|
HC Z SCREW 4.0X65 CANC LOCK
|
Facility
|
IP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603778
|
|
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 4.0X65 CANN LAG
|
Facility
|
OP
|
$858.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606784
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$798.40 |
| Rate for Payer: Aetna Commercial |
$724.57
|
| Rate for Payer: Aetna Medicare |
$274.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$266.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$493.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$536.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$315.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$302.19
|
| Rate for Payer: Cash Price |
$515.10
|
| Rate for Payer: Cash Price |
$515.10
|
| Rate for Payer: Centivo All Commercial |
$467.02
|
| Rate for Payer: Cigna All Commercial |
$740.89
|
| Rate for Payer: CORVEL All Commercial |
$798.40
|
| Rate for Payer: Coventry All Commercial |
$755.48
|
| Rate for Payer: Encore All Commercial |
$790.25
|
| Rate for Payer: Frontpath All Commercial |
$789.82
|
| Rate for Payer: Humana ChoiceCare |
$741.49
|
| Rate for Payer: Humana Medicare |
$274.72
|
| Rate for Payer: Lucent All Commercial |
$467.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$772.65
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$643.88
|
| Rate for Payer: PHP All Commercial |
$651.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$334.81
|
| Rate for Payer: Sagamore Health Network All Products |
$662.76
|
| Rate for Payer: Signature Care EPO |
$712.55
|
| Rate for Payer: Signature Care PPO |
$755.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$729.73
|
| Rate for Payer: United Healthcare Commercial |
$676.50
|
| Rate for Payer: United Healthcare Medicare |
$274.72
|
|
|
HC Z SCREW 4.0X65 CANN LAG
|
Facility
|
IP
|
$858.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606784
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$643.88 |
| Max. Negotiated Rate |
$798.40 |
| Rate for Payer: Aetna Commercial |
$741.74
|
| Rate for Payer: Cash Price |
$515.10
|
| Rate for Payer: Cigna All Commercial |
$740.89
|
| Rate for Payer: CORVEL All Commercial |
$798.40
|
| Rate for Payer: Coventry All Commercial |
$755.48
|
| Rate for Payer: Encore All Commercial |
$790.25
|
| Rate for Payer: Frontpath All Commercial |
$789.82
|
| Rate for Payer: Humana ChoiceCare |
$741.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$772.65
|
| Rate for Payer: PHCS All Commercial |
$643.88
|
| Rate for Payer: PHP All Commercial |
$651.09
|
| Rate for Payer: Sagamore Health Network All Products |
$662.76
|
| Rate for Payer: Signature Care EPO |
$712.55
|
| Rate for Payer: Signature Care PPO |
$755.48
|
| Rate for Payer: United Healthcare Commercial |
$676.50
|
|
|
HC Z SCREW 4.0X70 CANC LOCK
|
Facility
|
IP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603777
|
|
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 4.0X70 CANC LOCK
|
Facility
|
OP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603777
|
|
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 4.5 X 22 CORT FT
|
Facility
|
OP
|
$346.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608085
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$107.39 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$292.39
|
| Rate for Payer: Aetna Medicare |
$110.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$107.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$198.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$216.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$127.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$121.94
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Centivo All Commercial |
$188.46
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Humana Medicare |
$110.86
|
| Rate for Payer: Lucent All Commercial |
$188.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$135.11
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$294.47
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
| Rate for Payer: United Healthcare Medicare |
$110.86
|
|
|
HC Z SCREW 4.5 X 22 CORT FT
|
Facility
|
IP
|
$346.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608085
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$259.82 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$299.32
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
|
|
HC Z SCREW 4.5 X 24 CORT FT
|
Facility
|
OP
|
$346.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608086
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$107.39 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$292.39
|
| Rate for Payer: Aetna Medicare |
$110.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$107.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$198.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$216.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$127.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$121.94
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Centivo All Commercial |
$188.46
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Humana Medicare |
$110.86
|
| Rate for Payer: Lucent All Commercial |
$188.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$135.11
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$294.47
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
| Rate for Payer: United Healthcare Medicare |
$110.86
|
|
|
HC Z SCREW 4.5 X 24 CORT FT
|
Facility
|
IP
|
$346.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608086
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$259.82 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$299.32
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
|
|
HC Z SCREW 4.5 X 24 CORT LOCK
|
Facility
|
OP
|
$855.47
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608087
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$795.59 |
| Rate for Payer: Aetna Commercial |
$722.02
|
| Rate for Payer: Aetna Medicare |
$273.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$265.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$491.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$534.75
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$314.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$301.13
|
| Rate for Payer: Cash Price |
$513.28
|
| Rate for Payer: Cash Price |
$513.28
|
| Rate for Payer: Centivo All Commercial |
$465.38
|
| Rate for Payer: Cigna All Commercial |
$738.27
|
| Rate for Payer: CORVEL All Commercial |
$795.59
|
| Rate for Payer: Coventry All Commercial |
$752.81
|
| Rate for Payer: Encore All Commercial |
$787.46
|
| Rate for Payer: Frontpath All Commercial |
$787.03
|
| Rate for Payer: Humana ChoiceCare |
$738.87
|
| Rate for Payer: Humana Medicare |
$273.75
|
| Rate for Payer: Lucent All Commercial |
$465.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$769.92
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$641.60
|
| Rate for Payer: PHP All Commercial |
$648.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$333.63
|
| Rate for Payer: Sagamore Health Network All Products |
$660.42
|
| Rate for Payer: Signature Care EPO |
$710.04
|
| Rate for Payer: Signature Care PPO |
$752.81
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$727.15
|
| Rate for Payer: United Healthcare Commercial |
$674.11
|
| Rate for Payer: United Healthcare Medicare |
$273.75
|
|
|
HC Z SCREW 4.5 X 24 CORT LOCK
|
Facility
|
IP
|
$855.47
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608087
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$641.60 |
| Max. Negotiated Rate |
$795.59 |
| Rate for Payer: Aetna Commercial |
$739.13
|
| Rate for Payer: Cash Price |
$513.28
|
| Rate for Payer: Cigna All Commercial |
$738.27
|
| Rate for Payer: CORVEL All Commercial |
$795.59
|
| Rate for Payer: Coventry All Commercial |
$752.81
|
| Rate for Payer: Encore All Commercial |
$787.46
|
| Rate for Payer: Frontpath All Commercial |
$787.03
|
| Rate for Payer: Humana ChoiceCare |
$738.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$769.92
|
| Rate for Payer: PHCS All Commercial |
$641.60
|
| Rate for Payer: PHP All Commercial |
$648.79
|
| Rate for Payer: Sagamore Health Network All Products |
$660.42
|
| Rate for Payer: Signature Care EPO |
$710.04
|
| Rate for Payer: Signature Care PPO |
$752.81
|
| Rate for Payer: United Healthcare Commercial |
$674.11
|
|
|
HC Z SCREW 4.5X26 CORT FT
|
Facility
|
OP
|
$346.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607648
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$107.39 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$292.39
|
| Rate for Payer: Aetna Medicare |
$110.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$107.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$198.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$216.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$127.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$121.94
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Centivo All Commercial |
$188.46
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Humana Medicare |
$110.86
|
| Rate for Payer: Lucent All Commercial |
$188.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$135.11
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$294.47
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
| Rate for Payer: United Healthcare Medicare |
$110.86
|
|
|
HC Z SCREW 4.5X26 CORT FT
|
Facility
|
IP
|
$346.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607648
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$259.82 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$299.32
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
|
|
HC Z SCREW 4.5 X 26 CORT LOCK
|
Facility
|
OP
|
$855.47
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608088
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$795.59 |
| Rate for Payer: Aetna Commercial |
$722.02
|
| Rate for Payer: Aetna Medicare |
$273.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$265.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$491.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$534.75
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$314.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$301.13
|
| Rate for Payer: Cash Price |
$513.28
|
| Rate for Payer: Cash Price |
$513.28
|
| Rate for Payer: Centivo All Commercial |
$465.38
|
| Rate for Payer: Cigna All Commercial |
$738.27
|
| Rate for Payer: CORVEL All Commercial |
$795.59
|
| Rate for Payer: Coventry All Commercial |
$752.81
|
| Rate for Payer: Encore All Commercial |
$787.46
|
| Rate for Payer: Frontpath All Commercial |
$787.03
|
| Rate for Payer: Humana ChoiceCare |
$738.87
|
| Rate for Payer: Humana Medicare |
$273.75
|
| Rate for Payer: Lucent All Commercial |
$465.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$769.92
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$641.60
|
| Rate for Payer: PHP All Commercial |
$648.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$333.63
|
| Rate for Payer: Sagamore Health Network All Products |
$660.42
|
| Rate for Payer: Signature Care EPO |
$710.04
|
| Rate for Payer: Signature Care PPO |
$752.81
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$727.15
|
| Rate for Payer: United Healthcare Commercial |
$674.11
|
| Rate for Payer: United Healthcare Medicare |
$273.75
|
|
|
HC Z SCREW 4.5 X 26 CORT LOCK
|
Facility
|
IP
|
$855.47
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608088
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$641.60 |
| Max. Negotiated Rate |
$795.59 |
| Rate for Payer: Aetna Commercial |
$739.13
|
| Rate for Payer: Cash Price |
$513.28
|
| Rate for Payer: Cigna All Commercial |
$738.27
|
| Rate for Payer: CORVEL All Commercial |
$795.59
|
| Rate for Payer: Coventry All Commercial |
$752.81
|
| Rate for Payer: Encore All Commercial |
$787.46
|
| Rate for Payer: Frontpath All Commercial |
$787.03
|
| Rate for Payer: Humana ChoiceCare |
$738.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$769.92
|
| Rate for Payer: PHCS All Commercial |
$641.60
|
| Rate for Payer: PHP All Commercial |
$648.79
|
| Rate for Payer: Sagamore Health Network All Products |
$660.42
|
| Rate for Payer: Signature Care EPO |
$710.04
|
| Rate for Payer: Signature Care PPO |
$752.81
|
| Rate for Payer: United Healthcare Commercial |
$674.11
|
|
|
HC Z SCREW 4.5X28 CORT FT
|
Facility
|
IP
|
$346.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607649
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$259.82 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$299.32
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
|
|
HC Z SCREW 4.5X28 CORT FT
|
Facility
|
OP
|
$346.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607649
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$107.39 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$292.39
|
| Rate for Payer: Aetna Medicare |
$110.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$107.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$198.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$216.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$127.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$121.94
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Cash Price |
$207.86
|
| Rate for Payer: Centivo All Commercial |
$188.46
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Humana Medicare |
$110.86
|
| Rate for Payer: Lucent All Commercial |
$188.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$135.11
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$294.47
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
| Rate for Payer: United Healthcare Medicare |
$110.86
|
|
|
HC Z SCREW 48 HD
|
Facility
|
OP
|
$636.30
|
|
|
Service Code
|
CPT C1777
|
| Hospital Charge Code |
41608535
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$591.76 |
| Rate for Payer: Aetna Commercial |
$537.04
|
| Rate for Payer: Aetna Medicare |
$203.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$197.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$365.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$397.75
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$234.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$223.98
|
| Rate for Payer: Cash Price |
$381.78
|
| Rate for Payer: Cash Price |
$381.78
|
| Rate for Payer: Centivo All Commercial |
$346.15
|
| Rate for Payer: Cigna All Commercial |
$549.13
|
| Rate for Payer: CORVEL All Commercial |
$591.76
|
| Rate for Payer: Coventry All Commercial |
$559.94
|
| Rate for Payer: Encore All Commercial |
$585.71
|
| Rate for Payer: Frontpath All Commercial |
$585.40
|
| Rate for Payer: Humana ChoiceCare |
$549.57
|
| Rate for Payer: Humana Medicare |
$203.62
|
| Rate for Payer: Lucent All Commercial |
$346.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$572.67
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$477.23
|
| Rate for Payer: PHP All Commercial |
$482.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$248.16
|
| Rate for Payer: Sagamore Health Network All Products |
$491.22
|
| Rate for Payer: Signature Care EPO |
$528.13
|
| Rate for Payer: Signature Care PPO |
$559.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$540.86
|
| Rate for Payer: United Healthcare Commercial |
$501.40
|
| Rate for Payer: United Healthcare Medicare |
$203.62
|
|
|
HC Z SCREW 48 HD
|
Facility
|
IP
|
$636.30
|
|
|
Service Code
|
CPT C1777
|
| Hospital Charge Code |
41608535
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$477.23 |
| Max. Negotiated Rate |
$591.76 |
| Rate for Payer: Aetna Commercial |
$549.76
|
| Rate for Payer: Cash Price |
$381.78
|
| Rate for Payer: Cigna All Commercial |
$549.13
|
| Rate for Payer: CORVEL All Commercial |
$591.76
|
| Rate for Payer: Coventry All Commercial |
$559.94
|
| Rate for Payer: Encore All Commercial |
$585.71
|
| Rate for Payer: Frontpath All Commercial |
$585.40
|
| Rate for Payer: Humana ChoiceCare |
$549.57
|
| Rate for Payer: Lutheran Preferred All Commercial |
$572.67
|
| Rate for Payer: PHCS All Commercial |
$477.23
|
| Rate for Payer: PHP All Commercial |
$482.57
|
| Rate for Payer: Sagamore Health Network All Products |
$491.22
|
| Rate for Payer: Signature Care EPO |
$528.13
|
| Rate for Payer: Signature Care PPO |
$559.94
|
| Rate for Payer: United Healthcare Commercial |
$501.40
|
|
|
HC Z SCREW 4X26 AFFIX CORT
|
Facility
|
IP
|
$819.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608272
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$614.51 |
| Max. Negotiated Rate |
$762.00 |
| Rate for Payer: Aetna Commercial |
$707.92
|
| Rate for Payer: Cash Price |
$491.61
|
| Rate for Payer: Cigna All Commercial |
$707.10
|
| Rate for Payer: CORVEL All Commercial |
$762.00
|
| Rate for Payer: Coventry All Commercial |
$721.03
|
| Rate for Payer: Encore All Commercial |
$754.21
|
| Rate for Payer: Frontpath All Commercial |
$753.80
|
| Rate for Payer: Humana ChoiceCare |
$707.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$737.41
|
| Rate for Payer: PHCS All Commercial |
$614.51
|
| Rate for Payer: PHP All Commercial |
$621.40
|
| Rate for Payer: Sagamore Health Network All Products |
$632.54
|
| Rate for Payer: Signature Care EPO |
$680.06
|
| Rate for Payer: Signature Care PPO |
$721.03
|
| Rate for Payer: United Healthcare Commercial |
$645.65
|
|
|
HC Z SCREW 4X26 AFFIX CORT
|
Facility
|
OP
|
$819.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608272
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$762.00 |
| Rate for Payer: Aetna Commercial |
$691.53
|
| Rate for Payer: Aetna Medicare |
$262.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$254.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$470.55
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$512.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$301.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$288.41
|
| Rate for Payer: Cash Price |
$491.61
|
| Rate for Payer: Cash Price |
$491.61
|
| Rate for Payer: Centivo All Commercial |
$445.73
|
| Rate for Payer: Cigna All Commercial |
$707.10
|
| Rate for Payer: CORVEL All Commercial |
$762.00
|
| Rate for Payer: Coventry All Commercial |
$721.03
|
| Rate for Payer: Encore All Commercial |
$754.21
|
| Rate for Payer: Frontpath All Commercial |
$753.80
|
| Rate for Payer: Humana ChoiceCare |
$707.67
|
| Rate for Payer: Humana Medicare |
$262.19
|
| Rate for Payer: Lucent All Commercial |
$445.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$737.41
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$614.51
|
| Rate for Payer: PHP All Commercial |
$621.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$319.55
|
| Rate for Payer: Sagamore Health Network All Products |
$632.54
|
| Rate for Payer: Signature Care EPO |
$680.06
|
| Rate for Payer: Signature Care PPO |
$721.03
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$696.45
|
| Rate for Payer: United Healthcare Commercial |
$645.65
|
| Rate for Payer: United Healthcare Medicare |
$262.19
|
|
|
HC Z SCREW 4X28 AFFIX CORT
|
Facility
|
OP
|
$819.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608273
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$762.00 |
| Rate for Payer: Aetna Commercial |
$691.53
|
| Rate for Payer: Aetna Medicare |
$262.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$254.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$470.55
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$512.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$301.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$288.41
|
| Rate for Payer: Cash Price |
$491.61
|
| Rate for Payer: Cash Price |
$491.61
|
| Rate for Payer: Centivo All Commercial |
$445.73
|
| Rate for Payer: Cigna All Commercial |
$707.10
|
| Rate for Payer: CORVEL All Commercial |
$762.00
|
| Rate for Payer: Coventry All Commercial |
$721.03
|
| Rate for Payer: Encore All Commercial |
$754.21
|
| Rate for Payer: Frontpath All Commercial |
$753.80
|
| Rate for Payer: Humana ChoiceCare |
$707.67
|
| Rate for Payer: Humana Medicare |
$262.19
|
| Rate for Payer: Lucent All Commercial |
$445.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$737.41
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$614.51
|
| Rate for Payer: PHP All Commercial |
$621.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$319.55
|
| Rate for Payer: Sagamore Health Network All Products |
$632.54
|
| Rate for Payer: Signature Care EPO |
$680.06
|
| Rate for Payer: Signature Care PPO |
$721.03
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$696.45
|
| Rate for Payer: United Healthcare Commercial |
$645.65
|
| Rate for Payer: United Healthcare Medicare |
$262.19
|
|
|
HC Z SCREW 4X28 AFFIX CORT
|
Facility
|
IP
|
$819.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608273
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$614.51 |
| Max. Negotiated Rate |
$762.00 |
| Rate for Payer: Aetna Commercial |
$707.92
|
| Rate for Payer: Cash Price |
$491.61
|
| Rate for Payer: Cigna All Commercial |
$707.10
|
| Rate for Payer: CORVEL All Commercial |
$762.00
|
| Rate for Payer: Coventry All Commercial |
$721.03
|
| Rate for Payer: Encore All Commercial |
$754.21
|
| Rate for Payer: Frontpath All Commercial |
$753.80
|
| Rate for Payer: Humana ChoiceCare |
$707.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$737.41
|
| Rate for Payer: PHCS All Commercial |
$614.51
|
| Rate for Payer: PHP All Commercial |
$621.40
|
| Rate for Payer: Sagamore Health Network All Products |
$632.54
|
| Rate for Payer: Signature Care EPO |
$680.06
|
| Rate for Payer: Signature Care PPO |
$721.03
|
| Rate for Payer: United Healthcare Commercial |
$645.65
|
|
|
HC Z SCREW 4X38 AFFIX BT
|
Facility
|
IP
|
$827.70
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608271
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$620.77 |
| Max. Negotiated Rate |
$769.76 |
| Rate for Payer: Aetna Commercial |
$715.13
|
| Rate for Payer: Cash Price |
$496.62
|
| Rate for Payer: Cigna All Commercial |
$714.31
|
| Rate for Payer: CORVEL All Commercial |
$769.76
|
| Rate for Payer: Coventry All Commercial |
$728.38
|
| Rate for Payer: Encore All Commercial |
$761.90
|
| Rate for Payer: Frontpath All Commercial |
$761.48
|
| Rate for Payer: Humana ChoiceCare |
$714.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$744.93
|
| Rate for Payer: PHCS All Commercial |
$620.77
|
| Rate for Payer: PHP All Commercial |
$627.73
|
| Rate for Payer: Sagamore Health Network All Products |
$638.98
|
| Rate for Payer: Signature Care EPO |
$686.99
|
| Rate for Payer: Signature Care PPO |
$728.38
|
| Rate for Payer: United Healthcare Commercial |
$652.23
|
|
|
HC Z SCREW 4X38 AFFIX BT
|
Facility
|
OP
|
$827.70
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608271
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$769.76 |
| Rate for Payer: Aetna Commercial |
$698.58
|
| Rate for Payer: Aetna Medicare |
$264.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$256.59
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$475.35
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$517.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$304.59
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$291.35
|
| Rate for Payer: Cash Price |
$496.62
|
| Rate for Payer: Cash Price |
$496.62
|
| Rate for Payer: Centivo All Commercial |
$450.27
|
| Rate for Payer: Cigna All Commercial |
$714.31
|
| Rate for Payer: CORVEL All Commercial |
$769.76
|
| Rate for Payer: Coventry All Commercial |
$728.38
|
| Rate for Payer: Encore All Commercial |
$761.90
|
| Rate for Payer: Frontpath All Commercial |
$761.48
|
| Rate for Payer: Humana ChoiceCare |
$714.88
|
| Rate for Payer: Humana Medicare |
$264.86
|
| Rate for Payer: Lucent All Commercial |
$450.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$744.93
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$620.77
|
| Rate for Payer: PHP All Commercial |
$627.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$322.80
|
| Rate for Payer: Sagamore Health Network All Products |
$638.98
|
| Rate for Payer: Signature Care EPO |
$686.99
|
| Rate for Payer: Signature Care PPO |
$728.38
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$703.54
|
| Rate for Payer: United Healthcare Commercial |
$652.23
|
| Rate for Payer: United Healthcare Medicare |
$264.86
|
|
