HC SN SCREW 7.0X45 32 SS CANN PT
|
Facility
IP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603131
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,552.50 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,788.48
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
|
HC SN SCREW 7.0X45 SS CANN FT
|
Facility
OP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603151
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$524.16 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,747.08
|
Rate for Payer: Aetna Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,188.80
|
Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,293.96
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.56
|
Rate for Payer: CareSource Indiana of IN Medicare |
$751.41
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Centivo All Commercial |
$1,055.70
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Humana Medicare |
$1,055.70
|
Rate for Payer: Lucent All Commercial |
$1,055.70
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: Managed Health Services Medicaid |
$524.16
|
Rate for Payer: MDWise Medicaid |
$524.16
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Plain Church Group Ministry All Commercial |
$807.30
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: Three Rivers Preferred All Commercial |
$1,759.50
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
Rate for Payer: United Healthcare Medicare |
$683.10
|
|
HC SN SCREW 7.0X45 SS CANN FT
|
Facility
IP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603151
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,552.50 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,788.48
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
|
HC SN SCREW 7.0X50 16 SS CANN PT
|
Facility
OP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603117
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$524.16 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,747.08
|
Rate for Payer: Aetna Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,188.80
|
Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,293.96
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.56
|
Rate for Payer: CareSource Indiana of IN Medicare |
$751.41
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Centivo All Commercial |
$1,055.70
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Humana Medicare |
$1,055.70
|
Rate for Payer: Lucent All Commercial |
$1,055.70
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: Managed Health Services Medicaid |
$524.16
|
Rate for Payer: MDWise Medicaid |
$524.16
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Plain Church Group Ministry All Commercial |
$807.30
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: Three Rivers Preferred All Commercial |
$1,759.50
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
Rate for Payer: United Healthcare Medicare |
$683.10
|
|
HC SN SCREW 7.0X50 16 SS CANN PT
|
Facility
IP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603117
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,552.50 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,788.48
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
|
HC SN SCREW 7.0X50 32 SS CANN PT
|
Facility
OP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603132
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$524.16 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,747.08
|
Rate for Payer: Aetna Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,188.80
|
Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,293.96
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.56
|
Rate for Payer: CareSource Indiana of IN Medicare |
$751.41
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Centivo All Commercial |
$1,055.70
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Humana Medicare |
$1,055.70
|
Rate for Payer: Lucent All Commercial |
$1,055.70
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: Managed Health Services Medicaid |
$524.16
|
Rate for Payer: MDWise Medicaid |
$524.16
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Plain Church Group Ministry All Commercial |
$807.30
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: Three Rivers Preferred All Commercial |
$1,759.50
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
Rate for Payer: United Healthcare Medicare |
$683.10
|
|
HC SN SCREW 7.0X50 32 SS CANN PT
|
Facility
IP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603132
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,552.50 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,788.48
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
|
HC SN SCREW 7.0X50 SS CANN FT
|
Facility
OP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603152
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$524.16 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,747.08
|
Rate for Payer: Aetna Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,188.80
|
Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,293.96
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.56
|
Rate for Payer: CareSource Indiana of IN Medicare |
$751.41
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Centivo All Commercial |
$1,055.70
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Humana Medicare |
$1,055.70
|
Rate for Payer: Lucent All Commercial |
$1,055.70
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: Managed Health Services Medicaid |
$524.16
|
Rate for Payer: MDWise Medicaid |
$524.16
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Plain Church Group Ministry All Commercial |
$807.30
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: Three Rivers Preferred All Commercial |
$1,759.50
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
Rate for Payer: United Healthcare Medicare |
$683.10
|
|
HC SN SCREW 7.0X50 SS CANN FT
|
Facility
IP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603152
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,552.50 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,788.48
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
|
HC SN SCREW 7.0X55 16 SS CANN PT
|
Facility
OP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603118
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$524.16 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,747.08
|
Rate for Payer: Aetna Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,188.80
|
Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,293.96
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.56
|
Rate for Payer: CareSource Indiana of IN Medicare |
$751.41
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Centivo All Commercial |
$1,055.70
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Humana Medicare |
$1,055.70
|
Rate for Payer: Lucent All Commercial |
$1,055.70
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: Managed Health Services Medicaid |
$524.16
|
Rate for Payer: MDWise Medicaid |
$524.16
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Plain Church Group Ministry All Commercial |
$807.30
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: Three Rivers Preferred All Commercial |
$1,759.50
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
Rate for Payer: United Healthcare Medicare |
$683.10
|
|
HC SN SCREW 7.0X55 16 SS CANN PT
|
Facility
IP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603118
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,552.50 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,788.48
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
|
HC SN SCREW 7.0X55 32 SS CANN PT
|
Facility
IP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603133
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,552.50 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,788.48
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
|
HC SN SCREW 7.0X55 32 SS CANN PT
|
Facility
OP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603133
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$524.16 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,747.08
|
Rate for Payer: Aetna Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,188.80
|
Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,293.96
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.56
|
Rate for Payer: CareSource Indiana of IN Medicare |
$751.41
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Centivo All Commercial |
$1,055.70
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Humana Medicare |
$1,055.70
|
Rate for Payer: Lucent All Commercial |
$1,055.70
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: Managed Health Services Medicaid |
$524.16
|
Rate for Payer: MDWise Medicaid |
$524.16
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Plain Church Group Ministry All Commercial |
$807.30
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: Three Rivers Preferred All Commercial |
$1,759.50
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
Rate for Payer: United Healthcare Medicare |
$683.10
|
|
HC SN SCREW 7.0X55 SS CANN FT
|
Facility
IP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603153
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,552.50 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,788.48
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
|
HC SN SCREW 7.0X55 SS CANN FT
|
Facility
OP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603153
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$524.16 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,747.08
|
Rate for Payer: Aetna Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,188.80
|
Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,293.96
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.56
|
Rate for Payer: CareSource Indiana of IN Medicare |
$751.41
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Centivo All Commercial |
$1,055.70
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Humana Medicare |
$1,055.70
|
Rate for Payer: Lucent All Commercial |
$1,055.70
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: Managed Health Services Medicaid |
$524.16
|
Rate for Payer: MDWise Medicaid |
$524.16
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Plain Church Group Ministry All Commercial |
$807.30
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: Three Rivers Preferred All Commercial |
$1,759.50
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
Rate for Payer: United Healthcare Medicare |
$683.10
|
|
HC SN SCREW 7.0X60 16 SS CANN PT
|
Facility
OP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603119
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$524.16 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,747.08
|
Rate for Payer: Aetna Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,188.80
|
Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,293.96
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.56
|
Rate for Payer: CareSource Indiana of IN Medicare |
$751.41
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Centivo All Commercial |
$1,055.70
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Humana Medicare |
$1,055.70
|
Rate for Payer: Lucent All Commercial |
$1,055.70
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: Managed Health Services Medicaid |
$524.16
|
Rate for Payer: MDWise Medicaid |
$524.16
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Plain Church Group Ministry All Commercial |
$807.30
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: Three Rivers Preferred All Commercial |
$1,759.50
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
Rate for Payer: United Healthcare Medicare |
$683.10
|
|
HC SN SCREW 7.0X60 16 SS CANN PT
|
Facility
IP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603119
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,552.50 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,788.48
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
|
HC SN SCREW 7.0X60 32 SS CANN PT
|
Facility
OP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603134
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$524.16 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,747.08
|
Rate for Payer: Aetna Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,188.80
|
Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,293.96
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.56
|
Rate for Payer: CareSource Indiana of IN Medicare |
$751.41
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Centivo All Commercial |
$1,055.70
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Humana Medicare |
$1,055.70
|
Rate for Payer: Lucent All Commercial |
$1,055.70
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: Managed Health Services Medicaid |
$524.16
|
Rate for Payer: MDWise Medicaid |
$524.16
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Plain Church Group Ministry All Commercial |
$807.30
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: Three Rivers Preferred All Commercial |
$1,759.50
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
Rate for Payer: United Healthcare Medicare |
$683.10
|
|
HC SN SCREW 7.0X60 32 SS CANN PT
|
Facility
IP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603134
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,552.50 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,788.48
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
|
HC SN SCREW 7.0X60 SS CANN FT
|
Facility
OP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603154
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$524.16 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,747.08
|
Rate for Payer: Aetna Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,188.80
|
Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,293.96
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.56
|
Rate for Payer: CareSource Indiana of IN Medicare |
$751.41
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Centivo All Commercial |
$1,055.70
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Humana Medicare |
$1,055.70
|
Rate for Payer: Lucent All Commercial |
$1,055.70
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: Managed Health Services Medicaid |
$524.16
|
Rate for Payer: MDWise Medicaid |
$524.16
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Plain Church Group Ministry All Commercial |
$807.30
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: Three Rivers Preferred All Commercial |
$1,759.50
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
Rate for Payer: United Healthcare Medicare |
$683.10
|
|
HC SN SCREW 7.0X60 SS CANN FT
|
Facility
IP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603154
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,552.50 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,788.48
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
|
HC SN SCREW 7.0X65 16 SS CANN PT
|
Facility
IP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603120
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,552.50 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,788.48
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
|
HC SN SCREW 7.0X65 16 SS CANN PT
|
Facility
OP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603120
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$524.16 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,747.08
|
Rate for Payer: Aetna Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,188.80
|
Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,293.96
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.56
|
Rate for Payer: CareSource Indiana of IN Medicare |
$751.41
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Centivo All Commercial |
$1,055.70
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Humana Medicare |
$1,055.70
|
Rate for Payer: Lucent All Commercial |
$1,055.70
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: Managed Health Services Medicaid |
$524.16
|
Rate for Payer: MDWise Medicaid |
$524.16
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Plain Church Group Ministry All Commercial |
$807.30
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: Three Rivers Preferred All Commercial |
$1,759.50
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
Rate for Payer: United Healthcare Medicare |
$683.10
|
|
HC SN SCREW 7.0X65 32 SS CANN PT
|
Facility
OP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603135
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$524.16 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,747.08
|
Rate for Payer: Aetna Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN Medicare |
$683.10
|
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,188.80
|
Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,293.96
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
Rate for Payer: CareSource Indiana of IN Just 4 Me |
$785.56
|
Rate for Payer: CareSource Indiana of IN Medicare |
$751.41
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Centivo All Commercial |
$1,055.70
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Humana Medicare |
$1,055.70
|
Rate for Payer: Lucent All Commercial |
$1,055.70
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: Managed Health Services Medicaid |
$524.16
|
Rate for Payer: MDWise Medicaid |
$524.16
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Plain Church Group Ministry All Commercial |
$807.30
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: Three Rivers Preferred All Commercial |
$1,759.50
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
Rate for Payer: United Healthcare Medicare |
$683.10
|
|
HC SN SCREW 7.0X65 32 SS CANN PT
|
Facility
IP
|
$2,070.00
|
|
Service Code
|
CPT C1713
|
Hospital Charge Code |
41603135
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,552.50 |
Max. Negotiated Rate |
$1,925.10 |
Rate for Payer: Aetna Commercial |
$1,788.48
|
Rate for Payer: Cash Price |
$1,283.40
|
Rate for Payer: Cigna All Commercial |
$1,786.41
|
Rate for Payer: CORVEL All Commercial |
$1,925.10
|
Rate for Payer: Coventry All Commercial |
$1,821.60
|
Rate for Payer: Encore All Commercial |
$1,905.44
|
Rate for Payer: Frontpath All Commercial |
$1,904.40
|
Rate for Payer: Humana ChoiceCare |
$1,787.86
|
Rate for Payer: Lutheran Preferred All Commercial |
$1,863.00
|
Rate for Payer: PHCS All Commercial |
$1,552.50
|
Rate for Payer: PHP All Commercial |
$1,569.89
|
Rate for Payer: Sagamore Health Network All Products |
$1,598.04
|
Rate for Payer: Signature Care EPO |
$1,718.10
|
Rate for Payer: Signature Care PPO |
$1,821.60
|
Rate for Payer: United Healthcare Commercial |
$1,631.16
|
|