|
HC ACU 4.0X50 PT CAN HXLB SCREW
|
Facility
IP
|
$570.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602762
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$353.40 |
| Max. Negotiated Rate |
$524.68 |
| Rate for Payer: Aetna Commercial |
$492.48
|
| Rate for Payer: Cigna All Products |
$491.91
|
| Rate for Payer: Coventry/First Health All Products |
$501.60
|
| Rate for Payer: Encore All Products |
$524.68
|
| Rate for Payer: Frontpath All Products |
$524.40
|
| Rate for Payer: Humana ChoiceCare |
$492.31
|
| Rate for Payer: Lutheran Preferred All Products |
$513.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$427.50
|
| Rate for Payer: PHP All Products |
$432.29
|
| Rate for Payer: Sagamore All Products |
$440.04
|
| Rate for Payer: Self Pay/Cash Rate |
$353.40
|
| Rate for Payer: Signature Care EPO |
$473.10
|
| Rate for Payer: Signature Care PPO |
$501.60
|
| Rate for Payer: United Healthcare Commercial |
$449.16
|
|
|
HC ACU 4.0X50 PT CAN HXLB SCREW
|
Facility
OP
|
$570.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602762
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.10 |
| Max. Negotiated Rate |
$524.68 |
| Rate for Payer: Aetna Commercial |
$481.08
|
| Rate for Payer: Aetna Medicare |
$188.10
|
| Rate for Payer: Anthem Exchange |
$327.35
|
| Rate for Payer: Anthem Medicare |
$188.10
|
| Rate for Payer: Anthem PPO |
$327.35
|
| Rate for Payer: Anthem Traditional |
$356.31
|
| Rate for Payer: Caresource Just 4 Me |
$216.31
|
| Rate for Payer: Caresource Medicare |
$206.91
|
| Rate for Payer: Centivo/Paragon All Products |
$290.70
|
| Rate for Payer: Cigna All Products |
$491.91
|
| Rate for Payer: Coventry/First Health All Products |
$501.60
|
| Rate for Payer: Encore All Products |
$524.68
|
| Rate for Payer: Frontpath All Products |
$524.40
|
| Rate for Payer: Humana ChoiceCare |
$492.31
|
| Rate for Payer: Humana Medicare |
$290.70
|
| Rate for Payer: Lucent/Coldwater Veneers |
$290.70
|
| Rate for Payer: Lutheran Preferred All Products |
$513.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$427.50
|
| Rate for Payer: PHP All Products |
$432.29
|
| Rate for Payer: Plain Church Group Ministry All Products |
$222.30
|
| Rate for Payer: Sagamore All Products |
$440.04
|
| Rate for Payer: Self Pay/Cash Rate |
$353.40
|
| Rate for Payer: Signature Care EPO |
$473.10
|
| Rate for Payer: Signature Care PPO |
$501.60
|
| Rate for Payer: Three Rivers Preferred All Products |
$484.50
|
| Rate for Payer: United Healthcare Commercial |
$449.16
|
| Rate for Payer: United Healthcare Medicare |
$188.10
|
|
|
HC ACU 4.0X55 CAN HEX SCREW
|
Facility
OP
|
$570.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602747
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.10 |
| Max. Negotiated Rate |
$524.68 |
| Rate for Payer: Aetna Commercial |
$481.08
|
| Rate for Payer: Aetna Medicare |
$188.10
|
| Rate for Payer: Anthem Exchange |
$327.35
|
| Rate for Payer: Anthem Medicare |
$188.10
|
| Rate for Payer: Anthem PPO |
$327.35
|
| Rate for Payer: Anthem Traditional |
$356.31
|
| Rate for Payer: Caresource Just 4 Me |
$216.31
|
| Rate for Payer: Caresource Medicare |
$206.91
|
| Rate for Payer: Centivo/Paragon All Products |
$290.70
|
| Rate for Payer: Cigna All Products |
$491.91
|
| Rate for Payer: Coventry/First Health All Products |
$501.60
|
| Rate for Payer: Encore All Products |
$524.68
|
| Rate for Payer: Frontpath All Products |
$524.40
|
| Rate for Payer: Humana ChoiceCare |
$492.31
|
| Rate for Payer: Humana Medicare |
$290.70
|
| Rate for Payer: Lucent/Coldwater Veneers |
$290.70
|
| Rate for Payer: Lutheran Preferred All Products |
$513.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$427.50
|
| Rate for Payer: PHP All Products |
$432.29
|
| Rate for Payer: Plain Church Group Ministry All Products |
$222.30
|
| Rate for Payer: Sagamore All Products |
$440.04
|
| Rate for Payer: Self Pay/Cash Rate |
$353.40
|
| Rate for Payer: Signature Care EPO |
$473.10
|
| Rate for Payer: Signature Care PPO |
$501.60
|
| Rate for Payer: Three Rivers Preferred All Products |
$484.50
|
| Rate for Payer: United Healthcare Commercial |
$449.16
|
| Rate for Payer: United Healthcare Medicare |
$188.10
|
|
|
HC ACU 4.0X55 CAN HEX SCREW
|
Facility
IP
|
$570.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602747
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$353.40 |
| Max. Negotiated Rate |
$524.68 |
| Rate for Payer: Aetna Commercial |
$492.48
|
| Rate for Payer: Cigna All Products |
$491.91
|
| Rate for Payer: Coventry/First Health All Products |
$501.60
|
| Rate for Payer: Encore All Products |
$524.68
|
| Rate for Payer: Frontpath All Products |
$524.40
|
| Rate for Payer: Humana ChoiceCare |
$492.31
|
| Rate for Payer: Lutheran Preferred All Products |
$513.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$427.50
|
| Rate for Payer: PHP All Products |
$432.29
|
| Rate for Payer: Sagamore All Products |
$440.04
|
| Rate for Payer: Self Pay/Cash Rate |
$353.40
|
| Rate for Payer: Signature Care EPO |
$473.10
|
| Rate for Payer: Signature Care PPO |
$501.60
|
| Rate for Payer: United Healthcare Commercial |
$449.16
|
|
|
HC ACU 4.0X55 PT CAN HXLB SCREW
|
Facility
OP
|
$570.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602763
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.10 |
| Max. Negotiated Rate |
$524.68 |
| Rate for Payer: Aetna Commercial |
$481.08
|
| Rate for Payer: Aetna Medicare |
$188.10
|
| Rate for Payer: Anthem Exchange |
$327.35
|
| Rate for Payer: Anthem Medicare |
$188.10
|
| Rate for Payer: Anthem PPO |
$327.35
|
| Rate for Payer: Anthem Traditional |
$356.31
|
| Rate for Payer: Caresource Just 4 Me |
$216.31
|
| Rate for Payer: Caresource Medicare |
$206.91
|
| Rate for Payer: Centivo/Paragon All Products |
$290.70
|
| Rate for Payer: Cigna All Products |
$491.91
|
| Rate for Payer: Coventry/First Health All Products |
$501.60
|
| Rate for Payer: Encore All Products |
$524.68
|
| Rate for Payer: Frontpath All Products |
$524.40
|
| Rate for Payer: Humana ChoiceCare |
$492.31
|
| Rate for Payer: Humana Medicare |
$290.70
|
| Rate for Payer: Lucent/Coldwater Veneers |
$290.70
|
| Rate for Payer: Lutheran Preferred All Products |
$513.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$427.50
|
| Rate for Payer: PHP All Products |
$432.29
|
| Rate for Payer: Plain Church Group Ministry All Products |
$222.30
|
| Rate for Payer: Sagamore All Products |
$440.04
|
| Rate for Payer: Self Pay/Cash Rate |
$353.40
|
| Rate for Payer: Signature Care EPO |
$473.10
|
| Rate for Payer: Signature Care PPO |
$501.60
|
| Rate for Payer: Three Rivers Preferred All Products |
$484.50
|
| Rate for Payer: United Healthcare Commercial |
$449.16
|
| Rate for Payer: United Healthcare Medicare |
$188.10
|
|
|
HC ACU 4.0X55 PT CAN HXLB SCREW
|
Facility
IP
|
$570.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602763
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$353.40 |
| Max. Negotiated Rate |
$524.68 |
| Rate for Payer: Aetna Commercial |
$492.48
|
| Rate for Payer: Cigna All Products |
$491.91
|
| Rate for Payer: Coventry/First Health All Products |
$501.60
|
| Rate for Payer: Encore All Products |
$524.68
|
| Rate for Payer: Frontpath All Products |
$524.40
|
| Rate for Payer: Humana ChoiceCare |
$492.31
|
| Rate for Payer: Lutheran Preferred All Products |
$513.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$427.50
|
| Rate for Payer: PHP All Products |
$432.29
|
| Rate for Payer: Sagamore All Products |
$440.04
|
| Rate for Payer: Self Pay/Cash Rate |
$353.40
|
| Rate for Payer: Signature Care EPO |
$473.10
|
| Rate for Payer: Signature Care PPO |
$501.60
|
| Rate for Payer: United Healthcare Commercial |
$449.16
|
|
|
HC ACU 4.0X60 CAN HEX SCREW
|
Facility
IP
|
$570.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602748
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$353.40 |
| Max. Negotiated Rate |
$524.68 |
| Rate for Payer: Aetna Commercial |
$492.48
|
| Rate for Payer: Cigna All Products |
$491.91
|
| Rate for Payer: Coventry/First Health All Products |
$501.60
|
| Rate for Payer: Encore All Products |
$524.68
|
| Rate for Payer: Frontpath All Products |
$524.40
|
| Rate for Payer: Humana ChoiceCare |
$492.31
|
| Rate for Payer: Lutheran Preferred All Products |
$513.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$427.50
|
| Rate for Payer: PHP All Products |
$432.29
|
| Rate for Payer: Sagamore All Products |
$440.04
|
| Rate for Payer: Self Pay/Cash Rate |
$353.40
|
| Rate for Payer: Signature Care EPO |
$473.10
|
| Rate for Payer: Signature Care PPO |
$501.60
|
| Rate for Payer: United Healthcare Commercial |
$449.16
|
|
|
HC ACU 4.0X60 CAN HEX SCREW
|
Facility
OP
|
$570.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602748
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.10 |
| Max. Negotiated Rate |
$524.68 |
| Rate for Payer: Aetna Commercial |
$481.08
|
| Rate for Payer: Aetna Medicare |
$188.10
|
| Rate for Payer: Anthem Exchange |
$327.35
|
| Rate for Payer: Anthem Medicare |
$188.10
|
| Rate for Payer: Anthem PPO |
$327.35
|
| Rate for Payer: Anthem Traditional |
$356.31
|
| Rate for Payer: Caresource Just 4 Me |
$216.31
|
| Rate for Payer: Caresource Medicare |
$206.91
|
| Rate for Payer: Centivo/Paragon All Products |
$290.70
|
| Rate for Payer: Cigna All Products |
$491.91
|
| Rate for Payer: Coventry/First Health All Products |
$501.60
|
| Rate for Payer: Encore All Products |
$524.68
|
| Rate for Payer: Frontpath All Products |
$524.40
|
| Rate for Payer: Humana ChoiceCare |
$492.31
|
| Rate for Payer: Humana Medicare |
$290.70
|
| Rate for Payer: Lucent/Coldwater Veneers |
$290.70
|
| Rate for Payer: Lutheran Preferred All Products |
$513.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$427.50
|
| Rate for Payer: PHP All Products |
$432.29
|
| Rate for Payer: Plain Church Group Ministry All Products |
$222.30
|
| Rate for Payer: Sagamore All Products |
$440.04
|
| Rate for Payer: Self Pay/Cash Rate |
$353.40
|
| Rate for Payer: Signature Care EPO |
$473.10
|
| Rate for Payer: Signature Care PPO |
$501.60
|
| Rate for Payer: Three Rivers Preferred All Products |
$484.50
|
| Rate for Payer: United Healthcare Commercial |
$449.16
|
| Rate for Payer: United Healthcare Medicare |
$188.10
|
|
|
HC ACU 4.0X60 PT CAN HXLB SCREW
|
Facility
OP
|
$570.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602764
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.10 |
| Max. Negotiated Rate |
$524.68 |
| Rate for Payer: Aetna Commercial |
$481.08
|
| Rate for Payer: Aetna Medicare |
$188.10
|
| Rate for Payer: Anthem Exchange |
$327.35
|
| Rate for Payer: Anthem Medicare |
$188.10
|
| Rate for Payer: Anthem PPO |
$327.35
|
| Rate for Payer: Anthem Traditional |
$356.31
|
| Rate for Payer: Caresource Just 4 Me |
$216.31
|
| Rate for Payer: Caresource Medicare |
$206.91
|
| Rate for Payer: Centivo/Paragon All Products |
$290.70
|
| Rate for Payer: Cigna All Products |
$491.91
|
| Rate for Payer: Coventry/First Health All Products |
$501.60
|
| Rate for Payer: Encore All Products |
$524.68
|
| Rate for Payer: Frontpath All Products |
$524.40
|
| Rate for Payer: Humana ChoiceCare |
$492.31
|
| Rate for Payer: Humana Medicare |
$290.70
|
| Rate for Payer: Lucent/Coldwater Veneers |
$290.70
|
| Rate for Payer: Lutheran Preferred All Products |
$513.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$427.50
|
| Rate for Payer: PHP All Products |
$432.29
|
| Rate for Payer: Plain Church Group Ministry All Products |
$222.30
|
| Rate for Payer: Sagamore All Products |
$440.04
|
| Rate for Payer: Self Pay/Cash Rate |
$353.40
|
| Rate for Payer: Signature Care EPO |
$473.10
|
| Rate for Payer: Signature Care PPO |
$501.60
|
| Rate for Payer: Three Rivers Preferred All Products |
$484.50
|
| Rate for Payer: United Healthcare Commercial |
$449.16
|
| Rate for Payer: United Healthcare Medicare |
$188.10
|
|
|
HC ACU 4.0X60 PT CAN HXLB SCREW
|
Facility
IP
|
$570.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602764
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$353.40 |
| Max. Negotiated Rate |
$524.68 |
| Rate for Payer: Aetna Commercial |
$492.48
|
| Rate for Payer: Cigna All Products |
$491.91
|
| Rate for Payer: Coventry/First Health All Products |
$501.60
|
| Rate for Payer: Encore All Products |
$524.68
|
| Rate for Payer: Frontpath All Products |
$524.40
|
| Rate for Payer: Humana ChoiceCare |
$492.31
|
| Rate for Payer: Lutheran Preferred All Products |
$513.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$427.50
|
| Rate for Payer: PHP All Products |
$432.29
|
| Rate for Payer: Sagamore All Products |
$440.04
|
| Rate for Payer: Self Pay/Cash Rate |
$353.40
|
| Rate for Payer: Signature Care EPO |
$473.10
|
| Rate for Payer: Signature Care PPO |
$501.60
|
| Rate for Payer: United Healthcare Commercial |
$449.16
|
|
|
HC ACU 70 TENSION BAND PIN
|
Facility
OP
|
$327.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602637
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$108.11 |
| Max. Negotiated Rate |
$301.56 |
| Rate for Payer: Aetna Commercial |
$276.49
|
| Rate for Payer: Aetna Medicare |
$108.11
|
| Rate for Payer: Anthem Exchange |
$188.14
|
| Rate for Payer: Anthem Medicare |
$108.11
|
| Rate for Payer: Anthem PPO |
$188.14
|
| Rate for Payer: Anthem Traditional |
$204.78
|
| Rate for Payer: Caresource Just 4 Me |
$124.32
|
| Rate for Payer: Caresource Medicare |
$118.92
|
| Rate for Payer: Centivo/Paragon All Products |
$167.08
|
| Rate for Payer: Cigna All Products |
$282.72
|
| Rate for Payer: Coventry/First Health All Products |
$288.29
|
| Rate for Payer: Encore All Products |
$301.56
|
| Rate for Payer: Frontpath All Products |
$301.39
|
| Rate for Payer: Humana ChoiceCare |
$282.95
|
| Rate for Payer: Humana Medicare |
$167.08
|
| Rate for Payer: Lucent/Coldwater Veneers |
$167.08
|
| Rate for Payer: Lutheran Preferred All Products |
$294.84
|
| Rate for Payer: PHCS/Multiplan All Products |
$245.70
|
| Rate for Payer: PHP All Products |
$248.45
|
| Rate for Payer: Plain Church Group Ministry All Products |
$127.76
|
| Rate for Payer: Sagamore All Products |
$252.91
|
| Rate for Payer: Self Pay/Cash Rate |
$203.11
|
| Rate for Payer: Signature Care EPO |
$271.91
|
| Rate for Payer: Signature Care PPO |
$288.29
|
| Rate for Payer: Three Rivers Preferred All Products |
$278.46
|
| Rate for Payer: United Healthcare Commercial |
$258.15
|
| Rate for Payer: United Healthcare Medicare |
$108.11
|
|
|
HC ACU 70 TENSION BAND PIN
|
Facility
IP
|
$327.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602637
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$203.11 |
| Max. Negotiated Rate |
$301.56 |
| Rate for Payer: Aetna Commercial |
$283.05
|
| Rate for Payer: Cigna All Products |
$282.72
|
| Rate for Payer: Coventry/First Health All Products |
$288.29
|
| Rate for Payer: Encore All Products |
$301.56
|
| Rate for Payer: Frontpath All Products |
$301.39
|
| Rate for Payer: Humana ChoiceCare |
$282.95
|
| Rate for Payer: Lutheran Preferred All Products |
$294.84
|
| Rate for Payer: PHCS/Multiplan All Products |
$245.70
|
| Rate for Payer: PHP All Products |
$248.45
|
| Rate for Payer: Sagamore All Products |
$252.91
|
| Rate for Payer: Self Pay/Cash Rate |
$203.11
|
| Rate for Payer: Signature Care EPO |
$271.91
|
| Rate for Payer: Signature Care PPO |
$288.29
|
| Rate for Payer: United Healthcare Commercial |
$258.15
|
|
|
HC ACU 90 TENSION BAND PIN
|
Facility
IP
|
$327.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602638
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$203.11 |
| Max. Negotiated Rate |
$301.56 |
| Rate for Payer: Aetna Commercial |
$283.05
|
| Rate for Payer: Cigna All Products |
$282.72
|
| Rate for Payer: Coventry/First Health All Products |
$288.29
|
| Rate for Payer: Encore All Products |
$301.56
|
| Rate for Payer: Frontpath All Products |
$301.39
|
| Rate for Payer: Humana ChoiceCare |
$282.95
|
| Rate for Payer: Lutheran Preferred All Products |
$294.84
|
| Rate for Payer: PHCS/Multiplan All Products |
$245.70
|
| Rate for Payer: PHP All Products |
$248.45
|
| Rate for Payer: Sagamore All Products |
$252.91
|
| Rate for Payer: Self Pay/Cash Rate |
$203.11
|
| Rate for Payer: Signature Care EPO |
$271.91
|
| Rate for Payer: Signature Care PPO |
$288.29
|
| Rate for Payer: United Healthcare Commercial |
$258.15
|
|
|
HC ACU 90 TENSION BAND PIN
|
Facility
OP
|
$327.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602638
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$108.11 |
| Max. Negotiated Rate |
$301.56 |
| Rate for Payer: Aetna Commercial |
$276.49
|
| Rate for Payer: Aetna Medicare |
$108.11
|
| Rate for Payer: Anthem Exchange |
$188.14
|
| Rate for Payer: Anthem Medicare |
$108.11
|
| Rate for Payer: Anthem PPO |
$188.14
|
| Rate for Payer: Anthem Traditional |
$204.78
|
| Rate for Payer: Caresource Just 4 Me |
$124.32
|
| Rate for Payer: Caresource Medicare |
$118.92
|
| Rate for Payer: Centivo/Paragon All Products |
$167.08
|
| Rate for Payer: Cigna All Products |
$282.72
|
| Rate for Payer: Coventry/First Health All Products |
$288.29
|
| Rate for Payer: Encore All Products |
$301.56
|
| Rate for Payer: Frontpath All Products |
$301.39
|
| Rate for Payer: Humana ChoiceCare |
$282.95
|
| Rate for Payer: Humana Medicare |
$167.08
|
| Rate for Payer: Lucent/Coldwater Veneers |
$167.08
|
| Rate for Payer: Lutheran Preferred All Products |
$294.84
|
| Rate for Payer: PHCS/Multiplan All Products |
$245.70
|
| Rate for Payer: PHP All Products |
$248.45
|
| Rate for Payer: Plain Church Group Ministry All Products |
$127.76
|
| Rate for Payer: Sagamore All Products |
$252.91
|
| Rate for Payer: Self Pay/Cash Rate |
$203.11
|
| Rate for Payer: Signature Care EPO |
$271.91
|
| Rate for Payer: Signature Care PPO |
$288.29
|
| Rate for Payer: Three Rivers Preferred All Products |
$278.46
|
| Rate for Payer: United Healthcare Commercial |
$258.15
|
| Rate for Payer: United Healthcare Medicare |
$108.11
|
|
|
HC ACU ANK SCREW 2.7X8 HEX LOCK
|
Facility
IP
|
$525.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603566
|
|
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 ANK SCREW 2.7X8 HEX LOCK
|
Facility
OP
|
$525.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603566
|
|
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 CANN SC WASHER 7ODX3.6ID
|
Facility
IP
|
$334.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602765
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$207.58 |
| Max. Negotiated Rate |
$308.18 |
| Rate for Payer: Aetna Commercial |
$289.27
|
| Rate for Payer: Cigna All Products |
$288.93
|
| Rate for Payer: Coventry/First Health All Products |
$294.62
|
| Rate for Payer: Encore All Products |
$308.18
|
| Rate for Payer: Frontpath All Products |
$308.02
|
| Rate for Payer: Humana ChoiceCare |
$289.17
|
| Rate for Payer: Lutheran Preferred All Products |
$301.32
|
| Rate for Payer: PHCS/Multiplan All Products |
$251.10
|
| Rate for Payer: PHP All Products |
$253.91
|
| Rate for Payer: Sagamore All Products |
$258.47
|
| Rate for Payer: Self Pay/Cash Rate |
$207.58
|
| Rate for Payer: Signature Care EPO |
$277.88
|
| Rate for Payer: Signature Care PPO |
$294.62
|
| Rate for Payer: United Healthcare Commercial |
$263.82
|
|
|
HC ACU CANN SC WASHER 7ODX3.6ID
|
Facility
OP
|
$334.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602765
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$110.48 |
| Max. Negotiated Rate |
$308.18 |
| Rate for Payer: Aetna Commercial |
$282.57
|
| Rate for Payer: Aetna Medicare |
$110.48
|
| Rate for Payer: Anthem Exchange |
$192.28
|
| Rate for Payer: Anthem Medicare |
$110.48
|
| Rate for Payer: Anthem PPO |
$192.28
|
| Rate for Payer: Anthem Traditional |
$209.28
|
| Rate for Payer: Caresource Just 4 Me |
$127.06
|
| Rate for Payer: Caresource Medicare |
$121.53
|
| Rate for Payer: Centivo/Paragon All Products |
$170.75
|
| Rate for Payer: Cigna All Products |
$288.93
|
| Rate for Payer: Coventry/First Health All Products |
$294.62
|
| Rate for Payer: Encore All Products |
$308.18
|
| Rate for Payer: Frontpath All Products |
$308.02
|
| Rate for Payer: Humana ChoiceCare |
$289.17
|
| Rate for Payer: Humana Medicare |
$170.75
|
| Rate for Payer: Lucent/Coldwater Veneers |
$170.75
|
| Rate for Payer: Lutheran Preferred All Products |
$301.32
|
| Rate for Payer: PHCS/Multiplan All Products |
$251.10
|
| Rate for Payer: PHP All Products |
$253.91
|
| Rate for Payer: Plain Church Group Ministry All Products |
$130.57
|
| Rate for Payer: Sagamore All Products |
$258.47
|
| Rate for Payer: Self Pay/Cash Rate |
$207.58
|
| Rate for Payer: Signature Care EPO |
$277.88
|
| Rate for Payer: Signature Care PPO |
$294.62
|
| Rate for Payer: Three Rivers Preferred All Products |
$284.58
|
| Rate for Payer: United Healthcare Commercial |
$263.82
|
| Rate for Payer: United Healthcare Medicare |
$110.48
|
|
|
HC ACU DIV RAD STYLOID PLATE
|
Facility
OP
|
$2,115.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602856
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$697.95 |
| Max. Negotiated Rate |
$1,946.86 |
| Rate for Payer: Aetna Commercial |
$1,785.06
|
| Rate for Payer: Aetna Medicare |
$697.95
|
| Rate for Payer: Anthem Exchange |
$1,214.64
|
| Rate for Payer: Anthem Medicare |
$697.95
|
| Rate for Payer: Anthem PPO |
$1,214.64
|
| Rate for Payer: Anthem Traditional |
$1,322.09
|
| Rate for Payer: Caresource Just 4 Me |
$802.64
|
| Rate for Payer: Caresource Medicare |
$767.75
|
| Rate for Payer: Centivo/Paragon All Products |
$1,078.65
|
| Rate for Payer: Cigna All Products |
$1,825.24
|
| Rate for Payer: Coventry/First Health All Products |
$1,861.20
|
| Rate for Payer: Encore All Products |
$1,946.86
|
| Rate for Payer: Frontpath All Products |
$1,945.80
|
| Rate for Payer: Humana ChoiceCare |
$1,826.73
|
| Rate for Payer: Humana Medicare |
$1,078.65
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,078.65
|
| Rate for Payer: Lutheran Preferred All Products |
$1,903.50
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,586.25
|
| Rate for Payer: PHP All Products |
$1,604.02
|
| Rate for Payer: Plain Church Group Ministry All Products |
$824.85
|
| Rate for Payer: Sagamore All Products |
$1,632.78
|
| Rate for Payer: Self Pay/Cash Rate |
$1,311.30
|
| Rate for Payer: Signature Care EPO |
$1,755.45
|
| Rate for Payer: Signature Care PPO |
$1,861.20
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,797.75
|
| Rate for Payer: United Healthcare Commercial |
$1,666.62
|
| Rate for Payer: United Healthcare Medicare |
$697.95
|
|
|
HC ACU DIV RAD STYLOID PLATE
|
Facility
IP
|
$2,115.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602856
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,311.30 |
| Max. Negotiated Rate |
$1,946.86 |
| Rate for Payer: Aetna Commercial |
$1,827.36
|
| Rate for Payer: Cigna All Products |
$1,825.24
|
| Rate for Payer: Coventry/First Health All Products |
$1,861.20
|
| Rate for Payer: Encore All Products |
$1,946.86
|
| Rate for Payer: Frontpath All Products |
$1,945.80
|
| Rate for Payer: Humana ChoiceCare |
$1,826.73
|
| Rate for Payer: Lutheran Preferred All Products |
$1,903.50
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,586.25
|
| Rate for Payer: PHP All Products |
$1,604.02
|
| Rate for Payer: Sagamore All Products |
$1,632.78
|
| Rate for Payer: Self Pay/Cash Rate |
$1,311.30
|
| Rate for Payer: Signature Care EPO |
$1,755.45
|
| Rate for Payer: Signature Care PPO |
$1,861.20
|
| Rate for Payer: United Healthcare Commercial |
$1,666.62
|
|
|
HC ACU DORSAL LUNATE PLATE LT
|
Facility
OP
|
$2,115.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602861
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$697.95 |
| Max. Negotiated Rate |
$1,946.86 |
| Rate for Payer: Aetna Commercial |
$1,785.06
|
| Rate for Payer: Aetna Medicare |
$697.95
|
| Rate for Payer: Anthem Exchange |
$1,214.64
|
| Rate for Payer: Anthem Medicare |
$697.95
|
| Rate for Payer: Anthem PPO |
$1,214.64
|
| Rate for Payer: Anthem Traditional |
$1,322.09
|
| Rate for Payer: Caresource Just 4 Me |
$802.64
|
| Rate for Payer: Caresource Medicare |
$767.75
|
| Rate for Payer: Centivo/Paragon All Products |
$1,078.65
|
| Rate for Payer: Cigna All Products |
$1,825.24
|
| Rate for Payer: Coventry/First Health All Products |
$1,861.20
|
| Rate for Payer: Encore All Products |
$1,946.86
|
| Rate for Payer: Frontpath All Products |
$1,945.80
|
| Rate for Payer: Humana ChoiceCare |
$1,826.73
|
| Rate for Payer: Humana Medicare |
$1,078.65
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,078.65
|
| Rate for Payer: Lutheran Preferred All Products |
$1,903.50
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,586.25
|
| Rate for Payer: PHP All Products |
$1,604.02
|
| Rate for Payer: Plain Church Group Ministry All Products |
$824.85
|
| Rate for Payer: Sagamore All Products |
$1,632.78
|
| Rate for Payer: Self Pay/Cash Rate |
$1,311.30
|
| Rate for Payer: Signature Care EPO |
$1,755.45
|
| Rate for Payer: Signature Care PPO |
$1,861.20
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,797.75
|
| Rate for Payer: United Healthcare Commercial |
$1,666.62
|
| Rate for Payer: United Healthcare Medicare |
$697.95
|
|
|
HC ACU DORSAL LUNATE PLATE LT
|
Facility
IP
|
$2,115.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602861
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,311.30 |
| Max. Negotiated Rate |
$1,946.86 |
| Rate for Payer: Aetna Commercial |
$1,827.36
|
| Rate for Payer: Cigna All Products |
$1,825.24
|
| Rate for Payer: Coventry/First Health All Products |
$1,861.20
|
| Rate for Payer: Encore All Products |
$1,946.86
|
| Rate for Payer: Frontpath All Products |
$1,945.80
|
| Rate for Payer: Humana ChoiceCare |
$1,826.73
|
| Rate for Payer: Lutheran Preferred All Products |
$1,903.50
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,586.25
|
| Rate for Payer: PHP All Products |
$1,604.02
|
| Rate for Payer: Sagamore All Products |
$1,632.78
|
| Rate for Payer: Self Pay/Cash Rate |
$1,311.30
|
| Rate for Payer: Signature Care EPO |
$1,755.45
|
| Rate for Payer: Signature Care PPO |
$1,861.20
|
| Rate for Payer: United Healthcare Commercial |
$1,666.62
|
|
|
HC ACU DORSAL LUNATE PLATE RT
|
Facility
IP
|
$2,115.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602860
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,311.30 |
| Max. Negotiated Rate |
$1,946.86 |
| Rate for Payer: Aetna Commercial |
$1,827.36
|
| Rate for Payer: Cigna All Products |
$1,825.24
|
| Rate for Payer: Coventry/First Health All Products |
$1,861.20
|
| Rate for Payer: Encore All Products |
$1,946.86
|
| Rate for Payer: Frontpath All Products |
$1,945.80
|
| Rate for Payer: Humana ChoiceCare |
$1,826.73
|
| Rate for Payer: Lutheran Preferred All Products |
$1,903.50
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,586.25
|
| Rate for Payer: PHP All Products |
$1,604.02
|
| Rate for Payer: Sagamore All Products |
$1,632.78
|
| Rate for Payer: Self Pay/Cash Rate |
$1,311.30
|
| Rate for Payer: Signature Care EPO |
$1,755.45
|
| Rate for Payer: Signature Care PPO |
$1,861.20
|
| Rate for Payer: United Healthcare Commercial |
$1,666.62
|
|
|
HC ACU DORSAL LUNATE PLATE RT
|
Facility
OP
|
$2,115.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602860
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$697.95 |
| Max. Negotiated Rate |
$1,946.86 |
| Rate for Payer: Aetna Commercial |
$1,785.06
|
| Rate for Payer: Aetna Medicare |
$697.95
|
| Rate for Payer: Anthem Exchange |
$1,214.64
|
| Rate for Payer: Anthem Medicare |
$697.95
|
| Rate for Payer: Anthem PPO |
$1,214.64
|
| Rate for Payer: Anthem Traditional |
$1,322.09
|
| Rate for Payer: Caresource Just 4 Me |
$802.64
|
| Rate for Payer: Caresource Medicare |
$767.75
|
| Rate for Payer: Centivo/Paragon All Products |
$1,078.65
|
| Rate for Payer: Cigna All Products |
$1,825.24
|
| Rate for Payer: Coventry/First Health All Products |
$1,861.20
|
| Rate for Payer: Encore All Products |
$1,946.86
|
| Rate for Payer: Frontpath All Products |
$1,945.80
|
| Rate for Payer: Humana ChoiceCare |
$1,826.73
|
| Rate for Payer: Humana Medicare |
$1,078.65
|
| Rate for Payer: Lucent/Coldwater Veneers |
$1,078.65
|
| Rate for Payer: Lutheran Preferred All Products |
$1,903.50
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,586.25
|
| Rate for Payer: PHP All Products |
$1,604.02
|
| Rate for Payer: Plain Church Group Ministry All Products |
$824.85
|
| Rate for Payer: Sagamore All Products |
$1,632.78
|
| Rate for Payer: Self Pay/Cash Rate |
$1,311.30
|
| Rate for Payer: Signature Care EPO |
$1,755.45
|
| Rate for Payer: Signature Care PPO |
$1,861.20
|
| Rate for Payer: Three Rivers Preferred All Products |
$1,797.75
|
| Rate for Payer: United Healthcare Commercial |
$1,666.62
|
| Rate for Payer: United Healthcare Medicare |
$697.95
|
|
|
HC ACU DORSAL PLATE NARR LT
|
Facility
IP
|
$2,235.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602854
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,385.70 |
| Max. Negotiated Rate |
$2,057.32 |
| Rate for Payer: Aetna Commercial |
$1,931.04
|
| Rate for Payer: Cigna All Products |
$1,928.81
|
| Rate for Payer: Coventry/First Health All Products |
$1,966.80
|
| Rate for Payer: Encore All Products |
$2,057.32
|
| Rate for Payer: Frontpath All Products |
$2,056.20
|
| Rate for Payer: Humana ChoiceCare |
$1,930.37
|
| Rate for Payer: Lutheran Preferred All Products |
$2,011.50
|
| Rate for Payer: PHCS/Multiplan All Products |
$1,676.25
|
| Rate for Payer: PHP All Products |
$1,695.02
|
| Rate for Payer: Sagamore All Products |
$1,725.42
|
| Rate for Payer: Self Pay/Cash Rate |
$1,385.70
|
| Rate for Payer: Signature Care EPO |
$1,855.05
|
| Rate for Payer: Signature Care PPO |
$1,966.80
|
| Rate for Payer: United Healthcare Commercial |
$1,761.18
|
|
