|
HC ACU 2 VDR PR PLT NARR LONG R
|
Facility
OP
|
$2,659.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602882
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$877.47 |
| Max. Negotiated Rate |
$2,447.61 |
| Rate for Payer: Aetna Commercial |
$2,244.20
|
| Rate for Payer: Aetna Medicare |
$877.47
|
| Rate for Payer: Anthem Exchange |
$1,527.06
|
| Rate for Payer: Anthem Medicare |
$877.47
|
| Rate for Payer: Anthem PPO |
$1,527.06
|
| Rate for Payer: Anthem Traditional |
$1,662.14
|
| Rate for Payer: Caresource Just 4 Me |
$1,009.09
|
| Rate for Payer: Caresource Medicare |
$965.22
|
| Rate for Payer: Centivo/Paragon All Products |
$1,356.09
|
| Rate for Payer: Cigna All Products |
$2,294.72
|
| Rate for Payer: Coventry/First Health All Products |
$2,339.92
|
| Rate for Payer: Encore All Products |
$2,447.61
|
| Rate for Payer: Frontpath All Products |
$2,446.28
|
| Rate for Payer: Humana ChoiceCare |
$2,296.58
|
| Rate for Payer: Humana Medicare |
$1,356.09
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,356.09
|
| Rate for Payer: Lutheran Preferred All Products |
$2,393.10
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,994.25
|
| Rate for Payer: PHP All Products |
$2,016.59
|
| Rate for Payer: Plain Church Group Ministry All Products |
$1,037.01
|
| Rate for Payer: Sagamore All Products |
$2,052.75
|
| Rate for Payer: Self Pay/Cash Rate |
$1,648.58
|
| Rate for Payer: Signature Care EPO |
$2,206.97
|
| Rate for Payer: Signature Care PPO |
$2,339.92
|
| Rate for Payer: Three Rivers Preferred All Products |
$2,260.15
|
| Rate for Payer: United Healthcare Commercial |
$2,095.29
|
| Rate for Payer: United Healthcare Medicare |
$877.47
|
|
|
HC ACU 2 VDR PR PLT STD LONG L
|
Facility
OP
|
$2,659.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602879
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$877.47 |
| Max. Negotiated Rate |
$2,447.61 |
| Rate for Payer: Aetna Commercial |
$2,244.20
|
| Rate for Payer: Aetna Medicare |
$877.47
|
| Rate for Payer: Anthem Exchange |
$1,527.06
|
| Rate for Payer: Anthem Medicare |
$877.47
|
| Rate for Payer: Anthem PPO |
$1,527.06
|
| Rate for Payer: Anthem Traditional |
$1,662.14
|
| Rate for Payer: Caresource Just 4 Me |
$1,009.09
|
| Rate for Payer: Caresource Medicare |
$965.22
|
| Rate for Payer: Centivo/Paragon All Products |
$1,356.09
|
| Rate for Payer: Cigna All Products |
$2,294.72
|
| Rate for Payer: Coventry/First Health All Products |
$2,339.92
|
| Rate for Payer: Encore All Products |
$2,447.61
|
| Rate for Payer: Frontpath All Products |
$2,446.28
|
| Rate for Payer: Humana ChoiceCare |
$2,296.58
|
| Rate for Payer: Humana Medicare |
$1,356.09
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,356.09
|
| Rate for Payer: Lutheran Preferred All Products |
$2,393.10
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,994.25
|
| Rate for Payer: PHP All Products |
$2,016.59
|
| Rate for Payer: Plain Church Group Ministry All Products |
$1,037.01
|
| Rate for Payer: Sagamore All Products |
$2,052.75
|
| Rate for Payer: Self Pay/Cash Rate |
$1,648.58
|
| Rate for Payer: Signature Care EPO |
$2,206.97
|
| Rate for Payer: Signature Care PPO |
$2,339.92
|
| Rate for Payer: Three Rivers Preferred All Products |
$2,260.15
|
| Rate for Payer: United Healthcare Commercial |
$2,095.29
|
| Rate for Payer: United Healthcare Medicare |
$877.47
|
|
|
HC ACU 2 VDR PR PLT STD LONG L
|
Facility
IP
|
$2,659.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602879
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,648.58 |
| Max. Negotiated Rate |
$2,447.61 |
| Rate for Payer: Aetna Commercial |
$2,297.38
|
| Rate for Payer: Cigna All Products |
$2,294.72
|
| Rate for Payer: Coventry/First Health All Products |
$2,339.92
|
| Rate for Payer: Encore All Products |
$2,447.61
|
| Rate for Payer: Frontpath All Products |
$2,446.28
|
| Rate for Payer: Humana ChoiceCare |
$2,296.58
|
| Rate for Payer: Lutheran Preferred All Products |
$2,393.10
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,994.25
|
| Rate for Payer: PHP All Products |
$2,016.59
|
| Rate for Payer: Sagamore All Products |
$2,052.75
|
| Rate for Payer: Self Pay/Cash Rate |
$1,648.58
|
| Rate for Payer: Signature Care EPO |
$2,206.97
|
| Rate for Payer: Signature Care PPO |
$2,339.92
|
| Rate for Payer: United Healthcare Commercial |
$2,095.29
|
|
|
HC ACU 2 VDR PR PLT STD LONG R
|
Facility
IP
|
$2,659.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602880
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,648.58 |
| Max. Negotiated Rate |
$2,447.61 |
| Rate for Payer: Aetna Commercial |
$2,297.38
|
| Rate for Payer: Cigna All Products |
$2,294.72
|
| Rate for Payer: Coventry/First Health All Products |
$2,339.92
|
| Rate for Payer: Encore All Products |
$2,447.61
|
| Rate for Payer: Frontpath All Products |
$2,446.28
|
| Rate for Payer: Humana ChoiceCare |
$2,296.58
|
| Rate for Payer: Lutheran Preferred All Products |
$2,393.10
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,994.25
|
| Rate for Payer: PHP All Products |
$2,016.59
|
| Rate for Payer: Sagamore All Products |
$2,052.75
|
| Rate for Payer: Self Pay/Cash Rate |
$1,648.58
|
| Rate for Payer: Signature Care EPO |
$2,206.97
|
| Rate for Payer: Signature Care PPO |
$2,339.92
|
| Rate for Payer: United Healthcare Commercial |
$2,095.29
|
|
|
HC ACU 2 VDR PR PLT STD LONG R
|
Facility
OP
|
$2,659.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602880
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$877.47 |
| Max. Negotiated Rate |
$2,447.61 |
| Rate for Payer: Aetna Commercial |
$2,244.20
|
| Rate for Payer: Aetna Medicare |
$877.47
|
| Rate for Payer: Anthem Exchange |
$1,527.06
|
| Rate for Payer: Anthem Medicare |
$877.47
|
| Rate for Payer: Anthem PPO |
$1,527.06
|
| Rate for Payer: Anthem Traditional |
$1,662.14
|
| Rate for Payer: Caresource Just 4 Me |
$1,009.09
|
| Rate for Payer: Caresource Medicare |
$965.22
|
| Rate for Payer: Centivo/Paragon All Products |
$1,356.09
|
| Rate for Payer: Cigna All Products |
$2,294.72
|
| Rate for Payer: Coventry/First Health All Products |
$2,339.92
|
| Rate for Payer: Encore All Products |
$2,447.61
|
| Rate for Payer: Frontpath All Products |
$2,446.28
|
| Rate for Payer: Humana ChoiceCare |
$2,296.58
|
| Rate for Payer: Humana Medicare |
$1,356.09
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,356.09
|
| Rate for Payer: Lutheran Preferred All Products |
$2,393.10
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,994.25
|
| Rate for Payer: PHP All Products |
$2,016.59
|
| Rate for Payer: Plain Church Group Ministry All Products |
$1,037.01
|
| Rate for Payer: Sagamore All Products |
$2,052.75
|
| Rate for Payer: Self Pay/Cash Rate |
$1,648.58
|
| Rate for Payer: Signature Care EPO |
$2,206.97
|
| Rate for Payer: Signature Care PPO |
$2,339.92
|
| Rate for Payer: Three Rivers Preferred All Products |
$2,260.15
|
| Rate for Payer: United Healthcare Commercial |
$2,095.29
|
| Rate for Payer: United Healthcare Medicare |
$877.47
|
|
|
HC ACU 30 TWIST-TRAK COMP SCREW
|
Facility
OP
|
$894.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602811
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$295.02 |
| Max. Negotiated Rate |
$822.93 |
| Rate for Payer: Signature Care PPO |
$786.72
|
| 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: 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 30 TWIST-TRAK COMP SCREW
|
Facility
IP
|
$894.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602811
|
|
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 3.5 QR SURGIBIT DRILL LAG
|
Facility
IP
|
$556.00
|
|
| Hospital Charge Code |
41602817
|
|
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 3.5 QR SURGIBIT DRILL LAG
|
Facility
OP
|
$556.00
|
|
| Hospital Charge Code |
41602817
|
|
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 3.5X10 LOCK HEX SCREW
|
Facility
OP
|
$525.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602827
|
|
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 3.5X10 LOCK HEX SCREW
|
Facility
IP
|
$525.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602827
|
|
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 3.5X10 NON-LOCK HEX SCREW
|
Facility
OP
|
$313.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602832
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$103.36 |
| Max. Negotiated Rate |
$288.30 |
| Rate for Payer: Signature Care PPO |
$275.62
|
| Rate for Payer: Aetna Commercial |
$264.34
|
| Rate for Payer: Aetna Medicare |
$103.36
|
| Rate for Payer: Anthem Exchange |
$179.87
|
| Rate for Payer: Anthem Medicare |
$103.36
|
| Rate for Payer: Anthem PPO |
$179.87
|
| Rate for Payer: Anthem Traditional |
$195.78
|
| Rate for Payer: Caresource Just 4 Me |
$118.86
|
| Rate for Payer: Caresource Medicare |
$113.69
|
| Rate for Payer: Centivo/Paragon All Products |
$159.73
|
| Rate for Payer: Cigna All Products |
$270.29
|
| Rate for Payer: Coventry/First Health All Products |
$275.62
|
| Rate for Payer: Encore All Products |
$288.30
|
| Rate for Payer: Frontpath All Products |
$288.14
|
| Rate for Payer: Humana ChoiceCare |
$270.51
|
| Rate for Payer: Humana Medicare |
$159.73
|
| Rate for Payer: Lucent/Coldwater Veneers |
$159.73
|
| Rate for Payer: Lutheran Preferred All Products |
$281.88
|
| Rate for Payer: PHCS/Multiplan All Products |
$234.90
|
| Rate for Payer: PHP All Products |
$237.53
|
| Rate for Payer: Plain Church Group Ministry All Products |
$122.15
|
| Rate for Payer: Sagamore All Products |
$241.79
|
| Rate for Payer: Self Pay/Cash Rate |
$194.18
|
| Rate for Payer: Signature Care EPO |
$259.96
|
| Rate for Payer: Three Rivers Preferred All Products |
$266.22
|
| Rate for Payer: United Healthcare Commercial |
$246.80
|
| Rate for Payer: United Healthcare Medicare |
$103.36
|
|
|
HC ACU 3.5X10 NON-LOCK HEX SCREW
|
Facility
IP
|
$313.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602832
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$194.18 |
| Max. Negotiated Rate |
$288.30 |
| Rate for Payer: Aetna Commercial |
$270.60
|
| Rate for Payer: Cigna All Products |
$270.29
|
| Rate for Payer: Coventry/First Health All Products |
$275.62
|
| Rate for Payer: Encore All Products |
$288.30
|
| Rate for Payer: Frontpath All Products |
$288.14
|
| Rate for Payer: Humana ChoiceCare |
$270.51
|
| Rate for Payer: Lutheran Preferred All Products |
$281.88
|
| Rate for Payer: PHCS/Multiplan All Products |
$234.90
|
| Rate for Payer: PHP All Products |
$237.53
|
| Rate for Payer: Sagamore All Products |
$241.79
|
| Rate for Payer: Self Pay/Cash Rate |
$194.18
|
| Rate for Payer: Signature Care EPO |
$259.96
|
| Rate for Payer: Signature Care PPO |
$275.62
|
| Rate for Payer: United Healthcare Commercial |
$246.80
|
|
|
HC ACU 3.5X12 LOCK HEX SCREW
|
Facility
IP
|
$696.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602828
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$431.52 |
| Max. Negotiated Rate |
$640.67 |
| Rate for Payer: Aetna Commercial |
$601.34
|
| Rate for Payer: Cigna All Products |
$600.65
|
| Rate for Payer: Coventry/First Health All Products |
$612.48
|
| Rate for Payer: Encore All Products |
$640.67
|
| Rate for Payer: Frontpath All Products |
$640.32
|
| Rate for Payer: Humana ChoiceCare |
$601.14
|
| Rate for Payer: Lutheran Preferred All Products |
$626.40
|
| Rate for Payer: PHCS/Multiplan All Products |
$522.00
|
| Rate for Payer: PHP All Products |
$527.85
|
| Rate for Payer: Sagamore All Products |
$537.31
|
| Rate for Payer: Self Pay/Cash Rate |
$431.52
|
| Rate for Payer: Signature Care EPO |
$577.68
|
| Rate for Payer: Signature Care PPO |
$612.48
|
| Rate for Payer: United Healthcare Commercial |
$548.45
|
|
|
HC ACU 3.5X12 LOCK HEX SCREW
|
Facility
OP
|
$696.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602828
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.68 |
| Max. Negotiated Rate |
$640.67 |
| Rate for Payer: Aetna Commercial |
$587.42
|
| Rate for Payer: Aetna Medicare |
$229.68
|
| Rate for Payer: Anthem Exchange |
$399.71
|
| Rate for Payer: Anthem Medicare |
$229.68
|
| Rate for Payer: Anthem PPO |
$399.71
|
| Rate for Payer: Anthem Traditional |
$435.07
|
| Rate for Payer: Caresource Just 4 Me |
$264.13
|
| Rate for Payer: Caresource Medicare |
$252.65
|
| Rate for Payer: Centivo/Paragon All Products |
$354.96
|
| Rate for Payer: Cigna All Products |
$600.65
|
| Rate for Payer: Coventry/First Health All Products |
$612.48
|
| Rate for Payer: Encore All Products |
$640.67
|
| Rate for Payer: Frontpath All Products |
$640.32
|
| Rate for Payer: Humana ChoiceCare |
$601.14
|
| Rate for Payer: Humana Medicare |
$354.96
|
| Rate for Payer: Lucent/Coldwater Veneers |
$354.96
|
| Rate for Payer: Lutheran Preferred All Products |
$626.40
|
| Rate for Payer: PHCS/Multiplan All Products |
$522.00
|
| Rate for Payer: PHP All Products |
$527.85
|
| Rate for Payer: Plain Church Group Ministry All Products |
$271.44
|
| Rate for Payer: Sagamore All Products |
$537.31
|
| Rate for Payer: Self Pay/Cash Rate |
$431.52
|
| Rate for Payer: Signature Care EPO |
$577.68
|
| Rate for Payer: Signature Care PPO |
$612.48
|
| Rate for Payer: Three Rivers Preferred All Products |
$591.60
|
| Rate for Payer: United Healthcare Commercial |
$548.45
|
| Rate for Payer: United Healthcare Medicare |
$229.68
|
|
|
HC ACU 3.5X12 NON-LOCK HEX SCREW
|
Facility
OP
|
$313.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602833
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$103.36 |
| Max. Negotiated Rate |
$288.30 |
| Rate for Payer: Aetna Commercial |
$264.34
|
| Rate for Payer: Aetna Medicare |
$103.36
|
| Rate for Payer: Anthem Exchange |
$179.87
|
| Rate for Payer: Anthem Medicare |
$103.36
|
| Rate for Payer: Anthem PPO |
$179.87
|
| Rate for Payer: Anthem Traditional |
$195.78
|
| Rate for Payer: Caresource Just 4 Me |
$118.86
|
| Rate for Payer: Caresource Medicare |
$113.69
|
| Rate for Payer: Centivo/Paragon All Products |
$159.73
|
| Rate for Payer: Cigna All Products |
$270.29
|
| Rate for Payer: Coventry/First Health All Products |
$275.62
|
| Rate for Payer: Encore All Products |
$288.30
|
| Rate for Payer: Frontpath All Products |
$288.14
|
| Rate for Payer: Humana ChoiceCare |
$270.51
|
| Rate for Payer: Humana Medicare |
$159.73
|
| Rate for Payer: Lucent/Coldwater Veneers |
$159.73
|
| Rate for Payer: Lutheran Preferred All Products |
$281.88
|
| Rate for Payer: PHCS/Multiplan All Products |
$234.90
|
| Rate for Payer: PHP All Products |
$237.53
|
| Rate for Payer: Plain Church Group Ministry All Products |
$122.15
|
| Rate for Payer: Sagamore All Products |
$241.79
|
| Rate for Payer: Self Pay/Cash Rate |
$194.18
|
| Rate for Payer: Signature Care EPO |
$259.96
|
| Rate for Payer: Signature Care PPO |
$275.62
|
| Rate for Payer: Three Rivers Preferred All Products |
$266.22
|
| Rate for Payer: United Healthcare Commercial |
$246.80
|
| Rate for Payer: United Healthcare Medicare |
$103.36
|
|
|
HC ACU 3.5X12 NON-LOCK HEX SCREW
|
Facility
IP
|
$313.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602833
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$194.18 |
| Max. Negotiated Rate |
$288.30 |
| Rate for Payer: Aetna Commercial |
$270.60
|
| Rate for Payer: Cigna All Products |
$270.29
|
| Rate for Payer: Coventry/First Health All Products |
$275.62
|
| Rate for Payer: Encore All Products |
$288.30
|
| Rate for Payer: Frontpath All Products |
$288.14
|
| Rate for Payer: Humana ChoiceCare |
$270.51
|
| Rate for Payer: Lutheran Preferred All Products |
$281.88
|
| Rate for Payer: PHCS/Multiplan All Products |
$234.90
|
| Rate for Payer: PHP All Products |
$237.53
|
| Rate for Payer: Sagamore All Products |
$241.79
|
| Rate for Payer: Self Pay/Cash Rate |
$194.18
|
| Rate for Payer: Signature Care EPO |
$259.96
|
| Rate for Payer: Signature Care PPO |
$275.62
|
| Rate for Payer: United Healthcare Commercial |
$246.80
|
|
|
HC ACU 3.5X14 LOCK HEX SCREW
|
Facility
OP
|
$696.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602829
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.68 |
| Max. Negotiated Rate |
$640.67 |
| Rate for Payer: Aetna Commercial |
$587.42
|
| Rate for Payer: Aetna Medicare |
$229.68
|
| Rate for Payer: Anthem Exchange |
$399.71
|
| Rate for Payer: Anthem Medicare |
$229.68
|
| Rate for Payer: Anthem PPO |
$399.71
|
| Rate for Payer: Anthem Traditional |
$435.07
|
| Rate for Payer: Caresource Just 4 Me |
$264.13
|
| Rate for Payer: Caresource Medicare |
$252.65
|
| Rate for Payer: Centivo/Paragon All Products |
$354.96
|
| Rate for Payer: Cigna All Products |
$600.65
|
| Rate for Payer: Coventry/First Health All Products |
$612.48
|
| Rate for Payer: Encore All Products |
$640.67
|
| Rate for Payer: Frontpath All Products |
$640.32
|
| Rate for Payer: Humana ChoiceCare |
$601.14
|
| Rate for Payer: Humana Medicare |
$354.96
|
| Rate for Payer: Lucent/Coldwater Veneers |
$354.96
|
| Rate for Payer: Lutheran Preferred All Products |
$626.40
|
| Rate for Payer: PHCS/Multiplan All Products |
$522.00
|
| Rate for Payer: PHP All Products |
$527.85
|
| Rate for Payer: Plain Church Group Ministry All Products |
$271.44
|
| Rate for Payer: Sagamore All Products |
$537.31
|
| Rate for Payer: Self Pay/Cash Rate |
$431.52
|
| Rate for Payer: Signature Care EPO |
$577.68
|
| Rate for Payer: Signature Care PPO |
$612.48
|
| Rate for Payer: Three Rivers Preferred All Products |
$591.60
|
| Rate for Payer: United Healthcare Commercial |
$548.45
|
| Rate for Payer: United Healthcare Medicare |
$229.68
|
|
|
HC ACU 3.5X14 LOCK HEX SCREW
|
Facility
IP
|
$696.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602829
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$431.52 |
| Max. Negotiated Rate |
$640.67 |
| Rate for Payer: Aetna Commercial |
$601.34
|
| Rate for Payer: Cigna All Products |
$600.65
|
| Rate for Payer: Coventry/First Health All Products |
$612.48
|
| Rate for Payer: Encore All Products |
$640.67
|
| Rate for Payer: Frontpath All Products |
$640.32
|
| Rate for Payer: Humana ChoiceCare |
$601.14
|
| Rate for Payer: Lutheran Preferred All Products |
$626.40
|
| Rate for Payer: PHCS/Multiplan All Products |
$522.00
|
| Rate for Payer: PHP All Products |
$527.85
|
| Rate for Payer: Sagamore All Products |
$537.31
|
| Rate for Payer: Self Pay/Cash Rate |
$431.52
|
| Rate for Payer: Signature Care EPO |
$577.68
|
| Rate for Payer: Signature Care PPO |
$612.48
|
| Rate for Payer: United Healthcare Commercial |
$548.45
|
|
|
HC ACU 3.5X14 NON-LOCK HEX SCREW
|
Facility
IP
|
$313.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602834
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$194.18 |
| Max. Negotiated Rate |
$288.30 |
| Rate for Payer: Aetna Commercial |
$270.60
|
| Rate for Payer: Cigna All Products |
$270.29
|
| Rate for Payer: Coventry/First Health All Products |
$275.62
|
| Rate for Payer: Encore All Products |
$288.30
|
| Rate for Payer: Frontpath All Products |
$288.14
|
| Rate for Payer: Humana ChoiceCare |
$270.51
|
| Rate for Payer: Lutheran Preferred All Products |
$281.88
|
| Rate for Payer: PHCS/Multiplan All Products |
$234.90
|
| Rate for Payer: PHP All Products |
$237.53
|
| Rate for Payer: Sagamore All Products |
$241.79
|
| Rate for Payer: Self Pay/Cash Rate |
$194.18
|
| Rate for Payer: Signature Care EPO |
$259.96
|
| Rate for Payer: Signature Care PPO |
$275.62
|
| Rate for Payer: United Healthcare Commercial |
$246.80
|
|
|
HC ACU 3.5X14 NON-LOCK HEX SCREW
|
Facility
OP
|
$313.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602834
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$103.36 |
| Max. Negotiated Rate |
$288.30 |
| Rate for Payer: Aetna Commercial |
$264.34
|
| Rate for Payer: Aetna Medicare |
$103.36
|
| Rate for Payer: Anthem Exchange |
$179.87
|
| Rate for Payer: Anthem Medicare |
$103.36
|
| Rate for Payer: Anthem PPO |
$179.87
|
| Rate for Payer: Anthem Traditional |
$195.78
|
| Rate for Payer: Caresource Just 4 Me |
$118.86
|
| Rate for Payer: Caresource Medicare |
$113.69
|
| Rate for Payer: Centivo/Paragon All Products |
$159.73
|
| Rate for Payer: Cigna All Products |
$270.29
|
| Rate for Payer: Coventry/First Health All Products |
$275.62
|
| Rate for Payer: Encore All Products |
$288.30
|
| Rate for Payer: Frontpath All Products |
$288.14
|
| Rate for Payer: Humana ChoiceCare |
$270.51
|
| Rate for Payer: Humana Medicare |
$159.73
|
| Rate for Payer: Lucent/Coldwater Veneers |
$159.73
|
| Rate for Payer: Lutheran Preferred All Products |
$281.88
|
| Rate for Payer: PHCS/Multiplan All Products |
$234.90
|
| Rate for Payer: PHP All Products |
$237.53
|
| Rate for Payer: Plain Church Group Ministry All Products |
$122.15
|
| Rate for Payer: Sagamore All Products |
$241.79
|
| Rate for Payer: Self Pay/Cash Rate |
$194.18
|
| Rate for Payer: Signature Care EPO |
$259.96
|
| Rate for Payer: Signature Care PPO |
$275.62
|
| Rate for Payer: Three Rivers Preferred All Products |
$266.22
|
| Rate for Payer: United Healthcare Commercial |
$246.80
|
| Rate for Payer: United Healthcare Medicare |
$103.36
|
|
|
HC ACU 3.5X16 LOCK HEX SCREW
|
Facility
IP
|
$696.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602830
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$431.52 |
| Max. Negotiated Rate |
$640.67 |
| Rate for Payer: Aetna Commercial |
$601.34
|
| Rate for Payer: Cigna All Products |
$600.65
|
| Rate for Payer: Coventry/First Health All Products |
$612.48
|
| Rate for Payer: Encore All Products |
$640.67
|
| Rate for Payer: Frontpath All Products |
$640.32
|
| Rate for Payer: Humana ChoiceCare |
$601.14
|
| Rate for Payer: Lutheran Preferred All Products |
$626.40
|
| Rate for Payer: PHCS/Multiplan All Products |
$522.00
|
| Rate for Payer: PHP All Products |
$527.85
|
| Rate for Payer: Sagamore All Products |
$537.31
|
| Rate for Payer: Self Pay/Cash Rate |
$431.52
|
| Rate for Payer: Signature Care EPO |
$577.68
|
| Rate for Payer: Signature Care PPO |
$612.48
|
| Rate for Payer: United Healthcare Commercial |
$548.45
|
|
|
HC ACU 3.5X16 LOCK HEX SCREW
|
Facility
OP
|
$696.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602830
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$229.68 |
| Max. Negotiated Rate |
$640.67 |
| Rate for Payer: Aetna Commercial |
$587.42
|
| Rate for Payer: Aetna Medicare |
$229.68
|
| Rate for Payer: Anthem Exchange |
$399.71
|
| Rate for Payer: Anthem Medicare |
$229.68
|
| Rate for Payer: Anthem PPO |
$399.71
|
| Rate for Payer: Anthem Traditional |
$435.07
|
| Rate for Payer: Caresource Just 4 Me |
$264.13
|
| Rate for Payer: Caresource Medicare |
$252.65
|
| Rate for Payer: Centivo/Paragon All Products |
$354.96
|
| Rate for Payer: Cigna All Products |
$600.65
|
| Rate for Payer: Coventry/First Health All Products |
$612.48
|
| Rate for Payer: Encore All Products |
$640.67
|
| Rate for Payer: Frontpath All Products |
$640.32
|
| Rate for Payer: Humana ChoiceCare |
$601.14
|
| Rate for Payer: Humana Medicare |
$354.96
|
| Rate for Payer: Lucent/Coldwater Veneers |
$354.96
|
| Rate for Payer: Lutheran Preferred All Products |
$626.40
|
| Rate for Payer: PHCS/Multiplan All Products |
$522.00
|
| Rate for Payer: PHP All Products |
$527.85
|
| Rate for Payer: Plain Church Group Ministry All Products |
$271.44
|
| Rate for Payer: Sagamore All Products |
$537.31
|
| Rate for Payer: Self Pay/Cash Rate |
$431.52
|
| Rate for Payer: Signature Care EPO |
$577.68
|
| Rate for Payer: Signature Care PPO |
$612.48
|
| Rate for Payer: Three Rivers Preferred All Products |
$591.60
|
| Rate for Payer: United Healthcare Commercial |
$548.45
|
| Rate for Payer: United Healthcare Medicare |
$229.68
|
|
|
HC ACU 3.5X16 NON-LOCK HEX SCREW
|
Facility
OP
|
$313.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602835
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$103.36 |
| Max. Negotiated Rate |
$288.30 |
| Rate for Payer: Aetna Commercial |
$264.34
|
| Rate for Payer: Aetna Medicare |
$103.36
|
| Rate for Payer: Anthem Exchange |
$179.87
|
| Rate for Payer: Anthem Medicare |
$103.36
|
| Rate for Payer: Anthem PPO |
$179.87
|
| Rate for Payer: Anthem Traditional |
$195.78
|
| Rate for Payer: Caresource Just 4 Me |
$118.86
|
| Rate for Payer: Caresource Medicare |
$113.69
|
| Rate for Payer: Centivo/Paragon All Products |
$159.73
|
| Rate for Payer: Cigna All Products |
$270.29
|
| Rate for Payer: Coventry/First Health All Products |
$275.62
|
| Rate for Payer: Encore All Products |
$288.30
|
| Rate for Payer: Frontpath All Products |
$288.14
|
| Rate for Payer: Humana ChoiceCare |
$270.51
|
| Rate for Payer: Humana Medicare |
$159.73
|
| Rate for Payer: Lucent/Coldwater Veneers |
$159.73
|
| Rate for Payer: Lutheran Preferred All Products |
$281.88
|
| Rate for Payer: PHCS/Multiplan All Products |
$234.90
|
| Rate for Payer: PHP All Products |
$237.53
|
| Rate for Payer: Plain Church Group Ministry All Products |
$122.15
|
| Rate for Payer: Sagamore All Products |
$241.79
|
| Rate for Payer: Self Pay/Cash Rate |
$194.18
|
| Rate for Payer: Signature Care EPO |
$259.96
|
| Rate for Payer: Signature Care PPO |
$275.62
|
| Rate for Payer: Three Rivers Preferred All Products |
$266.22
|
| Rate for Payer: United Healthcare Commercial |
$246.80
|
| Rate for Payer: United Healthcare Medicare |
$103.36
|
|
|
HC ACU 3.5X16 NON-LOCK HEX SCREW
|
Facility
IP
|
$313.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602835
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$194.18 |
| Max. Negotiated Rate |
$288.30 |
| Rate for Payer: Aetna Commercial |
$270.60
|
| Rate for Payer: Cigna All Products |
$270.29
|
| Rate for Payer: Coventry/First Health All Products |
$275.62
|
| Rate for Payer: Encore All Products |
$288.30
|
| Rate for Payer: Frontpath All Products |
$288.14
|
| Rate for Payer: Humana ChoiceCare |
$270.51
|
| Rate for Payer: Lutheran Preferred All Products |
$281.88
|
| Rate for Payer: PHCS/Multiplan All Products |
$234.90
|
| Rate for Payer: PHP All Products |
$237.53
|
| Rate for Payer: Sagamore All Products |
$241.79
|
| Rate for Payer: Self Pay/Cash Rate |
$194.18
|
| Rate for Payer: Signature Care EPO |
$259.96
|
| Rate for Payer: Signature Care PPO |
$275.62
|
| Rate for Payer: United Healthcare Commercial |
$246.80
|
|
