|
HC AR DRILL BIT 2.0 CALI LONG
|
Facility
|
IP
|
$920.00
|
|
| Hospital Charge Code |
41608323
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$690.00 |
| Max. Negotiated Rate |
$855.60 |
| Rate for Payer: Aetna Commercial |
$794.88
|
| Rate for Payer: Cash Price |
$552.00
|
| Rate for Payer: Cigna All Commercial |
$793.96
|
| Rate for Payer: CORVEL All Commercial |
$855.60
|
| Rate for Payer: Coventry All Commercial |
$809.60
|
| Rate for Payer: Encore All Commercial |
$846.86
|
| Rate for Payer: Frontpath All Commercial |
$846.40
|
| Rate for Payer: Humana ChoiceCare |
$794.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$828.00
|
| Rate for Payer: PHCS All Commercial |
$690.00
|
| Rate for Payer: PHP All Commercial |
$697.73
|
| Rate for Payer: Sagamore Health Network All Products |
$710.24
|
| Rate for Payer: Signature Care EPO |
$763.60
|
| Rate for Payer: Signature Care PPO |
$809.60
|
| Rate for Payer: United Healthcare Commercial |
$724.96
|
|
|
HC AR DRILL BIT 2.0 CALI LONG
|
Facility
|
OP
|
$920.00
|
|
| Hospital Charge Code |
41608323
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$855.60 |
| Rate for Payer: Aetna Commercial |
$776.48
|
| Rate for Payer: Aetna Medicare |
$294.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$285.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$528.36
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$575.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$338.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$323.84
|
| Rate for Payer: Cash Price |
$552.00
|
| Rate for Payer: Cash Price |
$552.00
|
| Rate for Payer: Centivo All Commercial |
$500.48
|
| Rate for Payer: Cigna All Commercial |
$793.96
|
| Rate for Payer: CORVEL All Commercial |
$855.60
|
| Rate for Payer: Coventry All Commercial |
$809.60
|
| Rate for Payer: Encore All Commercial |
$846.86
|
| Rate for Payer: Frontpath All Commercial |
$846.40
|
| Rate for Payer: Humana ChoiceCare |
$794.60
|
| Rate for Payer: Humana Medicare |
$294.40
|
| Rate for Payer: Lucent All Commercial |
$500.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$828.00
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$690.00
|
| Rate for Payer: PHP All Commercial |
$697.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$358.80
|
| Rate for Payer: Sagamore Health Network All Products |
$710.24
|
| Rate for Payer: Signature Care EPO |
$763.60
|
| Rate for Payer: Signature Care PPO |
$809.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$782.00
|
| Rate for Payer: United Healthcare Commercial |
$724.96
|
| Rate for Payer: United Healthcare Medicare |
$294.40
|
|
|
HC AR DRILL BIT 2.0 CANN
|
Facility
|
IP
|
$1,072.50
|
|
| Hospital Charge Code |
41602507
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$804.38 |
| Max. Negotiated Rate |
$997.42 |
| Rate for Payer: Aetna Commercial |
$926.64
|
| Rate for Payer: Cash Price |
$643.50
|
| Rate for Payer: Cigna All Commercial |
$925.57
|
| Rate for Payer: CORVEL All Commercial |
$997.42
|
| Rate for Payer: Coventry All Commercial |
$943.80
|
| Rate for Payer: Encore All Commercial |
$987.24
|
| Rate for Payer: Frontpath All Commercial |
$986.70
|
| Rate for Payer: Humana ChoiceCare |
$926.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$965.25
|
| Rate for Payer: PHCS All Commercial |
$804.38
|
| Rate for Payer: PHP All Commercial |
$813.38
|
| Rate for Payer: Sagamore Health Network All Products |
$827.97
|
| Rate for Payer: Signature Care EPO |
$890.17
|
| Rate for Payer: Signature Care PPO |
$943.80
|
| Rate for Payer: United Healthcare Commercial |
$845.13
|
|
|
HC AR DRILL BIT 2.0 CANN
|
Facility
|
OP
|
$1,072.50
|
|
| Hospital Charge Code |
41602507
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$997.42 |
| Rate for Payer: Aetna Commercial |
$905.19
|
| Rate for Payer: Aetna Medicare |
$343.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$332.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$615.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$670.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$394.68
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$377.52
|
| Rate for Payer: Cash Price |
$643.50
|
| Rate for Payer: Cash Price |
$643.50
|
| Rate for Payer: Centivo All Commercial |
$583.44
|
| Rate for Payer: Cigna All Commercial |
$925.57
|
| Rate for Payer: CORVEL All Commercial |
$997.42
|
| Rate for Payer: Coventry All Commercial |
$943.80
|
| Rate for Payer: Encore All Commercial |
$987.24
|
| Rate for Payer: Frontpath All Commercial |
$986.70
|
| Rate for Payer: Humana ChoiceCare |
$926.32
|
| Rate for Payer: Humana Medicare |
$343.20
|
| Rate for Payer: Lucent All Commercial |
$583.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$965.25
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$804.38
|
| Rate for Payer: PHP All Commercial |
$813.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$418.27
|
| Rate for Payer: Sagamore Health Network All Products |
$827.97
|
| Rate for Payer: Signature Care EPO |
$890.17
|
| Rate for Payer: Signature Care PPO |
$943.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$911.62
|
| Rate for Payer: United Healthcare Commercial |
$845.13
|
| Rate for Payer: United Healthcare Medicare |
$343.20
|
|
|
HC AR DRILL BIT 2.5 30
|
Facility
|
OP
|
$994.00
|
|
| Hospital Charge Code |
41608058
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$924.42 |
| Rate for Payer: Aetna Commercial |
$838.94
|
| Rate for Payer: Aetna Medicare |
$318.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$308.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$570.85
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$621.35
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$365.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$349.89
|
| Rate for Payer: Cash Price |
$596.40
|
| Rate for Payer: Cash Price |
$596.40
|
| Rate for Payer: Centivo All Commercial |
$540.74
|
| Rate for Payer: Cigna All Commercial |
$857.82
|
| Rate for Payer: CORVEL All Commercial |
$924.42
|
| Rate for Payer: Coventry All Commercial |
$874.72
|
| Rate for Payer: Encore All Commercial |
$914.98
|
| Rate for Payer: Frontpath All Commercial |
$914.48
|
| Rate for Payer: Humana ChoiceCare |
$858.52
|
| Rate for Payer: Humana Medicare |
$318.08
|
| Rate for Payer: Lucent All Commercial |
$540.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$894.60
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$745.50
|
| Rate for Payer: PHP All Commercial |
$753.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$387.66
|
| Rate for Payer: Sagamore Health Network All Products |
$767.37
|
| Rate for Payer: Signature Care EPO |
$825.02
|
| Rate for Payer: Signature Care PPO |
$874.72
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$844.90
|
| Rate for Payer: United Healthcare Commercial |
$783.27
|
| Rate for Payer: United Healthcare Medicare |
$318.08
|
|
|
HC AR DRILL BIT 2.5 30
|
Facility
|
IP
|
$994.00
|
|
| Hospital Charge Code |
41608058
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$745.50 |
| Max. Negotiated Rate |
$924.42 |
| Rate for Payer: Aetna Commercial |
$858.82
|
| Rate for Payer: Cash Price |
$596.40
|
| Rate for Payer: Cigna All Commercial |
$857.82
|
| Rate for Payer: CORVEL All Commercial |
$924.42
|
| Rate for Payer: Coventry All Commercial |
$874.72
|
| Rate for Payer: Encore All Commercial |
$914.98
|
| Rate for Payer: Frontpath All Commercial |
$914.48
|
| Rate for Payer: Humana ChoiceCare |
$858.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$894.60
|
| Rate for Payer: PHCS All Commercial |
$745.50
|
| Rate for Payer: PHP All Commercial |
$753.85
|
| Rate for Payer: Sagamore Health Network All Products |
$767.37
|
| Rate for Payer: Signature Care EPO |
$825.02
|
| Rate for Payer: Signature Care PPO |
$874.72
|
| Rate for Payer: United Healthcare Commercial |
$783.27
|
|
|
HC AR DRILL BIT 2.6 CANN
|
Facility
|
OP
|
$1,460.00
|
|
| Hospital Charge Code |
41608219
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$1,357.80 |
| Rate for Payer: Aetna Commercial |
$1,232.24
|
| Rate for Payer: Aetna Medicare |
$467.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$452.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$838.48
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$912.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$537.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$513.92
|
| Rate for Payer: Cash Price |
$876.00
|
| Rate for Payer: Cash Price |
$876.00
|
| Rate for Payer: Centivo All Commercial |
$794.24
|
| Rate for Payer: Cigna All Commercial |
$1,259.98
|
| Rate for Payer: CORVEL All Commercial |
$1,357.80
|
| Rate for Payer: Coventry All Commercial |
$1,284.80
|
| Rate for Payer: Encore All Commercial |
$1,343.93
|
| Rate for Payer: Frontpath All Commercial |
$1,343.20
|
| Rate for Payer: Humana ChoiceCare |
$1,261.00
|
| Rate for Payer: Humana Medicare |
$467.20
|
| Rate for Payer: Lucent All Commercial |
$794.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,314.00
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$1,095.00
|
| Rate for Payer: PHP All Commercial |
$1,107.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$569.40
|
| Rate for Payer: Sagamore Health Network All Products |
$1,127.12
|
| Rate for Payer: Signature Care EPO |
$1,211.80
|
| Rate for Payer: Signature Care PPO |
$1,284.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,241.00
|
| Rate for Payer: United Healthcare Commercial |
$1,150.48
|
| Rate for Payer: United Healthcare Medicare |
$467.20
|
|
|
HC AR DRILL BIT 2.6 CANN
|
Facility
|
IP
|
$1,460.00
|
|
| Hospital Charge Code |
41608219
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,095.00 |
| Max. Negotiated Rate |
$1,357.80 |
| Rate for Payer: Aetna Commercial |
$1,261.44
|
| Rate for Payer: Cash Price |
$876.00
|
| Rate for Payer: Cigna All Commercial |
$1,259.98
|
| Rate for Payer: CORVEL All Commercial |
$1,357.80
|
| Rate for Payer: Coventry All Commercial |
$1,284.80
|
| Rate for Payer: Encore All Commercial |
$1,343.93
|
| Rate for Payer: Frontpath All Commercial |
$1,343.20
|
| Rate for Payer: Humana ChoiceCare |
$1,261.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,314.00
|
| Rate for Payer: PHCS All Commercial |
$1,095.00
|
| Rate for Payer: PHP All Commercial |
$1,107.26
|
| Rate for Payer: Sagamore Health Network All Products |
$1,127.12
|
| Rate for Payer: Signature Care EPO |
$1,211.80
|
| Rate for Payer: Signature Care PPO |
$1,284.80
|
| Rate for Payer: United Healthcare Commercial |
$1,150.48
|
|
|
HC AR DRILL BIT 3.5 35
|
Facility
|
OP
|
$924.00
|
|
| Hospital Charge Code |
41608057
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$859.32 |
| Rate for Payer: Aetna Commercial |
$779.86
|
| Rate for Payer: Aetna Medicare |
$295.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$286.44
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$530.65
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$577.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$340.03
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$325.25
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Centivo All Commercial |
$502.66
|
| Rate for Payer: Cigna All Commercial |
$797.41
|
| Rate for Payer: CORVEL All Commercial |
$859.32
|
| Rate for Payer: Coventry All Commercial |
$813.12
|
| Rate for Payer: Encore All Commercial |
$850.54
|
| Rate for Payer: Frontpath All Commercial |
$850.08
|
| Rate for Payer: Humana ChoiceCare |
$798.06
|
| Rate for Payer: Humana Medicare |
$295.68
|
| Rate for Payer: Lucent All Commercial |
$502.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$831.60
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$693.00
|
| Rate for Payer: PHP All Commercial |
$700.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$360.36
|
| Rate for Payer: Sagamore Health Network All Products |
$713.33
|
| Rate for Payer: Signature Care EPO |
$766.92
|
| Rate for Payer: Signature Care PPO |
$813.12
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$785.40
|
| Rate for Payer: United Healthcare Commercial |
$728.11
|
| Rate for Payer: United Healthcare Medicare |
$295.68
|
|
|
HC AR DRILL BIT 3.5 35
|
Facility
|
IP
|
$924.00
|
|
| Hospital Charge Code |
41608057
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$693.00 |
| Max. Negotiated Rate |
$859.32 |
| Rate for Payer: Aetna Commercial |
$798.34
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Cigna All Commercial |
$797.41
|
| Rate for Payer: CORVEL All Commercial |
$859.32
|
| Rate for Payer: Coventry All Commercial |
$813.12
|
| Rate for Payer: Encore All Commercial |
$850.54
|
| Rate for Payer: Frontpath All Commercial |
$850.08
|
| Rate for Payer: Humana ChoiceCare |
$798.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$831.60
|
| Rate for Payer: PHCS All Commercial |
$693.00
|
| Rate for Payer: PHP All Commercial |
$700.76
|
| Rate for Payer: Sagamore Health Network All Products |
$713.33
|
| Rate for Payer: Signature Care EPO |
$766.92
|
| Rate for Payer: Signature Care PPO |
$813.12
|
| Rate for Payer: United Healthcare Commercial |
$728.11
|
|
|
HC AR DRILL BIT SWIVELOCK 4.75
|
Facility
|
IP
|
$2,062.50
|
|
| Hospital Charge Code |
41607963
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,546.88 |
| Max. Negotiated Rate |
$1,918.12 |
| Rate for Payer: Aetna Commercial |
$1,782.00
|
| Rate for Payer: Cash Price |
$1,237.50
|
| Rate for Payer: Cigna All Commercial |
$1,779.94
|
| Rate for Payer: CORVEL All Commercial |
$1,918.12
|
| Rate for Payer: Coventry All Commercial |
$1,815.00
|
| Rate for Payer: Encore All Commercial |
$1,898.53
|
| Rate for Payer: Frontpath All Commercial |
$1,897.50
|
| Rate for Payer: Humana ChoiceCare |
$1,781.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,856.25
|
| Rate for Payer: PHCS All Commercial |
$1,546.88
|
| Rate for Payer: PHP All Commercial |
$1,564.20
|
| Rate for Payer: Sagamore Health Network All Products |
$1,592.25
|
| Rate for Payer: Signature Care EPO |
$1,711.88
|
| Rate for Payer: Signature Care PPO |
$1,815.00
|
| Rate for Payer: United Healthcare Commercial |
$1,625.25
|
|
|
HC AR DRILL BIT SWIVELOCK 4.75
|
Facility
|
OP
|
$2,062.50
|
|
| Hospital Charge Code |
41607963
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$1,918.12 |
| Rate for Payer: Aetna Commercial |
$1,740.75
|
| Rate for Payer: Aetna Medicare |
$660.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$639.38
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,184.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,289.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$759.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$726.00
|
| Rate for Payer: Cash Price |
$1,237.50
|
| Rate for Payer: Cash Price |
$1,237.50
|
| Rate for Payer: Centivo All Commercial |
$1,122.00
|
| Rate for Payer: Cigna All Commercial |
$1,779.94
|
| Rate for Payer: CORVEL All Commercial |
$1,918.12
|
| Rate for Payer: Coventry All Commercial |
$1,815.00
|
| Rate for Payer: Encore All Commercial |
$1,898.53
|
| Rate for Payer: Frontpath All Commercial |
$1,897.50
|
| Rate for Payer: Humana ChoiceCare |
$1,781.38
|
| Rate for Payer: Humana Medicare |
$660.00
|
| Rate for Payer: Lucent All Commercial |
$1,122.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,856.25
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$1,546.88
|
| Rate for Payer: PHP All Commercial |
$1,564.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$804.38
|
| Rate for Payer: Sagamore Health Network All Products |
$1,592.25
|
| Rate for Payer: Signature Care EPO |
$1,711.88
|
| Rate for Payer: Signature Care PPO |
$1,815.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,753.12
|
| Rate for Payer: United Healthcare Commercial |
$1,625.25
|
| Rate for Payer: United Healthcare Medicare |
$660.00
|
|
|
HC AR DRILL FLIPCUTTER III
|
Facility
|
IP
|
$2,282.50
|
|
| Hospital Charge Code |
41606236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,711.88 |
| Max. Negotiated Rate |
$2,122.72 |
| Rate for Payer: Aetna Commercial |
$1,972.08
|
| Rate for Payer: Cash Price |
$1,369.50
|
| Rate for Payer: Cigna All Commercial |
$1,969.80
|
| Rate for Payer: CORVEL All Commercial |
$2,122.72
|
| Rate for Payer: Coventry All Commercial |
$2,008.60
|
| Rate for Payer: Encore All Commercial |
$2,101.04
|
| Rate for Payer: Frontpath All Commercial |
$2,099.90
|
| Rate for Payer: Humana ChoiceCare |
$1,971.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,054.25
|
| Rate for Payer: PHCS All Commercial |
$1,711.88
|
| Rate for Payer: PHP All Commercial |
$1,731.05
|
| Rate for Payer: Sagamore Health Network All Products |
$1,762.09
|
| Rate for Payer: Signature Care EPO |
$1,894.47
|
| Rate for Payer: Signature Care PPO |
$2,008.60
|
| Rate for Payer: United Healthcare Commercial |
$1,798.61
|
|
|
HC AR DRILL FLIPCUTTER III
|
Facility
|
OP
|
$2,282.50
|
|
| Hospital Charge Code |
41606236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$2,122.72 |
| Rate for Payer: Aetna Commercial |
$1,926.43
|
| Rate for Payer: Aetna Medicare |
$730.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$707.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,310.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,426.79
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$839.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$803.44
|
| Rate for Payer: Cash Price |
$1,369.50
|
| Rate for Payer: Cash Price |
$1,369.50
|
| Rate for Payer: Centivo All Commercial |
$1,241.68
|
| Rate for Payer: Cigna All Commercial |
$1,969.80
|
| Rate for Payer: CORVEL All Commercial |
$2,122.72
|
| Rate for Payer: Coventry All Commercial |
$2,008.60
|
| Rate for Payer: Encore All Commercial |
$2,101.04
|
| Rate for Payer: Frontpath All Commercial |
$2,099.90
|
| Rate for Payer: Humana ChoiceCare |
$1,971.40
|
| Rate for Payer: Humana Medicare |
$730.40
|
| Rate for Payer: Lucent All Commercial |
$1,241.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,054.25
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$1,711.88
|
| Rate for Payer: PHP All Commercial |
$1,731.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$890.17
|
| Rate for Payer: Sagamore Health Network All Products |
$1,762.09
|
| Rate for Payer: Signature Care EPO |
$1,894.47
|
| Rate for Payer: Signature Care PPO |
$2,008.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,940.12
|
| Rate for Payer: United Healthcare Commercial |
$1,798.61
|
| Rate for Payer: United Healthcare Medicare |
$730.40
|
|
|
HC AR DRILL PIN 4MM
|
Facility
|
IP
|
$962.50
|
|
| Hospital Charge Code |
41605848
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$721.88 |
| Max. Negotiated Rate |
$895.12 |
| Rate for Payer: Aetna Commercial |
$831.60
|
| Rate for Payer: Cash Price |
$577.50
|
| Rate for Payer: Cigna All Commercial |
$830.64
|
| Rate for Payer: CORVEL All Commercial |
$895.12
|
| Rate for Payer: Coventry All Commercial |
$847.00
|
| Rate for Payer: Encore All Commercial |
$885.98
|
| Rate for Payer: Frontpath All Commercial |
$885.50
|
| Rate for Payer: Humana ChoiceCare |
$831.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$866.25
|
| Rate for Payer: PHCS All Commercial |
$721.88
|
| Rate for Payer: PHP All Commercial |
$729.96
|
| Rate for Payer: Sagamore Health Network All Products |
$743.05
|
| Rate for Payer: Signature Care EPO |
$798.88
|
| Rate for Payer: Signature Care PPO |
$847.00
|
| Rate for Payer: United Healthcare Commercial |
$758.45
|
|
|
HC AR DRILL PIN 4MM
|
Facility
|
OP
|
$962.50
|
|
| Hospital Charge Code |
41605848
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$895.12 |
| Rate for Payer: Aetna Commercial |
$812.35
|
| Rate for Payer: Aetna Medicare |
$308.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$298.38
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$552.76
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$601.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$354.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$338.80
|
| Rate for Payer: Cash Price |
$577.50
|
| Rate for Payer: Cash Price |
$577.50
|
| Rate for Payer: Centivo All Commercial |
$523.60
|
| Rate for Payer: Cigna All Commercial |
$830.64
|
| Rate for Payer: CORVEL All Commercial |
$895.12
|
| Rate for Payer: Coventry All Commercial |
$847.00
|
| Rate for Payer: Encore All Commercial |
$885.98
|
| Rate for Payer: Frontpath All Commercial |
$885.50
|
| Rate for Payer: Humana ChoiceCare |
$831.31
|
| Rate for Payer: Humana Medicare |
$308.00
|
| Rate for Payer: Lucent All Commercial |
$523.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$866.25
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$721.88
|
| Rate for Payer: PHP All Commercial |
$729.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$375.38
|
| Rate for Payer: Sagamore Health Network All Products |
$743.05
|
| Rate for Payer: Signature Care EPO |
$798.88
|
| Rate for Payer: Signature Care PPO |
$847.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$818.12
|
| Rate for Payer: United Healthcare Commercial |
$758.45
|
| Rate for Payer: United Healthcare Medicare |
$308.00
|
|
|
HC AR FIBERLOCK SUSP SYSTEM
|
Facility
|
OP
|
$9,572.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608294
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$8,902.33 |
| Rate for Payer: Aetna Commercial |
$8,079.11
|
| Rate for Payer: Aetna Medicare |
$3,063.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,967.44
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$5,497.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,983.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,522.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,369.48
|
| Rate for Payer: Cash Price |
$5,743.44
|
| Rate for Payer: Cash Price |
$5,743.44
|
| Rate for Payer: Centivo All Commercial |
$5,207.39
|
| Rate for Payer: Cigna All Commercial |
$8,260.98
|
| Rate for Payer: CORVEL All Commercial |
$8,902.33
|
| Rate for Payer: Coventry All Commercial |
$8,423.71
|
| Rate for Payer: Encore All Commercial |
$8,811.39
|
| Rate for Payer: Frontpath All Commercial |
$8,806.61
|
| Rate for Payer: Humana ChoiceCare |
$8,267.68
|
| Rate for Payer: Humana Medicare |
$3,063.17
|
| Rate for Payer: Lucent All Commercial |
$5,207.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,615.16
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$7,179.30
|
| Rate for Payer: PHP All Commercial |
$7,259.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,733.24
|
| Rate for Payer: Sagamore Health Network All Products |
$7,389.89
|
| Rate for Payer: Signature Care EPO |
$7,945.09
|
| Rate for Payer: Signature Care PPO |
$8,423.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$8,136.54
|
| Rate for Payer: United Healthcare Commercial |
$7,543.05
|
| Rate for Payer: United Healthcare Medicare |
$3,063.17
|
|
|
HC AR FIBERLOCK SUSP SYSTEM
|
Facility
|
IP
|
$9,572.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608294
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,179.30 |
| Max. Negotiated Rate |
$8,902.33 |
| Rate for Payer: Aetna Commercial |
$8,270.55
|
| Rate for Payer: Cash Price |
$5,743.44
|
| Rate for Payer: Cigna All Commercial |
$8,260.98
|
| Rate for Payer: CORVEL All Commercial |
$8,902.33
|
| Rate for Payer: Coventry All Commercial |
$8,423.71
|
| Rate for Payer: Encore All Commercial |
$8,811.39
|
| Rate for Payer: Frontpath All Commercial |
$8,806.61
|
| Rate for Payer: Humana ChoiceCare |
$8,267.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,615.16
|
| Rate for Payer: PHCS All Commercial |
$7,179.30
|
| Rate for Payer: PHP All Commercial |
$7,259.71
|
| Rate for Payer: Sagamore Health Network All Products |
$7,389.89
|
| Rate for Payer: Signature Care EPO |
$7,945.09
|
| Rate for Payer: Signature Care PPO |
$8,423.71
|
| Rate for Payer: United Healthcare Commercial |
$7,543.05
|
|
|
HC AR FIBERLOOP 7534
|
Facility
|
IP
|
$819.00
|
|
| Hospital Charge Code |
41608299
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$614.25 |
| Max. Negotiated Rate |
$761.67 |
| Rate for Payer: Aetna Commercial |
$707.62
|
| Rate for Payer: Cash Price |
$491.40
|
| Rate for Payer: Cigna All Commercial |
$706.80
|
| Rate for Payer: CORVEL All Commercial |
$761.67
|
| Rate for Payer: Coventry All Commercial |
$720.72
|
| Rate for Payer: Encore All Commercial |
$753.89
|
| Rate for Payer: Frontpath All Commercial |
$753.48
|
| Rate for Payer: Humana ChoiceCare |
$707.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$737.10
|
| Rate for Payer: PHCS All Commercial |
$614.25
|
| Rate for Payer: PHP All Commercial |
$621.13
|
| Rate for Payer: Sagamore Health Network All Products |
$632.27
|
| Rate for Payer: Signature Care EPO |
$679.77
|
| Rate for Payer: Signature Care PPO |
$720.72
|
| Rate for Payer: United Healthcare Commercial |
$645.37
|
|
|
HC AR FIBERLOOP 7534
|
Facility
|
OP
|
$819.00
|
|
| Hospital Charge Code |
41608299
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$761.67 |
| Rate for Payer: Aetna Commercial |
$691.24
|
| Rate for Payer: Aetna Medicare |
$262.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$253.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$470.35
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$511.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$301.39
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$288.29
|
| Rate for Payer: Cash Price |
$491.40
|
| Rate for Payer: Cash Price |
$491.40
|
| Rate for Payer: Centivo All Commercial |
$445.54
|
| Rate for Payer: Cigna All Commercial |
$706.80
|
| Rate for Payer: CORVEL All Commercial |
$761.67
|
| Rate for Payer: Coventry All Commercial |
$720.72
|
| Rate for Payer: Encore All Commercial |
$753.89
|
| Rate for Payer: Frontpath All Commercial |
$753.48
|
| Rate for Payer: Humana ChoiceCare |
$707.37
|
| Rate for Payer: Humana Medicare |
$262.08
|
| Rate for Payer: Lucent All Commercial |
$445.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$737.10
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$614.25
|
| Rate for Payer: PHP All Commercial |
$621.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$319.41
|
| Rate for Payer: Sagamore Health Network All Products |
$632.27
|
| Rate for Payer: Signature Care EPO |
$679.77
|
| Rate for Payer: Signature Care PPO |
$720.72
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$696.15
|
| Rate for Payer: United Healthcare Commercial |
$645.37
|
| Rate for Payer: United Healthcare Medicare |
$262.08
|
|
|
HC AR FIBERSNARE 2
|
Facility
|
IP
|
$808.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606237
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$606.38 |
| Max. Negotiated Rate |
$751.90 |
| Rate for Payer: Aetna Commercial |
$698.54
|
| Rate for Payer: Cash Price |
$485.10
|
| Rate for Payer: Cigna All Commercial |
$697.74
|
| Rate for Payer: CORVEL All Commercial |
$751.90
|
| Rate for Payer: Coventry All Commercial |
$711.48
|
| Rate for Payer: Encore All Commercial |
$744.22
|
| Rate for Payer: Frontpath All Commercial |
$743.82
|
| Rate for Payer: Humana ChoiceCare |
$698.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$727.65
|
| Rate for Payer: PHCS All Commercial |
$606.38
|
| Rate for Payer: PHP All Commercial |
$613.17
|
| Rate for Payer: Sagamore Health Network All Products |
$624.16
|
| Rate for Payer: Signature Care EPO |
$671.05
|
| Rate for Payer: Signature Care PPO |
$711.48
|
| Rate for Payer: United Healthcare Commercial |
$637.10
|
|
|
HC AR FIBERSNARE 2
|
Facility
|
OP
|
$808.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606237
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$751.90 |
| Rate for Payer: Aetna Commercial |
$682.37
|
| Rate for Payer: Aetna Medicare |
$258.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$250.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$464.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$505.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$297.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$284.59
|
| Rate for Payer: Cash Price |
$485.10
|
| Rate for Payer: Cash Price |
$485.10
|
| Rate for Payer: Centivo All Commercial |
$439.82
|
| Rate for Payer: Cigna All Commercial |
$697.74
|
| Rate for Payer: CORVEL All Commercial |
$751.90
|
| Rate for Payer: Coventry All Commercial |
$711.48
|
| Rate for Payer: Encore All Commercial |
$744.22
|
| Rate for Payer: Frontpath All Commercial |
$743.82
|
| Rate for Payer: Humana ChoiceCare |
$698.30
|
| Rate for Payer: Humana Medicare |
$258.72
|
| Rate for Payer: Lucent All Commercial |
$439.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$727.65
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$606.38
|
| Rate for Payer: PHP All Commercial |
$613.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$315.31
|
| Rate for Payer: Sagamore Health Network All Products |
$624.16
|
| Rate for Payer: Signature Care EPO |
$671.05
|
| Rate for Payer: Signature Care PPO |
$711.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$687.23
|
| Rate for Payer: United Healthcare Commercial |
$637.10
|
| Rate for Payer: United Healthcare Medicare |
$258.72
|
|
|
HC AR FIBERSNARE 2 BLK/WH
|
Facility
|
IP
|
$875.00
|
|
| Hospital Charge Code |
41608177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$656.25 |
| Max. Negotiated Rate |
$813.75 |
| Rate for Payer: Aetna Commercial |
$756.00
|
| Rate for Payer: Cash Price |
$525.00
|
| Rate for Payer: Cigna All Commercial |
$755.12
|
| Rate for Payer: CORVEL All Commercial |
$813.75
|
| Rate for Payer: Coventry All Commercial |
$770.00
|
| Rate for Payer: Encore All Commercial |
$805.44
|
| Rate for Payer: Frontpath All Commercial |
$805.00
|
| Rate for Payer: Humana ChoiceCare |
$755.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$787.50
|
| Rate for Payer: PHCS All Commercial |
$656.25
|
| Rate for Payer: PHP All Commercial |
$663.60
|
| Rate for Payer: Sagamore Health Network All Products |
$675.50
|
| Rate for Payer: Signature Care EPO |
$726.25
|
| Rate for Payer: Signature Care PPO |
$770.00
|
| Rate for Payer: United Healthcare Commercial |
$689.50
|
|
|
HC AR FIBERSNARE 2 BLK/WH
|
Facility
|
OP
|
$875.00
|
|
| Hospital Charge Code |
41608177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$813.75 |
| Rate for Payer: Aetna Commercial |
$738.50
|
| Rate for Payer: Aetna Medicare |
$280.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$271.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$502.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$546.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$322.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$308.00
|
| Rate for Payer: Cash Price |
$525.00
|
| Rate for Payer: Cash Price |
$525.00
|
| Rate for Payer: Centivo All Commercial |
$476.00
|
| Rate for Payer: Cigna All Commercial |
$755.12
|
| Rate for Payer: CORVEL All Commercial |
$813.75
|
| Rate for Payer: Coventry All Commercial |
$770.00
|
| Rate for Payer: Encore All Commercial |
$805.44
|
| Rate for Payer: Frontpath All Commercial |
$805.00
|
| Rate for Payer: Humana ChoiceCare |
$755.74
|
| Rate for Payer: Humana Medicare |
$280.00
|
| Rate for Payer: Lucent All Commercial |
$476.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$787.50
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$656.25
|
| Rate for Payer: PHP All Commercial |
$663.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$341.25
|
| Rate for Payer: Sagamore Health Network All Products |
$675.50
|
| Rate for Payer: Signature Care EPO |
$726.25
|
| Rate for Payer: Signature Care PPO |
$770.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$743.75
|
| Rate for Payer: United Healthcare Commercial |
$689.50
|
| Rate for Payer: United Healthcare Medicare |
$280.00
|
|
|
HC AR FIBERSTITCH 1.5 CURV 2.0
|
Facility
|
IP
|
$3,301.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608221
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,475.90 |
| Max. Negotiated Rate |
$3,070.12 |
| Rate for Payer: Aetna Commercial |
$2,852.24
|
| Rate for Payer: Cash Price |
$1,980.72
|
| Rate for Payer: Cigna All Commercial |
$2,848.94
|
| Rate for Payer: CORVEL All Commercial |
$3,070.12
|
| Rate for Payer: Coventry All Commercial |
$2,905.06
|
| Rate for Payer: Encore All Commercial |
$3,038.75
|
| Rate for Payer: Frontpath All Commercial |
$3,037.10
|
| Rate for Payer: Humana ChoiceCare |
$2,851.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,971.08
|
| Rate for Payer: PHCS All Commercial |
$2,475.90
|
| Rate for Payer: PHP All Commercial |
$2,503.63
|
| Rate for Payer: Sagamore Health Network All Products |
$2,548.53
|
| Rate for Payer: Signature Care EPO |
$2,740.00
|
| Rate for Payer: Signature Care PPO |
$2,905.06
|
| Rate for Payer: United Healthcare Commercial |
$2,601.35
|
|
