|
HC DS SCREW 2.4X18 CRTX ST
|
Facility
|
OP
|
$1,024.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608378
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$953.06 |
| Rate for Payer: Aetna Commercial |
$864.93
|
| Rate for Payer: Aetna Medicare |
$327.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$317.69
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$588.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$640.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$377.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$360.73
|
| Rate for Payer: Cash Price |
$614.88
|
| Rate for Payer: Cash Price |
$614.88
|
| Rate for Payer: Centivo All Commercial |
$557.49
|
| Rate for Payer: Cigna All Commercial |
$884.40
|
| Rate for Payer: CORVEL All Commercial |
$953.06
|
| Rate for Payer: Coventry All Commercial |
$901.82
|
| Rate for Payer: Encore All Commercial |
$943.33
|
| Rate for Payer: Frontpath All Commercial |
$942.82
|
| Rate for Payer: Humana ChoiceCare |
$885.12
|
| Rate for Payer: Humana Medicare |
$327.94
|
| Rate for Payer: Lucent All Commercial |
$557.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$922.32
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$768.60
|
| Rate for Payer: PHP All Commercial |
$777.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$399.67
|
| Rate for Payer: Sagamore Health Network All Products |
$791.15
|
| Rate for Payer: Signature Care EPO |
$850.58
|
| Rate for Payer: Signature Care PPO |
$901.82
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$871.08
|
| Rate for Payer: United Healthcare Commercial |
$807.54
|
| Rate for Payer: United Healthcare Medicare |
$327.94
|
|
|
HC DS SCREW 2.4X18 CRTX ST
|
Facility
|
IP
|
$1,024.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608378
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$768.60 |
| Max. Negotiated Rate |
$953.06 |
| Rate for Payer: Aetna Commercial |
$885.43
|
| Rate for Payer: Cash Price |
$614.88
|
| Rate for Payer: Cigna All Commercial |
$884.40
|
| Rate for Payer: CORVEL All Commercial |
$953.06
|
| Rate for Payer: Coventry All Commercial |
$901.82
|
| Rate for Payer: Encore All Commercial |
$943.33
|
| Rate for Payer: Frontpath All Commercial |
$942.82
|
| Rate for Payer: Humana ChoiceCare |
$885.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$922.32
|
| Rate for Payer: PHCS All Commercial |
$768.60
|
| Rate for Payer: PHP All Commercial |
$777.21
|
| Rate for Payer: Sagamore Health Network All Products |
$791.15
|
| Rate for Payer: Signature Care EPO |
$850.58
|
| Rate for Payer: Signature Care PPO |
$901.82
|
| Rate for Payer: United Healthcare Commercial |
$807.54
|
|
|
HC DS SCREW 2.4X18 LOCK VA
|
Facility
|
IP
|
$1,692.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608376
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,269.00 |
| Max. Negotiated Rate |
$1,573.56 |
| Rate for Payer: Aetna Commercial |
$1,461.89
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cigna All Commercial |
$1,460.20
|
| Rate for Payer: CORVEL All Commercial |
$1,573.56
|
| Rate for Payer: Coventry All Commercial |
$1,488.96
|
| Rate for Payer: Encore All Commercial |
$1,557.49
|
| Rate for Payer: Frontpath All Commercial |
$1,556.64
|
| Rate for Payer: Humana ChoiceCare |
$1,461.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,522.80
|
| Rate for Payer: PHCS All Commercial |
$1,269.00
|
| Rate for Payer: PHP All Commercial |
$1,283.21
|
| Rate for Payer: Sagamore Health Network All Products |
$1,306.22
|
| Rate for Payer: Signature Care EPO |
$1,404.36
|
| Rate for Payer: Signature Care PPO |
$1,488.96
|
| Rate for Payer: United Healthcare Commercial |
$1,333.30
|
|
|
HC DS SCREW 2.4X18 LOCK VA
|
Facility
|
OP
|
$1,692.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608376
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$1,573.56 |
| Rate for Payer: Aetna Commercial |
$1,428.05
|
| Rate for Payer: Aetna Medicare |
$541.44
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$524.52
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$971.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,057.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$622.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$595.58
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Centivo All Commercial |
$920.45
|
| Rate for Payer: Cigna All Commercial |
$1,460.20
|
| Rate for Payer: CORVEL All Commercial |
$1,573.56
|
| Rate for Payer: Coventry All Commercial |
$1,488.96
|
| Rate for Payer: Encore All Commercial |
$1,557.49
|
| Rate for Payer: Frontpath All Commercial |
$1,556.64
|
| Rate for Payer: Humana ChoiceCare |
$1,461.38
|
| Rate for Payer: Humana Medicare |
$541.44
|
| Rate for Payer: Lucent All Commercial |
$920.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,522.80
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$1,269.00
|
| Rate for Payer: PHP All Commercial |
$1,283.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$659.88
|
| Rate for Payer: Sagamore Health Network All Products |
$1,306.22
|
| Rate for Payer: Signature Care EPO |
$1,404.36
|
| Rate for Payer: Signature Care PPO |
$1,488.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,438.20
|
| Rate for Payer: United Healthcare Commercial |
$1,333.30
|
| Rate for Payer: United Healthcare Medicare |
$541.44
|
|
|
HC DS SCREW 2.4X20 LOCK VA
|
Facility
|
OP
|
$1,692.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608373
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$1,573.56 |
| Rate for Payer: Aetna Commercial |
$1,428.05
|
| Rate for Payer: Aetna Medicare |
$541.44
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$524.52
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$971.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,057.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$622.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$595.58
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Centivo All Commercial |
$920.45
|
| Rate for Payer: Cigna All Commercial |
$1,460.20
|
| Rate for Payer: CORVEL All Commercial |
$1,573.56
|
| Rate for Payer: Coventry All Commercial |
$1,488.96
|
| Rate for Payer: Encore All Commercial |
$1,557.49
|
| Rate for Payer: Frontpath All Commercial |
$1,556.64
|
| Rate for Payer: Humana ChoiceCare |
$1,461.38
|
| Rate for Payer: Humana Medicare |
$541.44
|
| Rate for Payer: Lucent All Commercial |
$920.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,522.80
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$1,269.00
|
| Rate for Payer: PHP All Commercial |
$1,283.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$659.88
|
| Rate for Payer: Sagamore Health Network All Products |
$1,306.22
|
| Rate for Payer: Signature Care EPO |
$1,404.36
|
| Rate for Payer: Signature Care PPO |
$1,488.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,438.20
|
| Rate for Payer: United Healthcare Commercial |
$1,333.30
|
| Rate for Payer: United Healthcare Medicare |
$541.44
|
|
|
HC DS SCREW 2.4X20 LOCK VA
|
Facility
|
IP
|
$1,692.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608373
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,269.00 |
| Max. Negotiated Rate |
$1,573.56 |
| Rate for Payer: Aetna Commercial |
$1,461.89
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cigna All Commercial |
$1,460.20
|
| Rate for Payer: CORVEL All Commercial |
$1,573.56
|
| Rate for Payer: Coventry All Commercial |
$1,488.96
|
| Rate for Payer: Encore All Commercial |
$1,557.49
|
| Rate for Payer: Frontpath All Commercial |
$1,556.64
|
| Rate for Payer: Humana ChoiceCare |
$1,461.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,522.80
|
| Rate for Payer: PHCS All Commercial |
$1,269.00
|
| Rate for Payer: PHP All Commercial |
$1,283.21
|
| Rate for Payer: Sagamore Health Network All Products |
$1,306.22
|
| Rate for Payer: Signature Care EPO |
$1,404.36
|
| Rate for Payer: Signature Care PPO |
$1,488.96
|
| Rate for Payer: United Healthcare Commercial |
$1,333.30
|
|
|
HC DS SCREW 2.4X22 LOCK VA
|
Facility
|
OP
|
$1,692.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608374
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$1,573.56 |
| Rate for Payer: Aetna Commercial |
$1,428.05
|
| Rate for Payer: Aetna Medicare |
$541.44
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$524.52
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$971.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,057.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$622.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$595.58
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Centivo All Commercial |
$920.45
|
| Rate for Payer: Cigna All Commercial |
$1,460.20
|
| Rate for Payer: CORVEL All Commercial |
$1,573.56
|
| Rate for Payer: Coventry All Commercial |
$1,488.96
|
| Rate for Payer: Encore All Commercial |
$1,557.49
|
| Rate for Payer: Frontpath All Commercial |
$1,556.64
|
| Rate for Payer: Humana ChoiceCare |
$1,461.38
|
| Rate for Payer: Humana Medicare |
$541.44
|
| Rate for Payer: Lucent All Commercial |
$920.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,522.80
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$1,269.00
|
| Rate for Payer: PHP All Commercial |
$1,283.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$659.88
|
| Rate for Payer: Sagamore Health Network All Products |
$1,306.22
|
| Rate for Payer: Signature Care EPO |
$1,404.36
|
| Rate for Payer: Signature Care PPO |
$1,488.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,438.20
|
| Rate for Payer: United Healthcare Commercial |
$1,333.30
|
| Rate for Payer: United Healthcare Medicare |
$541.44
|
|
|
HC DS SCREW 2.4X22 LOCK VA
|
Facility
|
IP
|
$1,692.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608374
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,269.00 |
| Max. Negotiated Rate |
$1,573.56 |
| Rate for Payer: Aetna Commercial |
$1,461.89
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cigna All Commercial |
$1,460.20
|
| Rate for Payer: CORVEL All Commercial |
$1,573.56
|
| Rate for Payer: Coventry All Commercial |
$1,488.96
|
| Rate for Payer: Encore All Commercial |
$1,557.49
|
| Rate for Payer: Frontpath All Commercial |
$1,556.64
|
| Rate for Payer: Humana ChoiceCare |
$1,461.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,522.80
|
| Rate for Payer: PHCS All Commercial |
$1,269.00
|
| Rate for Payer: PHP All Commercial |
$1,283.21
|
| Rate for Payer: Sagamore Health Network All Products |
$1,306.22
|
| Rate for Payer: Signature Care EPO |
$1,404.36
|
| Rate for Payer: Signature Care PPO |
$1,488.96
|
| Rate for Payer: United Healthcare Commercial |
$1,333.30
|
|
|
HC DS SCREW 2.4 X 24 LOCK
|
Facility
|
OP
|
$948.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608427
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$881.64 |
| Rate for Payer: Aetna Commercial |
$800.11
|
| Rate for Payer: Aetna Medicare |
$303.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$293.88
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$544.44
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$592.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$348.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$333.70
|
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Centivo All Commercial |
$515.71
|
| Rate for Payer: Cigna All Commercial |
$818.12
|
| Rate for Payer: CORVEL All Commercial |
$881.64
|
| Rate for Payer: Coventry All Commercial |
$834.24
|
| Rate for Payer: Encore All Commercial |
$872.63
|
| Rate for Payer: Frontpath All Commercial |
$872.16
|
| Rate for Payer: Humana ChoiceCare |
$818.79
|
| Rate for Payer: Humana Medicare |
$303.36
|
| Rate for Payer: Lucent All Commercial |
$515.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$853.20
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$711.00
|
| Rate for Payer: PHP All Commercial |
$718.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$369.72
|
| Rate for Payer: Sagamore Health Network All Products |
$731.86
|
| Rate for Payer: Signature Care EPO |
$786.84
|
| Rate for Payer: Signature Care PPO |
$834.24
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$805.80
|
| Rate for Payer: United Healthcare Commercial |
$747.02
|
| Rate for Payer: United Healthcare Medicare |
$303.36
|
|
|
HC DS SCREW 2.4 X 24 LOCK
|
Facility
|
IP
|
$948.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608427
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$711.00 |
| Max. Negotiated Rate |
$881.64 |
| Rate for Payer: Aetna Commercial |
$819.07
|
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Cigna All Commercial |
$818.12
|
| Rate for Payer: CORVEL All Commercial |
$881.64
|
| Rate for Payer: Coventry All Commercial |
$834.24
|
| Rate for Payer: Encore All Commercial |
$872.63
|
| Rate for Payer: Frontpath All Commercial |
$872.16
|
| Rate for Payer: Humana ChoiceCare |
$818.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$853.20
|
| Rate for Payer: PHCS All Commercial |
$711.00
|
| Rate for Payer: PHP All Commercial |
$718.96
|
| Rate for Payer: Sagamore Health Network All Products |
$731.86
|
| Rate for Payer: Signature Care EPO |
$786.84
|
| Rate for Payer: Signature Care PPO |
$834.24
|
| Rate for Payer: United Healthcare Commercial |
$747.02
|
|
|
HC DS SCREW 2.4X26 LOCK VA
|
Facility
|
IP
|
$1,692.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608375
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,269.00 |
| Max. Negotiated Rate |
$1,573.56 |
| Rate for Payer: Aetna Commercial |
$1,461.89
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cigna All Commercial |
$1,460.20
|
| Rate for Payer: CORVEL All Commercial |
$1,573.56
|
| Rate for Payer: Coventry All Commercial |
$1,488.96
|
| Rate for Payer: Encore All Commercial |
$1,557.49
|
| Rate for Payer: Frontpath All Commercial |
$1,556.64
|
| Rate for Payer: Humana ChoiceCare |
$1,461.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,522.80
|
| Rate for Payer: PHCS All Commercial |
$1,269.00
|
| Rate for Payer: PHP All Commercial |
$1,283.21
|
| Rate for Payer: Sagamore Health Network All Products |
$1,306.22
|
| Rate for Payer: Signature Care EPO |
$1,404.36
|
| Rate for Payer: Signature Care PPO |
$1,488.96
|
| Rate for Payer: United Healthcare Commercial |
$1,333.30
|
|
|
HC DS SCREW 2.4X26 LOCK VA
|
Facility
|
OP
|
$1,692.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608375
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$1,573.56 |
| Rate for Payer: Aetna Commercial |
$1,428.05
|
| Rate for Payer: Aetna Medicare |
$541.44
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$524.52
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$971.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,057.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$622.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$595.58
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Centivo All Commercial |
$920.45
|
| Rate for Payer: Cigna All Commercial |
$1,460.20
|
| Rate for Payer: CORVEL All Commercial |
$1,573.56
|
| Rate for Payer: Coventry All Commercial |
$1,488.96
|
| Rate for Payer: Encore All Commercial |
$1,557.49
|
| Rate for Payer: Frontpath All Commercial |
$1,556.64
|
| Rate for Payer: Humana ChoiceCare |
$1,461.38
|
| Rate for Payer: Humana Medicare |
$541.44
|
| Rate for Payer: Lucent All Commercial |
$920.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,522.80
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$1,269.00
|
| Rate for Payer: PHP All Commercial |
$1,283.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$659.88
|
| Rate for Payer: Sagamore Health Network All Products |
$1,306.22
|
| Rate for Payer: Signature Care EPO |
$1,404.36
|
| Rate for Payer: Signature Care PPO |
$1,488.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,438.20
|
| Rate for Payer: United Healthcare Commercial |
$1,333.30
|
| Rate for Payer: United Healthcare Medicare |
$541.44
|
|
|
HC DS SCREW 25 LOCK
|
Facility
|
OP
|
$1,050.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608408
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$976.50 |
| Rate for Payer: Aetna Commercial |
$886.20
|
| Rate for Payer: Aetna Medicare |
$336.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$325.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$603.01
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$656.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$386.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$369.60
|
| Rate for Payer: Cash Price |
$630.00
|
| Rate for Payer: Cash Price |
$630.00
|
| Rate for Payer: Centivo All Commercial |
$571.20
|
| Rate for Payer: Cigna All Commercial |
$906.15
|
| Rate for Payer: CORVEL All Commercial |
$976.50
|
| Rate for Payer: Coventry All Commercial |
$924.00
|
| Rate for Payer: Encore All Commercial |
$966.52
|
| Rate for Payer: Frontpath All Commercial |
$966.00
|
| Rate for Payer: Humana ChoiceCare |
$906.88
|
| Rate for Payer: Humana Medicare |
$336.00
|
| Rate for Payer: Lucent All Commercial |
$571.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$945.00
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$787.50
|
| Rate for Payer: PHP All Commercial |
$796.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$409.50
|
| Rate for Payer: Sagamore Health Network All Products |
$810.60
|
| Rate for Payer: Signature Care EPO |
$871.50
|
| Rate for Payer: Signature Care PPO |
$924.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$892.50
|
| Rate for Payer: United Healthcare Commercial |
$827.40
|
| Rate for Payer: United Healthcare Medicare |
$336.00
|
|
|
HC DS SCREW 25 LOCK
|
Facility
|
IP
|
$1,050.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608408
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$787.50 |
| Max. Negotiated Rate |
$976.50 |
| Rate for Payer: Aetna Commercial |
$907.20
|
| Rate for Payer: Cash Price |
$630.00
|
| Rate for Payer: Cigna All Commercial |
$906.15
|
| Rate for Payer: CORVEL All Commercial |
$976.50
|
| Rate for Payer: Coventry All Commercial |
$924.00
|
| Rate for Payer: Encore All Commercial |
$966.52
|
| Rate for Payer: Frontpath All Commercial |
$966.00
|
| Rate for Payer: Humana ChoiceCare |
$906.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$945.00
|
| Rate for Payer: PHCS All Commercial |
$787.50
|
| Rate for Payer: PHP All Commercial |
$796.32
|
| Rate for Payer: Sagamore Health Network All Products |
$810.60
|
| Rate for Payer: Signature Care EPO |
$871.50
|
| Rate for Payer: Signature Care PPO |
$924.00
|
| Rate for Payer: United Healthcare Commercial |
$827.40
|
|
|
HC DS SCREW 35 LOCK
|
Facility
|
IP
|
$1,050.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608509
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$787.50 |
| Max. Negotiated Rate |
$976.50 |
| Rate for Payer: Aetna Commercial |
$907.20
|
| Rate for Payer: Cash Price |
$630.00
|
| Rate for Payer: Cigna All Commercial |
$906.15
|
| Rate for Payer: CORVEL All Commercial |
$976.50
|
| Rate for Payer: Coventry All Commercial |
$924.00
|
| Rate for Payer: Encore All Commercial |
$966.52
|
| Rate for Payer: Frontpath All Commercial |
$966.00
|
| Rate for Payer: Humana ChoiceCare |
$906.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$945.00
|
| Rate for Payer: PHCS All Commercial |
$787.50
|
| Rate for Payer: PHP All Commercial |
$796.32
|
| Rate for Payer: Sagamore Health Network All Products |
$810.60
|
| Rate for Payer: Signature Care EPO |
$871.50
|
| Rate for Payer: Signature Care PPO |
$924.00
|
| Rate for Payer: United Healthcare Commercial |
$827.40
|
|
|
HC DS SCREW 35 LOCK
|
Facility
|
OP
|
$1,050.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608509
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$976.50 |
| Rate for Payer: Aetna Commercial |
$886.20
|
| Rate for Payer: Aetna Medicare |
$336.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$325.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$603.01
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$656.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$386.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$369.60
|
| Rate for Payer: Cash Price |
$630.00
|
| Rate for Payer: Cash Price |
$630.00
|
| Rate for Payer: Centivo All Commercial |
$571.20
|
| Rate for Payer: Cigna All Commercial |
$906.15
|
| Rate for Payer: CORVEL All Commercial |
$976.50
|
| Rate for Payer: Coventry All Commercial |
$924.00
|
| Rate for Payer: Encore All Commercial |
$966.52
|
| Rate for Payer: Frontpath All Commercial |
$966.00
|
| Rate for Payer: Humana ChoiceCare |
$906.88
|
| Rate for Payer: Humana Medicare |
$336.00
|
| Rate for Payer: Lucent All Commercial |
$571.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$945.00
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$787.50
|
| Rate for Payer: PHP All Commercial |
$796.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$409.50
|
| Rate for Payer: Sagamore Health Network All Products |
$810.60
|
| Rate for Payer: Signature Care EPO |
$871.50
|
| Rate for Payer: Signature Care PPO |
$924.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$892.50
|
| Rate for Payer: United Healthcare Commercial |
$827.40
|
| Rate for Payer: United Healthcare Medicare |
$336.00
|
|
|
HC DS SCREW 5X38 LOCK
|
Facility
|
OP
|
$1,181.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608513
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$1,099.17 |
| Rate for Payer: Aetna Commercial |
$997.52
|
| Rate for Payer: Aetna Medicare |
$378.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$366.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$678.77
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$738.81
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$434.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$416.03
|
| Rate for Payer: Cash Price |
$709.14
|
| Rate for Payer: Cash Price |
$709.14
|
| Rate for Payer: Centivo All Commercial |
$642.95
|
| Rate for Payer: Cigna All Commercial |
$1,019.98
|
| Rate for Payer: CORVEL All Commercial |
$1,099.17
|
| Rate for Payer: Coventry All Commercial |
$1,040.07
|
| Rate for Payer: Encore All Commercial |
$1,087.94
|
| Rate for Payer: Frontpath All Commercial |
$1,087.35
|
| Rate for Payer: Humana ChoiceCare |
$1,020.81
|
| Rate for Payer: Humana Medicare |
$378.21
|
| Rate for Payer: Lucent All Commercial |
$642.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,063.71
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$886.42
|
| Rate for Payer: PHP All Commercial |
$896.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$460.94
|
| Rate for Payer: Sagamore Health Network All Products |
$912.43
|
| Rate for Payer: Signature Care EPO |
$980.98
|
| Rate for Payer: Signature Care PPO |
$1,040.07
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,004.62
|
| Rate for Payer: United Healthcare Commercial |
$931.34
|
| Rate for Payer: United Healthcare Medicare |
$378.21
|
|
|
HC DS SCREW 5X38 LOCK
|
Facility
|
IP
|
$1,181.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608513
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$886.42 |
| Max. Negotiated Rate |
$1,099.17 |
| Rate for Payer: Aetna Commercial |
$1,021.16
|
| Rate for Payer: Cash Price |
$709.14
|
| Rate for Payer: Cigna All Commercial |
$1,019.98
|
| Rate for Payer: CORVEL All Commercial |
$1,099.17
|
| Rate for Payer: Coventry All Commercial |
$1,040.07
|
| Rate for Payer: Encore All Commercial |
$1,087.94
|
| Rate for Payer: Frontpath All Commercial |
$1,087.35
|
| Rate for Payer: Humana ChoiceCare |
$1,020.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,063.71
|
| Rate for Payer: PHCS All Commercial |
$886.42
|
| Rate for Payer: PHP All Commercial |
$896.35
|
| Rate for Payer: Sagamore Health Network All Products |
$912.43
|
| Rate for Payer: Signature Care EPO |
$980.98
|
| Rate for Payer: Signature Care PPO |
$1,040.07
|
| Rate for Payer: United Healthcare Commercial |
$931.34
|
|
|
HC DS SCREW 5X38 XL25 LOCK
|
Facility
|
OP
|
$1,722.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608524
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$1,601.46 |
| Rate for Payer: Aetna Commercial |
$1,453.37
|
| Rate for Payer: Aetna Medicare |
$551.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$533.82
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$988.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,076.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$633.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$606.14
|
| Rate for Payer: Cash Price |
$1,033.20
|
| Rate for Payer: Cash Price |
$1,033.20
|
| Rate for Payer: Centivo All Commercial |
$936.77
|
| Rate for Payer: Cigna All Commercial |
$1,486.09
|
| Rate for Payer: CORVEL All Commercial |
$1,601.46
|
| Rate for Payer: Coventry All Commercial |
$1,515.36
|
| Rate for Payer: Encore All Commercial |
$1,585.10
|
| Rate for Payer: Frontpath All Commercial |
$1,584.24
|
| Rate for Payer: Humana ChoiceCare |
$1,487.29
|
| Rate for Payer: Humana Medicare |
$551.04
|
| Rate for Payer: Lucent All Commercial |
$936.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,549.80
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$1,291.50
|
| Rate for Payer: PHP All Commercial |
$1,305.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$671.58
|
| Rate for Payer: Sagamore Health Network All Products |
$1,329.38
|
| Rate for Payer: Signature Care EPO |
$1,429.26
|
| Rate for Payer: Signature Care PPO |
$1,515.36
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,463.70
|
| Rate for Payer: United Healthcare Commercial |
$1,356.94
|
| Rate for Payer: United Healthcare Medicare |
$551.04
|
|
|
HC DS SCREW 5X38 XL25 LOCK
|
Facility
|
IP
|
$1,722.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608524
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,291.50 |
| Max. Negotiated Rate |
$1,601.46 |
| Rate for Payer: Aetna Commercial |
$1,487.81
|
| Rate for Payer: Cash Price |
$1,033.20
|
| Rate for Payer: Cigna All Commercial |
$1,486.09
|
| Rate for Payer: CORVEL All Commercial |
$1,601.46
|
| Rate for Payer: Coventry All Commercial |
$1,515.36
|
| Rate for Payer: Encore All Commercial |
$1,585.10
|
| Rate for Payer: Frontpath All Commercial |
$1,584.24
|
| Rate for Payer: Humana ChoiceCare |
$1,487.29
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,549.80
|
| Rate for Payer: PHCS All Commercial |
$1,291.50
|
| Rate for Payer: PHP All Commercial |
$1,305.96
|
| Rate for Payer: Sagamore Health Network All Products |
$1,329.38
|
| Rate for Payer: Signature Care EPO |
$1,429.26
|
| Rate for Payer: Signature Care PPO |
$1,515.36
|
| Rate for Payer: United Healthcare Commercial |
$1,356.94
|
|
|
HC DS SCREW 6.0X30 CENTRAL
|
Facility
|
OP
|
$2,000.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608407
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$1,860.00 |
| Rate for Payer: Aetna Commercial |
$1,688.00
|
| Rate for Payer: Aetna Medicare |
$640.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$620.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,148.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,250.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$736.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$704.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Centivo All Commercial |
$1,088.00
|
| Rate for Payer: Cigna All Commercial |
$1,726.00
|
| Rate for Payer: CORVEL All Commercial |
$1,860.00
|
| Rate for Payer: Coventry All Commercial |
$1,760.00
|
| Rate for Payer: Encore All Commercial |
$1,841.00
|
| Rate for Payer: Frontpath All Commercial |
$1,840.00
|
| Rate for Payer: Humana ChoiceCare |
$1,727.40
|
| Rate for Payer: Humana Medicare |
$640.00
|
| Rate for Payer: Lucent All Commercial |
$1,088.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,800.00
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$1,500.00
|
| Rate for Payer: PHP All Commercial |
$1,516.80
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$780.00
|
| Rate for Payer: Sagamore Health Network All Products |
$1,544.00
|
| Rate for Payer: Signature Care EPO |
$1,660.00
|
| Rate for Payer: Signature Care PPO |
$1,760.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,700.00
|
| Rate for Payer: United Healthcare Commercial |
$1,576.00
|
| Rate for Payer: United Healthcare Medicare |
$640.00
|
|
|
HC DS SCREW 6.0X30 CENTRAL
|
Facility
|
IP
|
$2,000.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608407
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,500.00 |
| Max. Negotiated Rate |
$1,860.00 |
| Rate for Payer: Aetna Commercial |
$1,728.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cigna All Commercial |
$1,726.00
|
| Rate for Payer: CORVEL All Commercial |
$1,860.00
|
| Rate for Payer: Coventry All Commercial |
$1,760.00
|
| Rate for Payer: Encore All Commercial |
$1,841.00
|
| Rate for Payer: Frontpath All Commercial |
$1,840.00
|
| Rate for Payer: Humana ChoiceCare |
$1,727.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,800.00
|
| Rate for Payer: PHCS All Commercial |
$1,500.00
|
| Rate for Payer: PHP All Commercial |
$1,516.80
|
| Rate for Payer: Sagamore Health Network All Products |
$1,544.00
|
| Rate for Payer: Signature Care EPO |
$1,660.00
|
| Rate for Payer: Signature Care PPO |
$1,760.00
|
| Rate for Payer: United Healthcare Commercial |
$1,576.00
|
|
|
HC DS SCREW 90 TFNA
|
Facility
|
IP
|
$5,169.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607690
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,877.20 |
| Max. Negotiated Rate |
$4,807.73 |
| Rate for Payer: Aetna Commercial |
$4,466.53
|
| Rate for Payer: Cash Price |
$3,101.76
|
| Rate for Payer: Cigna All Commercial |
$4,461.36
|
| Rate for Payer: CORVEL All Commercial |
$4,807.73
|
| Rate for Payer: Coventry All Commercial |
$4,549.25
|
| Rate for Payer: Encore All Commercial |
$4,758.62
|
| Rate for Payer: Frontpath All Commercial |
$4,756.03
|
| Rate for Payer: Humana ChoiceCare |
$4,464.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,652.64
|
| Rate for Payer: PHCS All Commercial |
$3,877.20
|
| Rate for Payer: PHP All Commercial |
$3,920.62
|
| Rate for Payer: Sagamore Health Network All Products |
$3,990.93
|
| Rate for Payer: Signature Care EPO |
$4,290.77
|
| Rate for Payer: Signature Care PPO |
$4,549.25
|
| Rate for Payer: United Healthcare Commercial |
$4,073.64
|
|
|
HC DS SCREW 90 TFNA
|
Facility
|
OP
|
$5,169.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607690
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$4,807.73 |
| Rate for Payer: Aetna Commercial |
$4,363.14
|
| Rate for Payer: Aetna Medicare |
$1,654.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,602.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$2,968.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,231.52
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,902.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,819.70
|
| Rate for Payer: Cash Price |
$3,101.76
|
| Rate for Payer: Cash Price |
$3,101.76
|
| Rate for Payer: Centivo All Commercial |
$2,812.26
|
| Rate for Payer: Cigna All Commercial |
$4,461.36
|
| Rate for Payer: CORVEL All Commercial |
$4,807.73
|
| Rate for Payer: Coventry All Commercial |
$4,549.25
|
| Rate for Payer: Encore All Commercial |
$4,758.62
|
| Rate for Payer: Frontpath All Commercial |
$4,756.03
|
| Rate for Payer: Humana ChoiceCare |
$4,464.98
|
| Rate for Payer: Humana Medicare |
$1,654.27
|
| Rate for Payer: Lucent All Commercial |
$2,812.26
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,652.64
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$3,877.20
|
| Rate for Payer: PHP All Commercial |
$3,920.62
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,016.14
|
| Rate for Payer: Sagamore Health Network All Products |
$3,990.93
|
| Rate for Payer: Signature Care EPO |
$4,290.77
|
| Rate for Payer: Signature Care PPO |
$4,549.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,394.16
|
| Rate for Payer: United Healthcare Commercial |
$4,073.64
|
| Rate for Payer: United Healthcare Medicare |
$1,654.27
|
|
|
HC DS SCREW 90 TFNA FEN
|
Facility
|
OP
|
$2,968.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608512
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$2,761.03 |
| Rate for Payer: Aetna Commercial |
$2,505.71
|
| Rate for Payer: Aetna Medicare |
$950.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$920.34
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,705.01
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,855.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,092.54
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,045.04
|
| Rate for Payer: Cash Price |
$1,781.31
|
| Rate for Payer: Cash Price |
$1,781.31
|
| Rate for Payer: Centivo All Commercial |
$1,615.05
|
| Rate for Payer: Cigna All Commercial |
$2,562.12
|
| Rate for Payer: CORVEL All Commercial |
$2,761.03
|
| Rate for Payer: Coventry All Commercial |
$2,612.59
|
| Rate for Payer: Encore All Commercial |
$2,732.83
|
| Rate for Payer: Frontpath All Commercial |
$2,731.34
|
| Rate for Payer: Humana ChoiceCare |
$2,564.20
|
| Rate for Payer: Humana Medicare |
$950.03
|
| Rate for Payer: Lucent All Commercial |
$1,615.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,671.97
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$2,226.64
|
| Rate for Payer: PHP All Commercial |
$2,251.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,157.85
|
| Rate for Payer: Sagamore Health Network All Products |
$2,291.95
|
| Rate for Payer: Signature Care EPO |
$2,464.15
|
| Rate for Payer: Signature Care PPO |
$2,612.59
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,523.52
|
| Rate for Payer: United Healthcare Commercial |
$2,339.45
|
| Rate for Payer: United Healthcare Medicare |
$950.03
|
|
