|
HC S T8 SCREW 2.7X12 LOCK FT
|
Facility
OP
|
$1,475.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603921
|
|
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 SCREW 2.7X16 LOCK FT
|
Facility
IP
|
$1,475.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603922
|
|
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 2.7X16 LOCK FT
|
Facility
OP
|
$1,475.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603922
|
|
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 SCREW 2.7X18 LOCK FT
|
Facility
OP
|
$1,475.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603923
|
|
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 SCREW 2.7X18 LOCK FT
|
Facility
IP
|
$1,475.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603923
|
|
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 BONE 2.7X12 FT
|
Facility
IP
|
$860.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603924
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$645.00 |
| Max. Negotiated Rate |
$799.80 |
| Rate for Payer: Aetna Commercial |
$743.04
|
| Rate for Payer: Cash Price |
$533.20
|
| Rate for Payer: Cigna All Commercial |
$742.18
|
| Rate for Payer: CORVEL All Commercial |
$799.80
|
| Rate for Payer: Coventry All Commercial |
$756.80
|
| Rate for Payer: Encore All Commercial |
$791.63
|
| Rate for Payer: Frontpath All Commercial |
$791.20
|
| Rate for Payer: Humana ChoiceCare |
$742.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$774.00
|
| Rate for Payer: PHCS All Commercial |
$645.00
|
| Rate for Payer: PHP All Commercial |
$652.22
|
| Rate for Payer: Sagamore Health Network All Products |
$663.92
|
| Rate for Payer: Signature Care EPO |
$713.80
|
| Rate for Payer: Signature Care PPO |
$756.80
|
| Rate for Payer: United Healthcare Commercial |
$677.68
|
|
|
HC S T8 SCREW BONE 2.7X12 FT
|
Facility
OP
|
$860.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603924
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$283.80 |
| Max. Negotiated Rate |
$799.80 |
| Rate for Payer: Aetna Commercial |
$725.84
|
| Rate for Payer: Aetna Medicare |
$283.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$283.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$493.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$537.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$326.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$312.18
|
| Rate for Payer: Cash Price |
$533.20
|
| Rate for Payer: Cash Price |
$533.20
|
| Rate for Payer: Centivo All Commercial |
$438.60
|
| Rate for Payer: Cigna All Commercial |
$742.18
|
| Rate for Payer: CORVEL All Commercial |
$799.80
|
| Rate for Payer: Coventry All Commercial |
$756.80
|
| Rate for Payer: Encore All Commercial |
$791.63
|
| Rate for Payer: Frontpath All Commercial |
$791.20
|
| Rate for Payer: Humana ChoiceCare |
$742.78
|
| Rate for Payer: Humana Medicare |
$438.60
|
| Rate for Payer: Lucent All Commercial |
$438.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$774.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$645.00
|
| Rate for Payer: PHP All Commercial |
$652.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$335.40
|
| Rate for Payer: Sagamore Health Network All Products |
$663.92
|
| Rate for Payer: Signature Care EPO |
$713.80
|
| Rate for Payer: Signature Care PPO |
$756.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$731.00
|
| Rate for Payer: United Healthcare Commercial |
$677.68
|
| Rate for Payer: United Healthcare Medicare |
$283.80
|
|
|
HC S T8 SCREW BONE 2.7X16 FT
|
Facility
IP
|
$860.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603925
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$645.00 |
| Max. Negotiated Rate |
$799.80 |
| Rate for Payer: Aetna Commercial |
$743.04
|
| Rate for Payer: Cash Price |
$533.20
|
| Rate for Payer: Cigna All Commercial |
$742.18
|
| Rate for Payer: CORVEL All Commercial |
$799.80
|
| Rate for Payer: Coventry All Commercial |
$756.80
|
| Rate for Payer: Encore All Commercial |
$791.63
|
| Rate for Payer: Frontpath All Commercial |
$791.20
|
| Rate for Payer: Humana ChoiceCare |
$742.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$774.00
|
| Rate for Payer: PHCS All Commercial |
$645.00
|
| Rate for Payer: PHP All Commercial |
$652.22
|
| Rate for Payer: Sagamore Health Network All Products |
$663.92
|
| Rate for Payer: Signature Care EPO |
$713.80
|
| Rate for Payer: Signature Care PPO |
$756.80
|
| Rate for Payer: United Healthcare Commercial |
$677.68
|
|
|
HC S T8 SCREW BONE 2.7X16 FT
|
Facility
OP
|
$860.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603925
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$283.80 |
| Max. Negotiated Rate |
$799.80 |
| Rate for Payer: Aetna Commercial |
$725.84
|
| Rate for Payer: Aetna Medicare |
$283.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$283.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$493.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$537.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$326.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$312.18
|
| Rate for Payer: Cash Price |
$533.20
|
| Rate for Payer: Cash Price |
$533.20
|
| Rate for Payer: Centivo All Commercial |
$438.60
|
| Rate for Payer: Cigna All Commercial |
$742.18
|
| Rate for Payer: CORVEL All Commercial |
$799.80
|
| Rate for Payer: Coventry All Commercial |
$756.80
|
| Rate for Payer: Encore All Commercial |
$791.63
|
| Rate for Payer: Frontpath All Commercial |
$791.20
|
| Rate for Payer: Humana ChoiceCare |
$742.78
|
| Rate for Payer: Humana Medicare |
$438.60
|
| Rate for Payer: Lucent All Commercial |
$438.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$774.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$645.00
|
| Rate for Payer: PHP All Commercial |
$652.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$335.40
|
| Rate for Payer: Sagamore Health Network All Products |
$663.92
|
| Rate for Payer: Signature Care EPO |
$713.80
|
| Rate for Payer: Signature Care PPO |
$756.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$731.00
|
| Rate for Payer: United Healthcare Commercial |
$677.68
|
| Rate for Payer: United Healthcare Medicare |
$283.80
|
|
|
HC S T8 SCREW BONE 2.7X18 FT
|
Facility
IP
|
$860.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603926
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$645.00 |
| Max. Negotiated Rate |
$799.80 |
| Rate for Payer: Aetna Commercial |
$743.04
|
| Rate for Payer: Cash Price |
$533.20
|
| Rate for Payer: Cigna All Commercial |
$742.18
|
| Rate for Payer: CORVEL All Commercial |
$799.80
|
| Rate for Payer: Coventry All Commercial |
$756.80
|
| Rate for Payer: Encore All Commercial |
$791.63
|
| Rate for Payer: Frontpath All Commercial |
$791.20
|
| Rate for Payer: Humana ChoiceCare |
$742.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$774.00
|
| Rate for Payer: PHCS All Commercial |
$645.00
|
| Rate for Payer: PHP All Commercial |
$652.22
|
| Rate for Payer: Sagamore Health Network All Products |
$663.92
|
| Rate for Payer: Signature Care EPO |
$713.80
|
| Rate for Payer: Signature Care PPO |
$756.80
|
| Rate for Payer: United Healthcare Commercial |
$677.68
|
|
|
HC S T8 SCREW BONE 2.7X18 FT
|
Facility
OP
|
$860.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603926
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$283.80 |
| Max. Negotiated Rate |
$799.80 |
| Rate for Payer: Aetna Commercial |
$725.84
|
| Rate for Payer: Aetna Medicare |
$283.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$283.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$493.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$537.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$326.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$312.18
|
| Rate for Payer: Cash Price |
$533.20
|
| Rate for Payer: Cash Price |
$533.20
|
| Rate for Payer: Centivo All Commercial |
$438.60
|
| Rate for Payer: Cigna All Commercial |
$742.18
|
| Rate for Payer: CORVEL All Commercial |
$799.80
|
| Rate for Payer: Coventry All Commercial |
$756.80
|
| Rate for Payer: Encore All Commercial |
$791.63
|
| Rate for Payer: Frontpath All Commercial |
$791.20
|
| Rate for Payer: Humana ChoiceCare |
$742.78
|
| Rate for Payer: Humana Medicare |
$438.60
|
| Rate for Payer: Lucent All Commercial |
$438.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$774.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$645.00
|
| Rate for Payer: PHP All Commercial |
$652.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$335.40
|
| Rate for Payer: Sagamore Health Network All Products |
$663.92
|
| Rate for Payer: Signature Care EPO |
$713.80
|
| Rate for Payer: Signature Care PPO |
$756.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$731.00
|
| Rate for Payer: United Healthcare Commercial |
$677.68
|
| Rate for Payer: United Healthcare Medicare |
$283.80
|
|
|
HC S T8 SCREW BONE 2.7X22 FT
|
Facility
OP
|
$860.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603927
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$283.80 |
| Max. Negotiated Rate |
$799.80 |
| Rate for Payer: Aetna Commercial |
$725.84
|
| Rate for Payer: Aetna Medicare |
$283.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$283.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$493.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$537.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$326.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$312.18
|
| Rate for Payer: Cash Price |
$533.20
|
| Rate for Payer: Cash Price |
$533.20
|
| Rate for Payer: Centivo All Commercial |
$438.60
|
| Rate for Payer: Cigna All Commercial |
$742.18
|
| Rate for Payer: CORVEL All Commercial |
$799.80
|
| Rate for Payer: Coventry All Commercial |
$756.80
|
| Rate for Payer: Encore All Commercial |
$791.63
|
| Rate for Payer: Frontpath All Commercial |
$791.20
|
| Rate for Payer: Humana ChoiceCare |
$742.78
|
| Rate for Payer: Humana Medicare |
$438.60
|
| Rate for Payer: Lucent All Commercial |
$438.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$774.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$645.00
|
| Rate for Payer: PHP All Commercial |
$652.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$335.40
|
| Rate for Payer: Sagamore Health Network All Products |
$663.92
|
| Rate for Payer: Signature Care EPO |
$713.80
|
| Rate for Payer: Signature Care PPO |
$756.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$731.00
|
| Rate for Payer: United Healthcare Commercial |
$677.68
|
| Rate for Payer: United Healthcare Medicare |
$283.80
|
|
|
HC S T8 SCREW BONE 2.7X22 FT
|
Facility
IP
|
$860.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603927
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$645.00 |
| Max. Negotiated Rate |
$799.80 |
| Rate for Payer: Aetna Commercial |
$743.04
|
| Rate for Payer: Cash Price |
$533.20
|
| Rate for Payer: Cigna All Commercial |
$742.18
|
| Rate for Payer: CORVEL All Commercial |
$799.80
|
| Rate for Payer: Coventry All Commercial |
$756.80
|
| Rate for Payer: Encore All Commercial |
$791.63
|
| Rate for Payer: Frontpath All Commercial |
$791.20
|
| Rate for Payer: Humana ChoiceCare |
$742.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$774.00
|
| Rate for Payer: PHCS All Commercial |
$645.00
|
| Rate for Payer: PHP All Commercial |
$652.22
|
| Rate for Payer: Sagamore Health Network All Products |
$663.92
|
| Rate for Payer: Signature Care EPO |
$713.80
|
| Rate for Payer: Signature Care PPO |
$756.80
|
| Rate for Payer: United Healthcare Commercial |
$677.68
|
|
|
HC STAGRAFT DBM PLUS 10 CC
|
Facility
IP
|
$6,240.56
|
|
|
Service Code
|
CPT C9359
|
| Hospital Charge Code |
41602460
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,680.42 |
| Max. Negotiated Rate |
$5,803.72 |
| Rate for Payer: Aetna Commercial |
$5,391.84
|
| Rate for Payer: Cash Price |
$3,869.15
|
| Rate for Payer: Cigna All Commercial |
$5,385.60
|
| Rate for Payer: CORVEL All Commercial |
$5,803.72
|
| Rate for Payer: Coventry All Commercial |
$5,491.69
|
| Rate for Payer: Encore All Commercial |
$5,744.44
|
| Rate for Payer: Frontpath All Commercial |
$5,741.32
|
| Rate for Payer: Humana ChoiceCare |
$5,389.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,616.50
|
| Rate for Payer: PHCS All Commercial |
$4,680.42
|
| Rate for Payer: PHP All Commercial |
$4,732.84
|
| Rate for Payer: Sagamore Health Network All Products |
$4,817.71
|
| Rate for Payer: Signature Care EPO |
$5,179.66
|
| Rate for Payer: Signature Care PPO |
$5,491.69
|
| Rate for Payer: United Healthcare Commercial |
$4,917.56
|
|
|
HC STAGRAFT DBM PLUS 10 CC
|
Facility
OP
|
$6,240.56
|
|
|
Service Code
|
CPT C9359
|
| Hospital Charge Code |
41602460
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,803.72 |
| Rate for Payer: Aetna Commercial |
$5,267.03
|
| Rate for Payer: Aetna Medicare |
$2,059.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,059.38
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,583.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,900.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,368.29
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,265.32
|
| Rate for Payer: Cash Price |
$3,869.15
|
| Rate for Payer: Cash Price |
$3,869.15
|
| Rate for Payer: Centivo All Commercial |
$3,182.69
|
| Rate for Payer: Cigna All Commercial |
$5,385.60
|
| Rate for Payer: CORVEL All Commercial |
$5,803.72
|
| Rate for Payer: Coventry All Commercial |
$5,491.69
|
| Rate for Payer: Encore All Commercial |
$5,744.44
|
| Rate for Payer: Frontpath All Commercial |
$5,741.32
|
| Rate for Payer: Humana ChoiceCare |
$5,389.97
|
| Rate for Payer: Humana Medicare |
$3,182.69
|
| Rate for Payer: Lucent All Commercial |
$3,182.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,616.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,680.42
|
| Rate for Payer: PHP All Commercial |
$4,732.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,433.82
|
| Rate for Payer: Sagamore Health Network All Products |
$4,817.71
|
| Rate for Payer: Signature Care EPO |
$5,179.66
|
| Rate for Payer: Signature Care PPO |
$5,491.69
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,304.48
|
| Rate for Payer: United Healthcare Commercial |
$4,917.56
|
| Rate for Payer: United Healthcare Medicare |
$2,059.38
|
|
|
HC STAGRAFT DBM PLUS 5 CC
|
Facility
IP
|
$4,089.60
|
|
|
Service Code
|
CPT C9359
|
| Hospital Charge Code |
41602461
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,067.20 |
| Max. Negotiated Rate |
$3,803.33 |
| Rate for Payer: Aetna Commercial |
$3,533.41
|
| Rate for Payer: Cash Price |
$2,535.55
|
| Rate for Payer: Cigna All Commercial |
$3,529.32
|
| Rate for Payer: CORVEL All Commercial |
$3,803.33
|
| Rate for Payer: Coventry All Commercial |
$3,598.85
|
| Rate for Payer: Encore All Commercial |
$3,764.48
|
| Rate for Payer: Frontpath All Commercial |
$3,762.43
|
| Rate for Payer: Humana ChoiceCare |
$3,532.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,680.64
|
| Rate for Payer: PHCS All Commercial |
$3,067.20
|
| Rate for Payer: PHP All Commercial |
$3,101.55
|
| Rate for Payer: Sagamore Health Network All Products |
$3,157.17
|
| Rate for Payer: Signature Care EPO |
$3,394.37
|
| Rate for Payer: Signature Care PPO |
$3,598.85
|
| Rate for Payer: United Healthcare Commercial |
$3,222.60
|
|
|
HC STAGRAFT DBM PLUS 5 CC
|
Facility
OP
|
$4,089.60
|
|
|
Service Code
|
CPT C9359
|
| Hospital Charge Code |
41602461
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,803.33 |
| Rate for Payer: Aetna Commercial |
$3,451.62
|
| Rate for Payer: Aetna Medicare |
$1,349.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,349.57
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,348.66
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,556.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,552.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,484.52
|
| Rate for Payer: Cash Price |
$2,535.55
|
| Rate for Payer: Cash Price |
$2,535.55
|
| Rate for Payer: Centivo All Commercial |
$2,085.70
|
| Rate for Payer: Cigna All Commercial |
$3,529.32
|
| Rate for Payer: CORVEL All Commercial |
$3,803.33
|
| Rate for Payer: Coventry All Commercial |
$3,598.85
|
| Rate for Payer: Encore All Commercial |
$3,764.48
|
| Rate for Payer: Frontpath All Commercial |
$3,762.43
|
| Rate for Payer: Humana ChoiceCare |
$3,532.19
|
| Rate for Payer: Humana Medicare |
$2,085.70
|
| Rate for Payer: Lucent All Commercial |
$2,085.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,680.64
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,067.20
|
| Rate for Payer: PHP All Commercial |
$3,101.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,594.94
|
| Rate for Payer: Sagamore Health Network All Products |
$3,157.17
|
| Rate for Payer: Signature Care EPO |
$3,394.37
|
| Rate for Payer: Signature Care PPO |
$3,598.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,476.16
|
| Rate for Payer: United Healthcare Commercial |
$3,222.60
|
| Rate for Payer: United Healthcare Medicare |
$1,349.57
|
|
|
HC STAPLE ENDO 65 4.8
|
Facility
IP
|
$874.73
|
|
| Hospital Charge Code |
41602093
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$656.05 |
| Max. Negotiated Rate |
$813.50 |
| Rate for Payer: Aetna Commercial |
$755.77
|
| Rate for Payer: Cash Price |
$542.33
|
| Rate for Payer: Cigna All Commercial |
$754.89
|
| Rate for Payer: CORVEL All Commercial |
$813.50
|
| Rate for Payer: Coventry All Commercial |
$769.76
|
| Rate for Payer: Encore All Commercial |
$805.19
|
| Rate for Payer: Frontpath All Commercial |
$804.75
|
| Rate for Payer: Humana ChoiceCare |
$755.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$787.26
|
| Rate for Payer: PHCS All Commercial |
$656.05
|
| Rate for Payer: PHP All Commercial |
$663.40
|
| Rate for Payer: Sagamore Health Network All Products |
$675.29
|
| Rate for Payer: Signature Care EPO |
$726.03
|
| Rate for Payer: Signature Care PPO |
$769.76
|
| Rate for Payer: United Healthcare Commercial |
$689.29
|
|
|
HC STAPLE ENDO 65 4.8
|
Facility
OP
|
$874.73
|
|
| Hospital Charge Code |
41602093
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$96.84 |
| Max. Negotiated Rate |
$813.50 |
| Rate for Payer: Aetna Commercial |
$738.27
|
| Rate for Payer: Aetna Medicare |
$288.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$288.66
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$502.36
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$546.79
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$96.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$331.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$317.53
|
| Rate for Payer: Cash Price |
$542.33
|
| Rate for Payer: Cash Price |
$542.33
|
| Rate for Payer: Centivo All Commercial |
$446.11
|
| Rate for Payer: Cigna All Commercial |
$754.89
|
| Rate for Payer: CORVEL All Commercial |
$813.50
|
| Rate for Payer: Coventry All Commercial |
$769.76
|
| Rate for Payer: Encore All Commercial |
$805.19
|
| Rate for Payer: Frontpath All Commercial |
$804.75
|
| Rate for Payer: Humana ChoiceCare |
$755.50
|
| Rate for Payer: Humana Medicare |
$446.11
|
| Rate for Payer: Lucent All Commercial |
$446.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$787.26
|
| Rate for Payer: Managed Health Services Medicaid |
$96.84
|
| Rate for Payer: MDWise Medicaid |
$96.84
|
| Rate for Payer: PHCS All Commercial |
$656.05
|
| Rate for Payer: PHP All Commercial |
$663.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$341.14
|
| Rate for Payer: Sagamore Health Network All Products |
$675.29
|
| Rate for Payer: Signature Care EPO |
$726.03
|
| Rate for Payer: Signature Care PPO |
$769.76
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$743.52
|
| Rate for Payer: United Healthcare Commercial |
$689.29
|
| Rate for Payer: United Healthcare Medicare |
$288.66
|
|
|
HC STAPLE QUICK FIX SM 10MM
|
Facility
OP
|
$847.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601330
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$96.84 |
| Max. Negotiated Rate |
$787.71 |
| Rate for Payer: Aetna Commercial |
$714.87
|
| Rate for Payer: Aetna Medicare |
$279.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$279.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$486.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$529.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$96.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$321.44
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$307.46
|
| Rate for Payer: Cash Price |
$525.14
|
| Rate for Payer: Cash Price |
$525.14
|
| Rate for Payer: Centivo All Commercial |
$431.97
|
| Rate for Payer: Cigna All Commercial |
$730.96
|
| Rate for Payer: CORVEL All Commercial |
$787.71
|
| Rate for Payer: Coventry All Commercial |
$745.36
|
| Rate for Payer: Encore All Commercial |
$779.66
|
| Rate for Payer: Frontpath All Commercial |
$779.24
|
| Rate for Payer: Humana ChoiceCare |
$731.55
|
| Rate for Payer: Humana Medicare |
$431.97
|
| Rate for Payer: Lucent All Commercial |
$431.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$762.30
|
| Rate for Payer: Managed Health Services Medicaid |
$96.84
|
| Rate for Payer: MDWise Medicaid |
$96.84
|
| Rate for Payer: PHCS All Commercial |
$635.25
|
| Rate for Payer: PHP All Commercial |
$642.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$330.33
|
| Rate for Payer: Sagamore Health Network All Products |
$653.88
|
| Rate for Payer: Signature Care EPO |
$703.01
|
| Rate for Payer: Signature Care PPO |
$745.36
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$719.95
|
| Rate for Payer: United Healthcare Commercial |
$667.44
|
| Rate for Payer: United Healthcare Medicare |
$279.51
|
|
|
HC STAPLE QUICK FIX SM 10MM
|
Facility
IP
|
$847.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601330
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$635.25 |
| Max. Negotiated Rate |
$787.71 |
| Rate for Payer: Aetna Commercial |
$731.81
|
| Rate for Payer: Cash Price |
$525.14
|
| Rate for Payer: Cigna All Commercial |
$730.96
|
| Rate for Payer: CORVEL All Commercial |
$787.71
|
| Rate for Payer: Coventry All Commercial |
$745.36
|
| Rate for Payer: Encore All Commercial |
$779.66
|
| Rate for Payer: Frontpath All Commercial |
$779.24
|
| Rate for Payer: Humana ChoiceCare |
$731.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$762.30
|
| Rate for Payer: PHCS All Commercial |
$635.25
|
| Rate for Payer: PHP All Commercial |
$642.36
|
| Rate for Payer: Sagamore Health Network All Products |
$653.88
|
| Rate for Payer: Signature Care EPO |
$703.01
|
| Rate for Payer: Signature Care PPO |
$745.36
|
| Rate for Payer: United Healthcare Commercial |
$667.44
|
|
|
HC STAPLE QUICK FIX SM 8MM
|
Facility
IP
|
$847.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601331
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$635.25 |
| Max. Negotiated Rate |
$787.71 |
| Rate for Payer: Aetna Commercial |
$731.81
|
| Rate for Payer: Cash Price |
$525.14
|
| Rate for Payer: Cigna All Commercial |
$730.96
|
| Rate for Payer: CORVEL All Commercial |
$787.71
|
| Rate for Payer: Coventry All Commercial |
$745.36
|
| Rate for Payer: Encore All Commercial |
$779.66
|
| Rate for Payer: Frontpath All Commercial |
$779.24
|
| Rate for Payer: Humana ChoiceCare |
$731.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$762.30
|
| Rate for Payer: PHCS All Commercial |
$635.25
|
| Rate for Payer: PHP All Commercial |
$642.36
|
| Rate for Payer: Sagamore Health Network All Products |
$653.88
|
| Rate for Payer: Signature Care EPO |
$703.01
|
| Rate for Payer: Signature Care PPO |
$745.36
|
| Rate for Payer: United Healthcare Commercial |
$667.44
|
|
|
HC STAPLE QUICK FIX SM 8MM
|
Facility
OP
|
$847.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41601331
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$96.84 |
| Max. Negotiated Rate |
$787.71 |
| Rate for Payer: Aetna Commercial |
$714.87
|
| Rate for Payer: Aetna Medicare |
$279.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$279.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$486.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$529.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$96.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$321.44
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$307.46
|
| Rate for Payer: Cash Price |
$525.14
|
| Rate for Payer: Cash Price |
$525.14
|
| Rate for Payer: Centivo All Commercial |
$431.97
|
| Rate for Payer: Cigna All Commercial |
$730.96
|
| Rate for Payer: CORVEL All Commercial |
$787.71
|
| Rate for Payer: Coventry All Commercial |
$745.36
|
| Rate for Payer: Encore All Commercial |
$779.66
|
| Rate for Payer: Frontpath All Commercial |
$779.24
|
| Rate for Payer: Humana ChoiceCare |
$731.55
|
| Rate for Payer: Humana Medicare |
$431.97
|
| Rate for Payer: Lucent All Commercial |
$431.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$762.30
|
| Rate for Payer: Managed Health Services Medicaid |
$96.84
|
| Rate for Payer: MDWise Medicaid |
$96.84
|
| Rate for Payer: PHCS All Commercial |
$635.25
|
| Rate for Payer: PHP All Commercial |
$642.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$330.33
|
| Rate for Payer: Sagamore Health Network All Products |
$653.88
|
| Rate for Payer: Signature Care EPO |
$703.01
|
| Rate for Payer: Signature Care PPO |
$745.36
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$719.95
|
| Rate for Payer: United Healthcare Commercial |
$667.44
|
| Rate for Payer: United Healthcare Medicare |
$279.51
|
|
|
HC STAPLER 45 MM ECHELON 340MM
|
Facility
IP
|
$2,165.23
|
|
| Hospital Charge Code |
41607896
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,623.92 |
| Max. Negotiated Rate |
$2,013.66 |
| Rate for Payer: Aetna Commercial |
$1,870.76
|
| Rate for Payer: Cash Price |
$1,342.44
|
| Rate for Payer: Cigna All Commercial |
$1,868.59
|
| Rate for Payer: CORVEL All Commercial |
$2,013.66
|
| Rate for Payer: Coventry All Commercial |
$1,905.40
|
| Rate for Payer: Encore All Commercial |
$1,993.09
|
| Rate for Payer: Frontpath All Commercial |
$1,992.01
|
| Rate for Payer: Humana ChoiceCare |
$1,870.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,948.71
|
| Rate for Payer: PHCS All Commercial |
$1,623.92
|
| Rate for Payer: PHP All Commercial |
$1,642.11
|
| Rate for Payer: Sagamore Health Network All Products |
$1,671.56
|
| Rate for Payer: Signature Care EPO |
$1,797.14
|
| Rate for Payer: Signature Care PPO |
$1,905.40
|
| Rate for Payer: United Healthcare Commercial |
$1,706.20
|
|
|
HC STAPLER 45 MM ECHELON 340MM
|
Facility
OP
|
$2,165.23
|
|
| Hospital Charge Code |
41607896
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$2,013.66 |
| Rate for Payer: Aetna Commercial |
$1,827.45
|
| Rate for Payer: Aetna Medicare |
$714.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$714.53
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,243.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,353.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$821.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$785.98
|
| Rate for Payer: Cash Price |
$1,342.44
|
| Rate for Payer: Cash Price |
$1,342.44
|
| Rate for Payer: Centivo All Commercial |
$1,104.27
|
| Rate for Payer: Cigna All Commercial |
$1,868.59
|
| Rate for Payer: CORVEL All Commercial |
$2,013.66
|
| Rate for Payer: Coventry All Commercial |
$1,905.40
|
| Rate for Payer: Encore All Commercial |
$1,993.09
|
| Rate for Payer: Frontpath All Commercial |
$1,992.01
|
| Rate for Payer: Humana ChoiceCare |
$1,870.11
|
| Rate for Payer: Humana Medicare |
$1,104.27
|
| Rate for Payer: Lucent All Commercial |
$1,104.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,948.71
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,623.92
|
| Rate for Payer: PHP All Commercial |
$1,642.11
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$844.44
|
| Rate for Payer: Sagamore Health Network All Products |
$1,671.56
|
| Rate for Payer: Signature Care EPO |
$1,797.14
|
| Rate for Payer: Signature Care PPO |
$1,905.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,840.45
|
| Rate for Payer: United Healthcare Commercial |
$1,706.20
|
| Rate for Payer: United Healthcare Medicare |
$714.53
|
|
