|
HC Z SCREW 6.5X16X40 CANN
|
Facility
|
IP
|
$1,082.70
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608341
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$812.02 |
| Max. Negotiated Rate |
$1,006.91 |
| Rate for Payer: Aetna Commercial |
$935.45
|
| Rate for Payer: Cash Price |
$649.62
|
| Rate for Payer: Cigna All Commercial |
$934.37
|
| Rate for Payer: CORVEL All Commercial |
$1,006.91
|
| Rate for Payer: Coventry All Commercial |
$952.78
|
| Rate for Payer: Encore All Commercial |
$996.63
|
| Rate for Payer: Frontpath All Commercial |
$996.08
|
| Rate for Payer: Humana ChoiceCare |
$935.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$974.43
|
| Rate for Payer: PHCS All Commercial |
$812.02
|
| Rate for Payer: PHP All Commercial |
$821.12
|
| Rate for Payer: Sagamore Health Network All Products |
$835.84
|
| Rate for Payer: Signature Care EPO |
$898.64
|
| Rate for Payer: Signature Care PPO |
$952.78
|
| Rate for Payer: United Healthcare Commercial |
$853.17
|
|
|
HC Z SCREW 6.5X16X50 CANN
|
Facility
|
OP
|
$1,082.70
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608342
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$1,006.91 |
| Rate for Payer: Aetna Commercial |
$913.80
|
| Rate for Payer: Aetna Medicare |
$346.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$335.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$621.79
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$676.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$398.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$381.11
|
| Rate for Payer: Cash Price |
$649.62
|
| Rate for Payer: Cash Price |
$649.62
|
| Rate for Payer: Centivo All Commercial |
$588.99
|
| Rate for Payer: Cigna All Commercial |
$934.37
|
| Rate for Payer: CORVEL All Commercial |
$1,006.91
|
| Rate for Payer: Coventry All Commercial |
$952.78
|
| Rate for Payer: Encore All Commercial |
$996.63
|
| Rate for Payer: Frontpath All Commercial |
$996.08
|
| Rate for Payer: Humana ChoiceCare |
$935.13
|
| Rate for Payer: Humana Medicare |
$346.46
|
| Rate for Payer: Lucent All Commercial |
$588.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$974.43
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$812.02
|
| Rate for Payer: PHP All Commercial |
$821.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$422.25
|
| Rate for Payer: Sagamore Health Network All Products |
$835.84
|
| Rate for Payer: Signature Care EPO |
$898.64
|
| Rate for Payer: Signature Care PPO |
$952.78
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$920.29
|
| Rate for Payer: United Healthcare Commercial |
$853.17
|
| Rate for Payer: United Healthcare Medicare |
$346.46
|
|
|
HC Z SCREW 6.5X16X50 CANN
|
Facility
|
IP
|
$1,082.70
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608342
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$812.02 |
| Max. Negotiated Rate |
$1,006.91 |
| Rate for Payer: Aetna Commercial |
$935.45
|
| Rate for Payer: Cash Price |
$649.62
|
| Rate for Payer: Cigna All Commercial |
$934.37
|
| Rate for Payer: CORVEL All Commercial |
$1,006.91
|
| Rate for Payer: Coventry All Commercial |
$952.78
|
| Rate for Payer: Encore All Commercial |
$996.63
|
| Rate for Payer: Frontpath All Commercial |
$996.08
|
| Rate for Payer: Humana ChoiceCare |
$935.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$974.43
|
| Rate for Payer: PHCS All Commercial |
$812.02
|
| Rate for Payer: PHP All Commercial |
$821.12
|
| Rate for Payer: Sagamore Health Network All Products |
$835.84
|
| Rate for Payer: Signature Care EPO |
$898.64
|
| Rate for Payer: Signature Care PPO |
$952.78
|
| Rate for Payer: United Healthcare Commercial |
$853.17
|
|
|
HC Z SCREW 6.5X22X60 CANC
|
Facility
|
OP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608114
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.54 |
| Max. Negotiated Rate |
$361.63 |
| Rate for Payer: Aetna Commercial |
$328.19
|
| Rate for Payer: Aetna Medicare |
$124.43
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$120.54
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$223.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$243.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$143.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$136.88
|
| Rate for Payer: Cash Price |
$233.31
|
| Rate for Payer: Cash Price |
$233.31
|
| Rate for Payer: Centivo All Commercial |
$211.53
|
| Rate for Payer: Cigna All Commercial |
$335.58
|
| Rate for Payer: CORVEL All Commercial |
$361.63
|
| Rate for Payer: Coventry All Commercial |
$342.19
|
| Rate for Payer: Encore All Commercial |
$357.94
|
| Rate for Payer: Frontpath All Commercial |
$357.74
|
| Rate for Payer: Humana ChoiceCare |
$335.85
|
| Rate for Payer: Humana Medicare |
$124.43
|
| Rate for Payer: Lucent All Commercial |
$211.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$349.96
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$291.64
|
| Rate for Payer: PHP All Commercial |
$294.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$151.65
|
| Rate for Payer: Sagamore Health Network All Products |
$300.19
|
| Rate for Payer: Signature Care EPO |
$322.75
|
| Rate for Payer: Signature Care PPO |
$342.19
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$330.52
|
| Rate for Payer: United Healthcare Commercial |
$306.41
|
| Rate for Payer: United Healthcare Medicare |
$124.43
|
|
|
HC Z SCREW 6.5X22X60 CANC
|
Facility
|
IP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608114
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$291.64 |
| Max. Negotiated Rate |
$361.63 |
| Rate for Payer: Aetna Commercial |
$335.97
|
| Rate for Payer: Cash Price |
$233.31
|
| Rate for Payer: Cigna All Commercial |
$335.58
|
| Rate for Payer: CORVEL All Commercial |
$361.63
|
| Rate for Payer: Coventry All Commercial |
$342.19
|
| Rate for Payer: Encore All Commercial |
$357.94
|
| Rate for Payer: Frontpath All Commercial |
$357.74
|
| Rate for Payer: Humana ChoiceCare |
$335.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$349.96
|
| Rate for Payer: PHCS All Commercial |
$291.64
|
| Rate for Payer: PHP All Commercial |
$294.90
|
| Rate for Payer: Sagamore Health Network All Products |
$300.19
|
| Rate for Payer: Signature Care EPO |
$322.75
|
| Rate for Payer: Signature Care PPO |
$342.19
|
| Rate for Payer: United Healthcare Commercial |
$306.41
|
|
|
HC Z SCREW 6.5X25 S-T
|
Facility
|
IP
|
$579.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605403
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$434.70 |
| Max. Negotiated Rate |
$539.03 |
| Rate for Payer: Aetna Commercial |
$500.77
|
| Rate for Payer: Cash Price |
$347.76
|
| Rate for Payer: Cigna All Commercial |
$500.19
|
| Rate for Payer: CORVEL All Commercial |
$539.03
|
| Rate for Payer: Coventry All Commercial |
$510.05
|
| Rate for Payer: Encore All Commercial |
$533.52
|
| Rate for Payer: Frontpath All Commercial |
$533.23
|
| Rate for Payer: Humana ChoiceCare |
$500.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.64
|
| Rate for Payer: PHCS All Commercial |
$434.70
|
| Rate for Payer: PHP All Commercial |
$439.57
|
| Rate for Payer: Sagamore Health Network All Products |
$447.45
|
| Rate for Payer: Signature Care EPO |
$481.07
|
| Rate for Payer: Signature Care PPO |
$510.05
|
| Rate for Payer: United Healthcare Commercial |
$456.72
|
|
|
HC Z SCREW 6.5X25 S-T
|
Facility
|
OP
|
$579.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605403
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$539.03 |
| Rate for Payer: Aetna Commercial |
$489.18
|
| Rate for Payer: Aetna Medicare |
$185.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$179.68
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$332.86
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$362.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$213.29
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$204.02
|
| Rate for Payer: Cash Price |
$347.76
|
| Rate for Payer: Cash Price |
$347.76
|
| Rate for Payer: Centivo All Commercial |
$315.30
|
| Rate for Payer: Cigna All Commercial |
$500.19
|
| Rate for Payer: CORVEL All Commercial |
$539.03
|
| Rate for Payer: Coventry All Commercial |
$510.05
|
| Rate for Payer: Encore All Commercial |
$533.52
|
| Rate for Payer: Frontpath All Commercial |
$533.23
|
| Rate for Payer: Humana ChoiceCare |
$500.60
|
| Rate for Payer: Humana Medicare |
$185.47
|
| Rate for Payer: Lucent All Commercial |
$315.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.64
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$434.70
|
| Rate for Payer: PHP All Commercial |
$439.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$226.04
|
| Rate for Payer: Sagamore Health Network All Products |
$447.45
|
| Rate for Payer: Signature Care EPO |
$481.07
|
| Rate for Payer: Signature Care PPO |
$510.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$492.66
|
| Rate for Payer: United Healthcare Commercial |
$456.72
|
| Rate for Payer: United Healthcare Medicare |
$185.47
|
|
|
HC Z SCREW 6.5X30 S-T
|
Facility
|
OP
|
$579.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605404
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$539.03 |
| Rate for Payer: Aetna Commercial |
$489.18
|
| Rate for Payer: Aetna Medicare |
$185.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$179.68
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$332.86
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$362.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$213.29
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$204.02
|
| Rate for Payer: Cash Price |
$347.76
|
| Rate for Payer: Cash Price |
$347.76
|
| Rate for Payer: Centivo All Commercial |
$315.30
|
| Rate for Payer: Cigna All Commercial |
$500.19
|
| Rate for Payer: CORVEL All Commercial |
$539.03
|
| Rate for Payer: Coventry All Commercial |
$510.05
|
| Rate for Payer: Encore All Commercial |
$533.52
|
| Rate for Payer: Frontpath All Commercial |
$533.23
|
| Rate for Payer: Humana ChoiceCare |
$500.60
|
| Rate for Payer: Humana Medicare |
$185.47
|
| Rate for Payer: Lucent All Commercial |
$315.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.64
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$434.70
|
| Rate for Payer: PHP All Commercial |
$439.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$226.04
|
| Rate for Payer: Sagamore Health Network All Products |
$447.45
|
| Rate for Payer: Signature Care EPO |
$481.07
|
| Rate for Payer: Signature Care PPO |
$510.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$492.66
|
| Rate for Payer: United Healthcare Commercial |
$456.72
|
| Rate for Payer: United Healthcare Medicare |
$185.47
|
|
|
HC Z SCREW 6.5X30 S-T
|
Facility
|
IP
|
$579.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605404
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$434.70 |
| Max. Negotiated Rate |
$539.03 |
| Rate for Payer: Aetna Commercial |
$500.77
|
| Rate for Payer: Cash Price |
$347.76
|
| Rate for Payer: Cigna All Commercial |
$500.19
|
| Rate for Payer: CORVEL All Commercial |
$539.03
|
| Rate for Payer: Coventry All Commercial |
$510.05
|
| Rate for Payer: Encore All Commercial |
$533.52
|
| Rate for Payer: Frontpath All Commercial |
$533.23
|
| Rate for Payer: Humana ChoiceCare |
$500.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.64
|
| Rate for Payer: PHCS All Commercial |
$434.70
|
| Rate for Payer: PHP All Commercial |
$439.57
|
| Rate for Payer: Sagamore Health Network All Products |
$447.45
|
| Rate for Payer: Signature Care EPO |
$481.07
|
| Rate for Payer: Signature Care PPO |
$510.05
|
| Rate for Payer: United Healthcare Commercial |
$456.72
|
|
|
HC Z SCREW 6.5X35 S-T
|
Facility
|
IP
|
$579.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605405
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$434.70 |
| Max. Negotiated Rate |
$539.03 |
| Rate for Payer: Aetna Commercial |
$500.77
|
| Rate for Payer: Cash Price |
$347.76
|
| Rate for Payer: Cigna All Commercial |
$500.19
|
| Rate for Payer: CORVEL All Commercial |
$539.03
|
| Rate for Payer: Coventry All Commercial |
$510.05
|
| Rate for Payer: Encore All Commercial |
$533.52
|
| Rate for Payer: Frontpath All Commercial |
$533.23
|
| Rate for Payer: Humana ChoiceCare |
$500.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.64
|
| Rate for Payer: PHCS All Commercial |
$434.70
|
| Rate for Payer: PHP All Commercial |
$439.57
|
| Rate for Payer: Sagamore Health Network All Products |
$447.45
|
| Rate for Payer: Signature Care EPO |
$481.07
|
| Rate for Payer: Signature Care PPO |
$510.05
|
| Rate for Payer: United Healthcare Commercial |
$456.72
|
|
|
HC Z SCREW 6.5X35 S-T
|
Facility
|
OP
|
$579.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605405
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$539.03 |
| Rate for Payer: Aetna Commercial |
$489.18
|
| Rate for Payer: Aetna Medicare |
$185.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$179.68
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$332.86
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$362.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$213.29
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$204.02
|
| Rate for Payer: Cash Price |
$347.76
|
| Rate for Payer: Cash Price |
$347.76
|
| Rate for Payer: Centivo All Commercial |
$315.30
|
| Rate for Payer: Cigna All Commercial |
$500.19
|
| Rate for Payer: CORVEL All Commercial |
$539.03
|
| Rate for Payer: Coventry All Commercial |
$510.05
|
| Rate for Payer: Encore All Commercial |
$533.52
|
| Rate for Payer: Frontpath All Commercial |
$533.23
|
| Rate for Payer: Humana ChoiceCare |
$500.60
|
| Rate for Payer: Humana Medicare |
$185.47
|
| Rate for Payer: Lucent All Commercial |
$315.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.64
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$434.70
|
| Rate for Payer: PHP All Commercial |
$439.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$226.04
|
| Rate for Payer: Sagamore Health Network All Products |
$447.45
|
| Rate for Payer: Signature Care EPO |
$481.07
|
| Rate for Payer: Signature Care PPO |
$510.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$492.66
|
| Rate for Payer: United Healthcare Commercial |
$456.72
|
| Rate for Payer: United Healthcare Medicare |
$185.47
|
|
|
HC Z SCREW 6.5 X 40 CANC
|
Facility
|
IP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608109
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$291.64 |
| Max. Negotiated Rate |
$361.63 |
| Rate for Payer: Aetna Commercial |
$335.97
|
| Rate for Payer: Cash Price |
$233.31
|
| Rate for Payer: Cigna All Commercial |
$335.58
|
| Rate for Payer: CORVEL All Commercial |
$361.63
|
| Rate for Payer: Coventry All Commercial |
$342.19
|
| Rate for Payer: Encore All Commercial |
$357.94
|
| Rate for Payer: Frontpath All Commercial |
$357.74
|
| Rate for Payer: Humana ChoiceCare |
$335.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$349.96
|
| Rate for Payer: PHCS All Commercial |
$291.64
|
| Rate for Payer: PHP All Commercial |
$294.90
|
| Rate for Payer: Sagamore Health Network All Products |
$300.19
|
| Rate for Payer: Signature Care EPO |
$322.75
|
| Rate for Payer: Signature Care PPO |
$342.19
|
| Rate for Payer: United Healthcare Commercial |
$306.41
|
|
|
HC Z SCREW 6.5 X 40 CANC
|
Facility
|
OP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608109
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.54 |
| Max. Negotiated Rate |
$361.63 |
| Rate for Payer: Aetna Commercial |
$328.19
|
| Rate for Payer: Aetna Medicare |
$124.43
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$120.54
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$223.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$243.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$143.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$136.88
|
| Rate for Payer: Cash Price |
$233.31
|
| Rate for Payer: Cash Price |
$233.31
|
| Rate for Payer: Centivo All Commercial |
$211.53
|
| Rate for Payer: Cigna All Commercial |
$335.58
|
| Rate for Payer: CORVEL All Commercial |
$361.63
|
| Rate for Payer: Coventry All Commercial |
$342.19
|
| Rate for Payer: Encore All Commercial |
$357.94
|
| Rate for Payer: Frontpath All Commercial |
$357.74
|
| Rate for Payer: Humana ChoiceCare |
$335.85
|
| Rate for Payer: Humana Medicare |
$124.43
|
| Rate for Payer: Lucent All Commercial |
$211.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$349.96
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$291.64
|
| Rate for Payer: PHP All Commercial |
$294.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$151.65
|
| Rate for Payer: Sagamore Health Network All Products |
$300.19
|
| Rate for Payer: Signature Care EPO |
$322.75
|
| Rate for Payer: Signature Care PPO |
$342.19
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$330.52
|
| Rate for Payer: United Healthcare Commercial |
$306.41
|
| Rate for Payer: United Healthcare Medicare |
$124.43
|
|
|
HC Z SCREW 6.5X40X1110 CANC
|
Facility
|
IP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608242
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$291.64 |
| Max. Negotiated Rate |
$361.63 |
| Rate for Payer: Aetna Commercial |
$335.97
|
| Rate for Payer: Cash Price |
$233.31
|
| Rate for Payer: Cigna All Commercial |
$335.58
|
| Rate for Payer: CORVEL All Commercial |
$361.63
|
| Rate for Payer: Coventry All Commercial |
$342.19
|
| Rate for Payer: Encore All Commercial |
$357.94
|
| Rate for Payer: Frontpath All Commercial |
$357.74
|
| Rate for Payer: Humana ChoiceCare |
$335.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$349.96
|
| Rate for Payer: PHCS All Commercial |
$291.64
|
| Rate for Payer: PHP All Commercial |
$294.90
|
| Rate for Payer: Sagamore Health Network All Products |
$300.19
|
| Rate for Payer: Signature Care EPO |
$322.75
|
| Rate for Payer: Signature Care PPO |
$342.19
|
| Rate for Payer: United Healthcare Commercial |
$306.41
|
|
|
HC Z SCREW 6.5X40X1110 CANC
|
Facility
|
OP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608242
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.54 |
| Max. Negotiated Rate |
$361.63 |
| Rate for Payer: Aetna Commercial |
$328.19
|
| Rate for Payer: Aetna Medicare |
$124.43
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$120.54
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$223.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$243.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$143.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$136.88
|
| Rate for Payer: Cash Price |
$233.31
|
| Rate for Payer: Cash Price |
$233.31
|
| Rate for Payer: Centivo All Commercial |
$211.53
|
| Rate for Payer: Cigna All Commercial |
$335.58
|
| Rate for Payer: CORVEL All Commercial |
$361.63
|
| Rate for Payer: Coventry All Commercial |
$342.19
|
| Rate for Payer: Encore All Commercial |
$357.94
|
| Rate for Payer: Frontpath All Commercial |
$357.74
|
| Rate for Payer: Humana ChoiceCare |
$335.85
|
| Rate for Payer: Humana Medicare |
$124.43
|
| Rate for Payer: Lucent All Commercial |
$211.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$349.96
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$291.64
|
| Rate for Payer: PHP All Commercial |
$294.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$151.65
|
| Rate for Payer: Sagamore Health Network All Products |
$300.19
|
| Rate for Payer: Signature Care EPO |
$322.75
|
| Rate for Payer: Signature Care PPO |
$342.19
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$330.52
|
| Rate for Payer: United Healthcare Commercial |
$306.41
|
| Rate for Payer: United Healthcare Medicare |
$124.43
|
|
|
HC Z SCREW 7.0X70 16 CANN
|
Facility
|
IP
|
$1,115.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604031
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$836.29 |
| Max. Negotiated Rate |
$1,037.00 |
| Rate for Payer: Aetna Commercial |
$963.40
|
| Rate for Payer: Cash Price |
$669.03
|
| Rate for Payer: Cigna All Commercial |
$962.29
|
| Rate for Payer: CORVEL All Commercial |
$1,037.00
|
| Rate for Payer: Coventry All Commercial |
$981.24
|
| Rate for Payer: Encore All Commercial |
$1,026.40
|
| Rate for Payer: Frontpath All Commercial |
$1,025.85
|
| Rate for Payer: Humana ChoiceCare |
$963.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,003.54
|
| Rate for Payer: PHCS All Commercial |
$836.29
|
| Rate for Payer: PHP All Commercial |
$845.65
|
| Rate for Payer: Sagamore Health Network All Products |
$860.82
|
| Rate for Payer: Signature Care EPO |
$925.49
|
| Rate for Payer: Signature Care PPO |
$981.24
|
| Rate for Payer: United Healthcare Commercial |
$878.66
|
|
|
HC Z SCREW 7.0X70 16 CANN
|
Facility
|
OP
|
$1,115.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604031
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$1,037.00 |
| Rate for Payer: Aetna Commercial |
$941.10
|
| Rate for Payer: Aetna Medicare |
$356.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$345.67
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$640.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$697.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$410.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$392.50
|
| Rate for Payer: Cash Price |
$669.03
|
| Rate for Payer: Cash Price |
$669.03
|
| Rate for Payer: Centivo All Commercial |
$606.59
|
| Rate for Payer: Cigna All Commercial |
$962.29
|
| Rate for Payer: CORVEL All Commercial |
$1,037.00
|
| Rate for Payer: Coventry All Commercial |
$981.24
|
| Rate for Payer: Encore All Commercial |
$1,026.40
|
| Rate for Payer: Frontpath All Commercial |
$1,025.85
|
| Rate for Payer: Humana ChoiceCare |
$963.07
|
| Rate for Payer: Humana Medicare |
$356.82
|
| Rate for Payer: Lucent All Commercial |
$606.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,003.54
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$836.29
|
| Rate for Payer: PHP All Commercial |
$845.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$434.87
|
| Rate for Payer: Sagamore Health Network All Products |
$860.82
|
| Rate for Payer: Signature Care EPO |
$925.49
|
| Rate for Payer: Signature Care PPO |
$981.24
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$947.79
|
| Rate for Payer: United Healthcare Commercial |
$878.66
|
| Rate for Payer: United Healthcare Medicare |
$356.82
|
|
|
HC Z SCREW 7.0X70 32 CANN
|
Facility
|
OP
|
$1,115.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604032
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$1,037.00 |
| Rate for Payer: Aetna Commercial |
$941.10
|
| Rate for Payer: Aetna Medicare |
$356.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$345.67
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$640.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$697.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$410.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$392.50
|
| Rate for Payer: Cash Price |
$669.03
|
| Rate for Payer: Cash Price |
$669.03
|
| Rate for Payer: Centivo All Commercial |
$606.59
|
| Rate for Payer: Cigna All Commercial |
$962.29
|
| Rate for Payer: CORVEL All Commercial |
$1,037.00
|
| Rate for Payer: Coventry All Commercial |
$981.24
|
| Rate for Payer: Encore All Commercial |
$1,026.40
|
| Rate for Payer: Frontpath All Commercial |
$1,025.85
|
| Rate for Payer: Humana ChoiceCare |
$963.07
|
| Rate for Payer: Humana Medicare |
$356.82
|
| Rate for Payer: Lucent All Commercial |
$606.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,003.54
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$836.29
|
| Rate for Payer: PHP All Commercial |
$845.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$434.87
|
| Rate for Payer: Sagamore Health Network All Products |
$860.82
|
| Rate for Payer: Signature Care EPO |
$925.49
|
| Rate for Payer: Signature Care PPO |
$981.24
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$947.79
|
| Rate for Payer: United Healthcare Commercial |
$878.66
|
| Rate for Payer: United Healthcare Medicare |
$356.82
|
|
|
HC Z SCREW 7.0X70 32 CANN
|
Facility
|
IP
|
$1,115.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604032
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$836.29 |
| Max. Negotiated Rate |
$1,037.00 |
| Rate for Payer: Aetna Commercial |
$963.40
|
| Rate for Payer: Cash Price |
$669.03
|
| Rate for Payer: Cigna All Commercial |
$962.29
|
| Rate for Payer: CORVEL All Commercial |
$1,037.00
|
| Rate for Payer: Coventry All Commercial |
$981.24
|
| Rate for Payer: Encore All Commercial |
$1,026.40
|
| Rate for Payer: Frontpath All Commercial |
$1,025.85
|
| Rate for Payer: Humana ChoiceCare |
$963.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,003.54
|
| Rate for Payer: PHCS All Commercial |
$836.29
|
| Rate for Payer: PHP All Commercial |
$845.65
|
| Rate for Payer: Sagamore Health Network All Products |
$860.82
|
| Rate for Payer: Signature Care EPO |
$925.49
|
| Rate for Payer: Signature Care PPO |
$981.24
|
| Rate for Payer: United Healthcare Commercial |
$878.66
|
|
|
HC Z SCREW 7.0X75 16 CANN
|
Facility
|
IP
|
$1,115.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604034
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$836.29 |
| Max. Negotiated Rate |
$1,037.00 |
| Rate for Payer: Aetna Commercial |
$963.40
|
| Rate for Payer: Cash Price |
$669.03
|
| Rate for Payer: Cigna All Commercial |
$962.29
|
| Rate for Payer: CORVEL All Commercial |
$1,037.00
|
| Rate for Payer: Coventry All Commercial |
$981.24
|
| Rate for Payer: Encore All Commercial |
$1,026.40
|
| Rate for Payer: Frontpath All Commercial |
$1,025.85
|
| Rate for Payer: Humana ChoiceCare |
$963.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,003.54
|
| Rate for Payer: PHCS All Commercial |
$836.29
|
| Rate for Payer: PHP All Commercial |
$845.65
|
| Rate for Payer: Sagamore Health Network All Products |
$860.82
|
| Rate for Payer: Signature Care EPO |
$925.49
|
| Rate for Payer: Signature Care PPO |
$981.24
|
| Rate for Payer: United Healthcare Commercial |
$878.66
|
|
|
HC Z SCREW 7.0X75 16 CANN
|
Facility
|
OP
|
$1,115.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604034
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$1,037.00 |
| Rate for Payer: Aetna Commercial |
$941.10
|
| Rate for Payer: Aetna Medicare |
$356.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$345.67
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$640.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$697.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$410.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$392.50
|
| Rate for Payer: Cash Price |
$669.03
|
| Rate for Payer: Cash Price |
$669.03
|
| Rate for Payer: Centivo All Commercial |
$606.59
|
| Rate for Payer: Cigna All Commercial |
$962.29
|
| Rate for Payer: CORVEL All Commercial |
$1,037.00
|
| Rate for Payer: Coventry All Commercial |
$981.24
|
| Rate for Payer: Encore All Commercial |
$1,026.40
|
| Rate for Payer: Frontpath All Commercial |
$1,025.85
|
| Rate for Payer: Humana ChoiceCare |
$963.07
|
| Rate for Payer: Humana Medicare |
$356.82
|
| Rate for Payer: Lucent All Commercial |
$606.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,003.54
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$836.29
|
| Rate for Payer: PHP All Commercial |
$845.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$434.87
|
| Rate for Payer: Sagamore Health Network All Products |
$860.82
|
| Rate for Payer: Signature Care EPO |
$925.49
|
| Rate for Payer: Signature Care PPO |
$981.24
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$947.79
|
| Rate for Payer: United Healthcare Commercial |
$878.66
|
| Rate for Payer: United Healthcare Medicare |
$356.82
|
|
|
HC Z SCREW 7.0X80 16 CANN
|
Facility
|
OP
|
$1,115.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$1,037.00 |
| Rate for Payer: Aetna Commercial |
$941.10
|
| Rate for Payer: Aetna Medicare |
$356.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$345.67
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$640.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$697.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$410.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$392.50
|
| Rate for Payer: Cash Price |
$669.03
|
| Rate for Payer: Cash Price |
$669.03
|
| Rate for Payer: Centivo All Commercial |
$606.59
|
| Rate for Payer: Cigna All Commercial |
$962.29
|
| Rate for Payer: CORVEL All Commercial |
$1,037.00
|
| Rate for Payer: Coventry All Commercial |
$981.24
|
| Rate for Payer: Encore All Commercial |
$1,026.40
|
| Rate for Payer: Frontpath All Commercial |
$1,025.85
|
| Rate for Payer: Humana ChoiceCare |
$963.07
|
| Rate for Payer: Humana Medicare |
$356.82
|
| Rate for Payer: Lucent All Commercial |
$606.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,003.54
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$836.29
|
| Rate for Payer: PHP All Commercial |
$845.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$434.87
|
| Rate for Payer: Sagamore Health Network All Products |
$860.82
|
| Rate for Payer: Signature Care EPO |
$925.49
|
| Rate for Payer: Signature Care PPO |
$981.24
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$947.79
|
| Rate for Payer: United Healthcare Commercial |
$878.66
|
| Rate for Payer: United Healthcare Medicare |
$356.82
|
|
|
HC Z SCREW 7.0X80 16 CANN
|
Facility
|
IP
|
$1,115.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$836.29 |
| Max. Negotiated Rate |
$1,037.00 |
| Rate for Payer: Aetna Commercial |
$963.40
|
| Rate for Payer: Cash Price |
$669.03
|
| Rate for Payer: Cigna All Commercial |
$962.29
|
| Rate for Payer: CORVEL All Commercial |
$1,037.00
|
| Rate for Payer: Coventry All Commercial |
$981.24
|
| Rate for Payer: Encore All Commercial |
$1,026.40
|
| Rate for Payer: Frontpath All Commercial |
$1,025.85
|
| Rate for Payer: Humana ChoiceCare |
$963.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,003.54
|
| Rate for Payer: PHCS All Commercial |
$836.29
|
| Rate for Payer: PHP All Commercial |
$845.65
|
| Rate for Payer: Sagamore Health Network All Products |
$860.82
|
| Rate for Payer: Signature Care EPO |
$925.49
|
| Rate for Payer: Signature Care PPO |
$981.24
|
| Rate for Payer: United Healthcare Commercial |
$878.66
|
|
|
HC Z SCREW 7.0X80 32 CANN
|
Facility
|
IP
|
$1,115.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604038
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$836.29 |
| Max. Negotiated Rate |
$1,037.00 |
| Rate for Payer: Aetna Commercial |
$963.40
|
| Rate for Payer: Cash Price |
$669.03
|
| Rate for Payer: Cigna All Commercial |
$962.29
|
| Rate for Payer: CORVEL All Commercial |
$1,037.00
|
| Rate for Payer: Coventry All Commercial |
$981.24
|
| Rate for Payer: Encore All Commercial |
$1,026.40
|
| Rate for Payer: Frontpath All Commercial |
$1,025.85
|
| Rate for Payer: Humana ChoiceCare |
$963.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,003.54
|
| Rate for Payer: PHCS All Commercial |
$836.29
|
| Rate for Payer: PHP All Commercial |
$845.65
|
| Rate for Payer: Sagamore Health Network All Products |
$860.82
|
| Rate for Payer: Signature Care EPO |
$925.49
|
| Rate for Payer: Signature Care PPO |
$981.24
|
| Rate for Payer: United Healthcare Commercial |
$878.66
|
|
|
HC Z SCREW 7.0X80 32 CANN
|
Facility
|
OP
|
$1,115.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604038
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$1,037.00 |
| Rate for Payer: Aetna Commercial |
$941.10
|
| Rate for Payer: Aetna Medicare |
$356.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$345.67
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$640.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$697.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$410.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$392.50
|
| Rate for Payer: Cash Price |
$669.03
|
| Rate for Payer: Cash Price |
$669.03
|
| Rate for Payer: Centivo All Commercial |
$606.59
|
| Rate for Payer: Cigna All Commercial |
$962.29
|
| Rate for Payer: CORVEL All Commercial |
$1,037.00
|
| Rate for Payer: Coventry All Commercial |
$981.24
|
| Rate for Payer: Encore All Commercial |
$1,026.40
|
| Rate for Payer: Frontpath All Commercial |
$1,025.85
|
| Rate for Payer: Humana ChoiceCare |
$963.07
|
| Rate for Payer: Humana Medicare |
$356.82
|
| Rate for Payer: Lucent All Commercial |
$606.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,003.54
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$836.29
|
| Rate for Payer: PHP All Commercial |
$845.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$434.87
|
| Rate for Payer: Sagamore Health Network All Products |
$860.82
|
| Rate for Payer: Signature Care EPO |
$925.49
|
| Rate for Payer: Signature Care PPO |
$981.24
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$947.79
|
| Rate for Payer: United Healthcare Commercial |
$878.66
|
| Rate for Payer: United Healthcare Medicare |
$356.82
|
|
