|
HC ACU 2.3X14 LOCK CORT SCREW
|
Facility
OP
|
$378.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602917
|
|
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 2.3X14 NON-TOG CORT SCREW
|
Facility
OP
|
$378.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602886
|
|
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 2.3X14 NON-TOG CORT SCREW
|
Facility
IP
|
$378.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602886
|
|
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 2.3X16 LKG VAR ANG SCREW
|
Facility
IP
|
$718.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602841
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$445.16 |
| Max. Negotiated Rate |
$660.92 |
| Rate for Payer: Aetna Commercial |
$620.35
|
| Rate for Payer: Cigna All Products |
$619.63
|
| Rate for Payer: Coventry/First Health All Products |
$631.84
|
| Rate for Payer: Encore All Products |
$660.92
|
| Rate for Payer: Frontpath All Products |
$660.56
|
| Rate for Payer: Humana ChoiceCare |
$620.14
|
| Rate for Payer: Lutheran Preferred All Products |
$646.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$538.50
|
| Rate for Payer: PHP All Products |
$544.53
|
| Rate for Payer: Sagamore All Products |
$554.30
|
| Rate for Payer: Self Pay/Cash Rate |
$445.16
|
| Rate for Payer: Signature Care EPO |
$595.94
|
| Rate for Payer: Signature Care PPO |
$631.84
|
| Rate for Payer: United Healthcare Commercial |
$565.78
|
|
|
HC ACU 2.3X16 LKG VAR ANG SCREW
|
Facility
OP
|
$718.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602841
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$236.94 |
| Max. Negotiated Rate |
$660.92 |
| Rate for Payer: Aetna Commercial |
$605.99
|
| Rate for Payer: Aetna Medicare |
$236.94
|
| Rate for Payer: Anthem Exchange |
$412.35
|
| Rate for Payer: Anthem Medicare |
$236.94
|
| Rate for Payer: Anthem PPO |
$412.35
|
| Rate for Payer: Anthem Traditional |
$448.82
|
| Rate for Payer: Caresource Just 4 Me |
$272.48
|
| Rate for Payer: Caresource Medicare |
$260.63
|
| Rate for Payer: Centivo/Paragon All Products |
$366.18
|
| Rate for Payer: Cigna All Products |
$619.63
|
| Rate for Payer: Coventry/First Health All Products |
$631.84
|
| Rate for Payer: Encore All Products |
$660.92
|
| Rate for Payer: Frontpath All Products |
$660.56
|
| Rate for Payer: Humana ChoiceCare |
$620.14
|
| Rate for Payer: Humana Medicare |
$366.18
|
| Rate for Payer: Lucent/Coldwater Veneers |
$366.18
|
| Rate for Payer: Lutheran Preferred All Products |
$646.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$538.50
|
| Rate for Payer: PHP All Products |
$544.53
|
| Rate for Payer: Plain Church Group Ministry All Products |
$280.02
|
| Rate for Payer: Sagamore All Products |
$554.30
|
| Rate for Payer: Self Pay/Cash Rate |
$445.16
|
| Rate for Payer: Signature Care EPO |
$595.94
|
| Rate for Payer: Signature Care PPO |
$631.84
|
| Rate for Payer: Three Rivers Preferred All Products |
$610.30
|
| Rate for Payer: United Healthcare Commercial |
$565.78
|
| Rate for Payer: United Healthcare Medicare |
$236.94
|
|
|
HC ACU 2.3X16 LOCK CORT PEG
|
Facility
OP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602907
|
|
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 2.3X16 LOCK CORT PEG
|
Facility
IP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602907
|
|
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 2.3X16 LOCK CORT SCREW
|
Facility
OP
|
$378.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602918
|
|
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 2.3X16 LOCK CORT SCREW
|
Facility
IP
|
$378.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602918
|
|
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 2.3X16 NON-TOG CORT SCREW
|
Facility
IP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602887
|
|
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 2.3X16 NON-TOG CORT SCREW
|
Facility
OP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602887
|
|
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 2.3X18 LKG VAR ANG SCREW
|
Facility
IP
|
$718.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602842
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$445.16 |
| Max. Negotiated Rate |
$660.92 |
| Rate for Payer: Aetna Commercial |
$620.35
|
| Rate for Payer: Cigna All Products |
$619.63
|
| Rate for Payer: Coventry/First Health All Products |
$631.84
|
| Rate for Payer: Encore All Products |
$660.92
|
| Rate for Payer: Frontpath All Products |
$660.56
|
| Rate for Payer: Humana ChoiceCare |
$620.14
|
| Rate for Payer: Lutheran Preferred All Products |
$646.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$538.50
|
| Rate for Payer: PHP All Products |
$544.53
|
| Rate for Payer: Sagamore All Products |
$554.30
|
| Rate for Payer: Self Pay/Cash Rate |
$445.16
|
| Rate for Payer: Signature Care EPO |
$595.94
|
| Rate for Payer: Signature Care PPO |
$631.84
|
| Rate for Payer: United Healthcare Commercial |
$565.78
|
|
|
HC ACU 2.3X18 LKG VAR ANG SCREW
|
Facility
OP
|
$718.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602842
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$236.94 |
| Max. Negotiated Rate |
$660.92 |
| Rate for Payer: Aetna Commercial |
$605.99
|
| Rate for Payer: Aetna Medicare |
$236.94
|
| Rate for Payer: Anthem Exchange |
$412.35
|
| Rate for Payer: Anthem Medicare |
$236.94
|
| Rate for Payer: Anthem PPO |
$412.35
|
| Rate for Payer: Anthem Traditional |
$448.82
|
| Rate for Payer: Caresource Just 4 Me |
$272.48
|
| Rate for Payer: Caresource Medicare |
$260.63
|
| Rate for Payer: Centivo/Paragon All Products |
$366.18
|
| Rate for Payer: Cigna All Products |
$619.63
|
| Rate for Payer: Coventry/First Health All Products |
$631.84
|
| Rate for Payer: Encore All Products |
$660.92
|
| Rate for Payer: Frontpath All Products |
$660.56
|
| Rate for Payer: Humana ChoiceCare |
$620.14
|
| Rate for Payer: Humana Medicare |
$366.18
|
| Rate for Payer: Lucent/Coldwater Veneers |
$366.18
|
| Rate for Payer: Lutheran Preferred All Products |
$646.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$538.50
|
| Rate for Payer: PHP All Products |
$544.53
|
| Rate for Payer: Plain Church Group Ministry All Products |
$280.02
|
| Rate for Payer: Sagamore All Products |
$554.30
|
| Rate for Payer: Self Pay/Cash Rate |
$445.16
|
| Rate for Payer: Signature Care EPO |
$595.94
|
| Rate for Payer: Signature Care PPO |
$631.84
|
| Rate for Payer: Three Rivers Preferred All Products |
$610.30
|
| Rate for Payer: United Healthcare Commercial |
$565.78
|
| Rate for Payer: United Healthcare Medicare |
$236.94
|
|
|
HC ACU 2.3X18 LOCK CORT SCREW
|
Facility
OP
|
$378.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602919
|
|
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 2.3X18 LOCK CORT SCREW
|
Facility
IP
|
$378.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602919
|
|
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 2.3X18 NON-TOG CORT SCREW
|
Facility
OP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602888
|
|
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 2.3X18 NON-TOG CORT SCREW
|
Facility
IP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602888
|
|
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 2.3X20 LKG VAR ANG SCREW
|
Facility
IP
|
$718.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602843
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$445.16 |
| Max. Negotiated Rate |
$660.92 |
| Rate for Payer: Aetna Commercial |
$620.35
|
| Rate for Payer: Cigna All Products |
$619.63
|
| Rate for Payer: Coventry/First Health All Products |
$631.84
|
| Rate for Payer: Encore All Products |
$660.92
|
| Rate for Payer: Frontpath All Products |
$660.56
|
| Rate for Payer: Humana ChoiceCare |
$620.14
|
| Rate for Payer: Lutheran Preferred All Products |
$646.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$538.50
|
| Rate for Payer: PHP All Products |
$544.53
|
| Rate for Payer: Sagamore All Products |
$554.30
|
| Rate for Payer: Self Pay/Cash Rate |
$445.16
|
| Rate for Payer: Signature Care EPO |
$595.94
|
| Rate for Payer: Signature Care PPO |
$631.84
|
| Rate for Payer: United Healthcare Commercial |
$565.78
|
|
|
HC ACU 2.3X20 LKG VAR ANG SCREW
|
Facility
OP
|
$718.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602843
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$236.94 |
| Max. Negotiated Rate |
$660.92 |
| Rate for Payer: Aetna Commercial |
$605.99
|
| Rate for Payer: Aetna Medicare |
$236.94
|
| Rate for Payer: Anthem Exchange |
$412.35
|
| Rate for Payer: Anthem Medicare |
$236.94
|
| Rate for Payer: Anthem PPO |
$412.35
|
| Rate for Payer: Anthem Traditional |
$448.82
|
| Rate for Payer: Caresource Just 4 Me |
$272.48
|
| Rate for Payer: Caresource Medicare |
$260.63
|
| Rate for Payer: Centivo/Paragon All Products |
$366.18
|
| Rate for Payer: Cigna All Products |
$619.63
|
| Rate for Payer: Coventry/First Health All Products |
$631.84
|
| Rate for Payer: Encore All Products |
$660.92
|
| Rate for Payer: Frontpath All Products |
$660.56
|
| Rate for Payer: Humana ChoiceCare |
$620.14
|
| Rate for Payer: Humana Medicare |
$366.18
|
| Rate for Payer: Lucent/Coldwater Veneers |
$366.18
|
| Rate for Payer: Lutheran Preferred All Products |
$646.20
|
| Rate for Payer: PHCS/Multiplan All Products |
$538.50
|
| Rate for Payer: PHP All Products |
$544.53
|
| Rate for Payer: Plain Church Group Ministry All Products |
$280.02
|
| Rate for Payer: Sagamore All Products |
$554.30
|
| Rate for Payer: Self Pay/Cash Rate |
$445.16
|
| Rate for Payer: Signature Care EPO |
$595.94
|
| Rate for Payer: Signature Care PPO |
$631.84
|
| Rate for Payer: Three Rivers Preferred All Products |
$610.30
|
| Rate for Payer: United Healthcare Commercial |
$565.78
|
| Rate for Payer: United Healthcare Medicare |
$236.94
|
|
|
HC ACU 2.3X20 LOCK CORT PEG
|
Facility
OP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602909
|
|
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 2.3X20 LOCK CORT PEG
|
Facility
IP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602909
|
|
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 2.3X20 LOCK CORT SCREW
|
Facility
OP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602920
|
|
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 2.3X20 LOCK CORT SCREW
|
Facility
IP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602920
|
|
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 2.3X20 NON-TOG CORT SCREW
|
Facility
OP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602889
|
|
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 2.3X20 NON-TOG CORT SCREW
|
Facility
IP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602889
|
|
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
|
|
