|
HC Z DRILL BIT 2.7 RVS
|
Facility
|
OP
|
$867.10
|
|
| Hospital Charge Code |
41605695
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$806.40 |
| Rate for Payer: Aetna Commercial |
$731.83
|
| Rate for Payer: Aetna Medicare |
$277.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$268.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$497.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$542.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$319.09
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$305.22
|
| Rate for Payer: Cash Price |
$520.26
|
| Rate for Payer: Cash Price |
$520.26
|
| Rate for Payer: Centivo All Commercial |
$471.70
|
| Rate for Payer: Cigna All Commercial |
$748.31
|
| Rate for Payer: CORVEL All Commercial |
$806.40
|
| Rate for Payer: Coventry All Commercial |
$763.05
|
| Rate for Payer: Encore All Commercial |
$798.17
|
| Rate for Payer: Frontpath All Commercial |
$797.73
|
| Rate for Payer: Humana ChoiceCare |
$748.91
|
| Rate for Payer: Humana Medicare |
$277.47
|
| Rate for Payer: Lucent All Commercial |
$471.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$780.39
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$650.33
|
| Rate for Payer: PHP All Commercial |
$657.61
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$338.17
|
| Rate for Payer: Sagamore Health Network All Products |
$669.40
|
| Rate for Payer: Signature Care EPO |
$719.69
|
| Rate for Payer: Signature Care PPO |
$763.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$737.03
|
| Rate for Payer: United Healthcare Commercial |
$683.27
|
| Rate for Payer: United Healthcare Medicare |
$277.47
|
|
|
HC Z DRILL BIT 2.7 RVS
|
Facility
|
IP
|
$867.10
|
|
| Hospital Charge Code |
41605695
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$650.33 |
| Max. Negotiated Rate |
$806.40 |
| Rate for Payer: Aetna Commercial |
$749.17
|
| Rate for Payer: Cash Price |
$520.26
|
| Rate for Payer: Cigna All Commercial |
$748.31
|
| Rate for Payer: CORVEL All Commercial |
$806.40
|
| Rate for Payer: Coventry All Commercial |
$763.05
|
| Rate for Payer: Encore All Commercial |
$798.17
|
| Rate for Payer: Frontpath All Commercial |
$797.73
|
| Rate for Payer: Humana ChoiceCare |
$748.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$780.39
|
| Rate for Payer: PHCS All Commercial |
$650.33
|
| Rate for Payer: PHP All Commercial |
$657.61
|
| Rate for Payer: Sagamore Health Network All Products |
$669.40
|
| Rate for Payer: Signature Care EPO |
$719.69
|
| Rate for Payer: Signature Care PPO |
$763.05
|
| Rate for Payer: United Healthcare Commercial |
$683.27
|
|
|
HC Z DRILL BIT 2.7 SHORT
|
Facility
|
OP
|
$346.43
|
|
| Hospital Charge Code |
41607398
|
|
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 2.7 SHORT
|
Facility
|
IP
|
$346.43
|
|
| Hospital Charge Code |
41607398
|
|
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 2.7X145
|
Facility
|
OP
|
$544.39
|
|
| Hospital Charge Code |
41607399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$506.28 |
| Rate for Payer: Aetna Commercial |
$459.47
|
| Rate for Payer: Aetna Medicare |
$174.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$168.76
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$312.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$340.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$200.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$191.63
|
| Rate for Payer: Cash Price |
$326.63
|
| Rate for Payer: Cash Price |
$326.63
|
| Rate for Payer: Centivo All Commercial |
$296.15
|
| Rate for Payer: Cigna All Commercial |
$469.81
|
| Rate for Payer: CORVEL All Commercial |
$506.28
|
| Rate for Payer: Coventry All Commercial |
$479.06
|
| Rate for Payer: Encore All Commercial |
$501.11
|
| Rate for Payer: Frontpath All Commercial |
$500.84
|
| Rate for Payer: Humana ChoiceCare |
$470.19
|
| Rate for Payer: Humana Medicare |
$174.20
|
| Rate for Payer: Lucent All Commercial |
$296.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$489.95
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$408.29
|
| Rate for Payer: PHP All Commercial |
$412.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$212.31
|
| Rate for Payer: Sagamore Health Network All Products |
$420.27
|
| Rate for Payer: Signature Care EPO |
$451.84
|
| Rate for Payer: Signature Care PPO |
$479.06
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$462.73
|
| Rate for Payer: United Healthcare Commercial |
$428.98
|
| Rate for Payer: United Healthcare Medicare |
$174.20
|
|
|
HC Z DRILL BIT 2.7X145
|
Facility
|
IP
|
$544.39
|
|
| Hospital Charge Code |
41607399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$408.29 |
| Max. Negotiated Rate |
$506.28 |
| Rate for Payer: Aetna Commercial |
$470.35
|
| Rate for Payer: Cash Price |
$326.63
|
| Rate for Payer: Cigna All Commercial |
$469.81
|
| Rate for Payer: CORVEL All Commercial |
$506.28
|
| Rate for Payer: Coventry All Commercial |
$479.06
|
| Rate for Payer: Encore All Commercial |
$501.11
|
| Rate for Payer: Frontpath All Commercial |
$500.84
|
| Rate for Payer: Humana ChoiceCare |
$470.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$489.95
|
| Rate for Payer: PHCS All Commercial |
$408.29
|
| Rate for Payer: PHP All Commercial |
$412.87
|
| Rate for Payer: Sagamore Health Network All Products |
$420.27
|
| Rate for Payer: Signature Care EPO |
$451.84
|
| Rate for Payer: Signature Care PPO |
$479.06
|
| Rate for Payer: United Healthcare Commercial |
$428.98
|
|
|
HC Z DRILL BIT 2.9 NS
|
Facility
|
IP
|
$657.51
|
|
| Hospital Charge Code |
41606494
|
|
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 2.9 NS
|
Facility
|
OP
|
$657.51
|
|
| Hospital Charge Code |
41606494
|
|
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 2.9X70 CANN
|
Facility
|
OP
|
$999.90
|
|
| Hospital Charge Code |
41603887
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$929.91 |
| Rate for Payer: Aetna Commercial |
$843.92
|
| Rate for Payer: Aetna Medicare |
$319.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$309.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$574.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$625.04
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$367.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$351.96
|
| Rate for Payer: Cash Price |
$599.94
|
| Rate for Payer: Cash Price |
$599.94
|
| Rate for Payer: Centivo All Commercial |
$543.95
|
| Rate for Payer: Cigna All Commercial |
$862.91
|
| Rate for Payer: CORVEL All Commercial |
$929.91
|
| Rate for Payer: Coventry All Commercial |
$879.91
|
| Rate for Payer: Encore All Commercial |
$920.41
|
| Rate for Payer: Frontpath All Commercial |
$919.91
|
| Rate for Payer: Humana ChoiceCare |
$863.61
|
| Rate for Payer: Humana Medicare |
$319.97
|
| Rate for Payer: Lucent All Commercial |
$543.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$899.91
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$749.92
|
| Rate for Payer: PHP All Commercial |
$758.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$389.96
|
| Rate for Payer: Sagamore Health Network All Products |
$771.92
|
| Rate for Payer: Signature Care EPO |
$829.92
|
| Rate for Payer: Signature Care PPO |
$879.91
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$849.91
|
| Rate for Payer: United Healthcare Commercial |
$787.92
|
| Rate for Payer: United Healthcare Medicare |
$319.97
|
|
|
HC Z DRILL BIT 2.9X70 CANN
|
Facility
|
IP
|
$999.90
|
|
| Hospital Charge Code |
41603887
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$749.92 |
| Max. Negotiated Rate |
$929.91 |
| Rate for Payer: Aetna Commercial |
$863.91
|
| Rate for Payer: Cash Price |
$599.94
|
| Rate for Payer: Cigna All Commercial |
$862.91
|
| Rate for Payer: CORVEL All Commercial |
$929.91
|
| Rate for Payer: Coventry All Commercial |
$879.91
|
| Rate for Payer: Encore All Commercial |
$920.41
|
| Rate for Payer: Frontpath All Commercial |
$919.91
|
| Rate for Payer: Humana ChoiceCare |
$863.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$899.91
|
| Rate for Payer: PHCS All Commercial |
$749.92
|
| Rate for Payer: PHP All Commercial |
$758.32
|
| Rate for Payer: Sagamore Health Network All Products |
$771.92
|
| Rate for Payer: Signature Care EPO |
$829.92
|
| Rate for Payer: Signature Care PPO |
$879.91
|
| Rate for Payer: United Healthcare Commercial |
$787.92
|
|
|
HC Z DRILL BIT 3.2 9315
|
Facility
|
IP
|
$829.78
|
|
| Hospital Charge Code |
41607088
|
|
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 3.2 9315
|
Facility
|
OP
|
$829.78
|
|
| Hospital Charge Code |
41607088
|
|
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 3.2X145
|
Facility
|
IP
|
$489.37
|
|
| Hospital Charge Code |
41608090
|
|
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 3.2X145
|
Facility
|
OP
|
$489.37
|
|
| Hospital Charge Code |
41608090
|
|
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 3.2X15 RINGLOC QC
|
Facility
|
IP
|
$627.90
|
|
| Hospital Charge Code |
41603529
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$470.93 |
| Max. Negotiated Rate |
$583.95 |
| Rate for Payer: Aetna Commercial |
$542.51
|
| Rate for Payer: Cash Price |
$376.74
|
| Rate for Payer: Cigna All Commercial |
$541.88
|
| Rate for Payer: CORVEL All Commercial |
$583.95
|
| Rate for Payer: Coventry All Commercial |
$552.55
|
| Rate for Payer: Encore All Commercial |
$577.98
|
| Rate for Payer: Frontpath All Commercial |
$577.67
|
| Rate for Payer: Humana ChoiceCare |
$542.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$565.11
|
| Rate for Payer: PHCS All Commercial |
$470.93
|
| Rate for Payer: PHP All Commercial |
$476.20
|
| Rate for Payer: Sagamore Health Network All Products |
$484.74
|
| Rate for Payer: Signature Care EPO |
$521.16
|
| Rate for Payer: Signature Care PPO |
$552.55
|
| Rate for Payer: United Healthcare Commercial |
$494.79
|
|
|
HC Z DRILL BIT 3.2X15 RINGLOC QC
|
Facility
|
OP
|
$627.90
|
|
| Hospital Charge Code |
41603529
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$583.95 |
| Rate for Payer: Aetna Commercial |
$529.95
|
| Rate for Payer: Aetna Medicare |
$200.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$194.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$360.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$392.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$231.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$221.02
|
| Rate for Payer: Cash Price |
$376.74
|
| Rate for Payer: Cash Price |
$376.74
|
| Rate for Payer: Centivo All Commercial |
$341.58
|
| Rate for Payer: Cigna All Commercial |
$541.88
|
| Rate for Payer: CORVEL All Commercial |
$583.95
|
| Rate for Payer: Coventry All Commercial |
$552.55
|
| Rate for Payer: Encore All Commercial |
$577.98
|
| Rate for Payer: Frontpath All Commercial |
$577.67
|
| Rate for Payer: Humana ChoiceCare |
$542.32
|
| Rate for Payer: Humana Medicare |
$200.93
|
| Rate for Payer: Lucent All Commercial |
$341.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$565.11
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$470.93
|
| Rate for Payer: PHP All Commercial |
$476.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$244.88
|
| Rate for Payer: Sagamore Health Network All Products |
$484.74
|
| Rate for Payer: Signature Care EPO |
$521.16
|
| Rate for Payer: Signature Care PPO |
$552.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$533.72
|
| Rate for Payer: United Healthcare Commercial |
$494.79
|
| Rate for Payer: United Healthcare Medicare |
$200.93
|
|
|
HC Z DRILL BIT 3.2X20 ACET QC
|
Facility
|
OP
|
$627.90
|
|
| Hospital Charge Code |
41603486
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$583.95 |
| Rate for Payer: Aetna Commercial |
$529.95
|
| Rate for Payer: Aetna Medicare |
$200.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$194.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$360.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$392.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$231.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$221.02
|
| Rate for Payer: Cash Price |
$376.74
|
| Rate for Payer: Cash Price |
$376.74
|
| Rate for Payer: Centivo All Commercial |
$341.58
|
| Rate for Payer: Cigna All Commercial |
$541.88
|
| Rate for Payer: CORVEL All Commercial |
$583.95
|
| Rate for Payer: Coventry All Commercial |
$552.55
|
| Rate for Payer: Encore All Commercial |
$577.98
|
| Rate for Payer: Frontpath All Commercial |
$577.67
|
| Rate for Payer: Humana ChoiceCare |
$542.32
|
| Rate for Payer: Humana Medicare |
$200.93
|
| Rate for Payer: Lucent All Commercial |
$341.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$565.11
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$470.93
|
| Rate for Payer: PHP All Commercial |
$476.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$244.88
|
| Rate for Payer: Sagamore Health Network All Products |
$484.74
|
| Rate for Payer: Signature Care EPO |
$521.16
|
| Rate for Payer: Signature Care PPO |
$552.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$533.72
|
| Rate for Payer: United Healthcare Commercial |
$494.79
|
| Rate for Payer: United Healthcare Medicare |
$200.93
|
|
|
HC Z DRILL BIT 3.2X20 ACET QC
|
Facility
|
IP
|
$627.90
|
|
| Hospital Charge Code |
41603486
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$470.93 |
| Max. Negotiated Rate |
$583.95 |
| Rate for Payer: Aetna Commercial |
$542.51
|
| Rate for Payer: Cash Price |
$376.74
|
| Rate for Payer: Cigna All Commercial |
$541.88
|
| Rate for Payer: CORVEL All Commercial |
$583.95
|
| Rate for Payer: Coventry All Commercial |
$552.55
|
| Rate for Payer: Encore All Commercial |
$577.98
|
| Rate for Payer: Frontpath All Commercial |
$577.67
|
| Rate for Payer: Humana ChoiceCare |
$542.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$565.11
|
| Rate for Payer: PHCS All Commercial |
$470.93
|
| Rate for Payer: PHP All Commercial |
$476.20
|
| Rate for Payer: Sagamore Health Network All Products |
$484.74
|
| Rate for Payer: Signature Care EPO |
$521.16
|
| Rate for Payer: Signature Care PPO |
$552.55
|
| Rate for Payer: United Healthcare Commercial |
$494.79
|
|
|
HC Z DRILL BIT 3.2X75
|
Facility
|
IP
|
$1,720.40
|
|
| Hospital Charge Code |
41605482
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,290.30 |
| Max. Negotiated Rate |
$1,599.97 |
| Rate for Payer: Aetna Commercial |
$1,486.43
|
| Rate for Payer: Cash Price |
$1,032.24
|
| Rate for Payer: Cigna All Commercial |
$1,484.71
|
| Rate for Payer: CORVEL All Commercial |
$1,599.97
|
| Rate for Payer: Coventry All Commercial |
$1,513.95
|
| Rate for Payer: Encore All Commercial |
$1,583.63
|
| Rate for Payer: Frontpath All Commercial |
$1,582.77
|
| Rate for Payer: Humana ChoiceCare |
$1,485.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,548.36
|
| Rate for Payer: PHCS All Commercial |
$1,290.30
|
| Rate for Payer: PHP All Commercial |
$1,304.75
|
| Rate for Payer: Sagamore Health Network All Products |
$1,328.15
|
| Rate for Payer: Signature Care EPO |
$1,427.93
|
| Rate for Payer: Signature Care PPO |
$1,513.95
|
| Rate for Payer: United Healthcare Commercial |
$1,355.68
|
|
|
HC Z DRILL BIT 3.2X75
|
Facility
|
OP
|
$1,720.40
|
|
| Hospital Charge Code |
41605482
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$1,599.97 |
| Rate for Payer: Aetna Commercial |
$1,452.02
|
| Rate for Payer: Aetna Medicare |
$550.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$533.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$988.03
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,075.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$633.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$605.58
|
| Rate for Payer: Cash Price |
$1,032.24
|
| Rate for Payer: Cash Price |
$1,032.24
|
| Rate for Payer: Centivo All Commercial |
$935.90
|
| Rate for Payer: Cigna All Commercial |
$1,484.71
|
| Rate for Payer: CORVEL All Commercial |
$1,599.97
|
| Rate for Payer: Coventry All Commercial |
$1,513.95
|
| Rate for Payer: Encore All Commercial |
$1,583.63
|
| Rate for Payer: Frontpath All Commercial |
$1,582.77
|
| Rate for Payer: Humana ChoiceCare |
$1,485.91
|
| Rate for Payer: Humana Medicare |
$550.53
|
| Rate for Payer: Lucent All Commercial |
$935.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,548.36
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$1,290.30
|
| Rate for Payer: PHP All Commercial |
$1,304.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$670.96
|
| Rate for Payer: Sagamore Health Network All Products |
$1,328.15
|
| Rate for Payer: Signature Care EPO |
$1,427.93
|
| Rate for Payer: Signature Care PPO |
$1,513.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,462.34
|
| Rate for Payer: United Healthcare Commercial |
$1,355.68
|
| Rate for Payer: United Healthcare Medicare |
$550.53
|
|
|
HC Z DRILL BIT 3.5 110 QC
|
Facility
|
IP
|
$489.37
|
|
| Hospital Charge Code |
41603998
|
|
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 3.5 110 QC
|
Facility
|
OP
|
$489.37
|
|
| Hospital Charge Code |
41603998
|
|
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 3.8 CALI
|
Facility
|
OP
|
$855.47
|
|
| Hospital Charge Code |
41608089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$795.59 |
| Rate for Payer: Aetna Commercial |
$722.02
|
| Rate for Payer: Aetna Medicare |
$273.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$265.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$491.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$534.75
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$314.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$301.13
|
| Rate for Payer: Cash Price |
$513.28
|
| Rate for Payer: Cash Price |
$513.28
|
| Rate for Payer: Centivo All Commercial |
$465.38
|
| Rate for Payer: Cigna All Commercial |
$738.27
|
| Rate for Payer: CORVEL All Commercial |
$795.59
|
| Rate for Payer: Coventry All Commercial |
$752.81
|
| Rate for Payer: Encore All Commercial |
$787.46
|
| Rate for Payer: Frontpath All Commercial |
$787.03
|
| Rate for Payer: Humana ChoiceCare |
$738.87
|
| Rate for Payer: Humana Medicare |
$273.75
|
| Rate for Payer: Lucent All Commercial |
$465.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$769.92
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$641.60
|
| Rate for Payer: PHP All Commercial |
$648.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$333.63
|
| Rate for Payer: Sagamore Health Network All Products |
$660.42
|
| Rate for Payer: Signature Care EPO |
$710.04
|
| Rate for Payer: Signature Care PPO |
$752.81
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$727.15
|
| Rate for Payer: United Healthcare Commercial |
$674.11
|
| Rate for Payer: United Healthcare Medicare |
$273.75
|
|
|
HC Z DRILL BIT 3.8 CALI
|
Facility
|
IP
|
$855.47
|
|
| Hospital Charge Code |
41608089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$641.60 |
| Max. Negotiated Rate |
$795.59 |
| Rate for Payer: Aetna Commercial |
$739.13
|
| Rate for Payer: Cash Price |
$513.28
|
| Rate for Payer: Cigna All Commercial |
$738.27
|
| Rate for Payer: CORVEL All Commercial |
$795.59
|
| Rate for Payer: Coventry All Commercial |
$752.81
|
| Rate for Payer: Encore All Commercial |
$787.46
|
| Rate for Payer: Frontpath All Commercial |
$787.03
|
| Rate for Payer: Humana ChoiceCare |
$738.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$769.92
|
| Rate for Payer: PHCS All Commercial |
$641.60
|
| Rate for Payer: PHP All Commercial |
$648.79
|
| Rate for Payer: Sagamore Health Network All Products |
$660.42
|
| Rate for Payer: Signature Care EPO |
$710.04
|
| Rate for Payer: Signature Care PPO |
$752.81
|
| Rate for Payer: United Healthcare Commercial |
$674.11
|
|
|
HC Z DRILL BIT 3.8 LG FRAG
|
Facility
|
IP
|
$855.47
|
|
| Hospital Charge Code |
41607865
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$641.60 |
| Max. Negotiated Rate |
$795.59 |
| Rate for Payer: Aetna Commercial |
$739.13
|
| Rate for Payer: Cash Price |
$513.28
|
| Rate for Payer: Cigna All Commercial |
$738.27
|
| Rate for Payer: CORVEL All Commercial |
$795.59
|
| Rate for Payer: Coventry All Commercial |
$752.81
|
| Rate for Payer: Encore All Commercial |
$787.46
|
| Rate for Payer: Frontpath All Commercial |
$787.03
|
| Rate for Payer: Humana ChoiceCare |
$738.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$769.92
|
| Rate for Payer: PHCS All Commercial |
$641.60
|
| Rate for Payer: PHP All Commercial |
$648.79
|
| Rate for Payer: Sagamore Health Network All Products |
$660.42
|
| Rate for Payer: Signature Care EPO |
$710.04
|
| Rate for Payer: Signature Care PPO |
$752.81
|
| Rate for Payer: United Healthcare Commercial |
$674.11
|
|
