare Commercial |
$447.58
|
| Rate for Payer: United Healthcare Medicare |
$187.44
|
|
|
HC ACU 2.3MM X 14MM HEX LAG SCREW
|
Facility
IP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603235
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$352.16 |
| Max. Negotiated Rate |
$522.84 |
| Rate for Payer: Aetna Commercial |
$490.75
|
| Rate for Payer: Cigna All Products |
$490.18
|
| Rate for Payer: Coventry/First Health All Products |
$499.84
|
| Rate for Payer: Encore All Products |
$522.84
|
| Rate for Payer: Frontpath All Products |
$522.56
|
| Rate for Payer: Humana ChoiceCare |
$490.58
|
| Rate for Payer: Lutheran Preferred All Products |
$511.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$426.00
|
| Rate for Payer: PHP All Products |
$430.77
|
| Rate for Payer: Sagamore All Products |
$438.50
|
| Rate for Payer: Self Pay/Cash Rate |
$352.16
|
| Rate for Payer: Signature Care EPO |
$471.44
|
| Rate for Payer: Signature Care PPO |
$499.84
|
| Rate for Payer: United Healthcare Commercial |
$447.58
|
|
|
HC ACU 2.3MM X 14MM HEX LAG SCREW
|
Facility
OP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603235
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$187.44 |
| Max. Negotiated Rate |
$522.84 |
| Rate for Payer: Aetna Commercial |
$479.39
|
| Rate for Payer: Aetna Medicare |
$187.44
|
| Rate for Payer: Anthem Exchange |
$326.20
|
| Rate for Payer: Anthem Medicare |
$187.44
|
| Rate for Payer: Anthem PPO |
$326.20
|
| Rate for Payer: Anthem Traditional |
$355.06
|
| Rate for Payer: Caresource Just 4 Me |
$215.56
|
| Rate for Payer: Caresource Medicare |
$206.18
|
| Rate for Payer: Centivo/Paragon All Products |
$289.68
|
| Rate for Payer: Cigna All Products |
$490.18
|
| Rate for Payer: Coventry/First Health All Products |
$499.84
|
| Rate for Payer: Encore All Products |
$522.84
|
| Rate for Payer: Frontpath All Products |
$522.56
|
| Rate for Payer: Humana ChoiceCare |
$490.58
|
| Rate for Payer: Humana Medicare |
$289.68
|
| Rate for Payer: Lucent/Coldwater Veneers |
$289.68
|
| Rate for Payer: Lutheran Preferred All Products |
$511.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$426.00
|
| Rate for Payer: PHP All Products |
$430.77
|
| Rate for Payer: Plain Church Group Ministry All Products |
$221.52
|
| Rate for Payer: Sagamore All Products |
$438.50
|
| Rate for Payer: Self Pay/Cash Rate |
$352.16
|
| Rate for Payer: Signature Care EPO |
$471.44
|
| Rate for Payer: Signature Care PPO |
$499.84
|
| Rate for Payer: Three Rivers Preferred All Products |
$482.80
|
| Rate for Payer: United Healthcare Commercial |
$447.58
|
| Rate for Payer: United Healthcare Medicare |
$187.44
|
|
|
HC ACU 2.3MM X 14MM HEX MLT SCREW
|
Facility
IP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603209
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$352.16 |
| Max. Negotiated Rate |
$522.84 |
| Rate for Payer: Aetna Commercial |
$490.75
|
| Rate for Payer: Cigna All Products |
$490.18
|
| Rate for Payer: Coventry/First Health All Products |
$499.84
|
| Rate for Payer: Encore All Products |
$522.84
|
| Rate for Payer: Frontpath All Products |
$522.56
|
| Rate for Payer: Humana ChoiceCare |
$490.58
|
| Rate for Payer: Lutheran Preferred All Products |
$511.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$426.00
|
| Rate for Payer: PHP All Products |
$430.77
|
| Rate for Payer: Sagamore All Products |
$438.50
|
| Rate for Payer: Self Pay/Cash Rate |
$352.16
|
| Rate for Payer: Signature Care EPO |
$471.44
|
| Rate for Payer: Signature Care PPO |
$499.84
|
| Rate for Payer: United Healthcare Commercial |
$447.58
|
|
