|
HC ACU 2.3X8 LOCK CORT PEG
|
Facility
OP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602903
|
|
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 2.3X8 LOCK CORT PEG
|
Facility
IP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602903
|
|
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 2.3X8 LOCK CORT PEG
|
Facility
OP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602908
|
|
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 2.3X8 LOCK CORT SCREW
|
Facility
OP
|
$378.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602914
|
|
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 2.3X8 LOCK CORT SCREW
|
Facility
IP
|
$378.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602914
|
|
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 2.3X8 NON-TOG CORT SCREW
|
Facility
OP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602883
|
|
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 2.3X8 NON-TOG CORT SCREW
|
Facility
IP
|
$568.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602883
|
|
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 26 TWIST-TRAK COMP SCREW
|
Facility
IP
|
$894.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602810
|
|
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 26 TWIST-TRAK COMP SCREW
|
Facility
OP
|
$894.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602810
|
|
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 2.7MM CANN DRILL QC
|
Facility
OP
|
$886.00
|
|
| Hospital Charge Code |
41602814
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$292.38 |
| Max. Negotiated Rate |
$815.56 |
| Rate for Payer: Aetna Commercial |
$747.78
|
| Rate for Payer: Aetna Medicare |
$292.38
|
| Rate for Payer: Anthem Exchange |
$508.83
|
| Rate for Payer: Anthem Medicare |
$292.38
|
| Rate for Payer: Anthem PPO |
$508.83
|
| Rate for Payer: Anthem Traditional |
$553.84
|
| Rate for Payer: Caresource Just 4 Me |
$336.24
|
| Rate for Payer: Caresource Medicare |
$321.62
|
| Rate for Payer: Centivo/Paragon All Products |
$451.86
|
| Rate for Payer: Cigna All Products |
$764.62
|
| Rate for Payer: Coventry/First Health All Products |
$779.68
|
| Rate for Payer: Encore All Products |
$815.56
|
| Rate for Payer: Frontpath All Products |
$815.12
|
| Rate for Payer: Humana ChoiceCare |
$765.24
|
| Rate for Payer: Humana Medicare |
$451.86
|
| Rate for Payer: Lucent/Coldwater Veneers |
$451.86
|
| Rate for Payer: Lutheran Preferred All Products |
$797.40
|
| Rate for Payer: PHCS/Multiplan All Products |
$664.50
|
| Rate for Payer: PHP All Products |
$671.94
|
| Rate for Payer: Plain Church Group Ministry All Products |
$345.54
|
| Rate for Payer: Sagamore All Products |
$683.99
|
| Rate for Payer: Self Pay/Cash Rate |
$549.32
|
| Rate for Payer: Signature Care EPO |
$735.38
|
| Rate for Payer: Signature Care PPO |
$779.68
|
| Rate for Payer: Three Rivers Preferred All Products |
$753.10
|
| Rate for Payer: United Healthcare Commercial |
$698.17
|
| Rate for Payer: United Healthcare Medicare |
$292.38
|
|
|
HC ACU 2.7MM CANN DRILL QC
|
Facility
IP
|
$886.00
|
|
| Hospital Charge Code |
41602814
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$549.32 |
| Max. Negotiated Rate |
$815.56 |
| Rate for Payer: Aetna Commercial |
$765.50
|
| Rate for Payer: Cigna All Products |
$764.62
|
| Rate for Payer: Coventry/First Health All Products |
$779.68
|
| Rate for Payer: Encore All Products |
$815.56
|
| Rate for Payer: Frontpath All Products |
$815.12
|
| Rate for Payer: Humana ChoiceCare |
$765.24
|
| Rate for Payer: Lutheran Preferred All Products |
$797.40
|
| Rate for Payer: PHCS/Multiplan All Products |
$664.50
|
| Rate for Payer: PHP All Products |
$671.94
|
| Rate for Payer: Sagamore All Products |
$683.99
|
| Rate for Payer: Self Pay/Cash Rate |
$549.32
|
| Rate for Payer: Signature Care EPO |
$735.38
|
| Rate for Payer: Signature Care PPO |
$779.68
|
| Rate for Payer: United Healthcare Commercial |
$698.17
|
|
|
HC ACU 2.7MM QR SURGIBIT DRILL LAG
|
Facility
IP
|
$556.00
|
|
| Hospital Charge Code |
41602816
|
|
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 2.7MM QR SURGIBIT DRILL LAG
|
Facility
OP
|
$556.00
|
|
| Hospital Charge Code |
41602816
|
|
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 2.7X 10 LOCK HEX SCREW
|
Facility
OP
|
$525.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602672
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$173.45 |
| Max. Negotiated Rate |
$483.81 |
| Rate for Payer: Signature Care PPO |
$462.53
|
| Rate for Payer: Aetna Commercial |
$443.61
|
| Rate for Payer: Aetna Medicare |
$173.45
|
| Rate for Payer: Anthem Exchange |
$301.85
|
| Rate for Payer: Anthem Medicare |
$173.45
|
| Rate for Payer: Anthem PPO |
$301.85
|
| Rate for Payer: Anthem Traditional |
$328.55
|
| Rate for Payer: Caresource Just 4 Me |
$199.47
|
| Rate for Payer: Caresource Medicare |
$190.79
|
| Rate for Payer: Centivo/Paragon All Products |
$268.06
|
| Rate for Payer: Cigna All Products |
$453.59
|
| Rate for Payer: Coventry/First Health All Products |
$462.53
|
| Rate for Payer: Encore All Products |
$483.81
|
| Rate for Payer: Frontpath All Products |
$483.55
|
| Rate for Payer: Humana ChoiceCare |
$453.96
|
| Rate for Payer: Humana Medicare |
$268.06
|
| Rate for Payer: Lucent/Coldwater Veneers |
$268.06
|
| Rate for Payer: Lutheran Preferred All Products |
$473.04
|
| Rate for Payer: PHCS/Multiplan All Products |
$394.20
|
| Rate for Payer: PHP All Products |
$398.62
|
| Rate for Payer: Plain Church Group Ministry All Products |
$204.98
|
| Rate for Payer: Sagamore All Products |
$405.76
|
| Rate for Payer: Self Pay/Cash Rate |
$325.87
|
| Rate for Payer: Signature Care EPO |
$436.25
|
| Rate for Payer: Three Rivers Preferred All Products |
$446.76
|
| Rate for Payer: United Healthcare Commercial |
$414.17
|
| Rate for Payer: United Healthcare Medicare |
$173.45
|
|
|
HC ACU 2.7X 10 LOCK HEX SCREW
|
Facility
IP
|
$525.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602672
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$325.87 |
| Max. Negotiated Rate |
$483.81 |
| Rate for Payer: Aetna Commercial |
$454.12
|
| Rate for Payer: Cigna All Products |
$453.59
|
| Rate for Payer: Coventry/First Health All Products |
$462.53
|
| Rate for Payer: Encore All Products |
$483.81
|
| Rate for Payer: Frontpath All Products |
$483.55
|
| Rate for Payer: Humana ChoiceCare |
$453.96
|
| Rate for Payer: Lutheran Preferred All Products |
$473.04
|
| Rate for Payer: PHCS/Multiplan All Products |
$394.20
|
| Rate for Payer: PHP All Products |
$398.62
|
| Rate for Payer: Sagamore All Products |
$405.76
|
| Rate for Payer: Self Pay/Cash Rate |
$325.87
|
| Rate for Payer: Signature Care EPO |
$436.25
|
| Rate for Payer: Signature Care PPO |
$462.53
|
| Rate for Payer: United Healthcare Commercial |
$414.17
|
|
|
HC ACU 2.7X10 NON-LOCK HEX SCREW
|
Facility
OP
|
$489.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602688
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$161.57 |
| Max. Negotiated Rate |
$450.68 |
| Rate for Payer: Aetna Commercial |
$413.22
|
| Rate for Payer: Aetna Medicare |
$161.57
|
| Rate for Payer: Anthem Exchange |
$281.18
|
| Rate for Payer: Anthem Medicare |
$161.57
|
| Rate for Payer: Anthem PPO |
$281.18
|
| Rate for Payer: Anthem Traditional |
$306.05
|
| Rate for Payer: Caresource Just 4 Me |
$185.80
|
| Rate for Payer: Caresource Medicare |
$177.72
|
| Rate for Payer: Centivo/Paragon All Products |
$249.70
|
| Rate for Payer: Cigna All Products |
$422.52
|
| Rate for Payer: Coventry/First Health All Products |
$430.85
|
| Rate for Payer: Encore All Products |
$450.68
|
| Rate for Payer: Frontpath All Products |
$450.43
|
| Rate for Payer: Humana ChoiceCare |
$422.87
|
| Rate for Payer: Humana Medicare |
$249.70
|
| Rate for Payer: Lucent/Coldwater Veneers |
$249.70
|
| Rate for Payer: Lutheran Preferred All Products |
$440.64
|
| Rate for Payer: PHCS/Multiplan All Products |
$367.20
|
| Rate for Payer: PHP All Products |
$371.31
|
| Rate for Payer: Plain Church Group Ministry All Products |
$190.94
|
| Rate for Payer: Sagamore All Products |
$377.97
|
| Rate for Payer: Self Pay/Cash Rate |
$303.55
|
| Rate for Payer: Signature Care EPO |
$406.37
|
| Rate for Payer: Signature Care PPO |
$430.85
|
| Rate for Payer: Three Rivers Preferred All Products |
$416.16
|
| Rate for Payer: United Healthcare Commercial |
$385.80
|
| Rate for Payer: United Healthcare Medicare |
$161.57
|
|
|
HC ACU 2.7X10 NON-LOCK HEX SCREW
|
Facility
IP
|
$489.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602688
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$303.55 |
| Max. Negotiated Rate |
$450.68 |
| Rate for Payer: Aetna Commercial |
$423.01
|
| Rate for Payer: Cigna All Products |
$422.52
|
| Rate for Payer: Coventry/First Health All Products |
$430.85
|
| Rate for Payer: Encore All Products |
$450.68
|
| Rate for Payer: Frontpath All Products |
$450.43
|
| Rate for Payer: Humana ChoiceCare |
$422.87
|
| Rate for Payer: Lutheran Preferred All Products |
$440.64
|
| Rate for Payer: PHCS/Multiplan All Products |
$367.20
|
| Rate for Payer: PHP All Products |
$371.31
|
| Rate for Payer: Sagamore All Products |
$377.97
|
| Rate for Payer: Self Pay/Cash Rate |
$303.55
|
| Rate for Payer: Signature Care EPO |
$406.37
|
| Rate for Payer: Signature Care PPO |
$430.85
|
| Rate for Payer: United Healthcare Commercial |
$385.80
|
|
|
HC ACU 2.7X10 VAR ANG HEX SCREW
|
Facility
OP
|
$556.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603064
|
|
Hospital Revenue Code
|
278
|
| 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 2.7X10 VAR ANG HEX SCREW
|
Facility
IP
|
$556.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603064
|
|
Hospital Revenue Code
|
278
|
| 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 2.7X12 LOCK HEX SCREW
|
Facility
IP
|
$525.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602673
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$325.87 |
| Max. Negotiated Rate |
$483.81 |
| Rate for Payer: Aetna Commercial |
$454.12
|
| Rate for Payer: Cigna All Products |
$453.59
|
| Rate for Payer: Coventry/First Health All Products |
$462.53
|
| Rate for Payer: Encore All Products |
$483.81
|
| Rate for Payer: Frontpath All Products |
$483.55
|
| Rate for Payer: Humana ChoiceCare |
$453.96
|
| Rate for Payer: Lutheran Preferred All Products |
$473.04
|
| Rate for Payer: PHCS/Multiplan All Products |
$394.20
|
| Rate for Payer: PHP All Products |
$398.62
|
| Rate for Payer: Sagamore All Products |
$405.76
|
| Rate for Payer: Self Pay/Cash Rate |
$325.87
|
| Rate for Payer: Signature Care EPO |
$436.25
|
| Rate for Payer: Signature Care PPO |
$462.53
|
| Rate for Payer: United Healthcare Commercial |
$414.17
|
|
|
HC ACU 2.7X12 LOCK HEX SCREW
|
Facility
OP
|
$525.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602673
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$173.45 |
| Max. Negotiated Rate |
$483.81 |
| Rate for Payer: Aetna Commercial |
$443.61
|
| Rate for Payer: Aetna Medicare |
$173.45
|
| Rate for Payer: Anthem Exchange |
$301.85
|
| Rate for Payer: Anthem Medicare |
$173.45
|
| Rate for Payer: Anthem PPO |
$301.85
|
| Rate for Payer: Anthem Traditional |
$328.55
|
| Rate for Payer: Caresource Just 4 Me |
$199.47
|
| Rate for Payer: Caresource Medicare |
$190.79
|
| Rate for Payer: Centivo/Paragon All Products |
$268.06
|
| Rate for Payer: Cigna All Products |
$453.59
|
| Rate for Payer: Coventry/First Health All Products |
$462.53
|
| Rate for Payer: Encore All Products |
$483.81
|
| Rate for Payer: Frontpath All Products |
$483.55
|
| Rate for Payer: Humana ChoiceCare |
$453.96
|
| Rate for Payer: Humana Medicare |
$268.06
|
| Rate for Payer: Lucent/Coldwater Veneers |
$268.06
|
| Rate for Payer: Lutheran Preferred All Products |
$473.04
|
| Rate for Payer: PHCS/Multiplan All Products |
$394.20
|
| Rate for Payer: PHP All Products |
$398.62
|
| Rate for Payer: Plain Church Group Ministry All Products |
$204.98
|
| Rate for Payer: Sagamore All Products |
$405.76
|
| Rate for Payer: Self Pay/Cash Rate |
$325.87
|
| Rate for Payer: Signature Care EPO |
$436.25
|
| Rate for Payer: Signature Care PPO |
$462.53
|
| Rate for Payer: Three Rivers Preferred All Products |
$446.76
|
| Rate for Payer: United Healthcare Commercial |
$414.17
|
| Rate for Payer: United Healthcare Medicare |
$173.45
|
|
|
HC ACU 2.7X12 NON-LOCK HEX SCREW
|
Facility
OP
|
$489.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602689
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$161.57 |
| Max. Negotiated Rate |
$450.68 |
| Rate for Payer: Aetna Commercial |
$413.22
|
| Rate for Payer: Aetna Medicare |
$161.57
|
| Rate for Payer: Anthem Exchange |
$281.18
|
| Rate for Payer: Anthem Medicare |
$161.57
|
| Rate for Payer: Anthem PPO |
$281.18
|
| Rate for Payer: Anthem Traditional |
$306.05
|
| Rate for Payer: Caresource Just 4 Me |
$185.80
|
| Rate for Payer: Caresource Medicare |
$177.72
|
| Rate for Payer: Centivo/Paragon All Products |
$249.70
|
| Rate for Payer: Cigna All Products |
$422.52
|
| Rate for Payer: Coventry/First Health All Products |
$430.85
|
| Rate for Payer: Encore All Products |
$450.68
|
| Rate for Payer: Frontpath All Products |
$450.43
|
| Rate for Payer: Humana ChoiceCare |
$422.87
|
| Rate for Payer: Humana Medicare |
$249.70
|
| Rate for Payer: Lucent/Coldwater Veneers |
$249.70
|
| Rate for Payer: Lutheran Preferred All Products |
$440.64
|
| Rate for Payer: PHCS/Multiplan All Products |
$367.20
|
| Rate for Payer: PHP All Products |
$371.31
|
| Rate for Payer: Plain Church Group Ministry All Products |
$190.94
|
| Rate for Payer: Sagamore All Products |
$377.97
|
| Rate for Payer: Self Pay/Cash Rate |
$303.55
|
| Rate for Payer: Signature Care EPO |
$406.37
|
| Rate for Payer: Signature Care PPO |
$430.85
|
| Rate for Payer: Three Rivers Preferred All Products |
$416.16
|
| Rate for Payer: United Healthcare Commercial |
$385.80
|
| Rate for Payer: United Healthcare Medicare |
$161.57
|
|
|
HC ACU 2.7X12 NON-LOCK HEX SCREW
|
Facility
IP
|
$489.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602689
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$303.55 |
| Max. Negotiated Rate |
$450.68 |
| Rate for Payer: Aetna Commercial |
$423.01
|
| Rate for Payer: Cigna All Products |
$422.52
|
| Rate for Payer: Coventry/First Health All Products |
$430.85
|
| Rate for Payer: Encore All Products |
$450.68
|
| Rate for Payer: Frontpath All Products |
$450.43
|
| Rate for Payer: Humana ChoiceCare |
$422.87
|
| Rate for Payer: Lutheran Preferred All Products |
$440.64
|
| Rate for Payer: PHCS/Multiplan All Products |
$367.20
|
| Rate for Payer: PHP All Products |
$371.31
|
| Rate for Payer: Sagamore All Products |
$377.97
|
| Rate for Payer: Self Pay/Cash Rate |
$303.55
|
| Rate for Payer: Signature Care EPO |
$406.37
|
| Rate for Payer: Signature Care PPO |
$430.85
|
| Rate for Payer: United Healthcare Commercial |
$385.80
|
|
|
HC ACU 2.7X12 VAR ANG HEX SCREW
|
Facility
OP
|
$556.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603065
|
|
Hospital Revenue Code
|
278
|
| 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 2.7X12 VAR ANG HEX SCREW
|
Facility
IP
|
$556.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603065
|
|
Hospital Revenue Code
|
278
|
| 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
|
|
