|
HC S SUTURE XBRAID TT 2.2
|
Facility
IP
|
$772.50
|
|
| Hospital Charge Code |
41607526
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$579.38 |
| Max. Negotiated Rate |
$718.42 |
| Rate for Payer: Aetna Commercial |
$667.44
|
| Rate for Payer: Cash Price |
$478.95
|
| Rate for Payer: Cigna All Commercial |
$666.67
|
| Rate for Payer: CORVEL All Commercial |
$718.42
|
| Rate for Payer: Coventry All Commercial |
$679.80
|
| Rate for Payer: Encore All Commercial |
$711.09
|
| Rate for Payer: Frontpath All Commercial |
$710.70
|
| Rate for Payer: Humana ChoiceCare |
$667.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$695.25
|
| Rate for Payer: PHCS All Commercial |
$579.38
|
| Rate for Payer: PHP All Commercial |
$585.86
|
| Rate for Payer: Sagamore Health Network All Products |
$596.37
|
| Rate for Payer: Signature Care EPO |
$641.18
|
| Rate for Payer: Signature Care PPO |
$679.80
|
| Rate for Payer: United Healthcare Commercial |
$608.73
|
|
|
HC S SUTURE XBRAID TT 2.2
|
Facility
OP
|
$772.50
|
|
| Hospital Charge Code |
41607526
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$718.42 |
| Rate for Payer: Aetna Commercial |
$651.99
|
| Rate for Payer: Aetna Medicare |
$254.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$254.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$443.65
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$482.89
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$293.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$280.42
|
| Rate for Payer: Cash Price |
$478.95
|
| Rate for Payer: Cash Price |
$478.95
|
| Rate for Payer: Centivo All Commercial |
$393.98
|
| Rate for Payer: Cigna All Commercial |
$666.67
|
| Rate for Payer: CORVEL All Commercial |
$718.42
|
| Rate for Payer: Coventry All Commercial |
$679.80
|
| Rate for Payer: Encore All Commercial |
$711.09
|
| Rate for Payer: Frontpath All Commercial |
$710.70
|
| Rate for Payer: Humana ChoiceCare |
$667.21
|
| Rate for Payer: Humana Medicare |
$393.98
|
| Rate for Payer: Lucent All Commercial |
$393.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$695.25
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$579.38
|
| Rate for Payer: PHP All Commercial |
$585.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$301.28
|
| Rate for Payer: Sagamore Health Network All Products |
$596.37
|
| Rate for Payer: Signature Care EPO |
$641.18
|
| Rate for Payer: Signature Care PPO |
$679.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$656.62
|
| Rate for Payer: United Healthcare Commercial |
$608.73
|
| Rate for Payer: United Healthcare Medicare |
$254.92
|
|
|
HC S T10 BLADE SCREWDRIVER SR AO
|
Facility
OP
|
$2,214.00
|
|
| Hospital Charge Code |
41603941
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$2,059.02 |
| Rate for Payer: Aetna Commercial |
$1,868.62
|
| Rate for Payer: Aetna Medicare |
$730.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$730.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,271.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,383.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$840.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$803.68
|
| Rate for Payer: Cash Price |
$1,372.68
|
| Rate for Payer: Cash Price |
$1,372.68
|
| Rate for Payer: Centivo All Commercial |
$1,129.14
|
| Rate for Payer: Cigna All Commercial |
$1,910.68
|
| Rate for Payer: CORVEL All Commercial |
$2,059.02
|
| Rate for Payer: Coventry All Commercial |
$1,948.32
|
| Rate for Payer: Encore All Commercial |
$2,037.99
|
| Rate for Payer: Frontpath All Commercial |
$2,036.88
|
| Rate for Payer: Humana ChoiceCare |
$1,912.23
|
| Rate for Payer: Humana Medicare |
$1,129.14
|
| Rate for Payer: Lucent All Commercial |
$1,129.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,992.60
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,660.50
|
| Rate for Payer: PHP All Commercial |
$1,679.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$863.46
|
| Rate for Payer: Sagamore Health Network All Products |
$1,709.21
|
| Rate for Payer: Signature Care EPO |
$1,837.62
|
| Rate for Payer: Signature Care PPO |
$1,948.32
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,881.90
|
| Rate for Payer: United Healthcare Commercial |
$1,744.63
|
| Rate for Payer: United Healthcare Medicare |
$730.62
|
|
|
HC S T10 BLADE SCREWDRIVER SR AO
|
Facility
IP
|
$2,214.00
|
|
| Hospital Charge Code |
41603941
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,660.50 |
| Max. Negotiated Rate |
$2,059.02 |
| Rate for Payer: Aetna Commercial |
$1,912.90
|
| Rate for Payer: Cash Price |
$1,372.68
|
| Rate for Payer: Cigna All Commercial |
$1,910.68
|
| Rate for Payer: CORVEL All Commercial |
$2,059.02
|
| Rate for Payer: Coventry All Commercial |
$1,948.32
|
| Rate for Payer: Encore All Commercial |
$2,037.99
|
| Rate for Payer: Frontpath All Commercial |
$2,036.88
|
| Rate for Payer: Humana ChoiceCare |
$1,912.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,992.60
|
| Rate for Payer: PHCS All Commercial |
$1,660.50
|
| Rate for Payer: PHP All Commercial |
$1,679.10
|
| Rate for Payer: Sagamore Health Network All Products |
$1,709.21
|
| Rate for Payer: Signature Care EPO |
$1,837.62
|
| Rate for Payer: Signature Care PPO |
$1,948.32
|
| Rate for Payer: United Healthcare Commercial |
$1,744.63
|
|
|
HC S T10 SCREW 3.5X10 LOCK FT
|
Facility
IP
|
$1,645.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603930
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,233.75 |
| Max. Negotiated Rate |
$1,529.85 |
| Rate for Payer: Aetna Commercial |
$1,421.28
|
| Rate for Payer: Cash Price |
$1,019.90
|
| Rate for Payer: Cigna All Commercial |
$1,419.64
|
| Rate for Payer: CORVEL All Commercial |
$1,529.85
|
| Rate for Payer: Coventry All Commercial |
$1,447.60
|
| Rate for Payer: Encore All Commercial |
$1,514.22
|
| Rate for Payer: Frontpath All Commercial |
$1,513.40
|
| Rate for Payer: Humana ChoiceCare |
$1,420.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,480.50
|
| Rate for Payer: PHCS All Commercial |
$1,233.75
|
| Rate for Payer: PHP All Commercial |
$1,247.57
|
| Rate for Payer: Sagamore Health Network All Products |
$1,269.94
|
| Rate for Payer: Signature Care EPO |
$1,365.35
|
| Rate for Payer: Signature Care PPO |
$1,447.60
|
| Rate for Payer: United Healthcare Commercial |
$1,296.26
|
|
|
HC S T10 SCREW 3.5X10 LOCK FT
|
Facility
OP
|
$1,645.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603930
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,529.85 |
| Rate for Payer: Aetna Commercial |
$1,388.38
|
| Rate for Payer: Aetna Medicare |
$542.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$542.85
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$944.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,028.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$624.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$597.14
|
| Rate for Payer: Cash Price |
$1,019.90
|
| Rate for Payer: Cash Price |
$1,019.90
|
| Rate for Payer: Centivo All Commercial |
$838.95
|
| Rate for Payer: Cigna All Commercial |
$1,419.64
|
| Rate for Payer: CORVEL All Commercial |
$1,529.85
|
| Rate for Payer: Coventry All Commercial |
$1,447.60
|
| Rate for Payer: Encore All Commercial |
$1,514.22
|
| Rate for Payer: Frontpath All Commercial |
$1,513.40
|
| Rate for Payer: Humana ChoiceCare |
$1,420.79
|
| Rate for Payer: Humana Medicare |
$838.95
|
| Rate for Payer: Lucent All Commercial |
$838.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,480.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,233.75
|
| Rate for Payer: PHP All Commercial |
$1,247.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$641.55
|
| Rate for Payer: Sagamore Health Network All Products |
$1,269.94
|
| Rate for Payer: Signature Care EPO |
$1,365.35
|
| Rate for Payer: Signature Care PPO |
$1,447.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,398.25
|
| Rate for Payer: United Healthcare Commercial |
$1,296.26
|
| Rate for Payer: United Healthcare Medicare |
$542.85
|
|
|
HC S T10 SCREW 3.5X12 LOCK FT
|
Facility
OP
|
$1,645.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603931
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,529.85 |
| Rate for Payer: Aetna Commercial |
$1,388.38
|
| Rate for Payer: Aetna Medicare |
$542.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$542.85
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$944.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,028.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$624.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$597.14
|
| Rate for Payer: Cash Price |
$1,019.90
|
| Rate for Payer: Cash Price |
$1,019.90
|
| Rate for Payer: Centivo All Commercial |
$838.95
|
| Rate for Payer: Cigna All Commercial |
$1,419.64
|
| Rate for Payer: CORVEL All Commercial |
$1,529.85
|
| Rate for Payer: Coventry All Commercial |
$1,447.60
|
| Rate for Payer: Encore All Commercial |
$1,514.22
|
| Rate for Payer: Frontpath All Commercial |
$1,513.40
|
| Rate for Payer: Humana ChoiceCare |
$1,420.79
|
| Rate for Payer: Humana Medicare |
$838.95
|
| Rate for Payer: Lucent All Commercial |
$838.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,480.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,233.75
|
| Rate for Payer: PHP All Commercial |
$1,247.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$641.55
|
| Rate for Payer: Sagamore Health Network All Products |
$1,269.94
|
| Rate for Payer: Signature Care EPO |
$1,365.35
|
| Rate for Payer: Signature Care PPO |
$1,447.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,398.25
|
| Rate for Payer: United Healthcare Commercial |
$1,296.26
|
| Rate for Payer: United Healthcare Medicare |
$542.85
|
|
|
HC S T10 SCREW 3.5X12 LOCK FT
|
Facility
IP
|
$1,645.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603931
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,233.75 |
| Max. Negotiated Rate |
$1,529.85 |
| Rate for Payer: Aetna Commercial |
$1,421.28
|
| Rate for Payer: Cash Price |
$1,019.90
|
| Rate for Payer: Cigna All Commercial |
$1,419.64
|
| Rate for Payer: CORVEL All Commercial |
$1,529.85
|
| Rate for Payer: Coventry All Commercial |
$1,447.60
|
| Rate for Payer: Encore All Commercial |
$1,514.22
|
| Rate for Payer: Frontpath All Commercial |
$1,513.40
|
| Rate for Payer: Humana ChoiceCare |
$1,420.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,480.50
|
| Rate for Payer: PHCS All Commercial |
$1,233.75
|
| Rate for Payer: PHP All Commercial |
$1,247.57
|
| Rate for Payer: Sagamore Health Network All Products |
$1,269.94
|
| Rate for Payer: Signature Care EPO |
$1,365.35
|
| Rate for Payer: Signature Care PPO |
$1,447.60
|
| Rate for Payer: United Healthcare Commercial |
$1,296.26
|
|
|
HC S T10 SCREW 3.5X14 LOCK FT
|
Facility
OP
|
$1,645.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603932
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,529.85 |
| Rate for Payer: Aetna Commercial |
$1,388.38
|
| Rate for Payer: Aetna Medicare |
$542.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$542.85
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$944.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,028.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$624.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$597.14
|
| Rate for Payer: Cash Price |
$1,019.90
|
| Rate for Payer: Cash Price |
$1,019.90
|
| Rate for Payer: Centivo All Commercial |
$838.95
|
| Rate for Payer: Cigna All Commercial |
$1,419.64
|
| Rate for Payer: CORVEL All Commercial |
$1,529.85
|
| Rate for Payer: Coventry All Commercial |
$1,447.60
|
| Rate for Payer: Encore All Commercial |
$1,514.22
|
| Rate for Payer: Frontpath All Commercial |
$1,513.40
|
| Rate for Payer: Humana ChoiceCare |
$1,420.79
|
| Rate for Payer: Humana Medicare |
$838.95
|
| Rate for Payer: Lucent All Commercial |
$838.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,480.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,233.75
|
| Rate for Payer: PHP All Commercial |
$1,247.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$641.55
|
| Rate for Payer: Sagamore Health Network All Products |
$1,269.94
|
| Rate for Payer: Signature Care EPO |
$1,365.35
|
| Rate for Payer: Signature Care PPO |
$1,447.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,398.25
|
| Rate for Payer: United Healthcare Commercial |
$1,296.26
|
| Rate for Payer: United Healthcare Medicare |
$542.85
|
|
|
HC S T10 SCREW 3.5X14 LOCK FT
|
Facility
IP
|
$1,645.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603932
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,233.75 |
| Max. Negotiated Rate |
$1,529.85 |
| Rate for Payer: Aetna Commercial |
$1,421.28
|
| Rate for Payer: Cash Price |
$1,019.90
|
| Rate for Payer: Cigna All Commercial |
$1,419.64
|
| Rate for Payer: CORVEL All Commercial |
$1,529.85
|
| Rate for Payer: Coventry All Commercial |
$1,447.60
|
| Rate for Payer: Encore All Commercial |
$1,514.22
|
| Rate for Payer: Frontpath All Commercial |
$1,513.40
|
| Rate for Payer: Humana ChoiceCare |
$1,420.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,480.50
|
| Rate for Payer: PHCS All Commercial |
$1,233.75
|
| Rate for Payer: PHP All Commercial |
$1,247.57
|
| Rate for Payer: Sagamore Health Network All Products |
$1,269.94
|
| Rate for Payer: Signature Care EPO |
$1,365.35
|
| Rate for Payer: Signature Care PPO |
$1,447.60
|
| Rate for Payer: United Healthcare Commercial |
$1,296.26
|
|
|
HC S T10 SCREW 3.5X16 LOCK FT
|
Facility
IP
|
$1,645.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603933
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,233.75 |
| Max. Negotiated Rate |
$1,529.85 |
| Rate for Payer: Aetna Commercial |
$1,421.28
|
| Rate for Payer: Cash Price |
$1,019.90
|
| Rate for Payer: Cigna All Commercial |
$1,419.64
|
| Rate for Payer: CORVEL All Commercial |
$1,529.85
|
| Rate for Payer: Coventry All Commercial |
$1,447.60
|
| Rate for Payer: Encore All Commercial |
$1,514.22
|
| Rate for Payer: Frontpath All Commercial |
$1,513.40
|
| Rate for Payer: Humana ChoiceCare |
$1,420.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,480.50
|
| Rate for Payer: PHCS All Commercial |
$1,233.75
|
| Rate for Payer: PHP All Commercial |
$1,247.57
|
| Rate for Payer: Sagamore Health Network All Products |
$1,269.94
|
| Rate for Payer: Signature Care EPO |
$1,365.35
|
| Rate for Payer: Signature Care PPO |
$1,447.60
|
| Rate for Payer: United Healthcare Commercial |
$1,296.26
|
|
|
HC S T10 SCREW 3.5X16 LOCK FT
|
Facility
OP
|
$1,645.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603933
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,529.85 |
| Rate for Payer: Aetna Commercial |
$1,388.38
|
| Rate for Payer: Aetna Medicare |
$542.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$542.85
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$944.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,028.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$624.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$597.14
|
| Rate for Payer: Cash Price |
$1,019.90
|
| Rate for Payer: Cash Price |
$1,019.90
|
| Rate for Payer: Centivo All Commercial |
$838.95
|
| Rate for Payer: Cigna All Commercial |
$1,419.64
|
| Rate for Payer: CORVEL All Commercial |
$1,529.85
|
| Rate for Payer: Coventry All Commercial |
$1,447.60
|
| Rate for Payer: Encore All Commercial |
$1,514.22
|
| Rate for Payer: Frontpath All Commercial |
$1,513.40
|
| Rate for Payer: Humana ChoiceCare |
$1,420.79
|
| Rate for Payer: Humana Medicare |
$838.95
|
| Rate for Payer: Lucent All Commercial |
$838.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,480.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,233.75
|
| Rate for Payer: PHP All Commercial |
$1,247.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$641.55
|
| Rate for Payer: Sagamore Health Network All Products |
$1,269.94
|
| Rate for Payer: Signature Care EPO |
$1,365.35
|
| Rate for Payer: Signature Care PPO |
$1,447.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,398.25
|
| Rate for Payer: United Healthcare Commercial |
$1,296.26
|
| Rate for Payer: United Healthcare Medicare |
$542.85
|
|
|
HC S T10 SCREW 3.5X8 LOCK FT
|
Facility
OP
|
$1,645.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603929
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,529.85 |
| Rate for Payer: Aetna Commercial |
$1,388.38
|
| Rate for Payer: Aetna Medicare |
$542.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$542.85
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$944.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,028.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$624.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$597.14
|
| Rate for Payer: Cash Price |
$1,019.90
|
| Rate for Payer: Cash Price |
$1,019.90
|
| Rate for Payer: Centivo All Commercial |
$838.95
|
| Rate for Payer: Cigna All Commercial |
$1,419.64
|
| Rate for Payer: CORVEL All Commercial |
$1,529.85
|
| Rate for Payer: Coventry All Commercial |
$1,447.60
|
| Rate for Payer: Encore All Commercial |
$1,514.22
|
| Rate for Payer: Frontpath All Commercial |
$1,513.40
|
| Rate for Payer: Humana ChoiceCare |
$1,420.79
|
| Rate for Payer: Humana Medicare |
$838.95
|
| Rate for Payer: Lucent All Commercial |
$838.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,480.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,233.75
|
| Rate for Payer: PHP All Commercial |
$1,247.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$641.55
|
| Rate for Payer: Sagamore Health Network All Products |
$1,269.94
|
| Rate for Payer: Signature Care EPO |
$1,365.35
|
| Rate for Payer: Signature Care PPO |
$1,447.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,398.25
|
| Rate for Payer: United Healthcare Commercial |
$1,296.26
|
| Rate for Payer: United Healthcare Medicare |
$542.85
|
|
|
HC S T10 SCREW 3.5X8 LOCK FT
|
Facility
IP
|
$1,645.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603929
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,233.75 |
| Max. Negotiated Rate |
$1,529.85 |
| Rate for Payer: Aetna Commercial |
$1,421.28
|
| Rate for Payer: Cash Price |
$1,019.90
|
| Rate for Payer: Cigna All Commercial |
$1,419.64
|
| Rate for Payer: CORVEL All Commercial |
$1,529.85
|
| Rate for Payer: Coventry All Commercial |
$1,447.60
|
| Rate for Payer: Encore All Commercial |
$1,514.22
|
| Rate for Payer: Frontpath All Commercial |
$1,513.40
|
| Rate for Payer: Humana ChoiceCare |
$1,420.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,480.50
|
| Rate for Payer: PHCS All Commercial |
$1,233.75
|
| Rate for Payer: PHP All Commercial |
$1,247.57
|
| Rate for Payer: Sagamore Health Network All Products |
$1,269.94
|
| Rate for Payer: Signature Care EPO |
$1,365.35
|
| Rate for Payer: Signature Care PPO |
$1,447.60
|
| Rate for Payer: United Healthcare Commercial |
$1,296.26
|
|
|
HC S T10 SCREW BONE 3.5X10 FT
|
Facility
IP
|
$895.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603934
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$671.25 |
| Max. Negotiated Rate |
$832.35 |
| Rate for Payer: Aetna Commercial |
$773.28
|
| Rate for Payer: Cash Price |
$554.90
|
| Rate for Payer: Cigna All Commercial |
$772.38
|
| Rate for Payer: CORVEL All Commercial |
$832.35
|
| Rate for Payer: Coventry All Commercial |
$787.60
|
| Rate for Payer: Encore All Commercial |
$823.85
|
| Rate for Payer: Frontpath All Commercial |
$823.40
|
| Rate for Payer: Humana ChoiceCare |
$773.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$805.50
|
| Rate for Payer: PHCS All Commercial |
$671.25
|
| Rate for Payer: PHP All Commercial |
$678.77
|
| Rate for Payer: Sagamore Health Network All Products |
$690.94
|
| Rate for Payer: Signature Care EPO |
$742.85
|
| Rate for Payer: Signature Care PPO |
$787.60
|
| Rate for Payer: United Healthcare Commercial |
$705.26
|
|
|
HC S T10 SCREW BONE 3.5X10 FT
|
Facility
OP
|
$895.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603934
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$295.35 |
| Max. Negotiated Rate |
$832.35 |
| Rate for Payer: Aetna Commercial |
$755.38
|
| Rate for Payer: Aetna Medicare |
$295.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$295.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$514.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$559.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$339.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$324.88
|
| Rate for Payer: Cash Price |
$554.90
|
| Rate for Payer: Cash Price |
$554.90
|
| Rate for Payer: Centivo All Commercial |
$456.45
|
| Rate for Payer: Cigna All Commercial |
$772.38
|
| Rate for Payer: CORVEL All Commercial |
$832.35
|
| Rate for Payer: Coventry All Commercial |
$787.60
|
| Rate for Payer: Encore All Commercial |
$823.85
|
| Rate for Payer: Frontpath All Commercial |
$823.40
|
| Rate for Payer: Humana ChoiceCare |
$773.01
|
| Rate for Payer: Humana Medicare |
$456.45
|
| Rate for Payer: Lucent All Commercial |
$456.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$805.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$671.25
|
| Rate for Payer: PHP All Commercial |
$678.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$349.05
|
| Rate for Payer: Sagamore Health Network All Products |
$690.94
|
| Rate for Payer: Signature Care EPO |
$742.85
|
| Rate for Payer: Signature Care PPO |
$787.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$760.75
|
| Rate for Payer: United Healthcare Commercial |
$705.26
|
| Rate for Payer: United Healthcare Medicare |
$295.35
|
|
|
HC S T10 SCREW BONE 3.5X12 FT
|
Facility
IP
|
$895.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603935
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$671.25 |
| Max. Negotiated Rate |
$832.35 |
| Rate for Payer: Aetna Commercial |
$773.28
|
| Rate for Payer: Cash Price |
$554.90
|
| Rate for Payer: Cigna All Commercial |
$772.38
|
| Rate for Payer: CORVEL All Commercial |
$832.35
|
| Rate for Payer: Coventry All Commercial |
$787.60
|
| Rate for Payer: Encore All Commercial |
$823.85
|
| Rate for Payer: Frontpath All Commercial |
$823.40
|
| Rate for Payer: Humana ChoiceCare |
$773.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$805.50
|
| Rate for Payer: PHCS All Commercial |
$671.25
|
| Rate for Payer: PHP All Commercial |
$678.77
|
| Rate for Payer: Sagamore Health Network All Products |
$690.94
|
| Rate for Payer: Signature Care EPO |
$742.85
|
| Rate for Payer: Signature Care PPO |
$787.60
|
| Rate for Payer: United Healthcare Commercial |
$705.26
|
|
|
HC S T10 SCREW BONE 3.5X12 FT
|
Facility
OP
|
$895.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603935
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$295.35 |
| Max. Negotiated Rate |
$832.35 |
| Rate for Payer: Aetna Commercial |
$755.38
|
| Rate for Payer: Aetna Medicare |
$295.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$295.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$514.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$559.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$339.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$324.88
|
| Rate for Payer: Cash Price |
$554.90
|
| Rate for Payer: Cash Price |
$554.90
|
| Rate for Payer: Centivo All Commercial |
$456.45
|
| Rate for Payer: Cigna All Commercial |
$772.38
|
| Rate for Payer: CORVEL All Commercial |
$832.35
|
| Rate for Payer: Coventry All Commercial |
$787.60
|
| Rate for Payer: Encore All Commercial |
$823.85
|
| Rate for Payer: Frontpath All Commercial |
$823.40
|
| Rate for Payer: Humana ChoiceCare |
$773.01
|
| Rate for Payer: Humana Medicare |
$456.45
|
| Rate for Payer: Lucent All Commercial |
$456.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$805.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$671.25
|
| Rate for Payer: PHP All Commercial |
$678.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$349.05
|
| Rate for Payer: Sagamore Health Network All Products |
$690.94
|
| Rate for Payer: Signature Care EPO |
$742.85
|
| Rate for Payer: Signature Care PPO |
$787.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$760.75
|
| Rate for Payer: United Healthcare Commercial |
$705.26
|
| Rate for Payer: United Healthcare Medicare |
$295.35
|
|
|
HC S T10 SCREW BONE 3.5X14 FT
|
Facility
IP
|
$895.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603936
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$671.25 |
| Max. Negotiated Rate |
$832.35 |
| Rate for Payer: Aetna Commercial |
$773.28
|
| Rate for Payer: Cash Price |
$554.90
|
| Rate for Payer: Cigna All Commercial |
$772.38
|
| Rate for Payer: CORVEL All Commercial |
$832.35
|
| Rate for Payer: Coventry All Commercial |
$787.60
|
| Rate for Payer: Encore All Commercial |
$823.85
|
| Rate for Payer: Frontpath All Commercial |
$823.40
|
| Rate for Payer: Humana ChoiceCare |
$773.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$805.50
|
| Rate for Payer: PHCS All Commercial |
$671.25
|
| Rate for Payer: PHP All Commercial |
$678.77
|
| Rate for Payer: Sagamore Health Network All Products |
$690.94
|
| Rate for Payer: Signature Care EPO |
$742.85
|
| Rate for Payer: Signature Care PPO |
$787.60
|
| Rate for Payer: United Healthcare Commercial |
$705.26
|
|
|
HC S T10 SCREW BONE 3.5X14 FT
|
Facility
OP
|
$895.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603936
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$295.35 |
| Max. Negotiated Rate |
$832.35 |
| Rate for Payer: Aetna Commercial |
$755.38
|
| Rate for Payer: Aetna Medicare |
$295.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$295.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$514.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$559.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$339.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$324.88
|
| Rate for Payer: Cash Price |
$554.90
|
| Rate for Payer: Cash Price |
$554.90
|
| Rate for Payer: Centivo All Commercial |
$456.45
|
| Rate for Payer: Cigna All Commercial |
$772.38
|
| Rate for Payer: CORVEL All Commercial |
$832.35
|
| Rate for Payer: Coventry All Commercial |
$787.60
|
| Rate for Payer: Encore All Commercial |
$823.85
|
| Rate for Payer: Frontpath All Commercial |
$823.40
|
| Rate for Payer: Humana ChoiceCare |
$773.01
|
| Rate for Payer: Humana Medicare |
$456.45
|
| Rate for Payer: Lucent All Commercial |
$456.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$805.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$671.25
|
| Rate for Payer: PHP All Commercial |
$678.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$349.05
|
| Rate for Payer: Sagamore Health Network All Products |
$690.94
|
| Rate for Payer: Signature Care EPO |
$742.85
|
| Rate for Payer: Signature Care PPO |
$787.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$760.75
|
| Rate for Payer: United Healthcare Commercial |
$705.26
|
| Rate for Payer: United Healthcare Medicare |
$295.35
|
|
|
HC S T10 SCREW BONE 3.5X16 FT
|
Facility
IP
|
$895.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603937
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$671.25 |
| Max. Negotiated Rate |
$832.35 |
| Rate for Payer: Aetna Commercial |
$773.28
|
| Rate for Payer: Cash Price |
$554.90
|
| Rate for Payer: Cigna All Commercial |
$772.38
|
| Rate for Payer: CORVEL All Commercial |
$832.35
|
| Rate for Payer: Coventry All Commercial |
$787.60
|
| Rate for Payer: Encore All Commercial |
$823.85
|
| Rate for Payer: Frontpath All Commercial |
$823.40
|
| Rate for Payer: Humana ChoiceCare |
$773.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$805.50
|
| Rate for Payer: PHCS All Commercial |
$671.25
|
| Rate for Payer: PHP All Commercial |
$678.77
|
| Rate for Payer: Sagamore Health Network All Products |
$690.94
|
| Rate for Payer: Signature Care EPO |
$742.85
|
| Rate for Payer: Signature Care PPO |
$787.60
|
| Rate for Payer: United Healthcare Commercial |
$705.26
|
|
|
HC S T10 SCREW BONE 3.5X16 FT
|
Facility
OP
|
$895.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603937
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$295.35 |
| Max. Negotiated Rate |
$832.35 |
| Rate for Payer: Aetna Commercial |
$755.38
|
| Rate for Payer: Aetna Medicare |
$295.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$295.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$514.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$559.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$339.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$324.88
|
| Rate for Payer: Cash Price |
$554.90
|
| Rate for Payer: Cash Price |
$554.90
|
| Rate for Payer: Centivo All Commercial |
$456.45
|
| Rate for Payer: Cigna All Commercial |
$772.38
|
| Rate for Payer: CORVEL All Commercial |
$832.35
|
| Rate for Payer: Coventry All Commercial |
$787.60
|
| Rate for Payer: Encore All Commercial |
$823.85
|
| Rate for Payer: Frontpath All Commercial |
$823.40
|
| Rate for Payer: Humana ChoiceCare |
$773.01
|
| Rate for Payer: Humana Medicare |
$456.45
|
| Rate for Payer: Lucent All Commercial |
$456.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$805.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$671.25
|
| Rate for Payer: PHP All Commercial |
$678.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$349.05
|
| Rate for Payer: Sagamore Health Network All Products |
$690.94
|
| Rate for Payer: Signature Care EPO |
$742.85
|
| Rate for Payer: Signature Care PPO |
$787.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$760.75
|
| Rate for Payer: United Healthcare Commercial |
$705.26
|
| Rate for Payer: United Healthcare Medicare |
$295.35
|
|
|
HC S T8 PEG 2.0X18 LOCK
|
Facility
OP
|
$1,475.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603928
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$486.75 |
| Max. Negotiated Rate |
$1,371.75 |
| Rate for Payer: Aetna Commercial |
$1,244.90
|
| Rate for Payer: Aetna Medicare |
$486.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$486.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$847.09
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$922.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$559.76
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$535.42
|
| Rate for Payer: Cash Price |
$914.50
|
| Rate for Payer: Cash Price |
$914.50
|
| Rate for Payer: Centivo All Commercial |
$752.25
|
| Rate for Payer: Cigna All Commercial |
$1,272.92
|
| Rate for Payer: CORVEL All Commercial |
$1,371.75
|
| Rate for Payer: Coventry All Commercial |
$1,298.00
|
| Rate for Payer: Encore All Commercial |
$1,357.74
|
| Rate for Payer: Frontpath All Commercial |
$1,357.00
|
| Rate for Payer: Humana ChoiceCare |
$1,273.96
|
| Rate for Payer: Humana Medicare |
$752.25
|
| Rate for Payer: Lucent All Commercial |
$752.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,327.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,106.25
|
| Rate for Payer: PHP All Commercial |
$1,118.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$575.25
|
| Rate for Payer: Sagamore Health Network All Products |
$1,138.70
|
| Rate for Payer: Signature Care EPO |
$1,224.25
|
| Rate for Payer: Signature Care PPO |
$1,298.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,253.75
|
| Rate for Payer: United Healthcare Commercial |
$1,162.30
|
| Rate for Payer: United Healthcare Medicare |
$486.75
|
|
|
HC S T8 PEG 2.0X18 LOCK
|
Facility
IP
|
$1,475.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603928
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,106.25 |
| Max. Negotiated Rate |
$1,371.75 |
| Rate for Payer: Aetna Commercial |
$1,274.40
|
| Rate for Payer: Cash Price |
$914.50
|
| Rate for Payer: Cigna All Commercial |
$1,272.92
|
| Rate for Payer: CORVEL All Commercial |
$1,371.75
|
| Rate for Payer: Coventry All Commercial |
$1,298.00
|
| Rate for Payer: Encore All Commercial |
$1,357.74
|
| Rate for Payer: Frontpath All Commercial |
$1,357.00
|
| Rate for Payer: Humana ChoiceCare |
$1,273.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,327.50
|
| Rate for Payer: PHCS All Commercial |
$1,106.25
|
| Rate for Payer: PHP All Commercial |
$1,118.64
|
| Rate for Payer: Sagamore Health Network All Products |
$1,138.70
|
| Rate for Payer: Signature Care EPO |
$1,224.25
|
| Rate for Payer: Signature Care PPO |
$1,298.00
|
| Rate for Payer: United Healthcare Commercial |
$1,162.30
|
|
|
HC S T8 SCREW 2.7X12 LOCK FT
|
Facility
IP
|
$1,475.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603921
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,106.25 |
| Max. Negotiated Rate |
$1,371.75 |
| Rate for Payer: Aetna Commercial |
$1,274.40
|
| Rate for Payer: Cash Price |
$914.50
|
| Rate for Payer: Cigna All Commercial |
$1,272.92
|
| Rate for Payer: CORVEL All Commercial |
$1,371.75
|
| Rate for Payer: Coventry All Commercial |
$1,298.00
|
| Rate for Payer: Encore All Commercial |
$1,357.74
|
| Rate for Payer: Frontpath All Commercial |
$1,357.00
|
| Rate for Payer: Humana ChoiceCare |
$1,273.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,327.50
|
| Rate for Payer: PHCS All Commercial |
$1,106.25
|
| Rate for Payer: PHP All Commercial |
$1,118.64
|
| Rate for Payer: Sagamore Health Network All Products |
$1,138.70
|
| Rate for Payer: Signature Care EPO |
$1,224.25
|
| Rate for Payer: Signature Care PPO |
$1,298.00
|
| Rate for Payer: United Healthcare Commercial |
$1,162.30
|
|
