|
HC ACU 4.0X16 PT CAN HXLB SCREW
|
Facility
OP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602751
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$158.00 |
| Max. Negotiated Rate |
$440.74 |
| Rate for Payer: Signature Care PPO |
$421.34
|
| 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: 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 PT CAN HXLB SCREW
|
Facility
IP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602751
|
|
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 4.0X18 CAN HEX SCREW
|
Facility
OP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602736
|
|
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 4.0X18 CAN HEX SCREW
|
Facility
IP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602736
|
|
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 4.0X18 PT CAN HXLB SCREW
|
Facility
IP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602752
|
|
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 4.0X18 PT CAN HXLB SCREW
|
Facility
OP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602752
|
|
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 4.0X20 CAN HEX SCREW
|
Facility
OP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602737
|
|
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 4.0X20 CAN HEX SCREW
|
Facility
IP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602737
|
|
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 4.0X20 PT CAN HXLB SCREW
|
Facility
OP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602753
|
|
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 4.0X20 PT CAN HXLB SCREW
|
Facility
IP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602753
|
|
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 4.0X22 CAN HEX SCREW
|
Facility
OP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602738
|
|
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 4.0X22 CAN HEX SCREW
|
Facility
IP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602738
|
|
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 4.0X22 PT CAN HXLB SCREW
|
Facility
IP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602754
|
|
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 4.0X22 PT CAN HXLB SCREW
|
Facility
OP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602754
|
|
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 4.0X24 CAN HEX SCREW
|
Facility
OP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602739
|
|
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 4.0X24 CAN HEX SCREW
|
Facility
IP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602739
|
|
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 4.0X24 PT CAN HXLB SCREW
|
Facility
OP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602755
|
|
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 4.0X24 PT CAN HXLB SCREW
|
Facility
IP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602755
|
|
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 4.0X26 CAN HEX SCREW
|
Facility
IP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602740
|
|
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 4.0X26 CAN HEX SCREW
|
Facility
OP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602740
|
|
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 4.0X26 PT CAN HXLB SCREW
|
Facility
OP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602756
|
|
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 4.0X26 PT CAN HXLB SCREW
|
Facility
IP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602756
|
|
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 4.0X28 CAN HEX SCREW
|
Facility
IP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602741
|
|
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 4.0X28 CAN HEX SCREW
|
Facility
OP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602741
|
|
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 4.0X28 PT CAN HXLB SCREW
|
Facility
OP
|
$478.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602757
|
|
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
|
|
