|
HC Z SCREW 3.5X20 CORT LP
|
Facility
|
OP
|
$466.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606351
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$433.96 |
| Rate for Payer: Aetna Commercial |
$393.83
|
| Rate for Payer: Aetna Medicare |
$149.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$144.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$267.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$291.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$171.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$164.25
|
| Rate for Payer: Cash Price |
$279.97
|
| Rate for Payer: Cash Price |
$279.97
|
| Rate for Payer: Centivo All Commercial |
$253.84
|
| Rate for Payer: Cigna All Commercial |
$402.69
|
| Rate for Payer: CORVEL All Commercial |
$433.96
|
| Rate for Payer: Coventry All Commercial |
$410.63
|
| Rate for Payer: Encore All Commercial |
$429.52
|
| Rate for Payer: Frontpath All Commercial |
$429.29
|
| Rate for Payer: Humana ChoiceCare |
$403.02
|
| Rate for Payer: Humana Medicare |
$149.32
|
| Rate for Payer: Lucent All Commercial |
$253.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$419.96
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$349.96
|
| Rate for Payer: PHP All Commercial |
$353.88
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$181.98
|
| Rate for Payer: Sagamore Health Network All Products |
$360.23
|
| Rate for Payer: Signature Care EPO |
$387.29
|
| Rate for Payer: Signature Care PPO |
$410.63
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$396.63
|
| Rate for Payer: United Healthcare Commercial |
$367.70
|
| Rate for Payer: United Healthcare Medicare |
$149.32
|
|
|
HC Z SCREW 3.5X20 CORT LP
|
Facility
|
IP
|
$466.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606351
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$349.96 |
| Max. Negotiated Rate |
$433.96 |
| Rate for Payer: Aetna Commercial |
$403.16
|
| Rate for Payer: Cash Price |
$279.97
|
| Rate for Payer: Cigna All Commercial |
$402.69
|
| Rate for Payer: CORVEL All Commercial |
$433.96
|
| Rate for Payer: Coventry All Commercial |
$410.63
|
| Rate for Payer: Encore All Commercial |
$429.52
|
| Rate for Payer: Frontpath All Commercial |
$429.29
|
| Rate for Payer: Humana ChoiceCare |
$403.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$419.96
|
| Rate for Payer: PHCS All Commercial |
$349.96
|
| Rate for Payer: PHP All Commercial |
$353.88
|
| Rate for Payer: Sagamore Health Network All Products |
$360.23
|
| Rate for Payer: Signature Care EPO |
$387.29
|
| Rate for Payer: Signature Care PPO |
$410.63
|
| Rate for Payer: United Healthcare Commercial |
$367.70
|
|
|
HC Z SCREW 3.5X22 CORT
|
Facility
|
IP
|
$424.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606820
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$318.15 |
| Max. Negotiated Rate |
$394.51 |
| Rate for Payer: Aetna Commercial |
$366.51
|
| Rate for Payer: Cash Price |
$254.52
|
| Rate for Payer: Cigna All Commercial |
$366.08
|
| Rate for Payer: CORVEL All Commercial |
$394.51
|
| Rate for Payer: Coventry All Commercial |
$373.30
|
| Rate for Payer: Encore All Commercial |
$390.48
|
| Rate for Payer: Frontpath All Commercial |
$390.26
|
| Rate for Payer: Humana ChoiceCare |
$366.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$381.78
|
| Rate for Payer: PHCS All Commercial |
$318.15
|
| Rate for Payer: PHP All Commercial |
$321.71
|
| Rate for Payer: Sagamore Health Network All Products |
$327.48
|
| Rate for Payer: Signature Care EPO |
$352.09
|
| Rate for Payer: Signature Care PPO |
$373.30
|
| Rate for Payer: United Healthcare Commercial |
$334.27
|
|
|
HC Z SCREW 3.5X22 CORT
|
Facility
|
OP
|
$424.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606820
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$131.50 |
| Max. Negotiated Rate |
$394.51 |
| Rate for Payer: Aetna Commercial |
$358.02
|
| Rate for Payer: Aetna Medicare |
$135.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$131.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$243.62
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$265.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$156.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$149.32
|
| Rate for Payer: Cash Price |
$254.52
|
| Rate for Payer: Cash Price |
$254.52
|
| Rate for Payer: Centivo All Commercial |
$230.76
|
| Rate for Payer: Cigna All Commercial |
$366.08
|
| Rate for Payer: CORVEL All Commercial |
$394.51
|
| Rate for Payer: Coventry All Commercial |
$373.30
|
| Rate for Payer: Encore All Commercial |
$390.48
|
| Rate for Payer: Frontpath All Commercial |
$390.26
|
| Rate for Payer: Humana ChoiceCare |
$366.38
|
| Rate for Payer: Humana Medicare |
$135.74
|
| Rate for Payer: Lucent All Commercial |
$230.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$381.78
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$318.15
|
| Rate for Payer: PHP All Commercial |
$321.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$165.44
|
| Rate for Payer: Sagamore Health Network All Products |
$327.48
|
| Rate for Payer: Signature Care EPO |
$352.09
|
| Rate for Payer: Signature Care PPO |
$373.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$360.57
|
| Rate for Payer: United Healthcare Commercial |
$334.27
|
| Rate for Payer: United Healthcare Medicare |
$135.74
|
|
|
HC Z SCREW 3.5X22 CORT LOCK
|
Facility
|
OP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603818
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$867.91 |
| Rate for Payer: Aetna Commercial |
$787.65
|
| Rate for Payer: Aetna Medicare |
$298.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$289.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$535.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$583.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$343.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$328.50
|
| Rate for Payer: Cash Price |
$559.94
|
| Rate for Payer: Cash Price |
$559.94
|
| Rate for Payer: Centivo All Commercial |
$507.68
|
| Rate for Payer: Cigna All Commercial |
$805.39
|
| Rate for Payer: CORVEL All Commercial |
$867.91
|
| Rate for Payer: Coventry All Commercial |
$821.25
|
| Rate for Payer: Encore All Commercial |
$859.05
|
| Rate for Payer: Frontpath All Commercial |
$858.58
|
| Rate for Payer: Humana ChoiceCare |
$806.04
|
| Rate for Payer: Humana Medicare |
$298.64
|
| Rate for Payer: Lucent All Commercial |
$507.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$839.92
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$699.93
|
| Rate for Payer: PHP All Commercial |
$707.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$363.96
|
| Rate for Payer: Sagamore Health Network All Products |
$720.46
|
| Rate for Payer: Signature Care EPO |
$774.59
|
| Rate for Payer: Signature Care PPO |
$821.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$793.25
|
| Rate for Payer: United Healthcare Commercial |
$735.39
|
| Rate for Payer: United Healthcare Medicare |
$298.64
|
|
|
HC Z SCREW 3.5X22 CORT LOCK
|
Facility
|
IP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603818
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$699.93 |
| Max. Negotiated Rate |
$867.91 |
| Rate for Payer: Aetna Commercial |
$806.32
|
| Rate for Payer: Cash Price |
$559.94
|
| Rate for Payer: Cigna All Commercial |
$805.39
|
| Rate for Payer: CORVEL All Commercial |
$867.91
|
| Rate for Payer: Coventry All Commercial |
$821.25
|
| Rate for Payer: Encore All Commercial |
$859.05
|
| Rate for Payer: Frontpath All Commercial |
$858.58
|
| Rate for Payer: Humana ChoiceCare |
$806.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$839.92
|
| Rate for Payer: PHCS All Commercial |
$699.93
|
| Rate for Payer: PHP All Commercial |
$707.77
|
| Rate for Payer: Sagamore Health Network All Products |
$720.46
|
| Rate for Payer: Signature Care EPO |
$774.59
|
| Rate for Payer: Signature Care PPO |
$821.25
|
| Rate for Payer: United Healthcare Commercial |
$735.39
|
|
|
HC Z SCREW 3.5X28 CORT LOCK
|
Facility
|
OP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603815
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$867.91 |
| Rate for Payer: Aetna Commercial |
$787.65
|
| Rate for Payer: Aetna Medicare |
$298.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$289.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$535.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$583.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$343.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$328.50
|
| Rate for Payer: Cash Price |
$559.94
|
| Rate for Payer: Cash Price |
$559.94
|
| Rate for Payer: Centivo All Commercial |
$507.68
|
| Rate for Payer: Cigna All Commercial |
$805.39
|
| Rate for Payer: CORVEL All Commercial |
$867.91
|
| Rate for Payer: Coventry All Commercial |
$821.25
|
| Rate for Payer: Encore All Commercial |
$859.05
|
| Rate for Payer: Frontpath All Commercial |
$858.58
|
| Rate for Payer: Humana ChoiceCare |
$806.04
|
| Rate for Payer: Humana Medicare |
$298.64
|
| Rate for Payer: Lucent All Commercial |
$507.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$839.92
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$699.93
|
| Rate for Payer: PHP All Commercial |
$707.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$363.96
|
| Rate for Payer: Sagamore Health Network All Products |
$720.46
|
| Rate for Payer: Signature Care EPO |
$774.59
|
| Rate for Payer: Signature Care PPO |
$821.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$793.25
|
| Rate for Payer: United Healthcare Commercial |
$735.39
|
| Rate for Payer: United Healthcare Medicare |
$298.64
|
|
|
HC Z SCREW 3.5X28 CORT LOCK
|
Facility
|
IP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603815
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$699.93 |
| Max. Negotiated Rate |
$867.91 |
| Rate for Payer: Aetna Commercial |
$806.32
|
| Rate for Payer: Cash Price |
$559.94
|
| Rate for Payer: Cigna All Commercial |
$805.39
|
| Rate for Payer: CORVEL All Commercial |
$867.91
|
| Rate for Payer: Coventry All Commercial |
$821.25
|
| Rate for Payer: Encore All Commercial |
$859.05
|
| Rate for Payer: Frontpath All Commercial |
$858.58
|
| Rate for Payer: Humana ChoiceCare |
$806.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$839.92
|
| Rate for Payer: PHCS All Commercial |
$699.93
|
| Rate for Payer: PHP All Commercial |
$707.77
|
| Rate for Payer: Sagamore Health Network All Products |
$720.46
|
| Rate for Payer: Signature Care EPO |
$774.59
|
| Rate for Payer: Signature Care PPO |
$821.25
|
| Rate for Payer: United Healthcare Commercial |
$735.39
|
|
|
HC Z SCREW 3.5X32 CORT LOCK
|
Facility
|
OP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603813
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$867.91 |
| Rate for Payer: Aetna Commercial |
$787.65
|
| Rate for Payer: Aetna Medicare |
$298.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$289.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$535.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$583.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$343.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$328.50
|
| Rate for Payer: Cash Price |
$559.94
|
| Rate for Payer: Cash Price |
$559.94
|
| Rate for Payer: Centivo All Commercial |
$507.68
|
| Rate for Payer: Cigna All Commercial |
$805.39
|
| Rate for Payer: CORVEL All Commercial |
$867.91
|
| Rate for Payer: Coventry All Commercial |
$821.25
|
| Rate for Payer: Encore All Commercial |
$859.05
|
| Rate for Payer: Frontpath All Commercial |
$858.58
|
| Rate for Payer: Humana ChoiceCare |
$806.04
|
| Rate for Payer: Humana Medicare |
$298.64
|
| Rate for Payer: Lucent All Commercial |
$507.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$839.92
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$699.93
|
| Rate for Payer: PHP All Commercial |
$707.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$363.96
|
| Rate for Payer: Sagamore Health Network All Products |
$720.46
|
| Rate for Payer: Signature Care EPO |
$774.59
|
| Rate for Payer: Signature Care PPO |
$821.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$793.25
|
| Rate for Payer: United Healthcare Commercial |
$735.39
|
| Rate for Payer: United Healthcare Medicare |
$298.64
|
|
|
HC Z SCREW 3.5X32 CORT LOCK
|
Facility
|
IP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603813
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$699.93 |
| Max. Negotiated Rate |
$867.91 |
| Rate for Payer: Aetna Commercial |
$806.32
|
| Rate for Payer: Cash Price |
$559.94
|
| Rate for Payer: Cigna All Commercial |
$805.39
|
| Rate for Payer: CORVEL All Commercial |
$867.91
|
| Rate for Payer: Coventry All Commercial |
$821.25
|
| Rate for Payer: Encore All Commercial |
$859.05
|
| Rate for Payer: Frontpath All Commercial |
$858.58
|
| Rate for Payer: Humana ChoiceCare |
$806.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$839.92
|
| Rate for Payer: PHCS All Commercial |
$699.93
|
| Rate for Payer: PHP All Commercial |
$707.77
|
| Rate for Payer: Sagamore Health Network All Products |
$720.46
|
| Rate for Payer: Signature Care EPO |
$774.59
|
| Rate for Payer: Signature Care PPO |
$821.25
|
| Rate for Payer: United Healthcare Commercial |
$735.39
|
|
|
HC Z SCREW 3.5X34 CORT LP
|
Facility
|
IP
|
$466.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606710
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$349.96 |
| Max. Negotiated Rate |
$433.96 |
| Rate for Payer: Aetna Commercial |
$403.16
|
| Rate for Payer: Cash Price |
$279.97
|
| Rate for Payer: Cigna All Commercial |
$402.69
|
| Rate for Payer: CORVEL All Commercial |
$433.96
|
| Rate for Payer: Coventry All Commercial |
$410.63
|
| Rate for Payer: Encore All Commercial |
$429.52
|
| Rate for Payer: Frontpath All Commercial |
$429.29
|
| Rate for Payer: Humana ChoiceCare |
$403.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$419.96
|
| Rate for Payer: PHCS All Commercial |
$349.96
|
| Rate for Payer: PHP All Commercial |
$353.88
|
| Rate for Payer: Sagamore Health Network All Products |
$360.23
|
| Rate for Payer: Signature Care EPO |
$387.29
|
| Rate for Payer: Signature Care PPO |
$410.63
|
| Rate for Payer: United Healthcare Commercial |
$367.70
|
|
|
HC Z SCREW 3.5X34 CORT LP
|
Facility
|
OP
|
$466.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606710
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$433.96 |
| Rate for Payer: Aetna Commercial |
$393.83
|
| Rate for Payer: Aetna Medicare |
$149.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$144.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$267.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$291.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$171.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$164.25
|
| Rate for Payer: Cash Price |
$279.97
|
| Rate for Payer: Cash Price |
$279.97
|
| Rate for Payer: Centivo All Commercial |
$253.84
|
| Rate for Payer: Cigna All Commercial |
$402.69
|
| Rate for Payer: CORVEL All Commercial |
$433.96
|
| Rate for Payer: Coventry All Commercial |
$410.63
|
| Rate for Payer: Encore All Commercial |
$429.52
|
| Rate for Payer: Frontpath All Commercial |
$429.29
|
| Rate for Payer: Humana ChoiceCare |
$403.02
|
| Rate for Payer: Humana Medicare |
$149.32
|
| Rate for Payer: Lucent All Commercial |
$253.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$419.96
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$349.96
|
| Rate for Payer: PHP All Commercial |
$353.88
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$181.98
|
| Rate for Payer: Sagamore Health Network All Products |
$360.23
|
| Rate for Payer: Signature Care EPO |
$387.29
|
| Rate for Payer: Signature Care PPO |
$410.63
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$396.63
|
| Rate for Payer: United Healthcare Commercial |
$367.70
|
| Rate for Payer: United Healthcare Medicare |
$149.32
|
|
|
HC Z SCREW 3.5X36 CORT LP
|
Facility
|
OP
|
$466.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606711
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$433.96 |
| Rate for Payer: Aetna Commercial |
$393.83
|
| Rate for Payer: Aetna Medicare |
$149.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$144.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$267.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$291.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$171.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$164.25
|
| Rate for Payer: Cash Price |
$279.97
|
| Rate for Payer: Cash Price |
$279.97
|
| Rate for Payer: Centivo All Commercial |
$253.84
|
| Rate for Payer: Cigna All Commercial |
$402.69
|
| Rate for Payer: CORVEL All Commercial |
$433.96
|
| Rate for Payer: Coventry All Commercial |
$410.63
|
| Rate for Payer: Encore All Commercial |
$429.52
|
| Rate for Payer: Frontpath All Commercial |
$429.29
|
| Rate for Payer: Humana ChoiceCare |
$403.02
|
| Rate for Payer: Humana Medicare |
$149.32
|
| Rate for Payer: Lucent All Commercial |
$253.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$419.96
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$349.96
|
| Rate for Payer: PHP All Commercial |
$353.88
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$181.98
|
| Rate for Payer: Sagamore Health Network All Products |
$360.23
|
| Rate for Payer: Signature Care EPO |
$387.29
|
| Rate for Payer: Signature Care PPO |
$410.63
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$396.63
|
| Rate for Payer: United Healthcare Commercial |
$367.70
|
| Rate for Payer: United Healthcare Medicare |
$149.32
|
|
|
HC Z SCREW 3.5X36 CORT LP
|
Facility
|
IP
|
$466.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606711
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$349.96 |
| Max. Negotiated Rate |
$433.96 |
| Rate for Payer: Aetna Commercial |
$403.16
|
| Rate for Payer: Cash Price |
$279.97
|
| Rate for Payer: Cigna All Commercial |
$402.69
|
| Rate for Payer: CORVEL All Commercial |
$433.96
|
| Rate for Payer: Coventry All Commercial |
$410.63
|
| Rate for Payer: Encore All Commercial |
$429.52
|
| Rate for Payer: Frontpath All Commercial |
$429.29
|
| Rate for Payer: Humana ChoiceCare |
$403.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$419.96
|
| Rate for Payer: PHCS All Commercial |
$349.96
|
| Rate for Payer: PHP All Commercial |
$353.88
|
| Rate for Payer: Sagamore Health Network All Products |
$360.23
|
| Rate for Payer: Signature Care EPO |
$387.29
|
| Rate for Payer: Signature Care PPO |
$410.63
|
| Rate for Payer: United Healthcare Commercial |
$367.70
|
|
|
HC Z SCREW 3.5X38 CORT LP
|
Facility
|
IP
|
$466.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606712
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$349.96 |
| Max. Negotiated Rate |
$433.96 |
| Rate for Payer: Aetna Commercial |
$403.16
|
| Rate for Payer: Cash Price |
$279.97
|
| Rate for Payer: Cigna All Commercial |
$402.69
|
| Rate for Payer: CORVEL All Commercial |
$433.96
|
| Rate for Payer: Coventry All Commercial |
$410.63
|
| Rate for Payer: Encore All Commercial |
$429.52
|
| Rate for Payer: Frontpath All Commercial |
$429.29
|
| Rate for Payer: Humana ChoiceCare |
$403.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$419.96
|
| Rate for Payer: PHCS All Commercial |
$349.96
|
| Rate for Payer: PHP All Commercial |
$353.88
|
| Rate for Payer: Sagamore Health Network All Products |
$360.23
|
| Rate for Payer: Signature Care EPO |
$387.29
|
| Rate for Payer: Signature Care PPO |
$410.63
|
| Rate for Payer: United Healthcare Commercial |
$367.70
|
|
|
HC Z SCREW 3.5X38 CORT LP
|
Facility
|
OP
|
$466.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606712
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$433.96 |
| Rate for Payer: Aetna Commercial |
$393.83
|
| Rate for Payer: Aetna Medicare |
$149.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$144.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$267.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$291.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$171.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$164.25
|
| Rate for Payer: Cash Price |
$279.97
|
| Rate for Payer: Cash Price |
$279.97
|
| Rate for Payer: Centivo All Commercial |
$253.84
|
| Rate for Payer: Cigna All Commercial |
$402.69
|
| Rate for Payer: CORVEL All Commercial |
$433.96
|
| Rate for Payer: Coventry All Commercial |
$410.63
|
| Rate for Payer: Encore All Commercial |
$429.52
|
| Rate for Payer: Frontpath All Commercial |
$429.29
|
| Rate for Payer: Humana ChoiceCare |
$403.02
|
| Rate for Payer: Humana Medicare |
$149.32
|
| Rate for Payer: Lucent All Commercial |
$253.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$419.96
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$349.96
|
| Rate for Payer: PHP All Commercial |
$353.88
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$181.98
|
| Rate for Payer: Sagamore Health Network All Products |
$360.23
|
| Rate for Payer: Signature Care EPO |
$387.29
|
| Rate for Payer: Signature Care PPO |
$410.63
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$396.63
|
| Rate for Payer: United Healthcare Commercial |
$367.70
|
| Rate for Payer: United Healthcare Medicare |
$149.32
|
|
|
HC Z SCREW 3.5X40 CORT LP
|
Facility
|
OP
|
$466.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606352
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$433.96 |
| Rate for Payer: Aetna Commercial |
$393.83
|
| Rate for Payer: Aetna Medicare |
$149.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$144.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$267.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$291.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$171.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$164.25
|
| Rate for Payer: Cash Price |
$279.97
|
| Rate for Payer: Cash Price |
$279.97
|
| Rate for Payer: Centivo All Commercial |
$253.84
|
| Rate for Payer: Cigna All Commercial |
$402.69
|
| Rate for Payer: CORVEL All Commercial |
$433.96
|
| Rate for Payer: Coventry All Commercial |
$410.63
|
| Rate for Payer: Encore All Commercial |
$429.52
|
| Rate for Payer: Frontpath All Commercial |
$429.29
|
| Rate for Payer: Humana ChoiceCare |
$403.02
|
| Rate for Payer: Humana Medicare |
$149.32
|
| Rate for Payer: Lucent All Commercial |
$253.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$419.96
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$349.96
|
| Rate for Payer: PHP All Commercial |
$353.88
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$181.98
|
| Rate for Payer: Sagamore Health Network All Products |
$360.23
|
| Rate for Payer: Signature Care EPO |
$387.29
|
| Rate for Payer: Signature Care PPO |
$410.63
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$396.63
|
| Rate for Payer: United Healthcare Commercial |
$367.70
|
| Rate for Payer: United Healthcare Medicare |
$149.32
|
|
|
HC Z SCREW 3.5X40 CORT LP
|
Facility
|
IP
|
$466.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606352
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$349.96 |
| Max. Negotiated Rate |
$433.96 |
| Rate for Payer: Aetna Commercial |
$403.16
|
| Rate for Payer: Cash Price |
$279.97
|
| Rate for Payer: Cigna All Commercial |
$402.69
|
| Rate for Payer: CORVEL All Commercial |
$433.96
|
| Rate for Payer: Coventry All Commercial |
$410.63
|
| Rate for Payer: Encore All Commercial |
$429.52
|
| Rate for Payer: Frontpath All Commercial |
$429.29
|
| Rate for Payer: Humana ChoiceCare |
$403.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$419.96
|
| Rate for Payer: PHCS All Commercial |
$349.96
|
| Rate for Payer: PHP All Commercial |
$353.88
|
| Rate for Payer: Sagamore Health Network All Products |
$360.23
|
| Rate for Payer: Signature Care EPO |
$387.29
|
| Rate for Payer: Signature Care PPO |
$410.63
|
| Rate for Payer: United Healthcare Commercial |
$367.70
|
|
|
HC Z SCREW 3.5X4.75X15 LOCK
|
Facility
|
IP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605678
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$381.57 |
| Max. Negotiated Rate |
$473.15 |
| Rate for Payer: Aetna Commercial |
$439.57
|
| Rate for Payer: Cash Price |
$305.26
|
| Rate for Payer: Cigna All Commercial |
$439.06
|
| Rate for Payer: CORVEL All Commercial |
$473.15
|
| Rate for Payer: Coventry All Commercial |
$447.71
|
| Rate for Payer: Encore All Commercial |
$468.31
|
| Rate for Payer: Frontpath All Commercial |
$468.06
|
| Rate for Payer: Humana ChoiceCare |
$439.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.88
|
| Rate for Payer: PHCS All Commercial |
$381.57
|
| Rate for Payer: PHP All Commercial |
$385.84
|
| Rate for Payer: Sagamore Health Network All Products |
$392.76
|
| Rate for Payer: Signature Care EPO |
$422.27
|
| Rate for Payer: Signature Care PPO |
$447.71
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
|
|
HC Z SCREW 3.5X4.75X15 LOCK
|
Facility
|
OP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605678
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$473.15 |
| Rate for Payer: Aetna Commercial |
$429.39
|
| Rate for Payer: Aetna Medicare |
$162.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$157.72
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$292.18
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$318.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$187.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$179.08
|
| Rate for Payer: Cash Price |
$305.26
|
| Rate for Payer: Cash Price |
$305.26
|
| Rate for Payer: Centivo All Commercial |
$276.77
|
| Rate for Payer: Cigna All Commercial |
$439.06
|
| Rate for Payer: CORVEL All Commercial |
$473.15
|
| Rate for Payer: Coventry All Commercial |
$447.71
|
| Rate for Payer: Encore All Commercial |
$468.31
|
| Rate for Payer: Frontpath All Commercial |
$468.06
|
| Rate for Payer: Humana ChoiceCare |
$439.42
|
| Rate for Payer: Humana Medicare |
$162.80
|
| Rate for Payer: Lucent All Commercial |
$276.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.88
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$381.57
|
| Rate for Payer: PHP All Commercial |
$385.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$198.42
|
| Rate for Payer: Sagamore Health Network All Products |
$392.76
|
| Rate for Payer: Signature Care EPO |
$422.27
|
| Rate for Payer: Signature Care PPO |
$447.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$432.45
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
| Rate for Payer: United Healthcare Medicare |
$162.80
|
|
|
HC Z SCREW 3.5X4.75X20 LOCK
|
Facility
|
OP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605679
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$473.15 |
| Rate for Payer: Aetna Commercial |
$429.39
|
| Rate for Payer: Aetna Medicare |
$162.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$157.72
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$292.18
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$318.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$187.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$179.08
|
| Rate for Payer: Cash Price |
$305.26
|
| Rate for Payer: Cash Price |
$305.26
|
| Rate for Payer: Centivo All Commercial |
$276.77
|
| Rate for Payer: Cigna All Commercial |
$439.06
|
| Rate for Payer: CORVEL All Commercial |
$473.15
|
| Rate for Payer: Coventry All Commercial |
$447.71
|
| Rate for Payer: Encore All Commercial |
$468.31
|
| Rate for Payer: Frontpath All Commercial |
$468.06
|
| Rate for Payer: Humana ChoiceCare |
$439.42
|
| Rate for Payer: Humana Medicare |
$162.80
|
| Rate for Payer: Lucent All Commercial |
$276.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.88
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$381.57
|
| Rate for Payer: PHP All Commercial |
$385.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$198.42
|
| Rate for Payer: Sagamore Health Network All Products |
$392.76
|
| Rate for Payer: Signature Care EPO |
$422.27
|
| Rate for Payer: Signature Care PPO |
$447.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$432.45
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
| Rate for Payer: United Healthcare Medicare |
$162.80
|
|
|
HC Z SCREW 3.5X4.75X20 LOCK
|
Facility
|
IP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605679
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$381.57 |
| Max. Negotiated Rate |
$473.15 |
| Rate for Payer: Aetna Commercial |
$439.57
|
| Rate for Payer: Cash Price |
$305.26
|
| Rate for Payer: Cigna All Commercial |
$439.06
|
| Rate for Payer: CORVEL All Commercial |
$473.15
|
| Rate for Payer: Coventry All Commercial |
$447.71
|
| Rate for Payer: Encore All Commercial |
$468.31
|
| Rate for Payer: Frontpath All Commercial |
$468.06
|
| Rate for Payer: Humana ChoiceCare |
$439.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.88
|
| Rate for Payer: PHCS All Commercial |
$381.57
|
| Rate for Payer: PHP All Commercial |
$385.84
|
| Rate for Payer: Sagamore Health Network All Products |
$392.76
|
| Rate for Payer: Signature Care EPO |
$422.27
|
| Rate for Payer: Signature Care PPO |
$447.71
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
|
|
HC Z SCREW 3.5X4.75X25 LOCK
|
Facility
|
OP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605680
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$473.15 |
| Rate for Payer: Aetna Commercial |
$429.39
|
| Rate for Payer: Aetna Medicare |
$162.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$157.72
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$292.18
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$318.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$187.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$179.08
|
| Rate for Payer: Cash Price |
$305.26
|
| Rate for Payer: Cash Price |
$305.26
|
| Rate for Payer: Centivo All Commercial |
$276.77
|
| Rate for Payer: Cigna All Commercial |
$439.06
|
| Rate for Payer: CORVEL All Commercial |
$473.15
|
| Rate for Payer: Coventry All Commercial |
$447.71
|
| Rate for Payer: Encore All Commercial |
$468.31
|
| Rate for Payer: Frontpath All Commercial |
$468.06
|
| Rate for Payer: Humana ChoiceCare |
$439.42
|
| Rate for Payer: Humana Medicare |
$162.80
|
| Rate for Payer: Lucent All Commercial |
$276.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.88
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$381.57
|
| Rate for Payer: PHP All Commercial |
$385.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$198.42
|
| Rate for Payer: Sagamore Health Network All Products |
$392.76
|
| Rate for Payer: Signature Care EPO |
$422.27
|
| Rate for Payer: Signature Care PPO |
$447.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$432.45
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
| Rate for Payer: United Healthcare Medicare |
$162.80
|
|
|
HC Z SCREW 3.5X4.75X25 LOCK
|
Facility
|
IP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605680
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$381.57 |
| Max. Negotiated Rate |
$473.15 |
| Rate for Payer: Aetna Commercial |
$439.57
|
| Rate for Payer: Cash Price |
$305.26
|
| Rate for Payer: Cigna All Commercial |
$439.06
|
| Rate for Payer: CORVEL All Commercial |
$473.15
|
| Rate for Payer: Coventry All Commercial |
$447.71
|
| Rate for Payer: Encore All Commercial |
$468.31
|
| Rate for Payer: Frontpath All Commercial |
$468.06
|
| Rate for Payer: Humana ChoiceCare |
$439.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.88
|
| Rate for Payer: PHCS All Commercial |
$381.57
|
| Rate for Payer: PHP All Commercial |
$385.84
|
| Rate for Payer: Sagamore Health Network All Products |
$392.76
|
| Rate for Payer: Signature Care EPO |
$422.27
|
| Rate for Payer: Signature Care PPO |
$447.71
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
|
|
HC Z SCREW 3.5X4.75X30 LOCK
|
Facility
|
IP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605681
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$381.57 |
| Max. Negotiated Rate |
$473.15 |
| Rate for Payer: Aetna Commercial |
$439.57
|
| Rate for Payer: Cash Price |
$305.26
|
| Rate for Payer: Cigna All Commercial |
$439.06
|
| Rate for Payer: CORVEL All Commercial |
$473.15
|
| Rate for Payer: Coventry All Commercial |
$447.71
|
| Rate for Payer: Encore All Commercial |
$468.31
|
| Rate for Payer: Frontpath All Commercial |
$468.06
|
| Rate for Payer: Humana ChoiceCare |
$439.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.88
|
| Rate for Payer: PHCS All Commercial |
$381.57
|
| Rate for Payer: PHP All Commercial |
$385.84
|
| Rate for Payer: Sagamore Health Network All Products |
$392.76
|
| Rate for Payer: Signature Care EPO |
$422.27
|
| Rate for Payer: Signature Care PPO |
$447.71
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
|
