|
HC Z DRILL AUG 2.7
|
Facility
|
OP
|
$754.40
|
|
| Hospital Charge Code |
41606609
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$701.59 |
| Rate for Payer: Aetna Commercial |
$636.71
|
| Rate for Payer: Aetna Medicare |
$241.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$233.86
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$433.25
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$471.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$277.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$265.55
|
| Rate for Payer: Cash Price |
$452.64
|
| Rate for Payer: Cash Price |
$452.64
|
| Rate for Payer: Centivo All Commercial |
$410.39
|
| Rate for Payer: Cigna All Commercial |
$651.05
|
| Rate for Payer: CORVEL All Commercial |
$701.59
|
| Rate for Payer: Coventry All Commercial |
$663.87
|
| Rate for Payer: Encore All Commercial |
$694.43
|
| Rate for Payer: Frontpath All Commercial |
$694.05
|
| Rate for Payer: Humana ChoiceCare |
$651.58
|
| Rate for Payer: Humana Medicare |
$241.41
|
| Rate for Payer: Lucent All Commercial |
$410.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$678.96
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$565.80
|
| Rate for Payer: PHP All Commercial |
$572.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$294.22
|
| Rate for Payer: Sagamore Health Network All Products |
$582.40
|
| Rate for Payer: Signature Care EPO |
$626.15
|
| Rate for Payer: Signature Care PPO |
$663.87
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$641.24
|
| Rate for Payer: United Healthcare Commercial |
$594.47
|
| Rate for Payer: United Healthcare Medicare |
$241.41
|
|
|
HC Z DRILL BIT 100
|
Facility
|
OP
|
$735.28
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607761
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$683.81 |
| Rate for Payer: Aetna Commercial |
$620.58
|
| Rate for Payer: Aetna Medicare |
$235.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$227.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$422.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$459.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$270.58
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$258.82
|
| Rate for Payer: Cash Price |
$441.17
|
| Rate for Payer: Cash Price |
$441.17
|
| Rate for Payer: Centivo All Commercial |
$399.99
|
| Rate for Payer: Cigna All Commercial |
$634.55
|
| Rate for Payer: CORVEL All Commercial |
$683.81
|
| Rate for Payer: Coventry All Commercial |
$647.05
|
| Rate for Payer: Encore All Commercial |
$676.83
|
| Rate for Payer: Frontpath All Commercial |
$676.46
|
| Rate for Payer: Humana ChoiceCare |
$635.06
|
| Rate for Payer: Humana Medicare |
$235.29
|
| Rate for Payer: Lucent All Commercial |
$399.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$661.75
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$551.46
|
| Rate for Payer: PHP All Commercial |
$557.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$286.76
|
| Rate for Payer: Sagamore Health Network All Products |
$567.64
|
| Rate for Payer: Signature Care EPO |
$610.28
|
| Rate for Payer: Signature Care PPO |
$647.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$624.99
|
| Rate for Payer: United Healthcare Commercial |
$579.40
|
| Rate for Payer: United Healthcare Medicare |
$235.29
|
|
|
HC Z DRILL BIT 100
|
Facility
|
IP
|
$735.28
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607761
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$551.46 |
| Max. Negotiated Rate |
$683.81 |
| Rate for Payer: Aetna Commercial |
$635.28
|
| Rate for Payer: Cash Price |
$441.17
|
| Rate for Payer: Cigna All Commercial |
$634.55
|
| Rate for Payer: CORVEL All Commercial |
$683.81
|
| Rate for Payer: Coventry All Commercial |
$647.05
|
| Rate for Payer: Encore All Commercial |
$676.83
|
| Rate for Payer: Frontpath All Commercial |
$676.46
|
| Rate for Payer: Humana ChoiceCare |
$635.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$661.75
|
| Rate for Payer: PHCS All Commercial |
$551.46
|
| Rate for Payer: PHP All Commercial |
$557.64
|
| Rate for Payer: Sagamore Health Network All Products |
$567.64
|
| Rate for Payer: Signature Care EPO |
$610.28
|
| Rate for Payer: Signature Care PPO |
$647.05
|
| Rate for Payer: United Healthcare Commercial |
$579.40
|
|
|
HC Z DRILL BIT 1.1MM FAST
|
Facility
|
IP
|
$346.43
|
|
| Hospital Charge Code |
41605894
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$259.82 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$299.32
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
|
|
HC Z DRILL BIT 1.1MM FAST
|
Facility
|
OP
|
$346.43
|
|
| Hospital Charge Code |
41605894
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$292.39
|
| Rate for Payer: Aetna Medicare |
$110.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$107.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$198.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$216.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$127.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$121.94
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Centivo All Commercial |
$188.46
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Humana Medicare |
$110.86
|
| Rate for Payer: Lucent All Commercial |
$188.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$135.11
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$294.47
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
| Rate for Payer: United Healthcare Medicare |
$110.86
|
|
|
HC Z DRILL BIT 1.5 MINI QK
|
Facility
|
IP
|
$346.43
|
|
| Hospital Charge Code |
41608224
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$259.82 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$299.32
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
|
|
HC Z DRILL BIT 1.5 MINI QK
|
Facility
|
OP
|
$346.43
|
|
| Hospital Charge Code |
41608224
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$292.39
|
| Rate for Payer: Aetna Medicare |
$110.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$107.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$198.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$216.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$127.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$121.94
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Centivo All Commercial |
$188.46
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Humana Medicare |
$110.86
|
| Rate for Payer: Lucent All Commercial |
$188.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$135.11
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$294.47
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
| Rate for Payer: United Healthcare Medicare |
$110.86
|
|
|
HC Z DRILL BIT 2.0 100 QC
|
Facility
|
IP
|
$489.37
|
|
| Hospital Charge Code |
41604261
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$367.03 |
| Max. Negotiated Rate |
$455.11 |
| Rate for Payer: Aetna Commercial |
$422.82
|
| Rate for Payer: Cash Price |
$293.62
|
| Rate for Payer: Cigna All Commercial |
$422.33
|
| Rate for Payer: CORVEL All Commercial |
$455.11
|
| Rate for Payer: Coventry All Commercial |
$430.65
|
| Rate for Payer: Encore All Commercial |
$450.47
|
| Rate for Payer: Frontpath All Commercial |
$450.22
|
| Rate for Payer: Humana ChoiceCare |
$422.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$440.43
|
| Rate for Payer: PHCS All Commercial |
$367.03
|
| Rate for Payer: PHP All Commercial |
$371.14
|
| Rate for Payer: Sagamore Health Network All Products |
$377.79
|
| Rate for Payer: Signature Care EPO |
$406.18
|
| Rate for Payer: Signature Care PPO |
$430.65
|
| Rate for Payer: United Healthcare Commercial |
$385.62
|
|
|
HC Z DRILL BIT 2.0 100 QC
|
Facility
|
OP
|
$489.37
|
|
| Hospital Charge Code |
41604261
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$455.11 |
| Rate for Payer: Aetna Commercial |
$413.03
|
| Rate for Payer: Aetna Medicare |
$156.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$151.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$281.05
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$305.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$180.09
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$172.26
|
| Rate for Payer: Cash Price |
$293.62
|
| Rate for Payer: Cash Price |
$293.62
|
| Rate for Payer: Centivo All Commercial |
$266.22
|
| Rate for Payer: Cigna All Commercial |
$422.33
|
| Rate for Payer: CORVEL All Commercial |
$455.11
|
| Rate for Payer: Coventry All Commercial |
$430.65
|
| Rate for Payer: Encore All Commercial |
$450.47
|
| Rate for Payer: Frontpath All Commercial |
$450.22
|
| Rate for Payer: Humana ChoiceCare |
$422.67
|
| Rate for Payer: Humana Medicare |
$156.60
|
| Rate for Payer: Lucent All Commercial |
$266.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$440.43
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$367.03
|
| Rate for Payer: PHP All Commercial |
$371.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$190.85
|
| Rate for Payer: Sagamore Health Network All Products |
$377.79
|
| Rate for Payer: Signature Care EPO |
$406.18
|
| Rate for Payer: Signature Care PPO |
$430.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$415.96
|
| Rate for Payer: United Healthcare Commercial |
$385.62
|
| Rate for Payer: United Healthcare Medicare |
$156.60
|
|
|
HC Z DRILL BIT 2.0 9382
|
Facility
|
IP
|
$829.78
|
|
| Hospital Charge Code |
41606895
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$622.34 |
| Max. Negotiated Rate |
$771.70 |
| Rate for Payer: Aetna Commercial |
$716.93
|
| Rate for Payer: Cash Price |
$497.87
|
| Rate for Payer: Cigna All Commercial |
$716.10
|
| Rate for Payer: CORVEL All Commercial |
$771.70
|
| Rate for Payer: Coventry All Commercial |
$730.21
|
| Rate for Payer: Encore All Commercial |
$763.81
|
| Rate for Payer: Frontpath All Commercial |
$763.40
|
| Rate for Payer: Humana ChoiceCare |
$716.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$746.80
|
| Rate for Payer: PHCS All Commercial |
$622.34
|
| Rate for Payer: PHP All Commercial |
$629.31
|
| Rate for Payer: Sagamore Health Network All Products |
$640.59
|
| Rate for Payer: Signature Care EPO |
$688.72
|
| Rate for Payer: Signature Care PPO |
$730.21
|
| Rate for Payer: United Healthcare Commercial |
$653.87
|
|
|
HC Z DRILL BIT 2.0 9382
|
Facility
|
OP
|
$829.78
|
|
| Hospital Charge Code |
41606895
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$771.70 |
| Rate for Payer: Aetna Commercial |
$700.33
|
| Rate for Payer: Aetna Medicare |
$265.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$257.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$476.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$518.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$305.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$292.08
|
| Rate for Payer: Cash Price |
$497.87
|
| Rate for Payer: Cash Price |
$497.87
|
| Rate for Payer: Centivo All Commercial |
$451.40
|
| Rate for Payer: Cigna All Commercial |
$716.10
|
| Rate for Payer: CORVEL All Commercial |
$771.70
|
| Rate for Payer: Coventry All Commercial |
$730.21
|
| Rate for Payer: Encore All Commercial |
$763.81
|
| Rate for Payer: Frontpath All Commercial |
$763.40
|
| Rate for Payer: Humana ChoiceCare |
$716.68
|
| Rate for Payer: Humana Medicare |
$265.53
|
| Rate for Payer: Lucent All Commercial |
$451.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$746.80
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$622.34
|
| Rate for Payer: PHP All Commercial |
$629.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$323.61
|
| Rate for Payer: Sagamore Health Network All Products |
$640.59
|
| Rate for Payer: Signature Care EPO |
$688.72
|
| Rate for Payer: Signature Care PPO |
$730.21
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$705.31
|
| Rate for Payer: United Healthcare Commercial |
$653.87
|
| Rate for Payer: United Healthcare Medicare |
$265.53
|
|
|
HC Z DRILL BIT 2.0 FAST MINI
|
Facility
|
OP
|
$346.43
|
|
| Hospital Charge Code |
41607752
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$292.39
|
| Rate for Payer: Aetna Medicare |
$110.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$107.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$198.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$216.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$127.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$121.94
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Centivo All Commercial |
$188.46
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Humana Medicare |
$110.86
|
| Rate for Payer: Lucent All Commercial |
$188.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$135.11
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$294.47
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
| Rate for Payer: United Healthcare Medicare |
$110.86
|
|
|
HC Z DRILL BIT 2.0 FAST MINI
|
Facility
|
IP
|
$346.43
|
|
| Hospital Charge Code |
41607752
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$259.82 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$299.32
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
|
|
HC Z DRILL BIT 2.2MM
|
Facility
|
OP
|
$657.51
|
|
| Hospital Charge Code |
41605896
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$611.48 |
| Rate for Payer: Aetna Commercial |
$554.94
|
| Rate for Payer: Aetna Medicare |
$210.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$203.83
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$377.61
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$411.01
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$241.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$231.44
|
| Rate for Payer: Cash Price |
$394.51
|
| Rate for Payer: Cash Price |
$394.51
|
| Rate for Payer: Centivo All Commercial |
$357.69
|
| Rate for Payer: Cigna All Commercial |
$567.43
|
| Rate for Payer: CORVEL All Commercial |
$611.48
|
| Rate for Payer: Coventry All Commercial |
$578.61
|
| Rate for Payer: Encore All Commercial |
$605.24
|
| Rate for Payer: Frontpath All Commercial |
$604.91
|
| Rate for Payer: Humana ChoiceCare |
$567.89
|
| Rate for Payer: Humana Medicare |
$210.40
|
| Rate for Payer: Lucent All Commercial |
$357.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$591.76
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$493.13
|
| Rate for Payer: PHP All Commercial |
$498.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$256.43
|
| Rate for Payer: Sagamore Health Network All Products |
$507.60
|
| Rate for Payer: Signature Care EPO |
$545.73
|
| Rate for Payer: Signature Care PPO |
$578.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$558.88
|
| Rate for Payer: United Healthcare Commercial |
$518.12
|
| Rate for Payer: United Healthcare Medicare |
$210.40
|
|
|
HC Z DRILL BIT 2.2MM
|
Facility
|
IP
|
$657.51
|
|
| Hospital Charge Code |
41605896
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$493.13 |
| Max. Negotiated Rate |
$611.48 |
| Rate for Payer: Aetna Commercial |
$568.09
|
| Rate for Payer: Cash Price |
$394.51
|
| Rate for Payer: Cigna All Commercial |
$567.43
|
| Rate for Payer: CORVEL All Commercial |
$611.48
|
| Rate for Payer: Coventry All Commercial |
$578.61
|
| Rate for Payer: Encore All Commercial |
$605.24
|
| Rate for Payer: Frontpath All Commercial |
$604.91
|
| Rate for Payer: Humana ChoiceCare |
$567.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$591.76
|
| Rate for Payer: PHCS All Commercial |
$493.13
|
| Rate for Payer: PHP All Commercial |
$498.66
|
| Rate for Payer: Sagamore Health Network All Products |
$507.60
|
| Rate for Payer: Signature Care EPO |
$545.73
|
| Rate for Payer: Signature Care PPO |
$578.61
|
| Rate for Payer: United Healthcare Commercial |
$518.12
|
|
|
HC Z DRILL BIT 2.5
|
Facility
|
OP
|
$699.93
|
|
| Hospital Charge Code |
41603886
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$650.93 |
| Rate for Payer: Aetna Commercial |
$590.74
|
| Rate for Payer: Aetna Medicare |
$223.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$216.98
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$401.97
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$437.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$257.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$246.38
|
| Rate for Payer: Cash Price |
$419.96
|
| Rate for Payer: Cash Price |
$419.96
|
| Rate for Payer: Centivo All Commercial |
$380.76
|
| Rate for Payer: Cigna All Commercial |
$604.04
|
| Rate for Payer: CORVEL All Commercial |
$650.93
|
| Rate for Payer: Coventry All Commercial |
$615.94
|
| Rate for Payer: Encore All Commercial |
$644.29
|
| Rate for Payer: Frontpath All Commercial |
$643.94
|
| Rate for Payer: Humana ChoiceCare |
$604.53
|
| Rate for Payer: Humana Medicare |
$223.98
|
| Rate for Payer: Lucent All Commercial |
$380.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.94
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$524.95
|
| Rate for Payer: PHP All Commercial |
$530.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.97
|
| Rate for Payer: Sagamore Health Network All Products |
$540.35
|
| Rate for Payer: Signature Care EPO |
$580.94
|
| Rate for Payer: Signature Care PPO |
$615.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$594.94
|
| Rate for Payer: United Healthcare Commercial |
$551.54
|
| Rate for Payer: United Healthcare Medicare |
$223.98
|
|
|
HC Z DRILL BIT 2.5
|
Facility
|
IP
|
$699.93
|
|
| Hospital Charge Code |
41603886
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$524.95 |
| Max. Negotiated Rate |
$650.93 |
| Rate for Payer: Aetna Commercial |
$604.74
|
| Rate for Payer: Cash Price |
$419.96
|
| Rate for Payer: Cigna All Commercial |
$604.04
|
| Rate for Payer: CORVEL All Commercial |
$650.93
|
| Rate for Payer: Coventry All Commercial |
$615.94
|
| Rate for Payer: Encore All Commercial |
$644.29
|
| Rate for Payer: Frontpath All Commercial |
$643.94
|
| Rate for Payer: Humana ChoiceCare |
$604.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.94
|
| Rate for Payer: PHCS All Commercial |
$524.95
|
| Rate for Payer: PHP All Commercial |
$530.83
|
| Rate for Payer: Sagamore Health Network All Products |
$540.35
|
| Rate for Payer: Signature Care EPO |
$580.94
|
| Rate for Payer: Signature Care PPO |
$615.94
|
| Rate for Payer: United Healthcare Commercial |
$551.54
|
|
|
HC Z DRILL BIT 2.5 MINI
|
Facility
|
OP
|
$346.43
|
|
| Hospital Charge Code |
41606517
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$292.39
|
| Rate for Payer: Aetna Medicare |
$110.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$107.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$198.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$216.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$127.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$121.94
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Centivo All Commercial |
$188.46
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Humana Medicare |
$110.86
|
| Rate for Payer: Lucent All Commercial |
$188.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$135.11
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$294.47
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
| Rate for Payer: United Healthcare Medicare |
$110.86
|
|
|
HC Z DRILL BIT 2.5 MINI
|
Facility
|
IP
|
$346.43
|
|
| Hospital Charge Code |
41606517
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$259.82 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$299.32
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
|
|
HC Z DRILL B IT 2.5X100
|
Facility
|
OP
|
$699.93
|
|
| Hospital Charge Code |
41608049
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$650.93 |
| Rate for Payer: Aetna Commercial |
$590.74
|
| Rate for Payer: Aetna Medicare |
$223.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$216.98
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$401.97
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$437.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$257.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$246.38
|
| Rate for Payer: Cash Price |
$419.96
|
| Rate for Payer: Cash Price |
$419.96
|
| Rate for Payer: Centivo All Commercial |
$380.76
|
| Rate for Payer: Cigna All Commercial |
$604.04
|
| Rate for Payer: CORVEL All Commercial |
$650.93
|
| Rate for Payer: Coventry All Commercial |
$615.94
|
| Rate for Payer: Encore All Commercial |
$644.29
|
| Rate for Payer: Frontpath All Commercial |
$643.94
|
| Rate for Payer: Humana ChoiceCare |
$604.53
|
| Rate for Payer: Humana Medicare |
$223.98
|
| Rate for Payer: Lucent All Commercial |
$380.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.94
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$524.95
|
| Rate for Payer: PHP All Commercial |
$530.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.97
|
| Rate for Payer: Sagamore Health Network All Products |
$540.35
|
| Rate for Payer: Signature Care EPO |
$580.94
|
| Rate for Payer: Signature Care PPO |
$615.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$594.94
|
| Rate for Payer: United Healthcare Commercial |
$551.54
|
| Rate for Payer: United Healthcare Medicare |
$223.98
|
|
|
HC Z DRILL B IT 2.5X100
|
Facility
|
IP
|
$699.93
|
|
| Hospital Charge Code |
41608049
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$524.95 |
| Max. Negotiated Rate |
$650.93 |
| Rate for Payer: Aetna Commercial |
$604.74
|
| Rate for Payer: Cash Price |
$419.96
|
| Rate for Payer: Cigna All Commercial |
$604.04
|
| Rate for Payer: CORVEL All Commercial |
$650.93
|
| Rate for Payer: Coventry All Commercial |
$615.94
|
| Rate for Payer: Encore All Commercial |
$644.29
|
| Rate for Payer: Frontpath All Commercial |
$643.94
|
| Rate for Payer: Humana ChoiceCare |
$604.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.94
|
| Rate for Payer: PHCS All Commercial |
$524.95
|
| Rate for Payer: PHP All Commercial |
$530.83
|
| Rate for Payer: Sagamore Health Network All Products |
$540.35
|
| Rate for Payer: Signature Care EPO |
$580.94
|
| Rate for Payer: Signature Care PPO |
$615.94
|
| Rate for Payer: United Healthcare Commercial |
$551.54
|
|
|
HC Z DRILL BIT 2.7 CANN CALB
|
Facility
|
IP
|
$735.28
|
|
| Hospital Charge Code |
41603705
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$551.46 |
| Max. Negotiated Rate |
$683.81 |
| Rate for Payer: Aetna Commercial |
$635.28
|
| Rate for Payer: Cash Price |
$441.17
|
| Rate for Payer: Cigna All Commercial |
$634.55
|
| Rate for Payer: CORVEL All Commercial |
$683.81
|
| Rate for Payer: Coventry All Commercial |
$647.05
|
| Rate for Payer: Encore All Commercial |
$676.83
|
| Rate for Payer: Frontpath All Commercial |
$676.46
|
| Rate for Payer: Humana ChoiceCare |
$635.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$661.75
|
| Rate for Payer: PHCS All Commercial |
$551.46
|
| Rate for Payer: PHP All Commercial |
$557.64
|
| Rate for Payer: Sagamore Health Network All Products |
$567.64
|
| Rate for Payer: Signature Care EPO |
$610.28
|
| Rate for Payer: Signature Care PPO |
$647.05
|
| Rate for Payer: United Healthcare Commercial |
$579.40
|
|
|
HC Z DRILL BIT 2.7 CANN CALB
|
Facility
|
OP
|
$735.28
|
|
| Hospital Charge Code |
41603705
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$683.81 |
| Rate for Payer: Aetna Commercial |
$620.58
|
| Rate for Payer: Aetna Medicare |
$235.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$227.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$422.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$459.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$270.58
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$258.82
|
| Rate for Payer: Cash Price |
$441.17
|
| Rate for Payer: Cash Price |
$441.17
|
| Rate for Payer: Centivo All Commercial |
$399.99
|
| Rate for Payer: Cigna All Commercial |
$634.55
|
| Rate for Payer: CORVEL All Commercial |
$683.81
|
| Rate for Payer: Coventry All Commercial |
$647.05
|
| Rate for Payer: Encore All Commercial |
$676.83
|
| Rate for Payer: Frontpath All Commercial |
$676.46
|
| Rate for Payer: Humana ChoiceCare |
$635.06
|
| Rate for Payer: Humana Medicare |
$235.29
|
| Rate for Payer: Lucent All Commercial |
$399.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$661.75
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$551.46
|
| Rate for Payer: PHP All Commercial |
$557.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$286.76
|
| Rate for Payer: Sagamore Health Network All Products |
$567.64
|
| Rate for Payer: Signature Care EPO |
$610.28
|
| Rate for Payer: Signature Care PPO |
$647.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$624.99
|
| Rate for Payer: United Healthcare Commercial |
$579.40
|
| Rate for Payer: United Healthcare Medicare |
$235.29
|
|
|
HC Z DRILL BIT 2.7 CANN QC
|
Facility
|
IP
|
$1,845.61
|
|
| Hospital Charge Code |
41604383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,384.21 |
| Max. Negotiated Rate |
$1,716.42 |
| Rate for Payer: Aetna Commercial |
$1,594.61
|
| Rate for Payer: Cash Price |
$1,107.37
|
| Rate for Payer: Cigna All Commercial |
$1,592.76
|
| Rate for Payer: CORVEL All Commercial |
$1,716.42
|
| Rate for Payer: Coventry All Commercial |
$1,624.14
|
| Rate for Payer: Encore All Commercial |
$1,698.88
|
| Rate for Payer: Frontpath All Commercial |
$1,697.96
|
| Rate for Payer: Humana ChoiceCare |
$1,594.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,661.05
|
| Rate for Payer: PHCS All Commercial |
$1,384.21
|
| Rate for Payer: PHP All Commercial |
$1,399.71
|
| Rate for Payer: Sagamore Health Network All Products |
$1,424.81
|
| Rate for Payer: Signature Care EPO |
$1,531.86
|
| Rate for Payer: Signature Care PPO |
$1,624.14
|
| Rate for Payer: United Healthcare Commercial |
$1,454.34
|
|
|
HC Z DRILL BIT 2.7 CANN QC
|
Facility
|
OP
|
$1,845.61
|
|
| Hospital Charge Code |
41604383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$1,716.42 |
| Rate for Payer: Aetna Commercial |
$1,557.69
|
| Rate for Payer: Aetna Medicare |
$590.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$572.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,059.93
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,153.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$679.18
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$649.65
|
| Rate for Payer: Cash Price |
$1,107.37
|
| Rate for Payer: Cash Price |
$1,107.37
|
| Rate for Payer: Centivo All Commercial |
$1,004.01
|
| Rate for Payer: Cigna All Commercial |
$1,592.76
|
| Rate for Payer: CORVEL All Commercial |
$1,716.42
|
| Rate for Payer: Coventry All Commercial |
$1,624.14
|
| Rate for Payer: Encore All Commercial |
$1,698.88
|
| Rate for Payer: Frontpath All Commercial |
$1,697.96
|
| Rate for Payer: Humana ChoiceCare |
$1,594.05
|
| Rate for Payer: Humana Medicare |
$590.60
|
| Rate for Payer: Lucent All Commercial |
$1,004.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,661.05
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$1,384.21
|
| Rate for Payer: PHP All Commercial |
$1,399.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$719.79
|
| Rate for Payer: Sagamore Health Network All Products |
$1,424.81
|
| Rate for Payer: Signature Care EPO |
$1,531.86
|
| Rate for Payer: Signature Care PPO |
$1,624.14
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,568.77
|
| Rate for Payer: United Healthcare Commercial |
$1,454.34
|
| Rate for Payer: United Healthcare Medicare |
$590.60
|
|
