|
HC SN PL SCREW 4.0X40 CANC PT
|
Facility
IP
|
$143.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601700
|
|
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 4.0X40 CANN PT
|
Facility
OP
|
$1,076.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601716
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$355.08 |
| Max. Negotiated Rate |
$1,000.68 |
| Rate for Payer: Aetna Commercial |
$908.14
|
| Rate for Payer: Aetna Medicare |
$355.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$355.08
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$617.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$672.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$408.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$390.59
|
| Rate for Payer: Cash Price |
$667.12
|
| Rate for Payer: Cash Price |
$667.12
|
| Rate for Payer: Centivo All Commercial |
$548.76
|
| Rate for Payer: Cigna All Commercial |
$928.59
|
| Rate for Payer: CORVEL All Commercial |
$1,000.68
|
| Rate for Payer: Coventry All Commercial |
$946.88
|
| Rate for Payer: Encore All Commercial |
$990.46
|
| Rate for Payer: Frontpath All Commercial |
$989.92
|
| Rate for Payer: Humana ChoiceCare |
$929.34
|
| Rate for Payer: Humana Medicare |
$548.76
|
| Rate for Payer: Lucent All Commercial |
$548.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$968.40
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$807.00
|
| Rate for Payer: PHP All Commercial |
$816.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$419.64
|
| Rate for Payer: Sagamore Health Network All Products |
$830.67
|
| Rate for Payer: Signature Care EPO |
$893.08
|
| Rate for Payer: Signature Care PPO |
$946.88
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$914.60
|
| Rate for Payer: United Healthcare Commercial |
$847.89
|
| Rate for Payer: United Healthcare Medicare |
$355.08
|
|
|
HC SN PL SCREW 4.0X40 CANN PT
|
Facility
IP
|
$1,076.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601716
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$807.00 |
| Max. Negotiated Rate |
$1,000.68 |
| Rate for Payer: Aetna Commercial |
$929.66
|
| Rate for Payer: Cash Price |
$667.12
|
| Rate for Payer: Cigna All Commercial |
$928.59
|
| Rate for Payer: CORVEL All Commercial |
$1,000.68
|
| Rate for Payer: Coventry All Commercial |
$946.88
|
| Rate for Payer: Encore All Commercial |
$990.46
|
| Rate for Payer: Frontpath All Commercial |
$989.92
|
| Rate for Payer: Humana ChoiceCare |
$929.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$968.40
|
| Rate for Payer: PHCS All Commercial |
$807.00
|
| Rate for Payer: PHP All Commercial |
$816.04
|
| Rate for Payer: Sagamore Health Network All Products |
$830.67
|
| Rate for Payer: Signature Care EPO |
$893.08
|
| Rate for Payer: Signature Care PPO |
$946.88
|
| Rate for Payer: United Healthcare Commercial |
$847.89
|
|
|
HC SN PL SCREW 4.0X42 CANN PT
|
Facility
OP
|
$1,283.30
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601717
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$423.49 |
| Max. Negotiated Rate |
$1,193.47 |
| Rate for Payer: Aetna Commercial |
$1,083.11
|
| Rate for Payer: Aetna Medicare |
$423.49
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$423.49
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$737.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$802.19
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$487.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$465.84
|
| Rate for Payer: Cash Price |
$795.65
|
| Rate for Payer: Cash Price |
$795.65
|
| Rate for Payer: Centivo All Commercial |
$654.48
|
| Rate for Payer: Cigna All Commercial |
$1,107.49
|
| Rate for Payer: CORVEL All Commercial |
$1,193.47
|
| Rate for Payer: Coventry All Commercial |
$1,129.30
|
| Rate for Payer: Encore All Commercial |
$1,181.28
|
| Rate for Payer: Frontpath All Commercial |
$1,180.64
|
| Rate for Payer: Humana ChoiceCare |
$1,108.39
|
| Rate for Payer: Humana Medicare |
$654.48
|
| Rate for Payer: Lucent All Commercial |
$654.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,154.97
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$962.48
|
| Rate for Payer: PHP All Commercial |
$973.25
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$500.49
|
| Rate for Payer: Sagamore Health Network All Products |
$990.71
|
| Rate for Payer: Signature Care EPO |
$1,065.14
|
| Rate for Payer: Signature Care PPO |
$1,129.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,090.80
|
| Rate for Payer: United Healthcare Commercial |
$1,011.24
|
| Rate for Payer: United Healthcare Medicare |
$423.49
|
|
|
HC SN PL SCREW 4.0X42 CANN PT
|
Facility
IP
|
$1,283.30
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601717
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$962.48 |
| Max. Negotiated Rate |
$1,193.47 |
| Rate for Payer: Aetna Commercial |
$1,108.77
|
| Rate for Payer: Cash Price |
$795.65
|
| Rate for Payer: Cigna All Commercial |
$1,107.49
|
| Rate for Payer: CORVEL All Commercial |
$1,193.47
|
| Rate for Payer: Coventry All Commercial |
$1,129.30
|
| Rate for Payer: Encore All Commercial |
$1,181.28
|
| Rate for Payer: Frontpath All Commercial |
$1,180.64
|
| Rate for Payer: Humana ChoiceCare |
$1,108.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,154.97
|
| Rate for Payer: PHCS All Commercial |
$962.48
|
| Rate for Payer: PHP All Commercial |
$973.25
|
| Rate for Payer: Sagamore Health Network All Products |
$990.71
|
| Rate for Payer: Signature Care EPO |
$1,065.14
|
| Rate for Payer: Signature Care PPO |
$1,129.30
|
| Rate for Payer: United Healthcare Commercial |
$1,011.24
|
|
|
HC SN PL SCREW 4.0X44 CANN PT
|
Facility
OP
|
$1,496.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601718
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$493.68 |
| Max. Negotiated Rate |
$1,391.28 |
| Rate for Payer: Aetna Commercial |
$1,262.62
|
| Rate for Payer: Aetna Medicare |
$493.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$493.68
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$859.15
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$935.15
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$567.73
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$543.05
|
| Rate for Payer: Cash Price |
$927.52
|
| Rate for Payer: Cash Price |
$927.52
|
| Rate for Payer: Centivo All Commercial |
$762.96
|
| Rate for Payer: Cigna All Commercial |
$1,291.05
|
| Rate for Payer: CORVEL All Commercial |
$1,391.28
|
| Rate for Payer: Coventry All Commercial |
$1,316.48
|
| Rate for Payer: Encore All Commercial |
$1,377.07
|
| Rate for Payer: Frontpath All Commercial |
$1,376.32
|
| Rate for Payer: Humana ChoiceCare |
$1,292.10
|
| Rate for Payer: Humana Medicare |
$762.96
|
| Rate for Payer: Lucent All Commercial |
$762.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,346.40
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,122.00
|
| Rate for Payer: PHP All Commercial |
$1,134.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$583.44
|
| Rate for Payer: Sagamore Health Network All Products |
$1,154.91
|
| Rate for Payer: Signature Care EPO |
$1,241.68
|
| Rate for Payer: Signature Care PPO |
$1,316.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,271.60
|
| Rate for Payer: United Healthcare Commercial |
$1,178.85
|
| Rate for Payer: United Healthcare Medicare |
$493.68
|
|
|
HC SN PL SCREW 4.0X44 CANN PT
|
Facility
IP
|
$1,496.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601718
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,122.00 |
| Max. Negotiated Rate |
$1,391.28 |
| Rate for Payer: Aetna Commercial |
$1,292.54
|
| Rate for Payer: Cash Price |
$927.52
|
| Rate for Payer: Cigna All Commercial |
$1,291.05
|
| Rate for Payer: CORVEL All Commercial |
$1,391.28
|
| Rate for Payer: Coventry All Commercial |
$1,316.48
|
| Rate for Payer: Encore All Commercial |
$1,377.07
|
| Rate for Payer: Frontpath All Commercial |
$1,376.32
|
| Rate for Payer: Humana ChoiceCare |
$1,292.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,346.40
|
| Rate for Payer: PHCS All Commercial |
$1,122.00
|
| Rate for Payer: PHP All Commercial |
$1,134.57
|
| Rate for Payer: Sagamore Health Network All Products |
$1,154.91
|
| Rate for Payer: Signature Care EPO |
$1,241.68
|
| Rate for Payer: Signature Care PPO |
$1,316.48
|
| Rate for Payer: United Healthcare Commercial |
$1,178.85
|
|
|
HC SN PL SCREW 4.0X45 CANC FT
|
Facility
OP
|
$143.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601655
|
|
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 4.0X45 CANC FT
|
Facility
IP
|
$143.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601655
|
|
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 4.0X45 CANC PT
|
Facility
OP
|
$143.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601701
|
|
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 4.0X45 CANC PT
|
Facility
IP
|
$143.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601701
|
|
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 4.0X46 CANN PT
|
Facility
IP
|
$1,019.27
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601719
|
|
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 4.0X46 CANN PT
|
Facility
OP
|
$1,019.27
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601719
|
|
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 4.0X48 CANN PT
|
Facility
IP
|
$1,019.27
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601720
|
|
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 4.0X48 CANN PT
|
Facility
OP
|
$1,019.27
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601720
|
|
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 4.0X50 CANC FT
|
Facility
OP
|
$143.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601656
|
|
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 4.0X50 CANC FT
|
Facility
IP
|
$143.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601656
|
|
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 4.0X50 CANC PT
|
Facility
IP
|
$143.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601702
|
|
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 4.0X50 CANC PT
|
Facility
OP
|
$143.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601702
|
|
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 4.0X50 CANN PT
|
Facility
IP
|
$950.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601721
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$713.18 |
| Max. Negotiated Rate |
$884.34 |
| Rate for Payer: Aetna Commercial |
$821.58
|
| Rate for Payer: Cash Price |
$589.56
|
| Rate for Payer: Cigna All Commercial |
$820.63
|
| Rate for Payer: CORVEL All Commercial |
$884.34
|
| Rate for Payer: Coventry All Commercial |
$836.79
|
| Rate for Payer: Encore All Commercial |
$875.30
|
| Rate for Payer: Frontpath All Commercial |
$874.83
|
| Rate for Payer: Humana ChoiceCare |
$821.29
|
| Rate for Payer: Lutheran Preferred All Commercial |
$855.81
|
| Rate for Payer: PHCS All Commercial |
$713.18
|
| Rate for Payer: PHP All Commercial |
$721.16
|
| Rate for Payer: Sagamore Health Network All Products |
$734.09
|
| Rate for Payer: Signature Care EPO |
$789.25
|
| Rate for Payer: Signature Care PPO |
$836.79
|
| Rate for Payer: United Healthcare Commercial |
$749.31
|
|
|
HC SN PL SCREW 4.0X50 CANN PT
|
Facility
OP
|
$950.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601721
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$313.80 |
| Max. Negotiated Rate |
$884.34 |
| Rate for Payer: Aetna Commercial |
$802.56
|
| Rate for Payer: Aetna Medicare |
$313.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$313.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$546.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$594.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$360.87
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$345.18
|
| Rate for Payer: Cash Price |
$589.56
|
| Rate for Payer: Cash Price |
$589.56
|
| Rate for Payer: Centivo All Commercial |
$484.96
|
| Rate for Payer: Cigna All Commercial |
$820.63
|
| Rate for Payer: CORVEL All Commercial |
$884.34
|
| Rate for Payer: Coventry All Commercial |
$836.79
|
| Rate for Payer: Encore All Commercial |
$875.30
|
| Rate for Payer: Frontpath All Commercial |
$874.83
|
| Rate for Payer: Humana ChoiceCare |
$821.29
|
| Rate for Payer: Humana Medicare |
$484.96
|
| Rate for Payer: Lucent All Commercial |
$484.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$855.81
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$713.18
|
| Rate for Payer: PHP All Commercial |
$721.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$370.85
|
| Rate for Payer: Sagamore Health Network All Products |
$734.09
|
| Rate for Payer: Signature Care EPO |
$789.25
|
| Rate for Payer: Signature Care PPO |
$836.79
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$808.26
|
| Rate for Payer: United Healthcare Commercial |
$749.31
|
| Rate for Payer: United Healthcare Medicare |
$313.80
|
|
|
HC SN PL SCREW 4.0X52 CANN PT
|
Facility
OP
|
$1,019.27
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601668
|
|
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 4.0X52 CANN PT
|
Facility
IP
|
$1,019.27
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601668
|
|
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 4.0X54 CANN PT
|
Facility
OP
|
$1,019.27
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601669
|
|
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 4.0X54 CANN PT
|
Facility
IP
|
$1,019.27
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601669
|
|
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
|
|
