|
HC SN PL SCREW 3.5X24 LOCK
|
Facility
OP
|
$785.54
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601749
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$259.23 |
| Max. Negotiated Rate |
$730.55 |
| Rate for Payer: Aetna Commercial |
$663.00
|
| Rate for Payer: Aetna Medicare |
$259.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$259.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$451.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$491.04
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$298.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$285.15
|
| Rate for Payer: Cash Price |
$487.04
|
| Rate for Payer: Cash Price |
$487.04
|
| Rate for Payer: Centivo All Commercial |
$400.63
|
| Rate for Payer: Cigna All Commercial |
$677.92
|
| Rate for Payer: CORVEL All Commercial |
$730.55
|
| Rate for Payer: Coventry All Commercial |
$691.28
|
| Rate for Payer: Encore All Commercial |
$723.09
|
| Rate for Payer: Frontpath All Commercial |
$722.70
|
| Rate for Payer: Humana ChoiceCare |
$678.47
|
| Rate for Payer: Humana Medicare |
$400.63
|
| Rate for Payer: Lucent All Commercial |
$400.63
|
| Rate for Payer: Lutheran Preferred All Commercial |
$706.99
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$589.16
|
| Rate for Payer: PHP All Commercial |
$595.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$306.36
|
| Rate for Payer: Sagamore Health Network All Products |
$606.44
|
| Rate for Payer: Signature Care EPO |
$652.00
|
| Rate for Payer: Signature Care PPO |
$691.28
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$667.71
|
| Rate for Payer: United Healthcare Commercial |
$619.01
|
| Rate for Payer: United Healthcare Medicare |
$259.23
|
|
|
HC SN PL SCREW 3.5X24 NON-LOCK
|
Facility
OP
|
$173.18
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601726
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$57.15 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$146.16
|
| Rate for Payer: Aetna Medicare |
$57.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$57.15
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$99.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$108.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$65.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$62.86
|
| Rate for Payer: Cash Price |
$107.37
|
| Rate for Payer: Cash Price |
$107.37
|
| Rate for Payer: Centivo All Commercial |
$88.32
|
| Rate for Payer: Cigna All Commercial |
$149.45
|
| Rate for Payer: CORVEL All Commercial |
$161.06
|
| Rate for Payer: Coventry All Commercial |
$152.40
|
| Rate for Payer: Encore All Commercial |
$159.41
|
| Rate for Payer: Frontpath All Commercial |
$159.33
|
| Rate for Payer: Humana ChoiceCare |
$149.58
|
| Rate for Payer: Humana Medicare |
$88.32
|
| Rate for Payer: Lucent All Commercial |
$88.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$155.86
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$129.88
|
| Rate for Payer: PHP All Commercial |
$131.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$67.54
|
| Rate for Payer: Sagamore Health Network All Products |
$133.69
|
| Rate for Payer: Signature Care EPO |
$143.74
|
| Rate for Payer: Signature Care PPO |
$152.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$147.20
|
| Rate for Payer: United Healthcare Commercial |
$136.47
|
| Rate for Payer: United Healthcare Medicare |
$57.15
|
|
|
HC SN PL SCREW 3.5X24 NON-LOCK
|
Facility
IP
|
$173.18
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601726
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$129.88 |
| Max. Negotiated Rate |
$161.06 |
| Rate for Payer: Aetna Commercial |
$149.63
|
| Rate for Payer: Cash Price |
$107.37
|
| Rate for Payer: Cigna All Commercial |
$149.45
|
| Rate for Payer: CORVEL All Commercial |
$161.06
|
| Rate for Payer: Coventry All Commercial |
$152.40
|
| Rate for Payer: Encore All Commercial |
$159.41
|
| Rate for Payer: Frontpath All Commercial |
$159.33
|
| Rate for Payer: Humana ChoiceCare |
$149.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$155.86
|
| Rate for Payer: PHCS All Commercial |
$129.88
|
| Rate for Payer: PHP All Commercial |
$131.34
|
| Rate for Payer: Sagamore Health Network All Products |
$133.69
|
| Rate for Payer: Signature Care EPO |
$143.74
|
| Rate for Payer: Signature Care PPO |
$152.40
|
| Rate for Payer: United Healthcare Commercial |
$136.47
|
|
|
HC SN PL SCREW 3.5X26 LOCK
|
Facility
OP
|
$560.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601750
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$185.05 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$473.29
|
| Rate for Payer: Aetna Medicare |
$185.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$185.05
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$322.05
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$350.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$212.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$203.56
|
| Rate for Payer: Cash Price |
$347.68
|
| Rate for Payer: Cash Price |
$347.68
|
| Rate for Payer: Centivo All Commercial |
$285.99
|
| Rate for Payer: Cigna All Commercial |
$483.94
|
| Rate for Payer: CORVEL All Commercial |
$521.52
|
| Rate for Payer: Coventry All Commercial |
$493.48
|
| Rate for Payer: Encore All Commercial |
$516.19
|
| Rate for Payer: Frontpath All Commercial |
$515.91
|
| Rate for Payer: Humana ChoiceCare |
$484.34
|
| Rate for Payer: Humana Medicare |
$285.99
|
| Rate for Payer: Lucent All Commercial |
$285.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$504.69
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$420.58
|
| Rate for Payer: PHP All Commercial |
$425.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$218.70
|
| Rate for Payer: Sagamore Health Network All Products |
$432.91
|
| Rate for Payer: Signature Care EPO |
$465.44
|
| Rate for Payer: Signature Care PPO |
$493.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$476.65
|
| Rate for Payer: United Healthcare Commercial |
$441.89
|
| Rate for Payer: United Healthcare Medicare |
$185.05
|
|
|
HC SN PL SCREW 3.5X26 LOCK
|
Facility
IP
|
$560.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601750
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$420.58 |
| Max. Negotiated Rate |
$521.52 |
| Rate for Payer: Aetna Commercial |
$484.51
|
| Rate for Payer: Cash Price |
$347.68
|
| Rate for Payer: Cigna All Commercial |
$483.94
|
| Rate for Payer: CORVEL All Commercial |
$521.52
|
| Rate for Payer: Coventry All Commercial |
$493.48
|
| Rate for Payer: Encore All Commercial |
$516.19
|
| Rate for Payer: Frontpath All Commercial |
$515.91
|
| Rate for Payer: Humana ChoiceCare |
$484.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$504.69
|
| Rate for Payer: PHCS All Commercial |
$420.58
|
| Rate for Payer: PHP All Commercial |
$425.29
|
| Rate for Payer: Sagamore Health Network All Products |
$432.91
|
| Rate for Payer: Signature Care EPO |
$465.44
|
| Rate for Payer: Signature Care PPO |
$493.48
|
| Rate for Payer: United Healthcare Commercial |
$441.89
|
|
|
HC SN PL SCREW 3.5X26 NON-LOCK
|
Facility
OP
|
$108.78
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601727
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.90 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$91.81
|
| Rate for Payer: Aetna Medicare |
$35.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$35.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$62.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$68.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$41.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$39.49
|
| Rate for Payer: Cash Price |
$67.44
|
| Rate for Payer: Cash Price |
$67.44
|
| Rate for Payer: Centivo All Commercial |
$55.48
|
| Rate for Payer: Cigna All Commercial |
$93.88
|
| Rate for Payer: CORVEL All Commercial |
$101.17
|
| Rate for Payer: Coventry All Commercial |
$95.73
|
| Rate for Payer: Encore All Commercial |
$100.13
|
| Rate for Payer: Frontpath All Commercial |
$100.08
|
| Rate for Payer: Humana ChoiceCare |
$93.95
|
| Rate for Payer: Humana Medicare |
$55.48
|
| Rate for Payer: Lucent All Commercial |
$55.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$97.90
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$81.58
|
| Rate for Payer: PHP All Commercial |
$82.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$42.42
|
| Rate for Payer: Sagamore Health Network All Products |
$83.98
|
| Rate for Payer: Signature Care EPO |
$90.29
|
| Rate for Payer: Signature Care PPO |
$95.73
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$92.46
|
| Rate for Payer: United Healthcare Commercial |
$85.72
|
| Rate for Payer: United Healthcare Medicare |
$35.90
|
|
|
HC SN PL SCREW 3.5X26 NON-LOCK
|
Facility
IP
|
$108.78
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601727
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$81.58 |
| Max. Negotiated Rate |
$101.17 |
| Rate for Payer: Aetna Commercial |
$93.99
|
| Rate for Payer: Cash Price |
$67.44
|
| Rate for Payer: Cigna All Commercial |
$93.88
|
| Rate for Payer: CORVEL All Commercial |
$101.17
|
| Rate for Payer: Coventry All Commercial |
$95.73
|
| Rate for Payer: Encore All Commercial |
$100.13
|
| Rate for Payer: Frontpath All Commercial |
$100.08
|
| Rate for Payer: Humana ChoiceCare |
$93.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$97.90
|
| Rate for Payer: PHCS All Commercial |
$81.58
|
| Rate for Payer: PHP All Commercial |
$82.50
|
| Rate for Payer: Sagamore Health Network All Products |
$83.98
|
| Rate for Payer: Signature Care EPO |
$90.29
|
| Rate for Payer: Signature Care PPO |
$95.73
|
| Rate for Payer: United Healthcare Commercial |
$85.72
|
|
|
HC SN PL SCREW 3.5X28 LOCK
|
Facility
OP
|
$560.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601751
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$185.05 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$473.29
|
| Rate for Payer: Aetna Medicare |
$185.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$185.05
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$322.05
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$350.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$212.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$203.56
|
| Rate for Payer: Cash Price |
$347.68
|
| Rate for Payer: Cash Price |
$347.68
|
| Rate for Payer: Centivo All Commercial |
$285.99
|
| Rate for Payer: Cigna All Commercial |
$483.94
|
| Rate for Payer: CORVEL All Commercial |
$521.52
|
| Rate for Payer: Coventry All Commercial |
$493.48
|
| Rate for Payer: Encore All Commercial |
$516.19
|
| Rate for Payer: Frontpath All Commercial |
$515.91
|
| Rate for Payer: Humana ChoiceCare |
$484.34
|
| Rate for Payer: Humana Medicare |
$285.99
|
| Rate for Payer: Lucent All Commercial |
$285.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$504.69
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$420.58
|
| Rate for Payer: PHP All Commercial |
$425.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$218.70
|
| Rate for Payer: Sagamore Health Network All Products |
$432.91
|
| Rate for Payer: Signature Care EPO |
$465.44
|
| Rate for Payer: Signature Care PPO |
$493.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$476.65
|
| Rate for Payer: United Healthcare Commercial |
$441.89
|
| Rate for Payer: United Healthcare Medicare |
$185.05
|
|
|
HC SN PL SCREW 3.5X28 LOCK
|
Facility
IP
|
$560.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601751
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$420.58 |
| Max. Negotiated Rate |
$521.52 |
| Rate for Payer: Aetna Commercial |
$484.51
|
| Rate for Payer: Cash Price |
$347.68
|
| Rate for Payer: Cigna All Commercial |
$483.94
|
| Rate for Payer: CORVEL All Commercial |
$521.52
|
| Rate for Payer: Coventry All Commercial |
$493.48
|
| Rate for Payer: Encore All Commercial |
$516.19
|
| Rate for Payer: Frontpath All Commercial |
$515.91
|
| Rate for Payer: Humana ChoiceCare |
$484.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$504.69
|
| Rate for Payer: PHCS All Commercial |
$420.58
|
| Rate for Payer: PHP All Commercial |
$425.29
|
| Rate for Payer: Sagamore Health Network All Products |
$432.91
|
| Rate for Payer: Signature Care EPO |
$465.44
|
| Rate for Payer: Signature Care PPO |
$493.48
|
| Rate for Payer: United Healthcare Commercial |
$441.89
|
|
|
HC SN PL SCREW 3.5X28 NON-LOCK
|
Facility
OP
|
$108.78
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601728
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.90 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$91.81
|
| Rate for Payer: Aetna Medicare |
$35.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$35.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$62.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$68.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$41.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$39.49
|
| Rate for Payer: Cash Price |
$67.44
|
| Rate for Payer: Cash Price |
$67.44
|
| Rate for Payer: Centivo All Commercial |
$55.48
|
| Rate for Payer: Cigna All Commercial |
$93.88
|
| Rate for Payer: CORVEL All Commercial |
$101.17
|
| Rate for Payer: Coventry All Commercial |
$95.73
|
| Rate for Payer: Encore All Commercial |
$100.13
|
| Rate for Payer: Frontpath All Commercial |
$100.08
|
| Rate for Payer: Humana ChoiceCare |
$93.95
|
| Rate for Payer: Humana Medicare |
$55.48
|
| Rate for Payer: Lucent All Commercial |
$55.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$97.90
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$81.58
|
| Rate for Payer: PHP All Commercial |
$82.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$42.42
|
| Rate for Payer: Sagamore Health Network All Products |
$83.98
|
| Rate for Payer: Signature Care EPO |
$90.29
|
| Rate for Payer: Signature Care PPO |
$95.73
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$92.46
|
| Rate for Payer: United Healthcare Commercial |
$85.72
|
| Rate for Payer: United Healthcare Medicare |
$35.90
|
|
|
HC SN PL SCREW 3.5X28 NON-LOCK
|
Facility
IP
|
$108.78
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601728
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$81.58 |
| Max. Negotiated Rate |
$101.17 |
| Rate for Payer: Aetna Commercial |
$93.99
|
| Rate for Payer: Cash Price |
$67.44
|
| Rate for Payer: Cigna All Commercial |
$93.88
|
| Rate for Payer: CORVEL All Commercial |
$101.17
|
| Rate for Payer: Coventry All Commercial |
$95.73
|
| Rate for Payer: Encore All Commercial |
$100.13
|
| Rate for Payer: Frontpath All Commercial |
$100.08
|
| Rate for Payer: Humana ChoiceCare |
$93.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$97.90
|
| Rate for Payer: PHCS All Commercial |
$81.58
|
| Rate for Payer: PHP All Commercial |
$82.50
|
| Rate for Payer: Sagamore Health Network All Products |
$83.98
|
| Rate for Payer: Signature Care EPO |
$90.29
|
| Rate for Payer: Signature Care PPO |
$95.73
|
| Rate for Payer: United Healthcare Commercial |
$85.72
|
|
|
HC SN PL SCREW 3.5X30 LOCK
|
Facility
OP
|
$560.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601752
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$185.05 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$473.29
|
| Rate for Payer: Aetna Medicare |
$185.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$185.05
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$322.05
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$350.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$212.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$203.56
|
| Rate for Payer: Cash Price |
$347.68
|
| Rate for Payer: Cash Price |
$347.68
|
| Rate for Payer: Centivo All Commercial |
$285.99
|
| Rate for Payer: Cigna All Commercial |
$483.94
|
| Rate for Payer: CORVEL All Commercial |
$521.52
|
| Rate for Payer: Coventry All Commercial |
$493.48
|
| Rate for Payer: Encore All Commercial |
$516.19
|
| Rate for Payer: Frontpath All Commercial |
$515.91
|
| Rate for Payer: Humana ChoiceCare |
$484.34
|
| Rate for Payer: Humana Medicare |
$285.99
|
| Rate for Payer: Lucent All Commercial |
$285.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$504.69
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$420.58
|
| Rate for Payer: PHP All Commercial |
$425.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$218.70
|
| Rate for Payer: Sagamore Health Network All Products |
$432.91
|
| Rate for Payer: Signature Care EPO |
$465.44
|
| Rate for Payer: Signature Care PPO |
$493.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$476.65
|
| Rate for Payer: United Healthcare Commercial |
$441.89
|
| Rate for Payer: United Healthcare Medicare |
$185.05
|
|
|
HC SN PL SCREW 3.5X30 LOCK
|
Facility
IP
|
$560.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601752
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$420.58 |
| Max. Negotiated Rate |
$521.52 |
| Rate for Payer: Aetna Commercial |
$484.51
|
| Rate for Payer: Cash Price |
$347.68
|
| Rate for Payer: Cigna All Commercial |
$483.94
|
| Rate for Payer: CORVEL All Commercial |
$521.52
|
| Rate for Payer: Coventry All Commercial |
$493.48
|
| Rate for Payer: Encore All Commercial |
$516.19
|
| Rate for Payer: Frontpath All Commercial |
$515.91
|
| Rate for Payer: Humana ChoiceCare |
$484.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$504.69
|
| Rate for Payer: PHCS All Commercial |
$420.58
|
| Rate for Payer: PHP All Commercial |
$425.29
|
| Rate for Payer: Sagamore Health Network All Products |
$432.91
|
| Rate for Payer: Signature Care EPO |
$465.44
|
| Rate for Payer: Signature Care PPO |
$493.48
|
| Rate for Payer: United Healthcare Commercial |
$441.89
|
|
|
HC SN PL SCREW 3.5X30 NON-LOCK
|
Facility
OP
|
$108.78
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601729
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.90 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$91.81
|
| Rate for Payer: Aetna Medicare |
$35.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$35.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$62.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$68.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$41.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$39.49
|
| Rate for Payer: Cash Price |
$67.44
|
| Rate for Payer: Cash Price |
$67.44
|
| Rate for Payer: Centivo All Commercial |
$55.48
|
| Rate for Payer: Cigna All Commercial |
$93.88
|
| Rate for Payer: CORVEL All Commercial |
$101.17
|
| Rate for Payer: Coventry All Commercial |
$95.73
|
| Rate for Payer: Encore All Commercial |
$100.13
|
| Rate for Payer: Frontpath All Commercial |
$100.08
|
| Rate for Payer: Humana ChoiceCare |
$93.95
|
| Rate for Payer: Humana Medicare |
$55.48
|
| Rate for Payer: Lucent All Commercial |
$55.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$97.90
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$81.58
|
| Rate for Payer: PHP All Commercial |
$82.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$42.42
|
| Rate for Payer: Sagamore Health Network All Products |
$83.98
|
| Rate for Payer: Signature Care EPO |
$90.29
|
| Rate for Payer: Signature Care PPO |
$95.73
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$92.46
|
| Rate for Payer: United Healthcare Commercial |
$85.72
|
| Rate for Payer: United Healthcare Medicare |
$35.90
|
|
|
HC SN PL SCREW 3.5X30 NON-LOCK
|
Facility
IP
|
$108.78
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601729
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$81.58 |
| Max. Negotiated Rate |
$101.17 |
| Rate for Payer: Aetna Commercial |
$93.99
|
| Rate for Payer: Cash Price |
$67.44
|
| Rate for Payer: Cigna All Commercial |
$93.88
|
| Rate for Payer: CORVEL All Commercial |
$101.17
|
| Rate for Payer: Coventry All Commercial |
$95.73
|
| Rate for Payer: Encore All Commercial |
$100.13
|
| Rate for Payer: Frontpath All Commercial |
$100.08
|
| Rate for Payer: Humana ChoiceCare |
$93.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$97.90
|
| Rate for Payer: PHCS All Commercial |
$81.58
|
| Rate for Payer: PHP All Commercial |
$82.50
|
| Rate for Payer: Sagamore Health Network All Products |
$83.98
|
| Rate for Payer: Signature Care EPO |
$90.29
|
| Rate for Payer: Signature Care PPO |
$95.73
|
| Rate for Payer: United Healthcare Commercial |
$85.72
|
|
|
HC SN PL SCREW 3.5X32 LOCK
|
Facility
OP
|
$560.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601753
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$185.05 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$473.29
|
| Rate for Payer: Aetna Medicare |
$185.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$185.05
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$322.05
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$350.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$212.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$203.56
|
| Rate for Payer: Cash Price |
$347.68
|
| Rate for Payer: Cash Price |
$347.68
|
| Rate for Payer: Centivo All Commercial |
$285.99
|
| Rate for Payer: Cigna All Commercial |
$483.94
|
| Rate for Payer: CORVEL All Commercial |
$521.52
|
| Rate for Payer: Coventry All Commercial |
$493.48
|
| Rate for Payer: Encore All Commercial |
$516.19
|
| Rate for Payer: Frontpath All Commercial |
$515.91
|
| Rate for Payer: Humana ChoiceCare |
$484.34
|
| Rate for Payer: Humana Medicare |
$285.99
|
| Rate for Payer: Lucent All Commercial |
$285.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$504.69
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$420.58
|
| Rate for Payer: PHP All Commercial |
$425.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$218.70
|
| Rate for Payer: Sagamore Health Network All Products |
$432.91
|
| Rate for Payer: Signature Care EPO |
$465.44
|
| Rate for Payer: Signature Care PPO |
$493.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$476.65
|
| Rate for Payer: United Healthcare Commercial |
$441.89
|
| Rate for Payer: United Healthcare Medicare |
$185.05
|
|
|
HC SN PL SCREW 3.5X32 LOCK
|
Facility
IP
|
$560.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601753
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$420.58 |
| Max. Negotiated Rate |
$521.52 |
| Rate for Payer: Aetna Commercial |
$484.51
|
| Rate for Payer: Cash Price |
$347.68
|
| Rate for Payer: Cigna All Commercial |
$483.94
|
| Rate for Payer: CORVEL All Commercial |
$521.52
|
| Rate for Payer: Coventry All Commercial |
$493.48
|
| Rate for Payer: Encore All Commercial |
$516.19
|
| Rate for Payer: Frontpath All Commercial |
$515.91
|
| Rate for Payer: Humana ChoiceCare |
$484.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$504.69
|
| Rate for Payer: PHCS All Commercial |
$420.58
|
| Rate for Payer: PHP All Commercial |
$425.29
|
| Rate for Payer: Sagamore Health Network All Products |
$432.91
|
| Rate for Payer: Signature Care EPO |
$465.44
|
| Rate for Payer: Signature Care PPO |
$493.48
|
| Rate for Payer: United Healthcare Commercial |
$441.89
|
|
|
HC SN PL SCREW 3.5X32 NON-LOCK
|
Facility
OP
|
$108.78
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601730
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.90 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$91.81
|
| Rate for Payer: Aetna Medicare |
$35.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$35.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$62.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$68.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$41.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$39.49
|
| Rate for Payer: Cash Price |
$67.44
|
| Rate for Payer: Cash Price |
$67.44
|
| Rate for Payer: Centivo All Commercial |
$55.48
|
| Rate for Payer: Cigna All Commercial |
$93.88
|
| Rate for Payer: CORVEL All Commercial |
$101.17
|
| Rate for Payer: Coventry All Commercial |
$95.73
|
| Rate for Payer: Encore All Commercial |
$100.13
|
| Rate for Payer: Frontpath All Commercial |
$100.08
|
| Rate for Payer: Humana ChoiceCare |
$93.95
|
| Rate for Payer: Humana Medicare |
$55.48
|
| Rate for Payer: Lucent All Commercial |
$55.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$97.90
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$81.58
|
| Rate for Payer: PHP All Commercial |
$82.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$42.42
|
| Rate for Payer: Sagamore Health Network All Products |
$83.98
|
| Rate for Payer: Signature Care EPO |
$90.29
|
| Rate for Payer: Signature Care PPO |
$95.73
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$92.46
|
| Rate for Payer: United Healthcare Commercial |
$85.72
|
| Rate for Payer: United Healthcare Medicare |
$35.90
|
|
|
HC SN PL SCREW 3.5X32 NON-LOCK
|
Facility
IP
|
$108.78
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601730
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$81.58 |
| Max. Negotiated Rate |
$101.17 |
| Rate for Payer: Aetna Commercial |
$93.99
|
| Rate for Payer: Cash Price |
$67.44
|
| Rate for Payer: Cigna All Commercial |
$93.88
|
| Rate for Payer: CORVEL All Commercial |
$101.17
|
| Rate for Payer: Coventry All Commercial |
$95.73
|
| Rate for Payer: Encore All Commercial |
$100.13
|
| Rate for Payer: Frontpath All Commercial |
$100.08
|
| Rate for Payer: Humana ChoiceCare |
$93.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$97.90
|
| Rate for Payer: PHCS All Commercial |
$81.58
|
| Rate for Payer: PHP All Commercial |
$82.50
|
| Rate for Payer: Sagamore Health Network All Products |
$83.98
|
| Rate for Payer: Signature Care EPO |
$90.29
|
| Rate for Payer: Signature Care PPO |
$95.73
|
| Rate for Payer: United Healthcare Commercial |
$85.72
|
|
|
HC SN PL SCREW 3.5X34 LOCK
|
Facility
IP
|
$560.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601754
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$420.58 |
| Max. Negotiated Rate |
$521.52 |
| Rate for Payer: Aetna Commercial |
$484.51
|
| Rate for Payer: Cash Price |
$347.68
|
| Rate for Payer: Cigna All Commercial |
$483.94
|
| Rate for Payer: CORVEL All Commercial |
$521.52
|
| Rate for Payer: Coventry All Commercial |
$493.48
|
| Rate for Payer: Encore All Commercial |
$516.19
|
| Rate for Payer: Frontpath All Commercial |
$515.91
|
| Rate for Payer: Humana ChoiceCare |
$484.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$504.69
|
| Rate for Payer: PHCS All Commercial |
$420.58
|
| Rate for Payer: PHP All Commercial |
$425.29
|
| Rate for Payer: Sagamore Health Network All Products |
$432.91
|
| Rate for Payer: Signature Care EPO |
$465.44
|
| Rate for Payer: Signature Care PPO |
$493.48
|
| Rate for Payer: United Healthcare Commercial |
$441.89
|
|
|
HC SN PL SCREW 3.5X34 LOCK
|
Facility
OP
|
$560.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601754
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$185.05 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$473.29
|
| Rate for Payer: Aetna Medicare |
$185.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$185.05
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$322.05
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$350.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$212.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$203.56
|
| Rate for Payer: Cash Price |
$347.68
|
| Rate for Payer: Cash Price |
$347.68
|
| Rate for Payer: Centivo All Commercial |
$285.99
|
| Rate for Payer: Cigna All Commercial |
$483.94
|
| Rate for Payer: CORVEL All Commercial |
$521.52
|
| Rate for Payer: Coventry All Commercial |
$493.48
|
| Rate for Payer: Encore All Commercial |
$516.19
|
| Rate for Payer: Frontpath All Commercial |
$515.91
|
| Rate for Payer: Humana ChoiceCare |
$484.34
|
| Rate for Payer: Humana Medicare |
$285.99
|
| Rate for Payer: Lucent All Commercial |
$285.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$504.69
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$420.58
|
| Rate for Payer: PHP All Commercial |
$425.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$218.70
|
| Rate for Payer: Sagamore Health Network All Products |
$432.91
|
| Rate for Payer: Signature Care EPO |
$465.44
|
| Rate for Payer: Signature Care PPO |
$493.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$476.65
|
| Rate for Payer: United Healthcare Commercial |
$441.89
|
| Rate for Payer: United Healthcare Medicare |
$185.05
|
|
|
HC SN PL SCREW 3.5X34 NON-LOCK
|
Facility
IP
|
$108.78
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601731
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$81.58 |
| Max. Negotiated Rate |
$101.17 |
| Rate for Payer: Aetna Commercial |
$93.99
|
| Rate for Payer: Cash Price |
$67.44
|
| Rate for Payer: Cigna All Commercial |
$93.88
|
| Rate for Payer: CORVEL All Commercial |
$101.17
|
| Rate for Payer: Coventry All Commercial |
$95.73
|
| Rate for Payer: Encore All Commercial |
$100.13
|
| Rate for Payer: Frontpath All Commercial |
$100.08
|
| Rate for Payer: Humana ChoiceCare |
$93.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$97.90
|
| Rate for Payer: PHCS All Commercial |
$81.58
|
| Rate for Payer: PHP All Commercial |
$82.50
|
| Rate for Payer: Sagamore Health Network All Products |
$83.98
|
| Rate for Payer: Signature Care EPO |
$90.29
|
| Rate for Payer: Signature Care PPO |
$95.73
|
| Rate for Payer: United Healthcare Commercial |
$85.72
|
|
|
HC SN PL SCREW 3.5X34 NON-LOCK
|
Facility
OP
|
$108.78
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601731
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.90 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$91.81
|
| Rate for Payer: Aetna Medicare |
$35.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$35.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$62.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$68.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$41.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$39.49
|
| Rate for Payer: Cash Price |
$67.44
|
| Rate for Payer: Cash Price |
$67.44
|
| Rate for Payer: Centivo All Commercial |
$55.48
|
| Rate for Payer: Cigna All Commercial |
$93.88
|
| Rate for Payer: CORVEL All Commercial |
$101.17
|
| Rate for Payer: Coventry All Commercial |
$95.73
|
| Rate for Payer: Encore All Commercial |
$100.13
|
| Rate for Payer: Frontpath All Commercial |
$100.08
|
| Rate for Payer: Humana ChoiceCare |
$93.95
|
| Rate for Payer: Humana Medicare |
$55.48
|
| Rate for Payer: Lucent All Commercial |
$55.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$97.90
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$81.58
|
| Rate for Payer: PHP All Commercial |
$82.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$42.42
|
| Rate for Payer: Sagamore Health Network All Products |
$83.98
|
| Rate for Payer: Signature Care EPO |
$90.29
|
| Rate for Payer: Signature Care PPO |
$95.73
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$92.46
|
| Rate for Payer: United Healthcare Commercial |
$85.72
|
| Rate for Payer: United Healthcare Medicare |
$35.90
|
|
|
HC SN PL SCREW 3.5X36 LOCK
|
Facility
OP
|
$560.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601755
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$185.05 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$473.29
|
| Rate for Payer: Aetna Medicare |
$185.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$185.05
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$322.05
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$350.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$212.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$203.56
|
| Rate for Payer: Cash Price |
$347.68
|
| Rate for Payer: Cash Price |
$347.68
|
| Rate for Payer: Centivo All Commercial |
$285.99
|
| Rate for Payer: Cigna All Commercial |
$483.94
|
| Rate for Payer: CORVEL All Commercial |
$521.52
|
| Rate for Payer: Coventry All Commercial |
$493.48
|
| Rate for Payer: Encore All Commercial |
$516.19
|
| Rate for Payer: Frontpath All Commercial |
$515.91
|
| Rate for Payer: Humana ChoiceCare |
$484.34
|
| Rate for Payer: Humana Medicare |
$285.99
|
| Rate for Payer: Lucent All Commercial |
$285.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$504.69
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$420.58
|
| Rate for Payer: PHP All Commercial |
$425.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$218.70
|
| Rate for Payer: Sagamore Health Network All Products |
$432.91
|
| Rate for Payer: Signature Care EPO |
$465.44
|
| Rate for Payer: Signature Care PPO |
$493.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$476.65
|
| Rate for Payer: United Healthcare Commercial |
$441.89
|
| Rate for Payer: United Healthcare Medicare |
$185.05
|
|
|
HC SN PL SCREW 3.5X36 LOCK
|
Facility
IP
|
$560.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601755
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$420.58 |
| Max. Negotiated Rate |
$521.52 |
| Rate for Payer: Aetna Commercial |
$484.51
|
| Rate for Payer: Cash Price |
$347.68
|
| Rate for Payer: Cigna All Commercial |
$483.94
|
| Rate for Payer: CORVEL All Commercial |
$521.52
|
| Rate for Payer: Coventry All Commercial |
$493.48
|
| Rate for Payer: Encore All Commercial |
$516.19
|
| Rate for Payer: Frontpath All Commercial |
$515.91
|
| Rate for Payer: Humana ChoiceCare |
$484.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$504.69
|
| Rate for Payer: PHCS All Commercial |
$420.58
|
| Rate for Payer: PHP All Commercial |
$425.29
|
| Rate for Payer: Sagamore Health Network All Products |
$432.91
|
| Rate for Payer: Signature Care EPO |
$465.44
|
| Rate for Payer: Signature Care PPO |
$493.48
|
| Rate for Payer: United Healthcare Commercial |
$441.89
|
|
