|
HC DS SCREW 3.5X32 CORTEX ST
|
Facility
IP
|
$252.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606337
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$189.00 |
| Max. Negotiated Rate |
$234.36 |
| Rate for Payer: Aetna Commercial |
$217.73
|
| Rate for Payer: Cash Price |
$156.24
|
| Rate for Payer: Cigna All Commercial |
$217.48
|
| Rate for Payer: CORVEL All Commercial |
$234.36
|
| Rate for Payer: Coventry All Commercial |
$221.76
|
| Rate for Payer: Encore All Commercial |
$231.97
|
| Rate for Payer: Frontpath All Commercial |
$231.84
|
| Rate for Payer: Humana ChoiceCare |
$217.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$226.80
|
| Rate for Payer: PHCS All Commercial |
$189.00
|
| Rate for Payer: PHP All Commercial |
$191.12
|
| Rate for Payer: Sagamore Health Network All Products |
$194.54
|
| Rate for Payer: Signature Care EPO |
$209.16
|
| Rate for Payer: Signature Care PPO |
$221.76
|
| Rate for Payer: United Healthcare Commercial |
$198.58
|
|
|
HC DS SCREW 3.5 X 32 LOCK ST
|
Facility
IP
|
$1,137.10
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606330
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$852.82 |
| Max. Negotiated Rate |
$1,057.50 |
| Rate for Payer: Aetna Commercial |
$982.45
|
| Rate for Payer: Cash Price |
$705.00
|
| Rate for Payer: Cigna All Commercial |
$981.32
|
| Rate for Payer: CORVEL All Commercial |
$1,057.50
|
| Rate for Payer: Coventry All Commercial |
$1,000.65
|
| Rate for Payer: Encore All Commercial |
$1,046.70
|
| Rate for Payer: Frontpath All Commercial |
$1,046.13
|
| Rate for Payer: Humana ChoiceCare |
$982.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,023.39
|
| Rate for Payer: PHCS All Commercial |
$852.82
|
| Rate for Payer: PHP All Commercial |
$862.38
|
| Rate for Payer: Sagamore Health Network All Products |
$877.84
|
| Rate for Payer: Signature Care EPO |
$943.79
|
| Rate for Payer: Signature Care PPO |
$1,000.65
|
| Rate for Payer: United Healthcare Commercial |
$896.03
|
|
|
HC DS SCREW 3.5 X 32 LOCK ST
|
Facility
OP
|
$1,137.10
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606330
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$375.24 |
| Max. Negotiated Rate |
$1,057.50 |
| Rate for Payer: Aetna Commercial |
$959.71
|
| Rate for Payer: Aetna Medicare |
$375.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$375.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$653.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$710.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$431.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$412.77
|
| Rate for Payer: Cash Price |
$705.00
|
| Rate for Payer: Cash Price |
$705.00
|
| Rate for Payer: Centivo All Commercial |
$579.92
|
| Rate for Payer: Cigna All Commercial |
$981.32
|
| Rate for Payer: CORVEL All Commercial |
$1,057.50
|
| Rate for Payer: Coventry All Commercial |
$1,000.65
|
| Rate for Payer: Encore All Commercial |
$1,046.70
|
| Rate for Payer: Frontpath All Commercial |
$1,046.13
|
| Rate for Payer: Humana ChoiceCare |
$982.11
|
| Rate for Payer: Humana Medicare |
$579.92
|
| Rate for Payer: Lucent All Commercial |
$579.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,023.39
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$852.82
|
| Rate for Payer: PHP All Commercial |
$862.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$443.47
|
| Rate for Payer: Sagamore Health Network All Products |
$877.84
|
| Rate for Payer: Signature Care EPO |
$943.79
|
| Rate for Payer: Signature Care PPO |
$1,000.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$966.54
|
| Rate for Payer: United Healthcare Commercial |
$896.03
|
| Rate for Payer: United Healthcare Medicare |
$375.24
|
|
|
HC DS SCREW 3.5X32 STARDRIVE LOCK
|
Facility
OP
|
$916.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$302.28 |
| Max. Negotiated Rate |
$851.88 |
| Rate for Payer: Aetna Commercial |
$773.10
|
| Rate for Payer: Aetna Medicare |
$302.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$302.28
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$526.06
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$572.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$347.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$332.51
|
| Rate for Payer: Cash Price |
$567.92
|
| Rate for Payer: Cash Price |
$567.92
|
| Rate for Payer: Centivo All Commercial |
$467.16
|
| Rate for Payer: Cigna All Commercial |
$790.51
|
| Rate for Payer: CORVEL All Commercial |
$851.88
|
| Rate for Payer: Coventry All Commercial |
$806.08
|
| Rate for Payer: Encore All Commercial |
$843.18
|
| Rate for Payer: Frontpath All Commercial |
$842.72
|
| Rate for Payer: Humana ChoiceCare |
$791.15
|
| Rate for Payer: Humana Medicare |
$467.16
|
| Rate for Payer: Lucent All Commercial |
$467.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$824.40
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$687.00
|
| Rate for Payer: PHP All Commercial |
$694.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$357.24
|
| Rate for Payer: Sagamore Health Network All Products |
$707.15
|
| Rate for Payer: Signature Care EPO |
$760.28
|
| Rate for Payer: Signature Care PPO |
$806.08
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$778.60
|
| Rate for Payer: United Healthcare Commercial |
$721.81
|
| Rate for Payer: United Healthcare Medicare |
$302.28
|
|
|
HC DS SCREW 3.5X32 STARDRIVE LOCK
|
Facility
IP
|
$916.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$687.00 |
| Max. Negotiated Rate |
$851.88 |
| Rate for Payer: Aetna Commercial |
$791.42
|
| Rate for Payer: Cash Price |
$567.92
|
| Rate for Payer: Cigna All Commercial |
$790.51
|
| Rate for Payer: CORVEL All Commercial |
$851.88
|
| Rate for Payer: Coventry All Commercial |
$806.08
|
| Rate for Payer: Encore All Commercial |
$843.18
|
| Rate for Payer: Frontpath All Commercial |
$842.72
|
| Rate for Payer: Humana ChoiceCare |
$791.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$824.40
|
| Rate for Payer: PHCS All Commercial |
$687.00
|
| Rate for Payer: PHP All Commercial |
$694.69
|
| Rate for Payer: Sagamore Health Network All Products |
$707.15
|
| Rate for Payer: Signature Care EPO |
$760.28
|
| Rate for Payer: Signature Care PPO |
$806.08
|
| Rate for Payer: United Healthcare Commercial |
$721.81
|
|
|
HC DS SCREW 3.5X34 CORT ST
|
Facility
OP
|
$504.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607694
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.32 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$425.38
|
| Rate for Payer: Aetna Medicare |
$166.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$166.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$289.45
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$315.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$191.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$182.95
|
| Rate for Payer: Cash Price |
$312.48
|
| Rate for Payer: Cash Price |
$312.48
|
| Rate for Payer: Centivo All Commercial |
$257.04
|
| Rate for Payer: Cigna All Commercial |
$434.95
|
| Rate for Payer: CORVEL All Commercial |
$468.72
|
| Rate for Payer: Coventry All Commercial |
$443.52
|
| Rate for Payer: Encore All Commercial |
$463.93
|
| Rate for Payer: Frontpath All Commercial |
$463.68
|
| Rate for Payer: Humana ChoiceCare |
$435.30
|
| Rate for Payer: Humana Medicare |
$257.04
|
| Rate for Payer: Lucent All Commercial |
$257.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$453.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$378.00
|
| Rate for Payer: PHP All Commercial |
$382.23
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$196.56
|
| Rate for Payer: Sagamore Health Network All Products |
$389.09
|
| Rate for Payer: Signature Care EPO |
$418.32
|
| Rate for Payer: Signature Care PPO |
$443.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$428.40
|
| Rate for Payer: United Healthcare Commercial |
$397.15
|
| Rate for Payer: United Healthcare Medicare |
$166.32
|
|
|
HC DS SCREW 3.5X34 CORT ST
|
Facility
IP
|
$504.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607694
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$378.00 |
| Max. Negotiated Rate |
$468.72 |
| Rate for Payer: Aetna Commercial |
$435.46
|
| Rate for Payer: Cash Price |
$312.48
|
| Rate for Payer: Cigna All Commercial |
$434.95
|
| Rate for Payer: CORVEL All Commercial |
$468.72
|
| Rate for Payer: Coventry All Commercial |
$443.52
|
| Rate for Payer: Encore All Commercial |
$463.93
|
| Rate for Payer: Frontpath All Commercial |
$463.68
|
| Rate for Payer: Humana ChoiceCare |
$435.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$453.60
|
| Rate for Payer: PHCS All Commercial |
$378.00
|
| Rate for Payer: PHP All Commercial |
$382.23
|
| Rate for Payer: Sagamore Health Network All Products |
$389.09
|
| Rate for Payer: Signature Care EPO |
$418.32
|
| Rate for Payer: Signature Care PPO |
$443.52
|
| Rate for Payer: United Healthcare Commercial |
$397.15
|
|
|
HC DS SCREW 3.5 X 34 LOCK ST
|
Facility
OP
|
$1,137.10
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606331
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$375.24 |
| Max. Negotiated Rate |
$1,057.50 |
| Rate for Payer: Aetna Commercial |
$959.71
|
| Rate for Payer: Aetna Medicare |
$375.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$375.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$653.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$710.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$431.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$412.77
|
| Rate for Payer: Cash Price |
$705.00
|
| Rate for Payer: Cash Price |
$705.00
|
| Rate for Payer: Centivo All Commercial |
$579.92
|
| Rate for Payer: Cigna All Commercial |
$981.32
|
| Rate for Payer: CORVEL All Commercial |
$1,057.50
|
| Rate for Payer: Coventry All Commercial |
$1,000.65
|
| Rate for Payer: Encore All Commercial |
$1,046.70
|
| Rate for Payer: Frontpath All Commercial |
$1,046.13
|
| Rate for Payer: Humana ChoiceCare |
$982.11
|
| Rate for Payer: Humana Medicare |
$579.92
|
| Rate for Payer: Lucent All Commercial |
$579.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,023.39
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$852.82
|
| Rate for Payer: PHP All Commercial |
$862.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$443.47
|
| Rate for Payer: Sagamore Health Network All Products |
$877.84
|
| Rate for Payer: Signature Care EPO |
$943.79
|
| Rate for Payer: Signature Care PPO |
$1,000.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$966.54
|
| Rate for Payer: United Healthcare Commercial |
$896.03
|
| Rate for Payer: United Healthcare Medicare |
$375.24
|
|
|
HC DS SCREW 3.5 X 34 LOCK ST
|
Facility
IP
|
$1,137.10
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606331
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$852.82 |
| Max. Negotiated Rate |
$1,057.50 |
| Rate for Payer: Aetna Commercial |
$982.45
|
| Rate for Payer: Cash Price |
$705.00
|
| Rate for Payer: Cigna All Commercial |
$981.32
|
| Rate for Payer: CORVEL All Commercial |
$1,057.50
|
| Rate for Payer: Coventry All Commercial |
$1,000.65
|
| Rate for Payer: Encore All Commercial |
$1,046.70
|
| Rate for Payer: Frontpath All Commercial |
$1,046.13
|
| Rate for Payer: Humana ChoiceCare |
$982.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,023.39
|
| Rate for Payer: PHCS All Commercial |
$852.82
|
| Rate for Payer: PHP All Commercial |
$862.38
|
| Rate for Payer: Sagamore Health Network All Products |
$877.84
|
| Rate for Payer: Signature Care EPO |
$943.79
|
| Rate for Payer: Signature Care PPO |
$1,000.65
|
| Rate for Payer: United Healthcare Commercial |
$896.03
|
|
|
HC DS SCREW 3.5X34 STARDRIVE LOCK
|
Facility
OP
|
$916.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607047
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$302.28 |
| Max. Negotiated Rate |
$851.88 |
| Rate for Payer: Aetna Commercial |
$773.10
|
| Rate for Payer: Aetna Medicare |
$302.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$302.28
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$526.06
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$572.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$347.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$332.51
|
| Rate for Payer: Cash Price |
$567.92
|
| Rate for Payer: Cash Price |
$567.92
|
| Rate for Payer: Centivo All Commercial |
$467.16
|
| Rate for Payer: Cigna All Commercial |
$790.51
|
| Rate for Payer: CORVEL All Commercial |
$851.88
|
| Rate for Payer: Coventry All Commercial |
$806.08
|
| Rate for Payer: Encore All Commercial |
$843.18
|
| Rate for Payer: Frontpath All Commercial |
$842.72
|
| Rate for Payer: Humana ChoiceCare |
$791.15
|
| Rate for Payer: Humana Medicare |
$467.16
|
| Rate for Payer: Lucent All Commercial |
$467.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$824.40
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$687.00
|
| Rate for Payer: PHP All Commercial |
$694.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$357.24
|
| Rate for Payer: Sagamore Health Network All Products |
$707.15
|
| Rate for Payer: Signature Care EPO |
$760.28
|
| Rate for Payer: Signature Care PPO |
$806.08
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$778.60
|
| Rate for Payer: United Healthcare Commercial |
$721.81
|
| Rate for Payer: United Healthcare Medicare |
$302.28
|
|
|
HC DS SCREW 3.5X34 STARDRIVE LOCK
|
Facility
IP
|
$916.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607047
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$687.00 |
| Max. Negotiated Rate |
$851.88 |
| Rate for Payer: Aetna Commercial |
$791.42
|
| Rate for Payer: Cash Price |
$567.92
|
| Rate for Payer: Cigna All Commercial |
$790.51
|
| Rate for Payer: CORVEL All Commercial |
$851.88
|
| Rate for Payer: Coventry All Commercial |
$806.08
|
| Rate for Payer: Encore All Commercial |
$843.18
|
| Rate for Payer: Frontpath All Commercial |
$842.72
|
| Rate for Payer: Humana ChoiceCare |
$791.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$824.40
|
| Rate for Payer: PHCS All Commercial |
$687.00
|
| Rate for Payer: PHP All Commercial |
$694.69
|
| Rate for Payer: Sagamore Health Network All Products |
$707.15
|
| Rate for Payer: Signature Care EPO |
$760.28
|
| Rate for Payer: Signature Care PPO |
$806.08
|
| Rate for Payer: United Healthcare Commercial |
$721.81
|
|
|
HC DS SCREW 3.5X36 CORT ST
|
Facility
OP
|
$504.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607695
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$166.32 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$425.38
|
| Rate for Payer: Aetna Medicare |
$166.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$166.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$289.45
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$315.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$191.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$182.95
|
| Rate for Payer: Cash Price |
$312.48
|
| Rate for Payer: Cash Price |
$312.48
|
| Rate for Payer: Centivo All Commercial |
$257.04
|
| Rate for Payer: Cigna All Commercial |
$434.95
|
| Rate for Payer: CORVEL All Commercial |
$468.72
|
| Rate for Payer: Coventry All Commercial |
$443.52
|
| Rate for Payer: Encore All Commercial |
$463.93
|
| Rate for Payer: Frontpath All Commercial |
$463.68
|
| Rate for Payer: Humana ChoiceCare |
$435.30
|
| Rate for Payer: Humana Medicare |
$257.04
|
| Rate for Payer: Lucent All Commercial |
$257.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$453.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$378.00
|
| Rate for Payer: PHP All Commercial |
$382.23
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$196.56
|
| Rate for Payer: Sagamore Health Network All Products |
$389.09
|
| Rate for Payer: Signature Care EPO |
$418.32
|
| Rate for Payer: Signature Care PPO |
$443.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$428.40
|
| Rate for Payer: United Healthcare Commercial |
$397.15
|
| Rate for Payer: United Healthcare Medicare |
$166.32
|
|
|
HC DS SCREW 3.5X36 CORT ST
|
Facility
IP
|
$504.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607695
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$378.00 |
| Max. Negotiated Rate |
$468.72 |
| Rate for Payer: Aetna Commercial |
$435.46
|
| Rate for Payer: Cash Price |
$312.48
|
| Rate for Payer: Cigna All Commercial |
$434.95
|
| Rate for Payer: CORVEL All Commercial |
$468.72
|
| Rate for Payer: Coventry All Commercial |
$443.52
|
| Rate for Payer: Encore All Commercial |
$463.93
|
| Rate for Payer: Frontpath All Commercial |
$463.68
|
| Rate for Payer: Humana ChoiceCare |
$435.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$453.60
|
| Rate for Payer: PHCS All Commercial |
$378.00
|
| Rate for Payer: PHP All Commercial |
$382.23
|
| Rate for Payer: Sagamore Health Network All Products |
$389.09
|
| Rate for Payer: Signature Care EPO |
$418.32
|
| Rate for Payer: Signature Care PPO |
$443.52
|
| Rate for Payer: United Healthcare Commercial |
$397.15
|
|
|
HC DS SCREW 3.5X38 CORTEX ST
|
Facility
IP
|
$252.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606338
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$189.00 |
| Max. Negotiated Rate |
$234.36 |
| Rate for Payer: Aetna Commercial |
$217.73
|
| Rate for Payer: Cash Price |
$156.24
|
| Rate for Payer: Cigna All Commercial |
$217.48
|
| Rate for Payer: CORVEL All Commercial |
$234.36
|
| Rate for Payer: Coventry All Commercial |
$221.76
|
| Rate for Payer: Encore All Commercial |
$231.97
|
| Rate for Payer: Frontpath All Commercial |
$231.84
|
| Rate for Payer: Humana ChoiceCare |
$217.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$226.80
|
| Rate for Payer: PHCS All Commercial |
$189.00
|
| Rate for Payer: PHP All Commercial |
$191.12
|
| Rate for Payer: Sagamore Health Network All Products |
$194.54
|
| Rate for Payer: Signature Care EPO |
$209.16
|
| Rate for Payer: Signature Care PPO |
$221.76
|
| Rate for Payer: United Healthcare Commercial |
$198.58
|
|
|
HC DS SCREW 3.5X38 CORTEX ST
|
Facility
OP
|
$252.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606338
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$83.16 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$212.69
|
| Rate for Payer: Aetna Medicare |
$83.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$83.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$144.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$157.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$95.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$91.48
|
| Rate for Payer: Cash Price |
$156.24
|
| Rate for Payer: Cash Price |
$156.24
|
| Rate for Payer: Centivo All Commercial |
$128.52
|
| Rate for Payer: Cigna All Commercial |
$217.48
|
| Rate for Payer: CORVEL All Commercial |
$234.36
|
| Rate for Payer: Coventry All Commercial |
$221.76
|
| Rate for Payer: Encore All Commercial |
$231.97
|
| Rate for Payer: Frontpath All Commercial |
$231.84
|
| Rate for Payer: Humana ChoiceCare |
$217.65
|
| Rate for Payer: Humana Medicare |
$128.52
|
| Rate for Payer: Lucent All Commercial |
$128.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$226.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$189.00
|
| Rate for Payer: PHP All Commercial |
$191.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$98.28
|
| Rate for Payer: Sagamore Health Network All Products |
$194.54
|
| Rate for Payer: Signature Care EPO |
$209.16
|
| Rate for Payer: Signature Care PPO |
$221.76
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$214.20
|
| Rate for Payer: United Healthcare Commercial |
$198.58
|
| Rate for Payer: United Healthcare Medicare |
$83.16
|
|
|
HC DS SCREW 3.5X38 STARDRIVE LOCK
|
Facility
IP
|
$916.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$687.00 |
| Max. Negotiated Rate |
$851.88 |
| Rate for Payer: Aetna Commercial |
$791.42
|
| Rate for Payer: Cash Price |
$567.92
|
| Rate for Payer: Cigna All Commercial |
$790.51
|
| Rate for Payer: CORVEL All Commercial |
$851.88
|
| Rate for Payer: Coventry All Commercial |
$806.08
|
| Rate for Payer: Encore All Commercial |
$843.18
|
| Rate for Payer: Frontpath All Commercial |
$842.72
|
| Rate for Payer: Humana ChoiceCare |
$791.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$824.40
|
| Rate for Payer: PHCS All Commercial |
$687.00
|
| Rate for Payer: PHP All Commercial |
$694.69
|
| Rate for Payer: Sagamore Health Network All Products |
$707.15
|
| Rate for Payer: Signature Care EPO |
$760.28
|
| Rate for Payer: Signature Care PPO |
$806.08
|
| Rate for Payer: United Healthcare Commercial |
$721.81
|
|
|
HC DS SCREW 3.5X38 STARDRIVE LOCK
|
Facility
OP
|
$916.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$302.28 |
| Max. Negotiated Rate |
$851.88 |
| Rate for Payer: Aetna Commercial |
$773.10
|
| Rate for Payer: Aetna Medicare |
$302.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$302.28
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$526.06
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$572.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$347.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$332.51
|
| Rate for Payer: Cash Price |
$567.92
|
| Rate for Payer: Cash Price |
$567.92
|
| Rate for Payer: Centivo All Commercial |
$467.16
|
| Rate for Payer: Cigna All Commercial |
$790.51
|
| Rate for Payer: CORVEL All Commercial |
$851.88
|
| Rate for Payer: Coventry All Commercial |
$806.08
|
| Rate for Payer: Encore All Commercial |
$843.18
|
| Rate for Payer: Frontpath All Commercial |
$842.72
|
| Rate for Payer: Humana ChoiceCare |
$791.15
|
| Rate for Payer: Humana Medicare |
$467.16
|
| Rate for Payer: Lucent All Commercial |
$467.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$824.40
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$687.00
|
| Rate for Payer: PHP All Commercial |
$694.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$357.24
|
| Rate for Payer: Sagamore Health Network All Products |
$707.15
|
| Rate for Payer: Signature Care EPO |
$760.28
|
| Rate for Payer: Signature Care PPO |
$806.08
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$778.60
|
| Rate for Payer: United Healthcare Commercial |
$721.81
|
| Rate for Payer: United Healthcare Medicare |
$302.28
|
|
|
HC DS SCREW 3.5X40 CRTX
|
Facility
OP
|
$294.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603960
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$97.02 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$248.14
|
| Rate for Payer: Aetna Medicare |
$97.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$97.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$168.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$183.78
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$111.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$106.72
|
| Rate for Payer: Cash Price |
$182.28
|
| Rate for Payer: Cash Price |
$182.28
|
| Rate for Payer: Centivo All Commercial |
$149.94
|
| Rate for Payer: Cigna All Commercial |
$253.72
|
| Rate for Payer: CORVEL All Commercial |
$273.42
|
| Rate for Payer: Coventry All Commercial |
$258.72
|
| Rate for Payer: Encore All Commercial |
$270.63
|
| Rate for Payer: Frontpath All Commercial |
$270.48
|
| Rate for Payer: Humana ChoiceCare |
$253.93
|
| Rate for Payer: Humana Medicare |
$149.94
|
| Rate for Payer: Lucent All Commercial |
$149.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$264.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$220.50
|
| Rate for Payer: PHP All Commercial |
$222.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$114.66
|
| Rate for Payer: Sagamore Health Network All Products |
$226.97
|
| Rate for Payer: Signature Care EPO |
$244.02
|
| Rate for Payer: Signature Care PPO |
$258.72
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$249.90
|
| Rate for Payer: United Healthcare Commercial |
$231.67
|
| Rate for Payer: United Healthcare Medicare |
$97.02
|
|
|
HC DS SCREW 3.5X40 CRTX
|
Facility
IP
|
$294.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603960
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$220.50 |
| Max. Negotiated Rate |
$273.42 |
| Rate for Payer: Aetna Commercial |
$254.02
|
| Rate for Payer: Cash Price |
$182.28
|
| Rate for Payer: Cigna All Commercial |
$253.72
|
| Rate for Payer: CORVEL All Commercial |
$273.42
|
| Rate for Payer: Coventry All Commercial |
$258.72
|
| Rate for Payer: Encore All Commercial |
$270.63
|
| Rate for Payer: Frontpath All Commercial |
$270.48
|
| Rate for Payer: Humana ChoiceCare |
$253.93
|
| Rate for Payer: Lutheran Preferred All Commercial |
$264.60
|
| Rate for Payer: PHCS All Commercial |
$220.50
|
| Rate for Payer: PHP All Commercial |
$222.97
|
| Rate for Payer: Sagamore Health Network All Products |
$226.97
|
| Rate for Payer: Signature Care EPO |
$244.02
|
| Rate for Payer: Signature Care PPO |
$258.72
|
| Rate for Payer: United Healthcare Commercial |
$231.67
|
|
|
HC DS SCREW 3.5X40 STARDRIVE LOCK
|
Facility
OP
|
$916.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607049
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$302.28 |
| Max. Negotiated Rate |
$851.88 |
| Rate for Payer: Aetna Commercial |
$773.10
|
| Rate for Payer: Aetna Medicare |
$302.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$302.28
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$526.06
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$572.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$347.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$332.51
|
| Rate for Payer: Cash Price |
$567.92
|
| Rate for Payer: Cash Price |
$567.92
|
| Rate for Payer: Centivo All Commercial |
$467.16
|
| Rate for Payer: Cigna All Commercial |
$790.51
|
| Rate for Payer: CORVEL All Commercial |
$851.88
|
| Rate for Payer: Coventry All Commercial |
$806.08
|
| Rate for Payer: Encore All Commercial |
$843.18
|
| Rate for Payer: Frontpath All Commercial |
$842.72
|
| Rate for Payer: Humana ChoiceCare |
$791.15
|
| Rate for Payer: Humana Medicare |
$467.16
|
| Rate for Payer: Lucent All Commercial |
$467.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$824.40
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$687.00
|
| Rate for Payer: PHP All Commercial |
$694.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$357.24
|
| Rate for Payer: Sagamore Health Network All Products |
$707.15
|
| Rate for Payer: Signature Care EPO |
$760.28
|
| Rate for Payer: Signature Care PPO |
$806.08
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$778.60
|
| Rate for Payer: United Healthcare Commercial |
$721.81
|
| Rate for Payer: United Healthcare Medicare |
$302.28
|
|
|
HC DS SCREW 3.5X40 STARDRIVE LOCK
|
Facility
IP
|
$916.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607049
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$687.00 |
| Max. Negotiated Rate |
$851.88 |
| Rate for Payer: Aetna Commercial |
$791.42
|
| Rate for Payer: Cash Price |
$567.92
|
| Rate for Payer: Cigna All Commercial |
$790.51
|
| Rate for Payer: CORVEL All Commercial |
$851.88
|
| Rate for Payer: Coventry All Commercial |
$806.08
|
| Rate for Payer: Encore All Commercial |
$843.18
|
| Rate for Payer: Frontpath All Commercial |
$842.72
|
| Rate for Payer: Humana ChoiceCare |
$791.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$824.40
|
| Rate for Payer: PHCS All Commercial |
$687.00
|
| Rate for Payer: PHP All Commercial |
$694.69
|
| Rate for Payer: Sagamore Health Network All Products |
$707.15
|
| Rate for Payer: Signature Care EPO |
$760.28
|
| Rate for Payer: Signature Care PPO |
$806.08
|
| Rate for Payer: United Healthcare Commercial |
$721.81
|
|
|
HC DS SCREW 3.5X45 CORTEX ST
|
Facility
OP
|
$252.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606339
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$83.16 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$212.69
|
| Rate for Payer: Aetna Medicare |
$83.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$83.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$144.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$157.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$95.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$91.48
|
| Rate for Payer: Cash Price |
$156.24
|
| Rate for Payer: Cash Price |
$156.24
|
| Rate for Payer: Centivo All Commercial |
$128.52
|
| Rate for Payer: Cigna All Commercial |
$217.48
|
| Rate for Payer: CORVEL All Commercial |
$234.36
|
| Rate for Payer: Coventry All Commercial |
$221.76
|
| Rate for Payer: Encore All Commercial |
$231.97
|
| Rate for Payer: Frontpath All Commercial |
$231.84
|
| Rate for Payer: Humana ChoiceCare |
$217.65
|
| Rate for Payer: Humana Medicare |
$128.52
|
| Rate for Payer: Lucent All Commercial |
$128.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$226.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$189.00
|
| Rate for Payer: PHP All Commercial |
$191.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$98.28
|
| Rate for Payer: Sagamore Health Network All Products |
$194.54
|
| Rate for Payer: Signature Care EPO |
$209.16
|
| Rate for Payer: Signature Care PPO |
$221.76
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$214.20
|
| Rate for Payer: United Healthcare Commercial |
$198.58
|
| Rate for Payer: United Healthcare Medicare |
$83.16
|
|
|
HC DS SCREW 3.5X45 CORTEX ST
|
Facility
IP
|
$252.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606339
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$189.00 |
| Max. Negotiated Rate |
$234.36 |
| Rate for Payer: Aetna Commercial |
$217.73
|
| Rate for Payer: Cash Price |
$156.24
|
| Rate for Payer: Cigna All Commercial |
$217.48
|
| Rate for Payer: CORVEL All Commercial |
$234.36
|
| Rate for Payer: Coventry All Commercial |
$221.76
|
| Rate for Payer: Encore All Commercial |
$231.97
|
| Rate for Payer: Frontpath All Commercial |
$231.84
|
| Rate for Payer: Humana ChoiceCare |
$217.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$226.80
|
| Rate for Payer: PHCS All Commercial |
$189.00
|
| Rate for Payer: PHP All Commercial |
$191.12
|
| Rate for Payer: Sagamore Health Network All Products |
$194.54
|
| Rate for Payer: Signature Care EPO |
$209.16
|
| Rate for Payer: Signature Care PPO |
$221.76
|
| Rate for Payer: United Healthcare Commercial |
$198.58
|
|
|
HC DS SCREW 3.5X45 STARDRIVE LOCK
|
Facility
IP
|
$1,070.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603956
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$802.50 |
| Max. Negotiated Rate |
$995.10 |
| Rate for Payer: Aetna Commercial |
$924.48
|
| Rate for Payer: Cash Price |
$663.40
|
| Rate for Payer: Cigna All Commercial |
$923.41
|
| Rate for Payer: CORVEL All Commercial |
$995.10
|
| Rate for Payer: Coventry All Commercial |
$941.60
|
| Rate for Payer: Encore All Commercial |
$984.94
|
| Rate for Payer: Frontpath All Commercial |
$984.40
|
| Rate for Payer: Humana ChoiceCare |
$924.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$963.00
|
| Rate for Payer: PHCS All Commercial |
$802.50
|
| Rate for Payer: PHP All Commercial |
$811.49
|
| Rate for Payer: Sagamore Health Network All Products |
$826.04
|
| Rate for Payer: Signature Care EPO |
$888.10
|
| Rate for Payer: Signature Care PPO |
$941.60
|
| Rate for Payer: United Healthcare Commercial |
$843.16
|
|
|
HC DS SCREW 3.5X45 STARDRIVE LOCK
|
Facility
OP
|
$1,070.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603956
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$353.10 |
| Max. Negotiated Rate |
$995.10 |
| Rate for Payer: Aetna Commercial |
$903.08
|
| Rate for Payer: Aetna Medicare |
$353.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$353.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$614.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$668.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$406.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$388.41
|
| Rate for Payer: Cash Price |
$663.40
|
| Rate for Payer: Cash Price |
$663.40
|
| Rate for Payer: Centivo All Commercial |
$545.70
|
| Rate for Payer: Cigna All Commercial |
$923.41
|
| Rate for Payer: CORVEL All Commercial |
$995.10
|
| Rate for Payer: Coventry All Commercial |
$941.60
|
| Rate for Payer: Encore All Commercial |
$984.94
|
| Rate for Payer: Frontpath All Commercial |
$984.40
|
| Rate for Payer: Humana ChoiceCare |
$924.16
|
| Rate for Payer: Humana Medicare |
$545.70
|
| Rate for Payer: Lucent All Commercial |
$545.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$963.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$802.50
|
| Rate for Payer: PHP All Commercial |
$811.49
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$417.30
|
| Rate for Payer: Sagamore Health Network All Products |
$826.04
|
| Rate for Payer: Signature Care EPO |
$888.10
|
| Rate for Payer: Signature Care PPO |
$941.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$909.50
|
| Rate for Payer: United Healthcare Commercial |
$843.16
|
| Rate for Payer: United Healthcare Medicare |
$353.10
|
|
