|
HC SCREW CORTICAL 1.5 MM 6 MM
|
Facility
OP
|
$149.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602023
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$49.23 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$125.90
|
| Rate for Payer: Aetna Medicare |
$49.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$49.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$85.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$93.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$56.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$54.15
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Centivo All Commercial |
$76.08
|
| Rate for Payer: Cigna All Commercial |
$128.73
|
| Rate for Payer: CORVEL All Commercial |
$138.73
|
| Rate for Payer: Coventry All Commercial |
$131.27
|
| Rate for Payer: Encore All Commercial |
$137.31
|
| Rate for Payer: Frontpath All Commercial |
$137.24
|
| Rate for Payer: Humana ChoiceCare |
$128.84
|
| Rate for Payer: Humana Medicare |
$76.08
|
| Rate for Payer: Lucent All Commercial |
$76.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$134.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$111.88
|
| Rate for Payer: PHP All Commercial |
$113.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$58.18
|
| Rate for Payer: Sagamore Health Network All Products |
$115.16
|
| Rate for Payer: Signature Care EPO |
$123.81
|
| Rate for Payer: Signature Care PPO |
$131.27
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$126.79
|
| Rate for Payer: United Healthcare Commercial |
$117.55
|
| Rate for Payer: United Healthcare Medicare |
$49.23
|
|
|
HC SCREW CORTICAL 1.5 MM 6 MM
|
Facility
IP
|
$149.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602023
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$111.88 |
| Max. Negotiated Rate |
$138.73 |
| Rate for Payer: Aetna Commercial |
$128.88
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Cigna All Commercial |
$128.73
|
| Rate for Payer: CORVEL All Commercial |
$138.73
|
| Rate for Payer: Coventry All Commercial |
$131.27
|
| Rate for Payer: Encore All Commercial |
$137.31
|
| Rate for Payer: Frontpath All Commercial |
$137.24
|
| Rate for Payer: Humana ChoiceCare |
$128.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$134.25
|
| Rate for Payer: PHCS All Commercial |
$111.88
|
| Rate for Payer: PHP All Commercial |
$113.13
|
| Rate for Payer: Sagamore Health Network All Products |
$115.16
|
| Rate for Payer: Signature Care EPO |
$123.81
|
| Rate for Payer: Signature Care PPO |
$131.27
|
| Rate for Payer: United Healthcare Commercial |
$117.55
|
|
|
HC SCREW CORTICAL 1.5 MM 7 MM
|
Facility
OP
|
$149.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602024
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$49.23 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$125.90
|
| Rate for Payer: Aetna Medicare |
$49.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$49.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$85.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$93.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$56.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$54.15
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Centivo All Commercial |
$76.08
|
| Rate for Payer: Cigna All Commercial |
$128.73
|
| Rate for Payer: CORVEL All Commercial |
$138.73
|
| Rate for Payer: Coventry All Commercial |
$131.27
|
| Rate for Payer: Encore All Commercial |
$137.31
|
| Rate for Payer: Frontpath All Commercial |
$137.24
|
| Rate for Payer: Humana ChoiceCare |
$128.84
|
| Rate for Payer: Humana Medicare |
$76.08
|
| Rate for Payer: Lucent All Commercial |
$76.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$134.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$111.88
|
| Rate for Payer: PHP All Commercial |
$113.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$58.18
|
| Rate for Payer: Sagamore Health Network All Products |
$115.16
|
| Rate for Payer: Signature Care EPO |
$123.81
|
| Rate for Payer: Signature Care PPO |
$131.27
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$126.79
|
| Rate for Payer: United Healthcare Commercial |
$117.55
|
| Rate for Payer: United Healthcare Medicare |
$49.23
|
|
|
HC SCREW CORTICAL 1.5 MM 7 MM
|
Facility
IP
|
$149.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602024
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$111.88 |
| Max. Negotiated Rate |
$138.73 |
| Rate for Payer: Aetna Commercial |
$128.88
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Cigna All Commercial |
$128.73
|
| Rate for Payer: CORVEL All Commercial |
$138.73
|
| Rate for Payer: Coventry All Commercial |
$131.27
|
| Rate for Payer: Encore All Commercial |
$137.31
|
| Rate for Payer: Frontpath All Commercial |
$137.24
|
| Rate for Payer: Humana ChoiceCare |
$128.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$134.25
|
| Rate for Payer: PHCS All Commercial |
$111.88
|
| Rate for Payer: PHP All Commercial |
$113.13
|
| Rate for Payer: Sagamore Health Network All Products |
$115.16
|
| Rate for Payer: Signature Care EPO |
$123.81
|
| Rate for Payer: Signature Care PPO |
$131.27
|
| Rate for Payer: United Healthcare Commercial |
$117.55
|
|
|
HC SCREW CORTICAL 1.5 MM 8 MM
|
Facility
IP
|
$149.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$111.88 |
| Max. Negotiated Rate |
$138.73 |
| Rate for Payer: Aetna Commercial |
$128.88
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Cigna All Commercial |
$128.73
|
| Rate for Payer: CORVEL All Commercial |
$138.73
|
| Rate for Payer: Coventry All Commercial |
$131.27
|
| Rate for Payer: Encore All Commercial |
$137.31
|
| Rate for Payer: Frontpath All Commercial |
$137.24
|
| Rate for Payer: Humana ChoiceCare |
$128.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$134.25
|
| Rate for Payer: PHCS All Commercial |
$111.88
|
| Rate for Payer: PHP All Commercial |
$113.13
|
| Rate for Payer: Sagamore Health Network All Products |
$115.16
|
| Rate for Payer: Signature Care EPO |
$123.81
|
| Rate for Payer: Signature Care PPO |
$131.27
|
| Rate for Payer: United Healthcare Commercial |
$117.55
|
|
|
HC SCREW CORTICAL 1.5 MM 8 MM
|
Facility
OP
|
$149.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$49.23 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$125.90
|
| Rate for Payer: Aetna Medicare |
$49.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$49.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$85.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$93.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$56.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$54.15
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Centivo All Commercial |
$76.08
|
| Rate for Payer: Cigna All Commercial |
$128.73
|
| Rate for Payer: CORVEL All Commercial |
$138.73
|
| Rate for Payer: Coventry All Commercial |
$131.27
|
| Rate for Payer: Encore All Commercial |
$137.31
|
| Rate for Payer: Frontpath All Commercial |
$137.24
|
| Rate for Payer: Humana ChoiceCare |
$128.84
|
| Rate for Payer: Humana Medicare |
$76.08
|
| Rate for Payer: Lucent All Commercial |
$76.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$134.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$111.88
|
| Rate for Payer: PHP All Commercial |
$113.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$58.18
|
| Rate for Payer: Sagamore Health Network All Products |
$115.16
|
| Rate for Payer: Signature Care EPO |
$123.81
|
| Rate for Payer: Signature Care PPO |
$131.27
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$126.79
|
| Rate for Payer: United Healthcare Commercial |
$117.55
|
| Rate for Payer: United Healthcare Medicare |
$49.23
|
|
|
HC SCREW CORTICAL 1.5 MM 9 MM
|
Facility
OP
|
$122.78
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602026
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$40.52 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$103.63
|
| Rate for Payer: Aetna Medicare |
$40.52
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$40.52
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$70.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$76.75
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$46.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$44.57
|
| Rate for Payer: Cash Price |
$76.12
|
| Rate for Payer: Cash Price |
$76.12
|
| Rate for Payer: Centivo All Commercial |
$62.62
|
| Rate for Payer: Cigna All Commercial |
$105.96
|
| Rate for Payer: CORVEL All Commercial |
$114.19
|
| Rate for Payer: Coventry All Commercial |
$108.05
|
| Rate for Payer: Encore All Commercial |
$113.02
|
| Rate for Payer: Frontpath All Commercial |
$112.96
|
| Rate for Payer: Humana ChoiceCare |
$106.05
|
| Rate for Payer: Humana Medicare |
$62.62
|
| Rate for Payer: Lucent All Commercial |
$62.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$110.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$92.08
|
| Rate for Payer: PHP All Commercial |
$93.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$47.88
|
| Rate for Payer: Sagamore Health Network All Products |
$94.79
|
| Rate for Payer: Signature Care EPO |
$101.91
|
| Rate for Payer: Signature Care PPO |
$108.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$104.36
|
| Rate for Payer: United Healthcare Commercial |
$96.75
|
| Rate for Payer: United Healthcare Medicare |
$40.52
|
|
|
HC SCREW CORTICAL 1.5 MM 9 MM
|
Facility
IP
|
$122.78
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602026
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$92.08 |
| Max. Negotiated Rate |
$114.19 |
| Rate for Payer: Aetna Commercial |
$106.08
|
| Rate for Payer: Cash Price |
$76.12
|
| Rate for Payer: Cigna All Commercial |
$105.96
|
| Rate for Payer: CORVEL All Commercial |
$114.19
|
| Rate for Payer: Coventry All Commercial |
$108.05
|
| Rate for Payer: Encore All Commercial |
$113.02
|
| Rate for Payer: Frontpath All Commercial |
$112.96
|
| Rate for Payer: Humana ChoiceCare |
$106.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$110.50
|
| Rate for Payer: PHCS All Commercial |
$92.08
|
| Rate for Payer: PHP All Commercial |
$93.12
|
| Rate for Payer: Sagamore Health Network All Products |
$94.79
|
| Rate for Payer: Signature Care EPO |
$101.91
|
| Rate for Payer: Signature Care PPO |
$108.05
|
| Rate for Payer: United Healthcare Commercial |
$96.75
|
|
|
HC SCREW CORTICAL 2.0MM 12MM
|
Facility
OP
|
$163.17
|
|
| Hospital Charge Code |
41602211
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$53.85 |
| Max. Negotiated Rate |
$151.75 |
| Rate for Payer: Aetna Commercial |
$137.72
|
| Rate for Payer: Aetna Medicare |
$53.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$53.85
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$93.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$102.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$96.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$61.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$59.23
|
| Rate for Payer: Cash Price |
$101.17
|
| Rate for Payer: Cash Price |
$101.17
|
| Rate for Payer: Centivo All Commercial |
$83.22
|
| Rate for Payer: Cigna All Commercial |
$140.82
|
| Rate for Payer: CORVEL All Commercial |
$151.75
|
| Rate for Payer: Coventry All Commercial |
$143.59
|
| Rate for Payer: Encore All Commercial |
$150.20
|
| Rate for Payer: Frontpath All Commercial |
$150.12
|
| Rate for Payer: Humana ChoiceCare |
$140.93
|
| Rate for Payer: Humana Medicare |
$83.22
|
| Rate for Payer: Lucent All Commercial |
$83.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$146.85
|
| Rate for Payer: Managed Health Services Medicaid |
$96.84
|
| Rate for Payer: MDWise Medicaid |
$96.84
|
| Rate for Payer: PHCS All Commercial |
$122.38
|
| Rate for Payer: PHP All Commercial |
$123.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$63.64
|
| Rate for Payer: Sagamore Health Network All Products |
$125.97
|
| Rate for Payer: Signature Care EPO |
$135.43
|
| Rate for Payer: Signature Care PPO |
$143.59
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$138.69
|
| Rate for Payer: United Healthcare Commercial |
$128.58
|
| Rate for Payer: United Healthcare Medicare |
$53.85
|
|
|
HC SCREW CORTICAL 2.0MM 12MM
|
Facility
IP
|
$163.17
|
|
| Hospital Charge Code |
41602211
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$122.38 |
| Max. Negotiated Rate |
$151.75 |
| Rate for Payer: Aetna Commercial |
$140.98
|
| Rate for Payer: Cash Price |
$101.17
|
| Rate for Payer: Cigna All Commercial |
$140.82
|
| Rate for Payer: CORVEL All Commercial |
$151.75
|
| Rate for Payer: Coventry All Commercial |
$143.59
|
| Rate for Payer: Encore All Commercial |
$150.20
|
| Rate for Payer: Frontpath All Commercial |
$150.12
|
| Rate for Payer: Humana ChoiceCare |
$140.93
|
| Rate for Payer: Lutheran Preferred All Commercial |
$146.85
|
| Rate for Payer: PHCS All Commercial |
$122.38
|
| Rate for Payer: PHP All Commercial |
$123.75
|
| Rate for Payer: Sagamore Health Network All Products |
$125.97
|
| Rate for Payer: Signature Care EPO |
$135.43
|
| Rate for Payer: Signature Care PPO |
$143.59
|
| Rate for Payer: United Healthcare Commercial |
$128.58
|
|
|
HC SCREW CORTICAL 2.0MM 14MM
|
Facility
OP
|
$163.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$53.85 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$137.72
|
| Rate for Payer: Aetna Medicare |
$53.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$53.85
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$93.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$102.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$61.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$59.23
|
| Rate for Payer: Cash Price |
$101.17
|
| Rate for Payer: Cash Price |
$101.17
|
| Rate for Payer: Centivo All Commercial |
$83.22
|
| Rate for Payer: Cigna All Commercial |
$140.82
|
| Rate for Payer: CORVEL All Commercial |
$151.75
|
| Rate for Payer: Coventry All Commercial |
$143.59
|
| Rate for Payer: Encore All Commercial |
$150.20
|
| Rate for Payer: Frontpath All Commercial |
$150.12
|
| Rate for Payer: Humana ChoiceCare |
$140.93
|
| Rate for Payer: Humana Medicare |
$83.22
|
| Rate for Payer: Lucent All Commercial |
$83.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$146.85
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$122.38
|
| Rate for Payer: PHP All Commercial |
$123.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$63.64
|
| Rate for Payer: Sagamore Health Network All Products |
$125.97
|
| Rate for Payer: Signature Care EPO |
$135.43
|
| Rate for Payer: Signature Care PPO |
$143.59
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$138.69
|
| Rate for Payer: United Healthcare Commercial |
$128.58
|
| Rate for Payer: United Healthcare Medicare |
$53.85
|
|
|
HC SCREW CORTICAL 2.0MM 14MM
|
Facility
IP
|
$163.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602028
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$122.38 |
| Max. Negotiated Rate |
$151.75 |
| Rate for Payer: Aetna Commercial |
$140.98
|
| Rate for Payer: Cash Price |
$101.17
|
| Rate for Payer: Cigna All Commercial |
$140.82
|
| Rate for Payer: CORVEL All Commercial |
$151.75
|
| Rate for Payer: Coventry All Commercial |
$143.59
|
| Rate for Payer: Encore All Commercial |
$150.20
|
| Rate for Payer: Frontpath All Commercial |
$150.12
|
| Rate for Payer: Humana ChoiceCare |
$140.93
|
| Rate for Payer: Lutheran Preferred All Commercial |
$146.85
|
| Rate for Payer: PHCS All Commercial |
$122.38
|
| Rate for Payer: PHP All Commercial |
$123.75
|
| Rate for Payer: Sagamore Health Network All Products |
$125.97
|
| Rate for Payer: Signature Care EPO |
$135.43
|
| Rate for Payer: Signature Care PPO |
$143.59
|
| Rate for Payer: United Healthcare Commercial |
$128.58
|
|
|
HC SCREW CORTICAL 2.0MM 16MM
|
Facility
OP
|
$163.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602029
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$53.85 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$137.72
|
| Rate for Payer: Aetna Medicare |
$53.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$53.85
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$93.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$102.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$61.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$59.23
|
| Rate for Payer: Cash Price |
$101.17
|
| Rate for Payer: Cash Price |
$101.17
|
| Rate for Payer: Centivo All Commercial |
$83.22
|
| Rate for Payer: Cigna All Commercial |
$140.82
|
| Rate for Payer: CORVEL All Commercial |
$151.75
|
| Rate for Payer: Coventry All Commercial |
$143.59
|
| Rate for Payer: Encore All Commercial |
$150.20
|
| Rate for Payer: Frontpath All Commercial |
$150.12
|
| Rate for Payer: Humana ChoiceCare |
$140.93
|
| Rate for Payer: Humana Medicare |
$83.22
|
| Rate for Payer: Lucent All Commercial |
$83.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$146.85
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$122.38
|
| Rate for Payer: PHP All Commercial |
$123.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$63.64
|
| Rate for Payer: Sagamore Health Network All Products |
$125.97
|
| Rate for Payer: Signature Care EPO |
$135.43
|
| Rate for Payer: Signature Care PPO |
$143.59
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$138.69
|
| Rate for Payer: United Healthcare Commercial |
$128.58
|
| Rate for Payer: United Healthcare Medicare |
$53.85
|
|
|
HC SCREW CORTICAL 2.0MM 16MM
|
Facility
IP
|
$163.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602029
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$122.38 |
| Max. Negotiated Rate |
$151.75 |
| Rate for Payer: Aetna Commercial |
$140.98
|
| Rate for Payer: Cash Price |
$101.17
|
| Rate for Payer: Cigna All Commercial |
$140.82
|
| Rate for Payer: CORVEL All Commercial |
$151.75
|
| Rate for Payer: Coventry All Commercial |
$143.59
|
| Rate for Payer: Encore All Commercial |
$150.20
|
| Rate for Payer: Frontpath All Commercial |
$150.12
|
| Rate for Payer: Humana ChoiceCare |
$140.93
|
| Rate for Payer: Lutheran Preferred All Commercial |
$146.85
|
| Rate for Payer: PHCS All Commercial |
$122.38
|
| Rate for Payer: PHP All Commercial |
$123.75
|
| Rate for Payer: Sagamore Health Network All Products |
$125.97
|
| Rate for Payer: Signature Care EPO |
$135.43
|
| Rate for Payer: Signature Care PPO |
$143.59
|
| Rate for Payer: United Healthcare Commercial |
$128.58
|
|
|
HC SCREW CORTICAL 2.0MM 18MM
|
Facility
OP
|
$163.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602030
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$53.85 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$137.72
|
| Rate for Payer: Aetna Medicare |
$53.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$53.85
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$93.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$102.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$61.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$59.23
|
| Rate for Payer: Cash Price |
$101.17
|
| Rate for Payer: Cash Price |
$101.17
|
| Rate for Payer: Centivo All Commercial |
$83.22
|
| Rate for Payer: Cigna All Commercial |
$140.82
|
| Rate for Payer: CORVEL All Commercial |
$151.75
|
| Rate for Payer: Coventry All Commercial |
$143.59
|
| Rate for Payer: Encore All Commercial |
$150.20
|
| Rate for Payer: Frontpath All Commercial |
$150.12
|
| Rate for Payer: Humana ChoiceCare |
$140.93
|
| Rate for Payer: Humana Medicare |
$83.22
|
| Rate for Payer: Lucent All Commercial |
$83.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$146.85
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$122.38
|
| Rate for Payer: PHP All Commercial |
$123.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$63.64
|
| Rate for Payer: Sagamore Health Network All Products |
$125.97
|
| Rate for Payer: Signature Care EPO |
$135.43
|
| Rate for Payer: Signature Care PPO |
$143.59
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$138.69
|
| Rate for Payer: United Healthcare Commercial |
$128.58
|
| Rate for Payer: United Healthcare Medicare |
$53.85
|
|
|
HC SCREW CORTICAL 2.0MM 18MM
|
Facility
IP
|
$163.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602030
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$122.38 |
| Max. Negotiated Rate |
$151.75 |
| Rate for Payer: Aetna Commercial |
$140.98
|
| Rate for Payer: Cash Price |
$101.17
|
| Rate for Payer: Cigna All Commercial |
$140.82
|
| Rate for Payer: CORVEL All Commercial |
$151.75
|
| Rate for Payer: Coventry All Commercial |
$143.59
|
| Rate for Payer: Encore All Commercial |
$150.20
|
| Rate for Payer: Frontpath All Commercial |
$150.12
|
| Rate for Payer: Humana ChoiceCare |
$140.93
|
| Rate for Payer: Lutheran Preferred All Commercial |
$146.85
|
| Rate for Payer: PHCS All Commercial |
$122.38
|
| Rate for Payer: PHP All Commercial |
$123.75
|
| Rate for Payer: Sagamore Health Network All Products |
$125.97
|
| Rate for Payer: Signature Care EPO |
$135.43
|
| Rate for Payer: Signature Care PPO |
$143.59
|
| Rate for Payer: United Healthcare Commercial |
$128.58
|
|
|
HC SCREW CORTICAL 2.0MM 20MM
|
Facility
OP
|
$163.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602031
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$53.85 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$137.72
|
| Rate for Payer: Aetna Medicare |
$53.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$53.85
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$93.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$102.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$61.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$59.23
|
| Rate for Payer: Cash Price |
$101.17
|
| Rate for Payer: Cash Price |
$101.17
|
| Rate for Payer: Centivo All Commercial |
$83.22
|
| Rate for Payer: Cigna All Commercial |
$140.82
|
| Rate for Payer: CORVEL All Commercial |
$151.75
|
| Rate for Payer: Coventry All Commercial |
$143.59
|
| Rate for Payer: Encore All Commercial |
$150.20
|
| Rate for Payer: Frontpath All Commercial |
$150.12
|
| Rate for Payer: Humana ChoiceCare |
$140.93
|
| Rate for Payer: Humana Medicare |
$83.22
|
| Rate for Payer: Lucent All Commercial |
$83.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$146.85
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$122.38
|
| Rate for Payer: PHP All Commercial |
$123.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$63.64
|
| Rate for Payer: Sagamore Health Network All Products |
$125.97
|
| Rate for Payer: Signature Care EPO |
$135.43
|
| Rate for Payer: Signature Care PPO |
$143.59
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$138.69
|
| Rate for Payer: United Healthcare Commercial |
$128.58
|
| Rate for Payer: United Healthcare Medicare |
$53.85
|
|
|
HC SCREW CORTICAL 2.0MM 20MM
|
Facility
IP
|
$163.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602031
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$122.38 |
| Max. Negotiated Rate |
$151.75 |
| Rate for Payer: Aetna Commercial |
$140.98
|
| Rate for Payer: Cash Price |
$101.17
|
| Rate for Payer: Cigna All Commercial |
$140.82
|
| Rate for Payer: CORVEL All Commercial |
$151.75
|
| Rate for Payer: Coventry All Commercial |
$143.59
|
| Rate for Payer: Encore All Commercial |
$150.20
|
| Rate for Payer: Frontpath All Commercial |
$150.12
|
| Rate for Payer: Humana ChoiceCare |
$140.93
|
| Rate for Payer: Lutheran Preferred All Commercial |
$146.85
|
| Rate for Payer: PHCS All Commercial |
$122.38
|
| Rate for Payer: PHP All Commercial |
$123.75
|
| Rate for Payer: Sagamore Health Network All Products |
$125.97
|
| Rate for Payer: Signature Care EPO |
$135.43
|
| Rate for Payer: Signature Care PPO |
$143.59
|
| Rate for Payer: United Healthcare Commercial |
$128.58
|
|
|
HC SCREW CORTICAL 2.7MM 10MM
|
Facility
OP
|
$149.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602034
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$49.23 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$125.90
|
| Rate for Payer: Aetna Medicare |
$49.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$49.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$85.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$93.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$56.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$54.15
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Centivo All Commercial |
$76.08
|
| Rate for Payer: Cigna All Commercial |
$128.73
|
| Rate for Payer: CORVEL All Commercial |
$138.73
|
| Rate for Payer: Coventry All Commercial |
$131.27
|
| Rate for Payer: Encore All Commercial |
$137.31
|
| Rate for Payer: Frontpath All Commercial |
$137.24
|
| Rate for Payer: Humana ChoiceCare |
$128.84
|
| Rate for Payer: Humana Medicare |
$76.08
|
| Rate for Payer: Lucent All Commercial |
$76.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$134.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$111.88
|
| Rate for Payer: PHP All Commercial |
$113.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$58.18
|
| Rate for Payer: Sagamore Health Network All Products |
$115.16
|
| Rate for Payer: Signature Care EPO |
$123.81
|
| Rate for Payer: Signature Care PPO |
$131.27
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$126.79
|
| Rate for Payer: United Healthcare Commercial |
$117.55
|
| Rate for Payer: United Healthcare Medicare |
$49.23
|
|
|
HC SCREW CORTICAL 2.7MM 10MM
|
Facility
IP
|
$149.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602034
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$111.88 |
| Max. Negotiated Rate |
$138.73 |
| Rate for Payer: Aetna Commercial |
$128.88
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Cigna All Commercial |
$128.73
|
| Rate for Payer: CORVEL All Commercial |
$138.73
|
| Rate for Payer: Coventry All Commercial |
$131.27
|
| Rate for Payer: Encore All Commercial |
$137.31
|
| Rate for Payer: Frontpath All Commercial |
$137.24
|
| Rate for Payer: Humana ChoiceCare |
$128.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$134.25
|
| Rate for Payer: PHCS All Commercial |
$111.88
|
| Rate for Payer: PHP All Commercial |
$113.13
|
| Rate for Payer: Sagamore Health Network All Products |
$115.16
|
| Rate for Payer: Signature Care EPO |
$123.81
|
| Rate for Payer: Signature Care PPO |
$131.27
|
| Rate for Payer: United Healthcare Commercial |
$117.55
|
|
|
HC SCREW CORTICAL 2.7MM 12MM
|
Facility
OP
|
$149.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602035
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$49.23 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$125.90
|
| Rate for Payer: Aetna Medicare |
$49.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$49.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$85.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$93.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$56.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$54.15
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Centivo All Commercial |
$76.08
|
| Rate for Payer: Cigna All Commercial |
$128.73
|
| Rate for Payer: CORVEL All Commercial |
$138.73
|
| Rate for Payer: Coventry All Commercial |
$131.27
|
| Rate for Payer: Encore All Commercial |
$137.31
|
| Rate for Payer: Frontpath All Commercial |
$137.24
|
| Rate for Payer: Humana ChoiceCare |
$128.84
|
| Rate for Payer: Humana Medicare |
$76.08
|
| Rate for Payer: Lucent All Commercial |
$76.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$134.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$111.88
|
| Rate for Payer: PHP All Commercial |
$113.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$58.18
|
| Rate for Payer: Sagamore Health Network All Products |
$115.16
|
| Rate for Payer: Signature Care EPO |
$123.81
|
| Rate for Payer: Signature Care PPO |
$131.27
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$126.79
|
| Rate for Payer: United Healthcare Commercial |
$117.55
|
| Rate for Payer: United Healthcare Medicare |
$49.23
|
|
|
HC SCREW CORTICAL 2.7MM 12MM
|
Facility
IP
|
$149.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602035
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$111.88 |
| Max. Negotiated Rate |
$138.73 |
| Rate for Payer: Aetna Commercial |
$128.88
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Cigna All Commercial |
$128.73
|
| Rate for Payer: CORVEL All Commercial |
$138.73
|
| Rate for Payer: Coventry All Commercial |
$131.27
|
| Rate for Payer: Encore All Commercial |
$137.31
|
| Rate for Payer: Frontpath All Commercial |
$137.24
|
| Rate for Payer: Humana ChoiceCare |
$128.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$134.25
|
| Rate for Payer: PHCS All Commercial |
$111.88
|
| Rate for Payer: PHP All Commercial |
$113.13
|
| Rate for Payer: Sagamore Health Network All Products |
$115.16
|
| Rate for Payer: Signature Care EPO |
$123.81
|
| Rate for Payer: Signature Care PPO |
$131.27
|
| Rate for Payer: United Healthcare Commercial |
$117.55
|
|
|
HC SCREW CORTICAL 2.7MM 14MM
|
Facility
IP
|
$149.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$111.88 |
| Max. Negotiated Rate |
$138.73 |
| Rate for Payer: Aetna Commercial |
$128.88
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Cigna All Commercial |
$128.73
|
| Rate for Payer: CORVEL All Commercial |
$138.73
|
| Rate for Payer: Coventry All Commercial |
$131.27
|
| Rate for Payer: Encore All Commercial |
$137.31
|
| Rate for Payer: Frontpath All Commercial |
$137.24
|
| Rate for Payer: Humana ChoiceCare |
$128.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$134.25
|
| Rate for Payer: PHCS All Commercial |
$111.88
|
| Rate for Payer: PHP All Commercial |
$113.13
|
| Rate for Payer: Sagamore Health Network All Products |
$115.16
|
| Rate for Payer: Signature Care EPO |
$123.81
|
| Rate for Payer: Signature Care PPO |
$131.27
|
| Rate for Payer: United Healthcare Commercial |
$117.55
|
|
|
HC SCREW CORTICAL 2.7MM 14MM
|
Facility
OP
|
$149.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$49.23 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$125.90
|
| Rate for Payer: Aetna Medicare |
$49.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$49.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$85.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$93.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$56.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$54.15
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Centivo All Commercial |
$76.08
|
| Rate for Payer: Cigna All Commercial |
$128.73
|
| Rate for Payer: CORVEL All Commercial |
$138.73
|
| Rate for Payer: Coventry All Commercial |
$131.27
|
| Rate for Payer: Encore All Commercial |
$137.31
|
| Rate for Payer: Frontpath All Commercial |
$137.24
|
| Rate for Payer: Humana ChoiceCare |
$128.84
|
| Rate for Payer: Humana Medicare |
$76.08
|
| Rate for Payer: Lucent All Commercial |
$76.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$134.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$111.88
|
| Rate for Payer: PHP All Commercial |
$113.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$58.18
|
| Rate for Payer: Sagamore Health Network All Products |
$115.16
|
| Rate for Payer: Signature Care EPO |
$123.81
|
| Rate for Payer: Signature Care PPO |
$131.27
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$126.79
|
| Rate for Payer: United Healthcare Commercial |
$117.55
|
| Rate for Payer: United Healthcare Medicare |
$49.23
|
|
|
HC SCREW CORTICAL 2.7MM 16MM
|
Facility
OP
|
$149.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$49.23 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$125.90
|
| Rate for Payer: Aetna Medicare |
$49.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$49.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$85.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$93.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$56.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$54.15
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Centivo All Commercial |
$76.08
|
| Rate for Payer: Cigna All Commercial |
$128.73
|
| Rate for Payer: CORVEL All Commercial |
$138.73
|
| Rate for Payer: Coventry All Commercial |
$131.27
|
| Rate for Payer: Encore All Commercial |
$137.31
|
| Rate for Payer: Frontpath All Commercial |
$137.24
|
| Rate for Payer: Humana ChoiceCare |
$128.84
|
| Rate for Payer: Humana Medicare |
$76.08
|
| Rate for Payer: Lucent All Commercial |
$76.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$134.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$111.88
|
| Rate for Payer: PHP All Commercial |
$113.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$58.18
|
| Rate for Payer: Sagamore Health Network All Products |
$115.16
|
| Rate for Payer: Signature Care EPO |
$123.81
|
| Rate for Payer: Signature Care PPO |
$131.27
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$126.79
|
| Rate for Payer: United Healthcare Commercial |
$117.55
|
| Rate for Payer: United Healthcare Medicare |
$49.23
|
|
