|
HC Z SCREW 7.0X85 16 CANN
|
Facility
|
OP
|
$1,115.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604040
|
|
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 7.0X85 16 CANN
|
Facility
|
IP
|
$1,115.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604040
|
|
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 7.0X85 32 CANN
|
Facility
|
IP
|
$1,115.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604041
|
|
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 7.0X85 32 CANN
|
Facility
|
OP
|
$1,115.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604041
|
|
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 BONE 6.5X25
|
Facility
|
OP
|
$579.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604672
|
|
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 BONE 6.5X25
|
Facility
|
IP
|
$579.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604672
|
|
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 BONE 6.5X30
|
Facility
|
IP
|
$579.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604349
|
|
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 BONE 6.5X30
|
Facility
|
OP
|
$579.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604349
|
|
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 CAP NCB LOCKING
|
Facility
|
OP
|
$1,002.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606563
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$931.91 |
| Rate for Payer: Aetna Commercial |
$845.73
|
| Rate for Payer: Aetna Medicare |
$320.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$310.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$575.48
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$626.38
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$368.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$352.72
|
| Rate for Payer: Cash Price |
$601.23
|
| Rate for Payer: Cash Price |
$601.23
|
| Rate for Payer: Centivo All Commercial |
$545.12
|
| Rate for Payer: Cigna All Commercial |
$864.77
|
| Rate for Payer: CORVEL All Commercial |
$931.91
|
| Rate for Payer: Coventry All Commercial |
$881.80
|
| Rate for Payer: Encore All Commercial |
$922.39
|
| Rate for Payer: Frontpath All Commercial |
$921.89
|
| Rate for Payer: Humana ChoiceCare |
$865.47
|
| Rate for Payer: Humana Medicare |
$320.66
|
| Rate for Payer: Lucent All Commercial |
$545.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$901.85
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$751.54
|
| Rate for Payer: PHP All Commercial |
$759.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$390.80
|
| Rate for Payer: Sagamore Health Network All Products |
$773.58
|
| Rate for Payer: Signature Care EPO |
$831.70
|
| Rate for Payer: Signature Care PPO |
$881.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$851.74
|
| Rate for Payer: United Healthcare Commercial |
$789.62
|
| Rate for Payer: United Healthcare Medicare |
$320.66
|
|
|
HC Z SCREW CAP NCB LOCKING
|
Facility
|
IP
|
$1,002.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606563
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$751.54 |
| Max. Negotiated Rate |
$931.91 |
| Rate for Payer: Aetna Commercial |
$865.77
|
| Rate for Payer: Cash Price |
$601.23
|
| Rate for Payer: Cigna All Commercial |
$864.77
|
| Rate for Payer: CORVEL All Commercial |
$931.91
|
| Rate for Payer: Coventry All Commercial |
$881.80
|
| Rate for Payer: Encore All Commercial |
$922.39
|
| Rate for Payer: Frontpath All Commercial |
$921.89
|
| Rate for Payer: Humana ChoiceCare |
$865.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$901.85
|
| Rate for Payer: PHCS All Commercial |
$751.54
|
| Rate for Payer: PHP All Commercial |
$759.95
|
| Rate for Payer: Sagamore Health Network All Products |
$773.58
|
| Rate for Payer: Signature Care EPO |
$831.70
|
| Rate for Payer: Signature Care PPO |
$881.80
|
| Rate for Payer: United Healthcare Commercial |
$789.62
|
|
|
HC Z SCREW CENTRAL 6.5X25
|
Facility
|
IP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605672
|
|
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 CENTRAL 6.5X25
|
Facility
|
OP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605672
|
|
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 CENTRAL 6.5X30
|
Facility
|
IP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605673
|
|
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 CENTRAL 6.5X30
|
Facility
|
OP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605673
|
|
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 CENTRAL 6.5X35
|
Facility
|
IP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605674
|
|
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 CENTRAL 6.5X35
|
Facility
|
OP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605674
|
|
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 LAG 10.5X100
|
Facility
|
OP
|
$2,279.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606243
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$2,120.19 |
| Rate for Payer: Aetna Commercial |
$1,924.13
|
| Rate for Payer: Aetna Medicare |
$729.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$706.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,309.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,425.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$838.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$802.48
|
| Rate for Payer: Cash Price |
$1,367.86
|
| Rate for Payer: Cash Price |
$1,367.86
|
| Rate for Payer: Centivo All Commercial |
$1,240.19
|
| Rate for Payer: Cigna All Commercial |
$1,967.44
|
| Rate for Payer: CORVEL All Commercial |
$2,120.19
|
| Rate for Payer: Coventry All Commercial |
$2,006.20
|
| Rate for Payer: Encore All Commercial |
$2,098.53
|
| Rate for Payer: Frontpath All Commercial |
$2,097.39
|
| Rate for Payer: Humana ChoiceCare |
$1,969.04
|
| Rate for Payer: Humana Medicare |
$729.53
|
| Rate for Payer: Lucent All Commercial |
$1,240.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,051.79
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$1,709.83
|
| Rate for Payer: PHP All Commercial |
$1,728.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$889.11
|
| Rate for Payer: Sagamore Health Network All Products |
$1,759.98
|
| Rate for Payer: Signature Care EPO |
$1,892.21
|
| Rate for Payer: Signature Care PPO |
$2,006.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,937.80
|
| Rate for Payer: United Healthcare Commercial |
$1,796.46
|
| Rate for Payer: United Healthcare Medicare |
$729.53
|
|
|
HC Z SCREW LAG 10.5X100
|
Facility
|
IP
|
$2,279.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606243
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,709.83 |
| Max. Negotiated Rate |
$2,120.19 |
| Rate for Payer: Aetna Commercial |
$1,969.72
|
| Rate for Payer: Cash Price |
$1,367.86
|
| Rate for Payer: Cigna All Commercial |
$1,967.44
|
| Rate for Payer: CORVEL All Commercial |
$2,120.19
|
| Rate for Payer: Coventry All Commercial |
$2,006.20
|
| Rate for Payer: Encore All Commercial |
$2,098.53
|
| Rate for Payer: Frontpath All Commercial |
$2,097.39
|
| Rate for Payer: Humana ChoiceCare |
$1,969.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,051.79
|
| Rate for Payer: PHCS All Commercial |
$1,709.83
|
| Rate for Payer: PHP All Commercial |
$1,728.98
|
| Rate for Payer: Sagamore Health Network All Products |
$1,759.98
|
| Rate for Payer: Signature Care EPO |
$1,892.21
|
| Rate for Payer: Signature Care PPO |
$2,006.20
|
| Rate for Payer: United Healthcare Commercial |
$1,796.46
|
|
|
HC Z SCREW T15 3.5X10 CORT LP
|
Facility
|
OP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607467
|
|
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 T15 3.5X10 CORT LP
|
Facility
|
IP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607467
|
|
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 T15 3.5X12 CORT LP
|
Facility
|
IP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607400
|
|
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 T15 3.5X12 CORT LP
|
Facility
|
OP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607400
|
|
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 T15 3.5X14 CORT LP
|
Facility
|
IP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607401
|
|
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 T15 3.5X14 CORT LP
|
Facility
|
OP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607401
|
|
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 T15 3.5X16 CORT LP
|
Facility
|
IP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607402
|
|
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
|
|
