|
HC SN PL SCREW 3.5X48 NON-LOCK
|
Facility
|
OP
|
$108.78
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601738
|
|
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 3.5X50 LOCK
|
Facility
|
IP
|
$560.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601761
|
|
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 3.5X50 LOCK
|
Facility
|
OP
|
$560.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601761
|
|
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 3.5X50 NON-LOCK
|
Facility
|
OP
|
$108.78
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601739
|
|
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 3.5X50 NON-LOCK
|
Facility
|
IP
|
$108.78
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601739
|
|
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 3.5X55 LOCK
|
Facility
|
OP
|
$560.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601762
|
|
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 3.5X55 LOCK
|
Facility
|
IP
|
$560.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601762
|
|
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 3.5X55 NON-LOCK
|
Facility
|
OP
|
$108.78
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601740
|
|
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 3.5X55 NON-LOCK
|
Facility
|
IP
|
$108.78
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601740
|
|
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 3.5X60 LOCK
|
Facility
|
OP
|
$560.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601763
|
|
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 3.5X60 LOCK
|
Facility
|
IP
|
$560.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601763
|
|
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 3.5X60 NON-LOCK
|
Facility
|
IP
|
$108.78
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601741
|
|
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 3.5X60 NON-LOCK
|
Facility
|
OP
|
$108.78
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601741
|
|
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 4.0X10 CANC FT
|
Facility
|
OP
|
$143.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601639
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$47.33 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$121.05
|
| Rate for Payer: Aetna Medicare |
$47.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$47.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$82.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$89.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$54.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$52.07
|
| Rate for Payer: Cash Price |
$88.93
|
| Rate for Payer: Cash Price |
$88.93
|
| Rate for Payer: Centivo All Commercial |
$73.15
|
| Rate for Payer: Cigna All Commercial |
$123.78
|
| Rate for Payer: CORVEL All Commercial |
$133.39
|
| Rate for Payer: Coventry All Commercial |
$126.22
|
| Rate for Payer: Encore All Commercial |
$132.03
|
| Rate for Payer: Frontpath All Commercial |
$131.96
|
| Rate for Payer: Humana ChoiceCare |
$123.88
|
| Rate for Payer: Humana Medicare |
$73.15
|
| Rate for Payer: Lucent All Commercial |
$73.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$129.09
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$107.57
|
| Rate for Payer: PHP All Commercial |
$108.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$55.94
|
| Rate for Payer: Sagamore Health Network All Products |
$110.73
|
| Rate for Payer: Signature Care EPO |
$119.05
|
| Rate for Payer: Signature Care PPO |
$126.22
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$121.92
|
| Rate for Payer: United Healthcare Commercial |
$113.02
|
| Rate for Payer: United Healthcare Medicare |
$47.33
|
|
|
HC SN PL SCREW 4.0X10 CANC FT
|
Facility
|
IP
|
$143.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601639
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$107.57 |
| Max. Negotiated Rate |
$133.39 |
| Rate for Payer: Aetna Commercial |
$123.92
|
| Rate for Payer: Cash Price |
$88.93
|
| Rate for Payer: Cigna All Commercial |
$123.78
|
| Rate for Payer: CORVEL All Commercial |
$133.39
|
| Rate for Payer: Coventry All Commercial |
$126.22
|
| Rate for Payer: Encore All Commercial |
$132.03
|
| Rate for Payer: Frontpath All Commercial |
$131.96
|
| Rate for Payer: Humana ChoiceCare |
$123.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$129.09
|
| Rate for Payer: PHCS All Commercial |
$107.57
|
| Rate for Payer: PHP All Commercial |
$108.78
|
| Rate for Payer: Sagamore Health Network All Products |
$110.73
|
| Rate for Payer: Signature Care EPO |
$119.05
|
| Rate for Payer: Signature Care PPO |
$126.22
|
| Rate for Payer: United Healthcare Commercial |
$113.02
|
|
|
HC SN PL SCREW 4.0X10 CANC PT
|
Facility
|
IP
|
$143.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601659
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$107.57 |
| Max. Negotiated Rate |
$133.39 |
| Rate for Payer: Aetna Commercial |
$123.92
|
| Rate for Payer: Cash Price |
$88.93
|
| Rate for Payer: Cigna All Commercial |
$123.78
|
| Rate for Payer: CORVEL All Commercial |
$133.39
|
| Rate for Payer: Coventry All Commercial |
$126.22
|
| Rate for Payer: Encore All Commercial |
$132.03
|
| Rate for Payer: Frontpath All Commercial |
$131.96
|
| Rate for Payer: Humana ChoiceCare |
$123.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$129.09
|
| Rate for Payer: PHCS All Commercial |
$107.57
|
| Rate for Payer: PHP All Commercial |
$108.78
|
| Rate for Payer: Sagamore Health Network All Products |
$110.73
|
| Rate for Payer: Signature Care EPO |
$119.05
|
| Rate for Payer: Signature Care PPO |
$126.22
|
| Rate for Payer: United Healthcare Commercial |
$113.02
|
|
|
HC SN PL SCREW 4.0X10 CANC PT
|
Facility
|
OP
|
$143.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601659
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$47.33 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$121.05
|
| Rate for Payer: Aetna Medicare |
$47.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$47.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$82.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$89.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$54.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$52.07
|
| Rate for Payer: Cash Price |
$88.93
|
| Rate for Payer: Cash Price |
$88.93
|
| Rate for Payer: Centivo All Commercial |
$73.15
|
| Rate for Payer: Cigna All Commercial |
$123.78
|
| Rate for Payer: CORVEL All Commercial |
$133.39
|
| Rate for Payer: Coventry All Commercial |
$126.22
|
| Rate for Payer: Encore All Commercial |
$132.03
|
| Rate for Payer: Frontpath All Commercial |
$131.96
|
| Rate for Payer: Humana ChoiceCare |
$123.88
|
| Rate for Payer: Humana Medicare |
$73.15
|
| Rate for Payer: Lucent All Commercial |
$73.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$129.09
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$107.57
|
| Rate for Payer: PHP All Commercial |
$108.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$55.94
|
| Rate for Payer: Sagamore Health Network All Products |
$110.73
|
| Rate for Payer: Signature Care EPO |
$119.05
|
| Rate for Payer: Signature Care PPO |
$126.22
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$121.92
|
| Rate for Payer: United Healthcare Commercial |
$113.02
|
| Rate for Payer: United Healthcare Medicare |
$47.33
|
|
|
HC SN PL SCREW 4.0X10 CANN PT
|
Facility
|
OP
|
$1,019.27
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601705
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$336.36 |
| Max. Negotiated Rate |
$947.92 |
| Rate for Payer: Aetna Commercial |
$860.26
|
| Rate for Payer: Aetna Medicare |
$336.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$336.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$585.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$637.15
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$386.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$370.00
|
| Rate for Payer: Cash Price |
$631.95
|
| Rate for Payer: Cash Price |
$631.95
|
| Rate for Payer: Centivo All Commercial |
$519.83
|
| Rate for Payer: Cigna All Commercial |
$879.63
|
| Rate for Payer: CORVEL All Commercial |
$947.92
|
| Rate for Payer: Coventry All Commercial |
$896.96
|
| Rate for Payer: Encore All Commercial |
$938.24
|
| Rate for Payer: Frontpath All Commercial |
$937.73
|
| Rate for Payer: Humana ChoiceCare |
$880.34
|
| Rate for Payer: Humana Medicare |
$519.83
|
| Rate for Payer: Lucent All Commercial |
$519.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$917.34
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$764.45
|
| Rate for Payer: PHP All Commercial |
$773.01
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$397.52
|
| Rate for Payer: Sagamore Health Network All Products |
$786.88
|
| Rate for Payer: Signature Care EPO |
$845.99
|
| Rate for Payer: Signature Care PPO |
$896.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$866.38
|
| Rate for Payer: United Healthcare Commercial |
$803.18
|
| Rate for Payer: United Healthcare Medicare |
$336.36
|
|
|
HC SN PL SCREW 4.0X10 CANN PT
|
Facility
|
IP
|
$1,019.27
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601705
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$764.45 |
| Max. Negotiated Rate |
$947.92 |
| Rate for Payer: Aetna Commercial |
$880.65
|
| Rate for Payer: Cash Price |
$631.95
|
| Rate for Payer: Cigna All Commercial |
$879.63
|
| Rate for Payer: CORVEL All Commercial |
$947.92
|
| Rate for Payer: Coventry All Commercial |
$896.96
|
| Rate for Payer: Encore All Commercial |
$938.24
|
| Rate for Payer: Frontpath All Commercial |
$937.73
|
| Rate for Payer: Humana ChoiceCare |
$880.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$917.34
|
| Rate for Payer: PHCS All Commercial |
$764.45
|
| Rate for Payer: PHP All Commercial |
$773.01
|
| Rate for Payer: Sagamore Health Network All Products |
$786.88
|
| Rate for Payer: Signature Care EPO |
$845.99
|
| Rate for Payer: Signature Care PPO |
$896.96
|
| Rate for Payer: United Healthcare Commercial |
$803.18
|
|
|
HC SN PL SCREW 4.0X12 CANC FT
|
Facility
|
IP
|
$143.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601640
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$107.57 |
| Max. Negotiated Rate |
$133.39 |
| Rate for Payer: Aetna Commercial |
$123.92
|
| Rate for Payer: Cash Price |
$88.93
|
| Rate for Payer: Cigna All Commercial |
$123.78
|
| Rate for Payer: CORVEL All Commercial |
$133.39
|
| Rate for Payer: Coventry All Commercial |
$126.22
|
| Rate for Payer: Encore All Commercial |
$132.03
|
| Rate for Payer: Frontpath All Commercial |
$131.96
|
| Rate for Payer: Humana ChoiceCare |
$123.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$129.09
|
| Rate for Payer: PHCS All Commercial |
$107.57
|
| Rate for Payer: PHP All Commercial |
$108.78
|
| Rate for Payer: Sagamore Health Network All Products |
$110.73
|
| Rate for Payer: Signature Care EPO |
$119.05
|
| Rate for Payer: Signature Care PPO |
$126.22
|
| Rate for Payer: United Healthcare Commercial |
$113.02
|
|
|
HC SN PL SCREW 4.0X12 CANC FT
|
Facility
|
OP
|
$143.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601640
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$47.33 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$121.05
|
| Rate for Payer: Aetna Medicare |
$47.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$47.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$82.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$89.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$54.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$52.07
|
| Rate for Payer: Cash Price |
$88.93
|
| Rate for Payer: Cash Price |
$88.93
|
| Rate for Payer: Centivo All Commercial |
$73.15
|
| Rate for Payer: Cigna All Commercial |
$123.78
|
| Rate for Payer: CORVEL All Commercial |
$133.39
|
| Rate for Payer: Coventry All Commercial |
$126.22
|
| Rate for Payer: Encore All Commercial |
$132.03
|
| Rate for Payer: Frontpath All Commercial |
$131.96
|
| Rate for Payer: Humana ChoiceCare |
$123.88
|
| Rate for Payer: Humana Medicare |
$73.15
|
| Rate for Payer: Lucent All Commercial |
$73.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$129.09
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$107.57
|
| Rate for Payer: PHP All Commercial |
$108.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$55.94
|
| Rate for Payer: Sagamore Health Network All Products |
$110.73
|
| Rate for Payer: Signature Care EPO |
$119.05
|
| Rate for Payer: Signature Care PPO |
$126.22
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$121.92
|
| Rate for Payer: United Healthcare Commercial |
$113.02
|
| Rate for Payer: United Healthcare Medicare |
$47.33
|
|
|
HC SN PL SCREW 4.0X12 CANC PT
|
Facility
|
OP
|
$143.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601660
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$47.33 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$121.05
|
| Rate for Payer: Aetna Medicare |
$47.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$47.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$82.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$89.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$54.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$52.07
|
| Rate for Payer: Cash Price |
$88.93
|
| Rate for Payer: Cash Price |
$88.93
|
| Rate for Payer: Centivo All Commercial |
$73.15
|
| Rate for Payer: Cigna All Commercial |
$123.78
|
| Rate for Payer: CORVEL All Commercial |
$133.39
|
| Rate for Payer: Coventry All Commercial |
$126.22
|
| Rate for Payer: Encore All Commercial |
$132.03
|
| Rate for Payer: Frontpath All Commercial |
$131.96
|
| Rate for Payer: Humana ChoiceCare |
$123.88
|
| Rate for Payer: Humana Medicare |
$73.15
|
| Rate for Payer: Lucent All Commercial |
$73.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$129.09
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$107.57
|
| Rate for Payer: PHP All Commercial |
$108.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$55.94
|
| Rate for Payer: Sagamore Health Network All Products |
$110.73
|
| Rate for Payer: Signature Care EPO |
$119.05
|
| Rate for Payer: Signature Care PPO |
$126.22
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$121.92
|
| Rate for Payer: United Healthcare Commercial |
$113.02
|
| Rate for Payer: United Healthcare Medicare |
$47.33
|
|
|
HC SN PL SCREW 4.0X12 CANC PT
|
Facility
|
IP
|
$143.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601660
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$107.57 |
| Max. Negotiated Rate |
$133.39 |
| Rate for Payer: Aetna Commercial |
$123.92
|
| Rate for Payer: Cash Price |
$88.93
|
| Rate for Payer: Cigna All Commercial |
$123.78
|
| Rate for Payer: CORVEL All Commercial |
$133.39
|
| Rate for Payer: Coventry All Commercial |
$126.22
|
| Rate for Payer: Encore All Commercial |
$132.03
|
| Rate for Payer: Frontpath All Commercial |
$131.96
|
| Rate for Payer: Humana ChoiceCare |
$123.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$129.09
|
| Rate for Payer: PHCS All Commercial |
$107.57
|
| Rate for Payer: PHP All Commercial |
$108.78
|
| Rate for Payer: Sagamore Health Network All Products |
$110.73
|
| Rate for Payer: Signature Care EPO |
$119.05
|
| Rate for Payer: Signature Care PPO |
$126.22
|
| Rate for Payer: United Healthcare Commercial |
$113.02
|
|
|
HC SN PL SCREW 4.0X12 CANN PT
|
Facility
|
OP
|
$1,019.27
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601706
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$336.36 |
| Max. Negotiated Rate |
$947.92 |
| Rate for Payer: Aetna Commercial |
$860.26
|
| Rate for Payer: Aetna Medicare |
$336.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$336.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$585.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$637.15
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$386.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$370.00
|
| Rate for Payer: Cash Price |
$631.95
|
| Rate for Payer: Cash Price |
$631.95
|
| Rate for Payer: Centivo All Commercial |
$519.83
|
| Rate for Payer: Cigna All Commercial |
$879.63
|
| Rate for Payer: CORVEL All Commercial |
$947.92
|
| Rate for Payer: Coventry All Commercial |
$896.96
|
| Rate for Payer: Encore All Commercial |
$938.24
|
| Rate for Payer: Frontpath All Commercial |
$937.73
|
| Rate for Payer: Humana ChoiceCare |
$880.34
|
| Rate for Payer: Humana Medicare |
$519.83
|
| Rate for Payer: Lucent All Commercial |
$519.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$917.34
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$764.45
|
| Rate for Payer: PHP All Commercial |
$773.01
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$397.52
|
| Rate for Payer: Sagamore Health Network All Products |
$786.88
|
| Rate for Payer: Signature Care EPO |
$845.99
|
| Rate for Payer: Signature Care PPO |
$896.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$866.38
|
| Rate for Payer: United Healthcare Commercial |
$803.18
|
| Rate for Payer: United Healthcare Medicare |
$336.36
|
|
|
HC SN PL SCREW 4.0X12 CANN PT
|
Facility
|
IP
|
$1,019.27
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601706
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$764.45 |
| Max. Negotiated Rate |
$947.92 |
| Rate for Payer: Aetna Commercial |
$880.65
|
| Rate for Payer: Cash Price |
$631.95
|
| Rate for Payer: Cigna All Commercial |
$879.63
|
| Rate for Payer: CORVEL All Commercial |
$947.92
|
| Rate for Payer: Coventry All Commercial |
$896.96
|
| Rate for Payer: Encore All Commercial |
$938.24
|
| Rate for Payer: Frontpath All Commercial |
$937.73
|
| Rate for Payer: Humana ChoiceCare |
$880.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$917.34
|
| Rate for Payer: PHCS All Commercial |
$764.45
|
| Rate for Payer: PHP All Commercial |
$773.01
|
| Rate for Payer: Sagamore Health Network All Products |
$786.88
|
| Rate for Payer: Signature Care EPO |
$845.99
|
| Rate for Payer: Signature Care PPO |
$896.96
|
| Rate for Payer: United Healthcare Commercial |
$803.18
|
|
