|
HC SUTURE PROLENE 6-0 8680G
|
Facility
|
OP
|
$40.63
|
|
| Hospital Charge Code |
41601524
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.60 |
| Max. Negotiated Rate |
$37.79 |
| Rate for Payer: Aetna Commercial |
$34.29
|
| Rate for Payer: Aetna Medicare |
$13.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$12.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$23.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$25.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$14.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$14.30
|
| Rate for Payer: Cash Price |
$24.38
|
| Rate for Payer: Cash Price |
$24.38
|
| Rate for Payer: Centivo All Commercial |
$22.10
|
| Rate for Payer: Cigna All Commercial |
$35.06
|
| Rate for Payer: CORVEL All Commercial |
$37.79
|
| Rate for Payer: Coventry All Commercial |
$35.75
|
| Rate for Payer: Encore All Commercial |
$37.40
|
| Rate for Payer: Frontpath All Commercial |
$37.38
|
| Rate for Payer: Humana ChoiceCare |
$35.09
|
| Rate for Payer: Humana Medicare |
$13.00
|
| Rate for Payer: Lucent All Commercial |
$22.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$36.57
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$30.47
|
| Rate for Payer: PHP All Commercial |
$30.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$15.85
|
| Rate for Payer: Sagamore Health Network All Products |
$31.37
|
| Rate for Payer: Signature Care EPO |
$33.72
|
| Rate for Payer: Signature Care PPO |
$35.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$34.54
|
| Rate for Payer: United Healthcare Commercial |
$32.02
|
| Rate for Payer: United Healthcare Medicare |
$13.00
|
|
|
HC SUTURE SILK 0 424H
|
Facility
|
IP
|
$8.00
|
|
| Hospital Charge Code |
41601483
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$7.44 |
| Rate for Payer: Aetna Commercial |
$6.91
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cigna All Commercial |
$6.90
|
| Rate for Payer: CORVEL All Commercial |
$7.44
|
| Rate for Payer: Coventry All Commercial |
$7.04
|
| Rate for Payer: Encore All Commercial |
$7.36
|
| Rate for Payer: Frontpath All Commercial |
$7.36
|
| Rate for Payer: Humana ChoiceCare |
$6.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7.20
|
| Rate for Payer: PHCS All Commercial |
$6.00
|
| Rate for Payer: PHP All Commercial |
$6.07
|
| Rate for Payer: Sagamore Health Network All Products |
$6.18
|
| Rate for Payer: Signature Care EPO |
$6.64
|
| Rate for Payer: Signature Care PPO |
$7.04
|
| Rate for Payer: United Healthcare Commercial |
$6.30
|
|
|
HC SUTURE SILK 0 424H
|
Facility
|
OP
|
$8.00
|
|
| Hospital Charge Code |
41601483
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.48 |
| Max. Negotiated Rate |
$31.20 |
| Rate for Payer: Aetna Commercial |
$6.75
|
| Rate for Payer: Aetna Medicare |
$2.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$4.59
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2.82
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Centivo All Commercial |
$4.35
|
| Rate for Payer: Cigna All Commercial |
$6.90
|
| Rate for Payer: CORVEL All Commercial |
$7.44
|
| Rate for Payer: Coventry All Commercial |
$7.04
|
| Rate for Payer: Encore All Commercial |
$7.36
|
| Rate for Payer: Frontpath All Commercial |
$7.36
|
| Rate for Payer: Humana ChoiceCare |
$6.91
|
| Rate for Payer: Humana Medicare |
$2.56
|
| Rate for Payer: Lucent All Commercial |
$4.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7.20
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$6.00
|
| Rate for Payer: PHP All Commercial |
$6.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3.12
|
| Rate for Payer: Sagamore Health Network All Products |
$6.18
|
| Rate for Payer: Signature Care EPO |
$6.64
|
| Rate for Payer: Signature Care PPO |
$7.04
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6.80
|
| Rate for Payer: United Healthcare Commercial |
$6.30
|
| Rate for Payer: United Healthcare Medicare |
$2.56
|
|
|
HC SUTURE SILK 0 680H
|
Facility
|
OP
|
$10.50
|
|
| Hospital Charge Code |
41601155
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.25 |
| Max. Negotiated Rate |
$31.20 |
| Rate for Payer: Aetna Commercial |
$8.86
|
| Rate for Payer: Aetna Medicare |
$3.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$3.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$6.03
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$6.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3.70
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Centivo All Commercial |
$5.71
|
| Rate for Payer: Cigna All Commercial |
$9.06
|
| Rate for Payer: CORVEL All Commercial |
$9.77
|
| Rate for Payer: Coventry All Commercial |
$9.24
|
| Rate for Payer: Encore All Commercial |
$9.67
|
| Rate for Payer: Frontpath All Commercial |
$9.66
|
| Rate for Payer: Humana ChoiceCare |
$9.07
|
| Rate for Payer: Humana Medicare |
$3.36
|
| Rate for Payer: Lucent All Commercial |
$5.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$9.45
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$7.88
|
| Rate for Payer: PHP All Commercial |
$7.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4.09
|
| Rate for Payer: Sagamore Health Network All Products |
$8.11
|
| Rate for Payer: Signature Care EPO |
$8.71
|
| Rate for Payer: Signature Care PPO |
$9.24
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$8.93
|
| Rate for Payer: United Healthcare Commercial |
$8.27
|
| Rate for Payer: United Healthcare Medicare |
$3.36
|
|
|
HC SUTURE SILK 0 680H
|
Facility
|
IP
|
$10.50
|
|
| Hospital Charge Code |
41601155
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.88 |
| Max. Negotiated Rate |
$9.77 |
| Rate for Payer: Aetna Commercial |
$9.07
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cigna All Commercial |
$9.06
|
| Rate for Payer: CORVEL All Commercial |
$9.77
|
| Rate for Payer: Coventry All Commercial |
$9.24
|
| Rate for Payer: Encore All Commercial |
$9.67
|
| Rate for Payer: Frontpath All Commercial |
$9.66
|
| Rate for Payer: Humana ChoiceCare |
$9.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$9.45
|
| Rate for Payer: PHCS All Commercial |
$7.88
|
| Rate for Payer: PHP All Commercial |
$7.96
|
| Rate for Payer: Sagamore Health Network All Products |
$8.11
|
| Rate for Payer: Signature Care EPO |
$8.71
|
| Rate for Payer: Signature Care PPO |
$9.24
|
| Rate for Payer: United Healthcare Commercial |
$8.27
|
|
|
HC SUTURE SILK 0 A306H
|
Facility
|
IP
|
$8.84
|
|
| Hospital Charge Code |
41601541
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.63 |
| Max. Negotiated Rate |
$8.22 |
| Rate for Payer: Aetna Commercial |
$7.64
|
| Rate for Payer: Cash Price |
$5.30
|
| Rate for Payer: Cigna All Commercial |
$7.63
|
| Rate for Payer: CORVEL All Commercial |
$8.22
|
| Rate for Payer: Coventry All Commercial |
$7.78
|
| Rate for Payer: Encore All Commercial |
$8.14
|
| Rate for Payer: Frontpath All Commercial |
$8.13
|
| Rate for Payer: Humana ChoiceCare |
$7.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7.96
|
| Rate for Payer: PHCS All Commercial |
$6.63
|
| Rate for Payer: PHP All Commercial |
$6.70
|
| Rate for Payer: Sagamore Health Network All Products |
$6.82
|
| Rate for Payer: Signature Care EPO |
$7.34
|
| Rate for Payer: Signature Care PPO |
$7.78
|
| Rate for Payer: United Healthcare Commercial |
$6.97
|
|
|
HC SUTURE SILK 0 A306H
|
Facility
|
OP
|
$8.84
|
|
| Hospital Charge Code |
41601541
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$31.20 |
| Rate for Payer: Aetna Commercial |
$7.46
|
| Rate for Payer: Aetna Medicare |
$2.83
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2.74
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$5.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3.25
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3.11
|
| Rate for Payer: Cash Price |
$5.30
|
| Rate for Payer: Cash Price |
$5.30
|
| Rate for Payer: Centivo All Commercial |
$4.81
|
| Rate for Payer: Cigna All Commercial |
$7.63
|
| Rate for Payer: CORVEL All Commercial |
$8.22
|
| Rate for Payer: Coventry All Commercial |
$7.78
|
| Rate for Payer: Encore All Commercial |
$8.14
|
| Rate for Payer: Frontpath All Commercial |
$8.13
|
| Rate for Payer: Humana ChoiceCare |
$7.64
|
| Rate for Payer: Humana Medicare |
$2.83
|
| Rate for Payer: Lucent All Commercial |
$4.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7.96
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$6.63
|
| Rate for Payer: PHP All Commercial |
$6.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3.45
|
| Rate for Payer: Sagamore Health Network All Products |
$6.82
|
| Rate for Payer: Signature Care EPO |
$7.34
|
| Rate for Payer: Signature Care PPO |
$7.78
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7.51
|
| Rate for Payer: United Healthcare Commercial |
$6.97
|
| Rate for Payer: United Healthcare Medicare |
$2.83
|
|
|
HC SUTURE SILK 0 K834H
|
Facility
|
IP
|
$6.84
|
|
| Hospital Charge Code |
41601592
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$6.36 |
| Rate for Payer: Aetna Commercial |
$5.91
|
| Rate for Payer: Cash Price |
$4.10
|
| Rate for Payer: Cigna All Commercial |
$5.90
|
| Rate for Payer: CORVEL All Commercial |
$6.36
|
| Rate for Payer: Coventry All Commercial |
$6.02
|
| Rate for Payer: Encore All Commercial |
$6.30
|
| Rate for Payer: Frontpath All Commercial |
$6.29
|
| Rate for Payer: Humana ChoiceCare |
$5.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6.16
|
| Rate for Payer: PHCS All Commercial |
$5.13
|
| Rate for Payer: PHP All Commercial |
$5.19
|
| Rate for Payer: Sagamore Health Network All Products |
$5.28
|
| Rate for Payer: Signature Care EPO |
$5.68
|
| Rate for Payer: Signature Care PPO |
$6.02
|
| Rate for Payer: United Healthcare Commercial |
$5.39
|
|
|
HC SUTURE SILK 0 K834H
|
Facility
|
OP
|
$6.84
|
|
| Hospital Charge Code |
41601592
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.12 |
| Max. Negotiated Rate |
$31.20 |
| Rate for Payer: Aetna Commercial |
$5.77
|
| Rate for Payer: Aetna Medicare |
$2.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2.12
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$3.93
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4.28
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2.41
|
| Rate for Payer: Cash Price |
$4.10
|
| Rate for Payer: Cash Price |
$4.10
|
| Rate for Payer: Centivo All Commercial |
$3.72
|
| Rate for Payer: Cigna All Commercial |
$5.90
|
| Rate for Payer: CORVEL All Commercial |
$6.36
|
| Rate for Payer: Coventry All Commercial |
$6.02
|
| Rate for Payer: Encore All Commercial |
$6.30
|
| Rate for Payer: Frontpath All Commercial |
$6.29
|
| Rate for Payer: Humana ChoiceCare |
$5.91
|
| Rate for Payer: Humana Medicare |
$2.19
|
| Rate for Payer: Lucent All Commercial |
$3.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6.16
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$5.13
|
| Rate for Payer: PHP All Commercial |
$5.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2.67
|
| Rate for Payer: Sagamore Health Network All Products |
$5.28
|
| Rate for Payer: Signature Care EPO |
$5.68
|
| Rate for Payer: Signature Care PPO |
$6.02
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5.81
|
| Rate for Payer: United Healthcare Commercial |
$5.39
|
| Rate for Payer: United Healthcare Medicare |
$2.19
|
|
|
HC SUTURE SILK 2-0 K833H
|
Facility
|
OP
|
$6.71
|
|
| Hospital Charge Code |
41601534
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.08 |
| Max. Negotiated Rate |
$31.20 |
| Rate for Payer: Aetna Commercial |
$5.66
|
| Rate for Payer: Aetna Medicare |
$2.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2.08
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$3.85
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4.19
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2.36
|
| Rate for Payer: Cash Price |
$4.03
|
| Rate for Payer: Cash Price |
$4.03
|
| Rate for Payer: Centivo All Commercial |
$3.65
|
| Rate for Payer: Cigna All Commercial |
$5.79
|
| Rate for Payer: CORVEL All Commercial |
$6.24
|
| Rate for Payer: Coventry All Commercial |
$5.90
|
| Rate for Payer: Encore All Commercial |
$6.18
|
| Rate for Payer: Frontpath All Commercial |
$6.17
|
| Rate for Payer: Humana ChoiceCare |
$5.80
|
| Rate for Payer: Humana Medicare |
$2.15
|
| Rate for Payer: Lucent All Commercial |
$3.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6.04
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$5.03
|
| Rate for Payer: PHP All Commercial |
$5.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2.62
|
| Rate for Payer: Sagamore Health Network All Products |
$5.18
|
| Rate for Payer: Signature Care EPO |
$5.57
|
| Rate for Payer: Signature Care PPO |
$5.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5.70
|
| Rate for Payer: United Healthcare Commercial |
$5.29
|
| Rate for Payer: United Healthcare Medicare |
$2.15
|
|
|
HC SUTURE SILK 2-0 K833H
|
Facility
|
IP
|
$6.71
|
|
| Hospital Charge Code |
41601534
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.03 |
| Max. Negotiated Rate |
$6.24 |
| Rate for Payer: Aetna Commercial |
$5.80
|
| Rate for Payer: Cash Price |
$4.03
|
| Rate for Payer: Cigna All Commercial |
$5.79
|
| Rate for Payer: CORVEL All Commercial |
$6.24
|
| Rate for Payer: Coventry All Commercial |
$5.90
|
| Rate for Payer: Encore All Commercial |
$6.18
|
| Rate for Payer: Frontpath All Commercial |
$6.17
|
| Rate for Payer: Humana ChoiceCare |
$5.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6.04
|
| Rate for Payer: PHCS All Commercial |
$5.03
|
| Rate for Payer: PHP All Commercial |
$5.09
|
| Rate for Payer: Sagamore Health Network All Products |
$5.18
|
| Rate for Payer: Signature Care EPO |
$5.57
|
| Rate for Payer: Signature Care PPO |
$5.90
|
| Rate for Payer: United Healthcare Commercial |
$5.29
|
|
|
HC SUTURE SILK 3-0 675H
|
Facility
|
IP
|
$9.14
|
|
| Hospital Charge Code |
41601432
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.86 |
| Max. Negotiated Rate |
$8.50 |
| Rate for Payer: Aetna Commercial |
$7.90
|
| Rate for Payer: Cash Price |
$5.48
|
| Rate for Payer: Cigna All Commercial |
$7.89
|
| Rate for Payer: CORVEL All Commercial |
$8.50
|
| Rate for Payer: Coventry All Commercial |
$8.04
|
| Rate for Payer: Encore All Commercial |
$8.41
|
| Rate for Payer: Frontpath All Commercial |
$8.41
|
| Rate for Payer: Humana ChoiceCare |
$7.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8.23
|
| Rate for Payer: PHCS All Commercial |
$6.86
|
| Rate for Payer: PHP All Commercial |
$6.93
|
| Rate for Payer: Sagamore Health Network All Products |
$7.06
|
| Rate for Payer: Signature Care EPO |
$7.59
|
| Rate for Payer: Signature Care PPO |
$8.04
|
| Rate for Payer: United Healthcare Commercial |
$7.20
|
|
|
HC SUTURE SILK 3-0 675H
|
Facility
|
OP
|
$9.14
|
|
| Hospital Charge Code |
41601432
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.83 |
| Max. Negotiated Rate |
$31.20 |
| Rate for Payer: Aetna Commercial |
$7.71
|
| Rate for Payer: Aetna Medicare |
$2.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2.83
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$5.25
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3.22
|
| Rate for Payer: Cash Price |
$5.48
|
| Rate for Payer: Cash Price |
$5.48
|
| Rate for Payer: Centivo All Commercial |
$4.97
|
| Rate for Payer: Cigna All Commercial |
$7.89
|
| Rate for Payer: CORVEL All Commercial |
$8.50
|
| Rate for Payer: Coventry All Commercial |
$8.04
|
| Rate for Payer: Encore All Commercial |
$8.41
|
| Rate for Payer: Frontpath All Commercial |
$8.41
|
| Rate for Payer: Humana ChoiceCare |
$7.89
|
| Rate for Payer: Humana Medicare |
$2.92
|
| Rate for Payer: Lucent All Commercial |
$4.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8.23
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$6.86
|
| Rate for Payer: PHP All Commercial |
$6.93
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3.56
|
| Rate for Payer: Sagamore Health Network All Products |
$7.06
|
| Rate for Payer: Signature Care EPO |
$7.59
|
| Rate for Payer: Signature Care PPO |
$8.04
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7.77
|
| Rate for Payer: United Healthcare Commercial |
$7.20
|
| Rate for Payer: United Healthcare Medicare |
$2.92
|
|
|
HC SUTURE SILK 3-0 A184H
|
Facility
|
IP
|
$20.01
|
|
| Hospital Charge Code |
41601543
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.01 |
| Max. Negotiated Rate |
$18.61 |
| Rate for Payer: Aetna Commercial |
$17.29
|
| Rate for Payer: Cash Price |
$12.01
|
| Rate for Payer: Cigna All Commercial |
$17.27
|
| Rate for Payer: CORVEL All Commercial |
$18.61
|
| Rate for Payer: Coventry All Commercial |
$17.61
|
| Rate for Payer: Encore All Commercial |
$18.42
|
| Rate for Payer: Frontpath All Commercial |
$18.41
|
| Rate for Payer: Humana ChoiceCare |
$17.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$18.01
|
| Rate for Payer: PHCS All Commercial |
$15.01
|
| Rate for Payer: PHP All Commercial |
$15.18
|
| Rate for Payer: Sagamore Health Network All Products |
$15.45
|
| Rate for Payer: Signature Care EPO |
$16.61
|
| Rate for Payer: Signature Care PPO |
$17.61
|
| Rate for Payer: United Healthcare Commercial |
$15.77
|
|
|
HC SUTURE SILK 3-0 A184H
|
Facility
|
OP
|
$20.01
|
|
| Hospital Charge Code |
41601543
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.20 |
| Max. Negotiated Rate |
$31.20 |
| Rate for Payer: Aetna Commercial |
$16.89
|
| Rate for Payer: Aetna Medicare |
$6.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$6.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$11.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$12.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$7.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$7.04
|
| Rate for Payer: Cash Price |
$12.01
|
| Rate for Payer: Cash Price |
$12.01
|
| Rate for Payer: Centivo All Commercial |
$10.89
|
| Rate for Payer: Cigna All Commercial |
$17.27
|
| Rate for Payer: CORVEL All Commercial |
$18.61
|
| Rate for Payer: Coventry All Commercial |
$17.61
|
| Rate for Payer: Encore All Commercial |
$18.42
|
| Rate for Payer: Frontpath All Commercial |
$18.41
|
| Rate for Payer: Humana ChoiceCare |
$17.28
|
| Rate for Payer: Humana Medicare |
$6.40
|
| Rate for Payer: Lucent All Commercial |
$10.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$18.01
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$15.01
|
| Rate for Payer: PHP All Commercial |
$15.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$7.80
|
| Rate for Payer: Sagamore Health Network All Products |
$15.45
|
| Rate for Payer: Signature Care EPO |
$16.61
|
| Rate for Payer: Signature Care PPO |
$17.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$17.01
|
| Rate for Payer: United Healthcare Commercial |
$15.77
|
| Rate for Payer: United Healthcare Medicare |
$6.40
|
|
|
HC SUTURE SILK 3-0 K832H
|
Facility
|
IP
|
$6.72
|
|
| Hospital Charge Code |
41601542
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.04 |
| Max. Negotiated Rate |
$6.25 |
| Rate for Payer: Aetna Commercial |
$5.81
|
| Rate for Payer: Cash Price |
$4.03
|
| Rate for Payer: Cigna All Commercial |
$5.80
|
| Rate for Payer: CORVEL All Commercial |
$6.25
|
| Rate for Payer: Coventry All Commercial |
$5.91
|
| Rate for Payer: Encore All Commercial |
$6.19
|
| Rate for Payer: Frontpath All Commercial |
$6.18
|
| Rate for Payer: Humana ChoiceCare |
$5.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6.05
|
| Rate for Payer: PHCS All Commercial |
$5.04
|
| Rate for Payer: PHP All Commercial |
$5.10
|
| Rate for Payer: Sagamore Health Network All Products |
$5.19
|
| Rate for Payer: Signature Care EPO |
$5.58
|
| Rate for Payer: Signature Care PPO |
$5.91
|
| Rate for Payer: United Healthcare Commercial |
$5.30
|
|
|
HC SUTURE SILK 3-0 K832H
|
Facility
|
OP
|
$6.72
|
|
| Hospital Charge Code |
41601542
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.08 |
| Max. Negotiated Rate |
$31.20 |
| Rate for Payer: Aetna Commercial |
$5.67
|
| Rate for Payer: Aetna Medicare |
$2.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2.08
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$3.86
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2.37
|
| Rate for Payer: Cash Price |
$4.03
|
| Rate for Payer: Cash Price |
$4.03
|
| Rate for Payer: Centivo All Commercial |
$3.66
|
| Rate for Payer: Cigna All Commercial |
$5.80
|
| Rate for Payer: CORVEL All Commercial |
$6.25
|
| Rate for Payer: Coventry All Commercial |
$5.91
|
| Rate for Payer: Encore All Commercial |
$6.19
|
| Rate for Payer: Frontpath All Commercial |
$6.18
|
| Rate for Payer: Humana ChoiceCare |
$5.80
|
| Rate for Payer: Humana Medicare |
$2.15
|
| Rate for Payer: Lucent All Commercial |
$3.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6.05
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$5.04
|
| Rate for Payer: PHP All Commercial |
$5.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2.62
|
| Rate for Payer: Sagamore Health Network All Products |
$5.19
|
| Rate for Payer: Signature Care EPO |
$5.58
|
| Rate for Payer: Signature Care PPO |
$5.91
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5.71
|
| Rate for Payer: United Healthcare Commercial |
$5.30
|
| Rate for Payer: United Healthcare Medicare |
$2.15
|
|
|
HC SUTURE SILK 4-0 789G
|
Facility
|
IP
|
$31.75
|
|
| Hospital Charge Code |
41601590
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.81 |
| Max. Negotiated Rate |
$29.53 |
| Rate for Payer: Aetna Commercial |
$27.43
|
| Rate for Payer: Cash Price |
$19.05
|
| Rate for Payer: Cigna All Commercial |
$27.40
|
| Rate for Payer: CORVEL All Commercial |
$29.53
|
| Rate for Payer: Coventry All Commercial |
$27.94
|
| Rate for Payer: Encore All Commercial |
$29.23
|
| Rate for Payer: Frontpath All Commercial |
$29.21
|
| Rate for Payer: Humana ChoiceCare |
$27.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$28.57
|
| Rate for Payer: PHCS All Commercial |
$23.81
|
| Rate for Payer: PHP All Commercial |
$24.08
|
| Rate for Payer: Sagamore Health Network All Products |
$24.51
|
| Rate for Payer: Signature Care EPO |
$26.35
|
| Rate for Payer: Signature Care PPO |
$27.94
|
| Rate for Payer: United Healthcare Commercial |
$25.02
|
|
|
HC SUTURE SILK 4-0 789G
|
Facility
|
OP
|
$31.75
|
|
| Hospital Charge Code |
41601590
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.84 |
| Max. Negotiated Rate |
$31.20 |
| Rate for Payer: Aetna Commercial |
$26.80
|
| Rate for Payer: Aetna Medicare |
$10.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$9.84
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$18.23
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$19.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$11.68
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$11.18
|
| Rate for Payer: Cash Price |
$19.05
|
| Rate for Payer: Cash Price |
$19.05
|
| Rate for Payer: Centivo All Commercial |
$17.27
|
| Rate for Payer: Cigna All Commercial |
$27.40
|
| Rate for Payer: CORVEL All Commercial |
$29.53
|
| Rate for Payer: Coventry All Commercial |
$27.94
|
| Rate for Payer: Encore All Commercial |
$29.23
|
| Rate for Payer: Frontpath All Commercial |
$29.21
|
| Rate for Payer: Humana ChoiceCare |
$27.42
|
| Rate for Payer: Humana Medicare |
$10.16
|
| Rate for Payer: Lucent All Commercial |
$17.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$28.57
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$23.81
|
| Rate for Payer: PHP All Commercial |
$24.08
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$12.38
|
| Rate for Payer: Sagamore Health Network All Products |
$24.51
|
| Rate for Payer: Signature Care EPO |
$26.35
|
| Rate for Payer: Signature Care PPO |
$27.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$26.99
|
| Rate for Payer: United Healthcare Commercial |
$25.02
|
| Rate for Payer: United Healthcare Medicare |
$10.16
|
|
|
HC SUTURE SILK 4-0 K831H
|
Facility
|
IP
|
$8.37
|
|
| Hospital Charge Code |
41601536
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.28 |
| Max. Negotiated Rate |
$7.78 |
| Rate for Payer: Aetna Commercial |
$7.23
|
| Rate for Payer: Cash Price |
$5.02
|
| Rate for Payer: Cigna All Commercial |
$7.22
|
| Rate for Payer: CORVEL All Commercial |
$7.78
|
| Rate for Payer: Coventry All Commercial |
$7.37
|
| Rate for Payer: Encore All Commercial |
$7.70
|
| Rate for Payer: Frontpath All Commercial |
$7.70
|
| Rate for Payer: Humana ChoiceCare |
$7.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7.53
|
| Rate for Payer: PHCS All Commercial |
$6.28
|
| Rate for Payer: PHP All Commercial |
$6.35
|
| Rate for Payer: Sagamore Health Network All Products |
$6.46
|
| Rate for Payer: Signature Care EPO |
$6.95
|
| Rate for Payer: Signature Care PPO |
$7.37
|
| Rate for Payer: United Healthcare Commercial |
$6.60
|
|
|
HC SUTURE SILK 4-0 K831H
|
Facility
|
OP
|
$8.37
|
|
| Hospital Charge Code |
41601536
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.59 |
| Max. Negotiated Rate |
$31.20 |
| Rate for Payer: Aetna Commercial |
$7.06
|
| Rate for Payer: Aetna Medicare |
$2.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2.59
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$4.81
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5.23
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2.95
|
| Rate for Payer: Cash Price |
$5.02
|
| Rate for Payer: Cash Price |
$5.02
|
| Rate for Payer: Centivo All Commercial |
$4.55
|
| Rate for Payer: Cigna All Commercial |
$7.22
|
| Rate for Payer: CORVEL All Commercial |
$7.78
|
| Rate for Payer: Coventry All Commercial |
$7.37
|
| Rate for Payer: Encore All Commercial |
$7.70
|
| Rate for Payer: Frontpath All Commercial |
$7.70
|
| Rate for Payer: Humana ChoiceCare |
$7.23
|
| Rate for Payer: Humana Medicare |
$2.68
|
| Rate for Payer: Lucent All Commercial |
$4.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7.53
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$6.28
|
| Rate for Payer: PHP All Commercial |
$6.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3.26
|
| Rate for Payer: Sagamore Health Network All Products |
$6.46
|
| Rate for Payer: Signature Care EPO |
$6.95
|
| Rate for Payer: Signature Care PPO |
$7.37
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7.11
|
| Rate for Payer: United Healthcare Commercial |
$6.60
|
| Rate for Payer: United Healthcare Medicare |
$2.68
|
|
|
HC SUTURE TAPE UMBILICAL U11T
|
Facility
|
IP
|
$11.70
|
|
| Hospital Charge Code |
41601544
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.78 |
| Max. Negotiated Rate |
$10.88 |
| Rate for Payer: Aetna Commercial |
$10.11
|
| Rate for Payer: Cash Price |
$7.02
|
| Rate for Payer: Cigna All Commercial |
$10.10
|
| Rate for Payer: CORVEL All Commercial |
$10.88
|
| Rate for Payer: Coventry All Commercial |
$10.30
|
| Rate for Payer: Encore All Commercial |
$10.77
|
| Rate for Payer: Frontpath All Commercial |
$10.76
|
| Rate for Payer: Humana ChoiceCare |
$10.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10.53
|
| Rate for Payer: PHCS All Commercial |
$8.78
|
| Rate for Payer: PHP All Commercial |
$8.87
|
| Rate for Payer: Sagamore Health Network All Products |
$9.03
|
| Rate for Payer: Signature Care EPO |
$9.71
|
| Rate for Payer: Signature Care PPO |
$10.30
|
| Rate for Payer: United Healthcare Commercial |
$9.22
|
|
|
HC SUTURE TAPE UMBILICAL U11T
|
Facility
|
OP
|
$11.70
|
|
| Hospital Charge Code |
41601544
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.63 |
| Max. Negotiated Rate |
$31.20 |
| Rate for Payer: Aetna Commercial |
$9.87
|
| Rate for Payer: Aetna Medicare |
$3.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$3.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$6.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4.12
|
| Rate for Payer: Cash Price |
$7.02
|
| Rate for Payer: Cash Price |
$7.02
|
| Rate for Payer: Centivo All Commercial |
$6.36
|
| Rate for Payer: Cigna All Commercial |
$10.10
|
| Rate for Payer: CORVEL All Commercial |
$10.88
|
| Rate for Payer: Coventry All Commercial |
$10.30
|
| Rate for Payer: Encore All Commercial |
$10.77
|
| Rate for Payer: Frontpath All Commercial |
$10.76
|
| Rate for Payer: Humana ChoiceCare |
$10.11
|
| Rate for Payer: Humana Medicare |
$3.74
|
| Rate for Payer: Lucent All Commercial |
$6.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10.53
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$8.78
|
| Rate for Payer: PHP All Commercial |
$8.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4.56
|
| Rate for Payer: Sagamore Health Network All Products |
$9.03
|
| Rate for Payer: Signature Care EPO |
$9.71
|
| Rate for Payer: Signature Care PPO |
$10.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$9.95
|
| Rate for Payer: United Healthcare Commercial |
$9.22
|
| Rate for Payer: United Healthcare Medicare |
$3.74
|
|
|
HC SUTURE VESSEL LOOP RED
|
Facility
|
OP
|
$9.38
|
|
| Hospital Charge Code |
41601577
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.91 |
| Max. Negotiated Rate |
$31.20 |
| Rate for Payer: Aetna Commercial |
$7.92
|
| Rate for Payer: Aetna Medicare |
$3.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2.91
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$5.39
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3.30
|
| Rate for Payer: Cash Price |
$5.63
|
| Rate for Payer: Cash Price |
$5.63
|
| Rate for Payer: Centivo All Commercial |
$5.10
|
| Rate for Payer: Cigna All Commercial |
$8.09
|
| Rate for Payer: CORVEL All Commercial |
$8.72
|
| Rate for Payer: Coventry All Commercial |
$8.25
|
| Rate for Payer: Encore All Commercial |
$8.63
|
| Rate for Payer: Frontpath All Commercial |
$8.63
|
| Rate for Payer: Humana ChoiceCare |
$8.10
|
| Rate for Payer: Humana Medicare |
$3.00
|
| Rate for Payer: Lucent All Commercial |
$5.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8.44
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$7.04
|
| Rate for Payer: PHP All Commercial |
$7.11
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3.66
|
| Rate for Payer: Sagamore Health Network All Products |
$7.24
|
| Rate for Payer: Signature Care EPO |
$7.79
|
| Rate for Payer: Signature Care PPO |
$8.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7.97
|
| Rate for Payer: United Healthcare Commercial |
$7.39
|
| Rate for Payer: United Healthcare Medicare |
$3.00
|
|
|
HC SUTURE VESSEL LOOP RED
|
Facility
|
IP
|
$9.38
|
|
| Hospital Charge Code |
41601577
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.04 |
| Max. Negotiated Rate |
$8.72 |
| Rate for Payer: Aetna Commercial |
$8.10
|
| Rate for Payer: Cash Price |
$5.63
|
| Rate for Payer: Cigna All Commercial |
$8.09
|
| Rate for Payer: CORVEL All Commercial |
$8.72
|
| Rate for Payer: Coventry All Commercial |
$8.25
|
| Rate for Payer: Encore All Commercial |
$8.63
|
| Rate for Payer: Frontpath All Commercial |
$8.63
|
| Rate for Payer: Humana ChoiceCare |
$8.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8.44
|
| Rate for Payer: PHCS All Commercial |
$7.04
|
| Rate for Payer: PHP All Commercial |
$7.11
|
| Rate for Payer: Sagamore Health Network All Products |
$7.24
|
| Rate for Payer: Signature Care EPO |
$7.79
|
| Rate for Payer: Signature Care PPO |
$8.25
|
| Rate for Payer: United Healthcare Commercial |
$7.39
|
|
