|
HC ACU 3.5X60 NON-LOCK HEX SCREW
|
Facility
OP
|
$410.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602667
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$135.43 |
| Max. Negotiated Rate |
$377.77 |
| Rate for Payer: Aetna Commercial |
$346.38
|
| Rate for Payer: Aetna Medicare |
$135.43
|
| Rate for Payer: Anthem Exchange |
$235.69
|
| Rate for Payer: Anthem Medicare |
$135.43
|
| Rate for Payer: Anthem PPO |
$235.69
|
| Rate for Payer: Anthem Traditional |
$256.54
|
| Rate for Payer: Caresource Just 4 Me |
$155.75
|
| Rate for Payer: Caresource Medicare |
$148.98
|
| Rate for Payer: Centivo/Paragon All Products |
$209.30
|
| Rate for Payer: Cigna All Products |
$354.18
|
| Rate for Payer: Coventry/First Health All Products |
$361.15
|
| Rate for Payer: Encore All Products |
$377.77
|
| Rate for Payer: Frontpath All Products |
$377.57
|
| Rate for Payer: Humana ChoiceCare |
$354.46
|
| Rate for Payer: Humana Medicare |
$209.30
|
| Rate for Payer: Lucent/Coldwater Veneers |
$209.30
|
| Rate for Payer: Lutheran Preferred All Products |
$369.36
|
| Rate for Payer: PHCS/Multiplan All Products |
$307.80
|
| Rate for Payer: PHP All Products |
$311.25
|
| Rate for Payer: Plain Church Group Ministry All Products |
$160.06
|
| Rate for Payer: Sagamore All Products |
$316.83
|
| Rate for Payer: Self Pay/Cash Rate |
$254.45
|
| Rate for Payer: Signature Care EPO |
$340.63
|
| Rate for Payer: Signature Care PPO |
$361.15
|
| Rate for Payer: Three Rivers Preferred All Products |
$348.84
|
| Rate for Payer: United Healthcare Commercial |
$323.40
|
| Rate for Payer: United Healthcare Medicare |
$135.43
|
|
|
HC ACU 3.5X65 LOCK HEX SCREW
|
Facility
IP
|
$792.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602653
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$491.04 |
| Max. Negotiated Rate |
$729.04 |
| Rate for Payer: Aetna Commercial |
$684.29
|
| Rate for Payer: Cigna All Products |
$683.50
|
| Rate for Payer: Coventry/First Health All Products |
$696.96
|
| Rate for Payer: Encore All Products |
$729.04
|
| Rate for Payer: Frontpath All Products |
$728.64
|
| Rate for Payer: Humana ChoiceCare |
$684.05
|
| Rate for Payer: Lutheran Preferred All Products |
$712.80
|
| Rate for Payer: PHCS/Multiplan All Products |
$594.00
|
| Rate for Payer: PHP All Products |
$600.65
|
| Rate for Payer: Sagamore All Products |
$611.42
|
| Rate for Payer: Self Pay/Cash Rate |
$491.04
|
| Rate for Payer: Signature Care EPO |
$657.36
|
| Rate for Payer: Signature Care PPO |
$696.96
|
| Rate for Payer: United Healthcare Commercial |
$624.10
|
|
|
HC ACU 3.5X65 LOCK HEX SCREW
|
Facility
OP
|
$792.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602653
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$261.36 |
| Max. Negotiated Rate |
$729.04 |
| Rate for Payer: Aetna Commercial |
$668.45
|
| Rate for Payer: Aetna Medicare |
$261.36
|
| Rate for Payer: Anthem Exchange |
$454.85
|
| Rate for Payer: Anthem Medicare |
$261.36
|
| Rate for Payer: Anthem PPO |
$454.85
|
| Rate for Payer: Anthem Traditional |
$495.08
|
| Rate for Payer: Caresource Just 4 Me |
$300.56
|
| Rate for Payer: Caresource Medicare |
$287.50
|
| Rate for Payer: Centivo/Paragon All Products |
$403.92
|
| Rate for Payer: Cigna All Products |
$683.50
|
| Rate for Payer: Coventry/First Health All Products |
$696.96
|
| Rate for Payer: Encore All Products |
$729.04
|
| Rate for Payer: Frontpath All Products |
$728.64
|
| Rate for Payer: Humana ChoiceCare |
$684.05
|
| Rate for Payer: Humana Medicare |
$403.92
|
| Rate for Payer: Lucent/Coldwater Veneers |
$403.92
|
| Rate for Payer: Lutheran Preferred All Products |
$712.80
|
| Rate for Payer: PHCS/Multiplan All Products |
$594.00
|
| Rate for Payer: PHP All Products |
$600.65
|
| Rate for Payer: Plain Church Group Ministry All Products |
$308.88
|
| Rate for Payer: Sagamore All Products |
$611.42
|
| Rate for Payer: Self Pay/Cash Rate |
$491.04
|
| Rate for Payer: Signature Care EPO |
$657.36
|
| Rate for Payer: Signature Care PPO |
$696.96
|
| Rate for Payer: Three Rivers Preferred All Products |
$673.20
|
| Rate for Payer: United Healthcare Commercial |
$624.10
|
| Rate for Payer: United Healthcare Medicare |
$261.36
|
|
|
HC ACU 3.5X65 NON-LOCK HEX SCREW
|
Facility
IP
|
$596.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602668
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$369.52 |
| Max. Negotiated Rate |
$548.62 |
| Rate for Payer: Aetna Commercial |
$514.94
|
| Rate for Payer: Cigna All Products |
$514.35
|
| Rate for Payer: Coventry/First Health All Products |
$524.48
|
| Rate for Payer: Encore All Products |
$548.62
|
| Rate for Payer: Frontpath All Products |
$548.32
|
| Rate for Payer: Humana ChoiceCare |
$514.77
|
| Rate for Payer: Lutheran Preferred All Products |
$536.40
|
| Rate for Payer: PHCS/Multiplan All Products |
$447.00
|
| Rate for Payer: PHP All Products |
$452.01
|
| Rate for Payer: Sagamore All Products |
$460.11
|
| Rate for Payer: Self Pay/Cash Rate |
$369.52
|
| Rate for Payer: Signature Care EPO |
$494.68
|
| Rate for Payer: Signature Care PPO |
$524.48
|
| Rate for Payer: United Healthcare Commercial |
$469.65
|
|
|
HC ACU 3.5X65 NON-LOCK HEX SCREW
|
Facility
OP
|
$596.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602668
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$196.68 |
| Max. Negotiated Rate |
$548.62 |
| Rate for Payer: Aetna Commercial |
$503.02
|
| Rate for Payer: Aetna Medicare |
$196.68
|
| Rate for Payer: Anthem Exchange |
$342.28
|
| Rate for Payer: Anthem Medicare |
$196.68
|
| Rate for Payer: Anthem PPO |
$342.28
|
| Rate for Payer: Anthem Traditional |
$372.56
|
| Rate for Payer: Caresource Just 4 Me |
$226.18
|
| Rate for Payer: Caresource Medicare |
$216.35
|
| Rate for Payer: Centivo/Paragon All Products |
$303.96
|
| Rate for Payer: Cigna All Products |
$514.35
|
| Rate for Payer: Coventry/First Health All Products |
$524.48
|
| Rate for Payer: Encore All Products |
$548.62
|
| Rate for Payer: Frontpath All Products |
$548.32
|
| Rate for Payer: Humana ChoiceCare |
$514.77
|
| Rate for Payer: Humana Medicare |
$303.96
|
| Rate for Payer: Lucent/Coldwater Veneers |
$303.96
|
| Rate for Payer: Lutheran Preferred All Products |
$536.40
|
| Rate for Payer: PHCS/Multiplan All Products |
$447.00
|
| Rate for Payer: PHP All Products |
$452.01
|
| Rate for Payer: Plain Church Group Ministry All Products |
$232.44
|
| Rate for Payer: Sagamore All Products |
$460.11
|
| Rate for Payer: Self Pay/Cash Rate |
$369.52
|
| Rate for Payer: Signature Care EPO |
$494.68
|
| Rate for Payer: Signature Care PPO |
$524.48
|
| Rate for Payer: Three Rivers Preferred All Products |
$506.60
|
| Rate for Payer: United Healthcare Commercial |
$469.65
|
| Rate for Payer: United Healthcare Medicare |
$196.68
|
|
|
HC ACU 3.5X70 NON-LOCK HEX SCREW
|
Facility
OP
|
$489.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602669
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$161.57 |
| Max. Negotiated Rate |
$450.68 |
| Rate for Payer: Aetna Commercial |
$413.22
|
| Rate for Payer: Aetna Medicare |
$161.57
|
| Rate for Payer: Anthem Exchange |
$281.18
|
| Rate for Payer: Anthem Medicare |
$161.57
|
| Rate for Payer: Anthem PPO |
$281.18
|
| Rate for Payer: Anthem Traditional |
$306.05
|
| Rate for Payer: Caresource Just 4 Me |
$185.80
|
| Rate for Payer: Caresource Medicare |
$177.72
|
| Rate for Payer: Centivo/Paragon All Products |
$249.70
|
| Rate for Payer: Cigna All Products |
$422.52
|
| Rate for Payer: Coventry/First Health All Products |
$430.85
|
| Rate for Payer: Encore All Products |
$450.68
|
| Rate for Payer: Frontpath All Products |
$450.43
|
| Rate for Payer: Humana ChoiceCare |
$422.87
|
| Rate for Payer: Humana Medicare |
$249.70
|
| Rate for Payer: Lucent/Coldwater Veneers |
$249.70
|
| Rate for Payer: Lutheran Preferred All Products |
$440.64
|
| Rate for Payer: PHCS/Multiplan All Products |
$367.20
|
| Rate for Payer: PHP All Products |
$371.31
|
| Rate for Payer: Plain Church Group Ministry All Products |
$190.94
|
| Rate for Payer: Sagamore All Products |
$377.97
|
| Rate for Payer: Self Pay/Cash Rate |
$303.55
|
| Rate for Payer: Signature Care EPO |
$406.37
|
| Rate for Payer: Signature Care PPO |
$430.85
|
| Rate for Payer: Three Rivers Preferred All Products |
$416.16
|
| Rate for Payer: United Healthcare Commercial |
$385.80
|
| Rate for Payer: United Healthcare Medicare |
$161.57
|
|
|
HC ACU 3.5X70 NON-LOCK HEX SCREW
|
Facility
IP
|
$489.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602669
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$303.55 |
| Max. Negotiated Rate |
$450.68 |
| Rate for Payer: Aetna Commercial |
$423.01
|
| Rate for Payer: Cigna All Products |
$422.52
|
| Rate for Payer: Coventry/First Health All Products |
$430.85
|
| Rate for Payer: Encore All Products |
$450.68
|
| Rate for Payer: Frontpath All Products |
$450.43
|
| Rate for Payer: Humana ChoiceCare |
$422.87
|
| Rate for Payer: Lutheran Preferred All Products |
$440.64
|
| Rate for Payer: PHCS/Multiplan All Products |
$367.20
|
| Rate for Payer: PHP All Products |
$371.31
|
| Rate for Payer: Sagamore All Products |
$377.97
|
| Rate for Payer: Self Pay/Cash Rate |
$303.55
|
| Rate for Payer: Signature Care EPO |
$406.37
|
| Rate for Payer: Signature Care PPO |
$430.85
|
| Rate for Payer: United Healthcare Commercial |
$385.80
|
|
|
HC ACU 3.5X75 NON-LOCK HEX SCREW
|
Facility
IP
|
$489.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602670
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$303.55 |
| Max. Negotiated Rate |
$450.68 |
| Rate for Payer: Aetna Commercial |
$423.01
|
| Rate for Payer: Cigna All Products |
$422.52
|
| Rate for Payer: Coventry/First Health All Products |
$430.85
|
| Rate for Payer: Encore All Products |
$450.68
|
| Rate for Payer: Frontpath All Products |
$450.43
|
| Rate for Payer: Humana ChoiceCare |
$422.87
|
| Rate for Payer: Lutheran Preferred All Products |
$440.64
|
| Rate for Payer: PHCS/Multiplan All Products |
$367.20
|
| Rate for Payer: PHP All Products |
$371.31
|
| Rate for Payer: Sagamore All Products |
$377.97
|
| Rate for Payer: Self Pay/Cash Rate |
$303.55
|
| Rate for Payer: Signature Care EPO |
$406.37
|
| Rate for Payer: Signature Care PPO |
$430.85
|
| Rate for Payer: United Healthcare Commercial |
$385.80
|
|
|
HC ACU 3.5X75 NON-LOCK HEX SCREW
|
Facility
OP
|
$489.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602670
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$161.57 |
| Max. Negotiated Rate |
$450.68 |
| Rate for Payer: Aetna Commercial |
$413.22
|
| Rate for Payer: Aetna Medicare |
$161.57
|
| Rate for Payer: Anthem Exchange |
$281.18
|
| Rate for Payer: Anthem Medicare |
$161.57
|
| Rate for Payer: Anthem PPO |
$281.18
|
| Rate for Payer: Anthem Traditional |
$306.05
|
| Rate for Payer: Caresource Just 4 Me |
$185.80
|
| Rate for Payer: Caresource Medicare |
$177.72
|
| Rate for Payer: Centivo/Paragon All Products |
$249.70
|
| Rate for Payer: Cigna All Products |
$422.52
|
| Rate for Payer: Coventry/First Health All Products |
$430.85
|
| Rate for Payer: Encore All Products |
$450.68
|
| Rate for Payer: Frontpath All Products |
$450.43
|
| Rate for Payer: Humana ChoiceCare |
$422.87
|
| Rate for Payer: Humana Medicare |
$249.70
|
| Rate for Payer: Lucent/Coldwater Veneers |
$249.70
|
| Rate for Payer: Lutheran Preferred All Products |
$440.64
|
| Rate for Payer: PHCS/Multiplan All Products |
$367.20
|
| Rate for Payer: PHP All Products |
$371.31
|
| Rate for Payer: Plain Church Group Ministry All Products |
$190.94
|
| Rate for Payer: Sagamore All Products |
$377.97
|
| Rate for Payer: Self Pay/Cash Rate |
$303.55
|
| Rate for Payer: Signature Care EPO |
$406.37
|
| Rate for Payer: Signature Care PPO |
$430.85
|
| Rate for Payer: Three Rivers Preferred All Products |
$416.16
|
| Rate for Payer: United Healthcare Commercial |
$385.80
|
| Rate for Payer: United Healthcare Medicare |
$161.57
|
|
|
HC ACU 3.5X80 NON-LOCK HEX SCREW
|
Facility
IP
|
$489.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602671
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$303.55 |
| Max. Negotiated Rate |
$450.68 |
| Rate for Payer: Aetna Commercial |
$423.01
|
| Rate for Payer: Cigna All Products |
$422.52
|
| Rate for Payer: Coventry/First Health All Products |
$430.85
|
| Rate for Payer: Encore All Products |
$450.68
|
| Rate for Payer: Frontpath All Products |
$450.43
|
| Rate for Payer: Humana ChoiceCare |
$422.87
|
| Rate for Payer: Lutheran Preferred All Products |
$440.64
|
| Rate for Payer: PHCS/Multiplan All Products |
$367.20
|
| Rate for Payer: PHP All Products |
$371.31
|
| Rate for Payer: Sagamore All Products |
$377.97
|
| Rate for Payer: Self Pay/Cash Rate |
$303.55
|
| Rate for Payer: Signature Care EPO |
$406.37
|
| Rate for Payer: Signature Care PPO |
$430.85
|
| Rate for Payer: United Healthcare Commercial |
$385.80
|
|
|
HC ACU 3.5X80 NON-LOCK HEX SCREW
|
Facility
OP
|
$489.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602671
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$161.57 |
| Max. Negotiated Rate |
$450.68 |
| Rate for Payer: Aetna Commercial |
$413.22
|
| Rate for Payer: Aetna Medicare |
$161.57
|
| Rate for Payer: Anthem Exchange |
$281.18
|
| Rate for Payer: Anthem Medicare |
$161.57
|
| Rate for Payer: Anthem PPO |
$281.18
|
| Rate for Payer: Anthem Traditional |
$306.05
|
| Rate for Payer: Caresource Just 4 Me |
$185.80
|
| Rate for Payer: Caresource Medicare |
$177.72
|
| Rate for Payer: Centivo/Paragon All Products |
$249.70
|
| Rate for Payer: Cigna All Products |
$422.52
|
| Rate for Payer: Coventry/First Health All Products |
$430.85
|
| Rate for Payer: Encore All Products |
$450.68
|
| Rate for Payer: Frontpath All Products |
$450.43
|
| Rate for Payer: Humana ChoiceCare |
$422.87
|
| Rate for Payer: Humana Medicare |
$249.70
|
| Rate for Payer: Lucent/Coldwater Veneers |
$249.70
|
| Rate for Payer: Lutheran Preferred All Products |
$440.64
|
| Rate for Payer: PHCS/Multiplan All Products |
$367.20
|
| Rate for Payer: PHP All Products |
$371.31
|
| Rate for Payer: Plain Church Group Ministry All Products |
$190.94
|
| Rate for Payer: Sagamore All Products |
$377.97
|
| Rate for Payer: Self Pay/Cash Rate |
$303.55
|
| Rate for Payer: Signature Care EPO |
$406.37
|
| Rate for Payer: Signature Care PPO |
$430.85
|
| Rate for Payer: Three Rivers Preferred All Products |
$416.16
|
| Rate for Payer: United Healthcare Commercial |
$385.80
|
| Rate for Payer: United Healthcare Medicare |
$161.57
|
|
|
HC ACU 3.5X8 LOCK HEX SCREW
|
Facility
OP
|
$525.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602826
|
|
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 3.5X8 LOCK HEX SCREW
|
Facility
IP
|
$525.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602826
|
|
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 4.0X10 CAN HEX SCREW
|
Facility
IP
|
$316.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602732
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$196.42 |
| Max. Negotiated Rate |
$291.61 |
| Rate for Payer: Aetna Commercial |
$273.72
|
| Rate for Payer: Cigna All Products |
$273.40
|
| Rate for Payer: Coventry/First Health All Products |
$278.78
|
| Rate for Payer: Encore All Products |
$291.61
|
| Rate for Payer: Frontpath All Products |
$291.46
|
| Rate for Payer: Humana ChoiceCare |
$273.62
|
| Rate for Payer: Lutheran Preferred All Products |
$285.12
|
| Rate for Payer: PHCS/Multiplan All Products |
$237.60
|
| Rate for Payer: PHP All Products |
$240.26
|
| Rate for Payer: Sagamore All Products |
$244.57
|
| Rate for Payer: Self Pay/Cash Rate |
$196.42
|
| Rate for Payer: Signature Care EPO |
$262.94
|
| Rate for Payer: Signature Care PPO |
$278.78
|
| Rate for Payer: United Healthcare Commercial |
$249.64
|
|
|
HC ACU 4.0X10 CAN HEX SCREW
|
Facility
OP
|
$316.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602732
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$104.54 |
| Max. Negotiated Rate |
$291.61 |
| Rate for Payer: Aetna Commercial |
$267.38
|
| Rate for Payer: Aetna Medicare |
$104.54
|
| Rate for Payer: Anthem Exchange |
$181.94
|
| Rate for Payer: Anthem Medicare |
$104.54
|
| Rate for Payer: Anthem PPO |
$181.94
|
| Rate for Payer: Anthem Traditional |
$198.03
|
| Rate for Payer: Caresource Just 4 Me |
$120.23
|
| Rate for Payer: Caresource Medicare |
$115.00
|
| Rate for Payer: Centivo/Paragon All Products |
$161.57
|
| Rate for Payer: Cigna All Products |
$273.40
|
| Rate for Payer: Coventry/First Health All Products |
$278.78
|
| Rate for Payer: Encore All Products |
$291.61
|
| Rate for Payer: Frontpath All Products |
$291.46
|
| Rate for Payer: Humana ChoiceCare |
$273.62
|
| Rate for Payer: Humana Medicare |
$161.57
|
| Rate for Payer: Lucent/Coldwater Veneers |
$161.57
|
| Rate for Payer: Lutheran Preferred All Products |
$285.12
|
| Rate for Payer: PHCS/Multiplan All Products |
$237.60
|
| Rate for Payer: PHP All Products |
$240.26
|
| Rate for Payer: Plain Church Group Ministry All Products |
$123.55
|
| Rate for Payer: Sagamore All Products |
$244.57
|
| Rate for Payer: Self Pay/Cash Rate |
$196.42
|
| Rate for Payer: Signature Care EPO |
$262.94
|
| Rate for Payer: Signature Care PPO |
$278.78
|
| Rate for Payer: Three Rivers Preferred All Products |
$269.28
|
| Rate for Payer: United Healthcare Commercial |
$249.64
|
| Rate for Payer: United Healthcare Medicare |
$104.54
|
|
|
HC ACU 4.0X12 CAN HEX SCREW
|
Facility
IP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602733
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$296.86 |
| Max. Negotiated Rate |
$440.74 |
| Rate for Payer: Aetna Commercial |
$413.68
|
| Rate for Payer: Cigna All Products |
$413.20
|
| Rate for Payer: Coventry/First Health All Products |
$421.34
|
| Rate for Payer: Encore All Products |
$440.74
|
| Rate for Payer: Frontpath All Products |
$440.50
|
| Rate for Payer: Humana ChoiceCare |
$413.54
|
| Rate for Payer: Lutheran Preferred All Products |
$430.92
|
| Rate for Payer: PHCS/Multiplan All Products |
$359.10
|
| Rate for Payer: PHP All Products |
$363.12
|
| Rate for Payer: Sagamore All Products |
$369.63
|
| Rate for Payer: Self Pay/Cash Rate |
$296.86
|
| Rate for Payer: Signature Care EPO |
$397.40
|
| Rate for Payer: Signature Care PPO |
$421.34
|
| Rate for Payer: United Healthcare Commercial |
$377.29
|
|
|
HC ACU 4.0X12 CAN HEX SCREW
|
Facility
OP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602733
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$158.00 |
| Max. Negotiated Rate |
$440.74 |
| Rate for Payer: Aetna Commercial |
$404.11
|
| Rate for Payer: Aetna Medicare |
$158.00
|
| Rate for Payer: Anthem Exchange |
$274.97
|
| Rate for Payer: Anthem Medicare |
$158.00
|
| Rate for Payer: Anthem PPO |
$274.97
|
| Rate for Payer: Anthem Traditional |
$299.30
|
| Rate for Payer: Caresource Just 4 Me |
$181.70
|
| Rate for Payer: Caresource Medicare |
$173.80
|
| Rate for Payer: Centivo/Paragon All Products |
$244.19
|
| Rate for Payer: Cigna All Products |
$413.20
|
| Rate for Payer: Coventry/First Health All Products |
$421.34
|
| Rate for Payer: Encore All Products |
$440.74
|
| Rate for Payer: Frontpath All Products |
$440.50
|
| Rate for Payer: Humana ChoiceCare |
$413.54
|
| Rate for Payer: Humana Medicare |
$244.19
|
| Rate for Payer: Lucent/Coldwater Veneers |
$244.19
|
| Rate for Payer: Lutheran Preferred All Products |
$430.92
|
| Rate for Payer: PHCS/Multiplan All Products |
$359.10
|
| Rate for Payer: PHP All Products |
$363.12
|
| Rate for Payer: Plain Church Group Ministry All Products |
$186.73
|
| Rate for Payer: Sagamore All Products |
$369.63
|
| Rate for Payer: Self Pay/Cash Rate |
$296.86
|
| Rate for Payer: Signature Care EPO |
$397.40
|
| Rate for Payer: Signature Care PPO |
$421.34
|
| Rate for Payer: Three Rivers Preferred All Products |
$406.98
|
| Rate for Payer: United Healthcare Commercial |
$377.29
|
| Rate for Payer: United Healthcare Medicare |
$158.00
|
|
|
HC ACU 4.0X12 PT CAN HXLB SCREW
|
Facility
IP
|
$316.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602749
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$196.42 |
| Max. Negotiated Rate |
$291.61 |
| Rate for Payer: Aetna Commercial |
$273.72
|
| Rate for Payer: Cigna All Products |
$273.40
|
| Rate for Payer: Coventry/First Health All Products |
$278.78
|
| Rate for Payer: Encore All Products |
$291.61
|
| Rate for Payer: Frontpath All Products |
$291.46
|
| Rate for Payer: Humana ChoiceCare |
$273.62
|
| Rate for Payer: Lutheran Preferred All Products |
$285.12
|
| Rate for Payer: PHCS/Multiplan All Products |
$237.60
|
| Rate for Payer: PHP All Products |
$240.26
|
| Rate for Payer: Sagamore All Products |
$244.57
|
| Rate for Payer: Self Pay/Cash Rate |
$196.42
|
| Rate for Payer: Signature Care EPO |
$262.94
|
| Rate for Payer: Signature Care PPO |
$278.78
|
| Rate for Payer: United Healthcare Commercial |
$249.64
|
|
|
HC ACU 4.0X12 PT CAN HXLB SCREW
|
Facility
OP
|
$316.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602749
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$104.54 |
| Max. Negotiated Rate |
$291.61 |
| Rate for Payer: Aetna Commercial |
$267.38
|
| Rate for Payer: Aetna Medicare |
$104.54
|
| Rate for Payer: Anthem Exchange |
$181.94
|
| Rate for Payer: Anthem Medicare |
$104.54
|
| Rate for Payer: Anthem PPO |
$181.94
|
| Rate for Payer: Anthem Traditional |
$198.03
|
| Rate for Payer: Caresource Just 4 Me |
$120.23
|
| Rate for Payer: Caresource Medicare |
$115.00
|
| Rate for Payer: Centivo/Paragon All Products |
$161.57
|
| Rate for Payer: Cigna All Products |
$273.40
|
| Rate for Payer: Coventry/First Health All Products |
$278.78
|
| Rate for Payer: Encore All Products |
$291.61
|
| Rate for Payer: Frontpath All Products |
$291.46
|
| Rate for Payer: Humana ChoiceCare |
$273.62
|
| Rate for Payer: Humana Medicare |
$161.57
|
| Rate for Payer: Lucent/Coldwater Veneers |
$161.57
|
| Rate for Payer: Lutheran Preferred All Products |
$285.12
|
| Rate for Payer: PHCS/Multiplan All Products |
$237.60
|
| Rate for Payer: PHP All Products |
$240.26
|
| Rate for Payer: Plain Church Group Ministry All Products |
$123.55
|
| Rate for Payer: Sagamore All Products |
$244.57
|
| Rate for Payer: Self Pay/Cash Rate |
$196.42
|
| Rate for Payer: Signature Care EPO |
$262.94
|
| Rate for Payer: Signature Care PPO |
$278.78
|
| Rate for Payer: Three Rivers Preferred All Products |
$269.28
|
| Rate for Payer: United Healthcare Commercial |
$249.64
|
| Rate for Payer: United Healthcare Medicare |
$104.54
|
|
|
HC ACU 4.0X14 CAN HEX SCREW
|
Facility
IP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602734
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$296.86 |
| Max. Negotiated Rate |
$440.74 |
| Rate for Payer: Aetna Commercial |
$413.68
|
| Rate for Payer: Cigna All Products |
$413.20
|
| Rate for Payer: Coventry/First Health All Products |
$421.34
|
| Rate for Payer: Encore All Products |
$440.74
|
| Rate for Payer: Frontpath All Products |
$440.50
|
| Rate for Payer: Humana ChoiceCare |
$413.54
|
| Rate for Payer: Lutheran Preferred All Products |
$430.92
|
| Rate for Payer: PHCS/Multiplan All Products |
$359.10
|
| Rate for Payer: PHP All Products |
$363.12
|
| Rate for Payer: Sagamore All Products |
$369.63
|
| Rate for Payer: Self Pay/Cash Rate |
$296.86
|
| Rate for Payer: Signature Care EPO |
$397.40
|
| Rate for Payer: Signature Care PPO |
$421.34
|
| Rate for Payer: United Healthcare Commercial |
$377.29
|
|
|
HC ACU 4.0X14 CAN HEX SCREW
|
Facility
OP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602734
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$158.00 |
| Max. Negotiated Rate |
$440.74 |
| Rate for Payer: Aetna Commercial |
$404.11
|
| Rate for Payer: Aetna Medicare |
$158.00
|
| Rate for Payer: Anthem Exchange |
$274.97
|
| Rate for Payer: Anthem Medicare |
$158.00
|
| Rate for Payer: Anthem PPO |
$274.97
|
| Rate for Payer: Anthem Traditional |
$299.30
|
| Rate for Payer: Caresource Just 4 Me |
$181.70
|
| Rate for Payer: Caresource Medicare |
$173.80
|
| Rate for Payer: Centivo/Paragon All Products |
$244.19
|
| Rate for Payer: Cigna All Products |
$413.20
|
| Rate for Payer: Coventry/First Health All Products |
$421.34
|
| Rate for Payer: Encore All Products |
$440.74
|
| Rate for Payer: Frontpath All Products |
$440.50
|
| Rate for Payer: Humana ChoiceCare |
$413.54
|
| Rate for Payer: Humana Medicare |
$244.19
|
| Rate for Payer: Lucent/Coldwater Veneers |
$244.19
|
| Rate for Payer: Lutheran Preferred All Products |
$430.92
|
| Rate for Payer: PHCS/Multiplan All Products |
$359.10
|
| Rate for Payer: PHP All Products |
$363.12
|
| Rate for Payer: Plain Church Group Ministry All Products |
$186.73
|
| Rate for Payer: Sagamore All Products |
$369.63
|
| Rate for Payer: Self Pay/Cash Rate |
$296.86
|
| Rate for Payer: Signature Care EPO |
$397.40
|
| Rate for Payer: Signature Care PPO |
$421.34
|
| Rate for Payer: Three Rivers Preferred All Products |
$406.98
|
| Rate for Payer: United Healthcare Commercial |
$377.29
|
| Rate for Payer: United Healthcare Medicare |
$158.00
|
|
|
HC ACU 4.0X14 PT CAN HXLB SCREW
|
Facility
IP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602750
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$296.86 |
| Max. Negotiated Rate |
$440.74 |
| Rate for Payer: Aetna Commercial |
$413.68
|
| Rate for Payer: Cigna All Products |
$413.20
|
| Rate for Payer: Coventry/First Health All Products |
$421.34
|
| Rate for Payer: Encore All Products |
$440.74
|
| Rate for Payer: Frontpath All Products |
$440.50
|
| Rate for Payer: Humana ChoiceCare |
$413.54
|
| Rate for Payer: Lutheran Preferred All Products |
$430.92
|
| Rate for Payer: PHCS/Multiplan All Products |
$359.10
|
| Rate for Payer: PHP All Products |
$363.12
|
| Rate for Payer: Sagamore All Products |
$369.63
|
| Rate for Payer: Self Pay/Cash Rate |
$296.86
|
| Rate for Payer: Signature Care EPO |
$397.40
|
| Rate for Payer: Signature Care PPO |
$421.34
|
| Rate for Payer: United Healthcare Commercial |
$377.29
|
|
|
HC ACU 4.0X14 PT CAN HXLB SCREW
|
Facility
OP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602750
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$158.00 |
| Max. Negotiated Rate |
$440.74 |
| Rate for Payer: Aetna Commercial |
$404.11
|
| Rate for Payer: Aetna Medicare |
$158.00
|
| Rate for Payer: Anthem Exchange |
$274.97
|
| Rate for Payer: Anthem Medicare |
$158.00
|
| Rate for Payer: Anthem PPO |
$274.97
|
| Rate for Payer: Anthem Traditional |
$299.30
|
| Rate for Payer: Caresource Just 4 Me |
$181.70
|
| Rate for Payer: Caresource Medicare |
$173.80
|
| Rate for Payer: Centivo/Paragon All Products |
$244.19
|
| Rate for Payer: Cigna All Products |
$413.20
|
| Rate for Payer: Coventry/First Health All Products |
$421.34
|
| Rate for Payer: Encore All Products |
$440.74
|
| Rate for Payer: Frontpath All Products |
$440.50
|
| Rate for Payer: Humana ChoiceCare |
$413.54
|
| Rate for Payer: Humana Medicare |
$244.19
|
| Rate for Payer: Lucent/Coldwater Veneers |
$244.19
|
| Rate for Payer: Lutheran Preferred All Products |
$430.92
|
| Rate for Payer: PHCS/Multiplan All Products |
$359.10
|
| Rate for Payer: PHP All Products |
$363.12
|
| Rate for Payer: Plain Church Group Ministry All Products |
$186.73
|
| Rate for Payer: Sagamore All Products |
$369.63
|
| Rate for Payer: Self Pay/Cash Rate |
$296.86
|
| Rate for Payer: Signature Care EPO |
$397.40
|
| Rate for Payer: Signature Care PPO |
$421.34
|
| Rate for Payer: Three Rivers Preferred All Products |
$406.98
|
| Rate for Payer: United Healthcare Commercial |
$377.29
|
| Rate for Payer: United Healthcare Medicare |
$158.00
|
|
|
HC ACU 4.0X16 CAN HEX SCREW
|
Facility
OP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602735
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$158.00 |
| Max. Negotiated Rate |
$440.74 |
| Rate for Payer: Aetna Commercial |
$404.11
|
| Rate for Payer: Aetna Medicare |
$158.00
|
| Rate for Payer: Anthem Exchange |
$274.97
|
| Rate for Payer: Anthem Medicare |
$158.00
|
| Rate for Payer: Anthem PPO |
$274.97
|
| Rate for Payer: Anthem Traditional |
$299.30
|
| Rate for Payer: Caresource Just 4 Me |
$181.70
|
| Rate for Payer: Caresource Medicare |
$173.80
|
| Rate for Payer: Centivo/Paragon All Products |
$244.19
|
| Rate for Payer: Cigna All Products |
$413.20
|
| Rate for Payer: Coventry/First Health All Products |
$421.34
|
| Rate for Payer: Encore All Products |
$440.74
|
| Rate for Payer: Frontpath All Products |
$440.50
|
| Rate for Payer: Humana ChoiceCare |
$413.54
|
| Rate for Payer: Humana Medicare |
$244.19
|
| Rate for Payer: Lucent/Coldwater Veneers |
$244.19
|
| Rate for Payer: Lutheran Preferred All Products |
$430.92
|
| Rate for Payer: PHCS/Multiplan All Products |
$359.10
|
| Rate for Payer: PHP All Products |
$363.12
|
| Rate for Payer: Plain Church Group Ministry All Products |
$186.73
|
| Rate for Payer: Sagamore All Products |
$369.63
|
| Rate for Payer: Self Pay/Cash Rate |
$296.86
|
| Rate for Payer: Signature Care EPO |
$397.40
|
| Rate for Payer: Signature Care PPO |
$421.34
|
| Rate for Payer: Three Rivers Preferred All Products |
$406.98
|
| Rate for Payer: United Healthcare Commercial |
$377.29
|
| Rate for Payer: United Healthcare Medicare |
$158.00
|
|
|
HC ACU 4.0X16 CAN HEX SCREW
|
Facility
IP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602735
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$296.86 |
| Max. Negotiated Rate |
$440.74 |
| Rate for Payer: Aetna Commercial |
$413.68
|
| Rate for Payer: Cigna All Products |
$413.20
|
| Rate for Payer: Coventry/First Health All Products |
$421.34
|
| Rate for Payer: Encore All Products |
$440.74
|
| Rate for Payer: Frontpath All Products |
$440.50
|
| Rate for Payer: Humana ChoiceCare |
$413.54
|
| Rate for Payer: Lutheran Preferred All Products |
$430.92
|
| Rate for Payer: PHCS/Multiplan All Products |
$359.10
|
| Rate for Payer: PHP All Products |
$363.12
|
| Rate for Payer: Sagamore All Products |
$369.63
|
| Rate for Payer: Self Pay/Cash Rate |
$296.86
|
| Rate for Payer: Signature Care EPO |
$397.40
|
| Rate for Payer: Signature Care PPO |
$421.34
|
| Rate for Payer: United Healthcare Commercial |
$377.29
|
|
