|
HC W K-WIRE 1.4X150 BLUNT TROC
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604344
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.30 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$177.24
|
| Rate for Payer: Aetna Medicare |
$69.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$69.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$120.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$131.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$79.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$76.23
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Centivo All Commercial |
$107.10
|
| Rate for Payer: Cigna All Commercial |
$181.23
|
| Rate for Payer: CORVEL All Commercial |
$195.30
|
| Rate for Payer: Coventry All Commercial |
$184.80
|
| Rate for Payer: Encore All Commercial |
$193.30
|
| Rate for Payer: Frontpath All Commercial |
$193.20
|
| Rate for Payer: Humana ChoiceCare |
$181.38
|
| Rate for Payer: Humana Medicare |
$107.10
|
| Rate for Payer: Lucent All Commercial |
$107.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$189.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$157.50
|
| Rate for Payer: PHP All Commercial |
$159.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$81.90
|
| Rate for Payer: Sagamore Health Network All Products |
$162.12
|
| Rate for Payer: Signature Care EPO |
$174.30
|
| Rate for Payer: Signature Care PPO |
$184.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$178.50
|
| Rate for Payer: United Healthcare Commercial |
$165.48
|
| Rate for Payer: United Healthcare Medicare |
$69.30
|
|
|
HC W K-WIRE 1.6 150 TROC TIP
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604371
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$157.50 |
| Max. Negotiated Rate |
$195.30 |
| Rate for Payer: Aetna Commercial |
$181.44
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Cigna All Commercial |
$181.23
|
| Rate for Payer: CORVEL All Commercial |
$195.30
|
| Rate for Payer: Coventry All Commercial |
$184.80
|
| Rate for Payer: Encore All Commercial |
$193.30
|
| Rate for Payer: Frontpath All Commercial |
$193.20
|
| Rate for Payer: Humana ChoiceCare |
$181.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$189.00
|
| Rate for Payer: PHCS All Commercial |
$157.50
|
| Rate for Payer: PHP All Commercial |
$159.26
|
| Rate for Payer: Sagamore Health Network All Products |
$162.12
|
| Rate for Payer: Signature Care EPO |
$174.30
|
| Rate for Payer: Signature Care PPO |
$184.80
|
| Rate for Payer: United Healthcare Commercial |
$165.48
|
|
|
HC W K-WIRE 1.6 150 TROC TIP
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604371
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.30 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$177.24
|
| Rate for Payer: Aetna Medicare |
$69.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$69.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$120.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$131.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$79.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$76.23
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Centivo All Commercial |
$107.10
|
| Rate for Payer: Cigna All Commercial |
$181.23
|
| Rate for Payer: CORVEL All Commercial |
$195.30
|
| Rate for Payer: Coventry All Commercial |
$184.80
|
| Rate for Payer: Encore All Commercial |
$193.30
|
| Rate for Payer: Frontpath All Commercial |
$193.20
|
| Rate for Payer: Humana ChoiceCare |
$181.38
|
| Rate for Payer: Humana Medicare |
$107.10
|
| Rate for Payer: Lucent All Commercial |
$107.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$189.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$157.50
|
| Rate for Payer: PHP All Commercial |
$159.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$81.90
|
| Rate for Payer: Sagamore Health Network All Products |
$162.12
|
| Rate for Payer: Signature Care EPO |
$174.30
|
| Rate for Payer: Signature Care PPO |
$184.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$178.50
|
| Rate for Payer: United Healthcare Commercial |
$165.48
|
| Rate for Payer: United Healthcare Medicare |
$69.30
|
|
|
HC W K-WIRE 1.6X150 01615
|
Facility
|
IP
|
$658.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605807
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$493.50 |
| Max. Negotiated Rate |
$611.94 |
| Rate for Payer: Aetna Commercial |
$568.51
|
| Rate for Payer: Cash Price |
$407.96
|
| Rate for Payer: Cigna All Commercial |
$567.85
|
| Rate for Payer: CORVEL All Commercial |
$611.94
|
| Rate for Payer: Coventry All Commercial |
$579.04
|
| Rate for Payer: Encore All Commercial |
$605.69
|
| Rate for Payer: Frontpath All Commercial |
$605.36
|
| Rate for Payer: Humana ChoiceCare |
$568.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$592.20
|
| Rate for Payer: PHCS All Commercial |
$493.50
|
| Rate for Payer: PHP All Commercial |
$499.03
|
| Rate for Payer: Sagamore Health Network All Products |
$507.98
|
| Rate for Payer: Signature Care EPO |
$546.14
|
| Rate for Payer: Signature Care PPO |
$579.04
|
| Rate for Payer: United Healthcare Commercial |
$518.50
|
|
|
HC W K-WIRE 1.6X150 01615
|
Facility
|
OP
|
$658.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605807
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$217.14 |
| Max. Negotiated Rate |
$611.94 |
| Rate for Payer: Aetna Commercial |
$555.35
|
| Rate for Payer: Aetna Medicare |
$217.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$217.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$377.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$411.32
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$249.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$238.85
|
| Rate for Payer: Cash Price |
$407.96
|
| Rate for Payer: Cash Price |
$407.96
|
| Rate for Payer: Centivo All Commercial |
$335.58
|
| Rate for Payer: Cigna All Commercial |
$567.85
|
| Rate for Payer: CORVEL All Commercial |
$611.94
|
| Rate for Payer: Coventry All Commercial |
$579.04
|
| Rate for Payer: Encore All Commercial |
$605.69
|
| Rate for Payer: Frontpath All Commercial |
$605.36
|
| Rate for Payer: Humana ChoiceCare |
$568.31
|
| Rate for Payer: Humana Medicare |
$335.58
|
| Rate for Payer: Lucent All Commercial |
$335.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$592.20
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$493.50
|
| Rate for Payer: PHP All Commercial |
$499.03
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$256.62
|
| Rate for Payer: Sagamore Health Network All Products |
$507.98
|
| Rate for Payer: Signature Care EPO |
$546.14
|
| Rate for Payer: Signature Care PPO |
$579.04
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$559.30
|
| Rate for Payer: United Healthcare Commercial |
$518.50
|
| Rate for Payer: United Healthcare Medicare |
$217.14
|
|
|
HC W K-WIRE 1.6X150 1615
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605801
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.30 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$177.24
|
| Rate for Payer: Aetna Medicare |
$69.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$69.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$120.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$131.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$79.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$76.23
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Centivo All Commercial |
$107.10
|
| Rate for Payer: Cigna All Commercial |
$181.23
|
| Rate for Payer: CORVEL All Commercial |
$195.30
|
| Rate for Payer: Coventry All Commercial |
$184.80
|
| Rate for Payer: Encore All Commercial |
$193.30
|
| Rate for Payer: Frontpath All Commercial |
$193.20
|
| Rate for Payer: Humana ChoiceCare |
$181.38
|
| Rate for Payer: Humana Medicare |
$107.10
|
| Rate for Payer: Lucent All Commercial |
$107.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$189.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$157.50
|
| Rate for Payer: PHP All Commercial |
$159.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$81.90
|
| Rate for Payer: Sagamore Health Network All Products |
$162.12
|
| Rate for Payer: Signature Care EPO |
$174.30
|
| Rate for Payer: Signature Care PPO |
$184.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$178.50
|
| Rate for Payer: United Healthcare Commercial |
$165.48
|
| Rate for Payer: United Healthcare Medicare |
$69.30
|
|
|
HC W K-WIRE 1.6X150 1615
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605801
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$157.50 |
| Max. Negotiated Rate |
$195.30 |
| Rate for Payer: Aetna Commercial |
$181.44
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Cigna All Commercial |
$181.23
|
| Rate for Payer: CORVEL All Commercial |
$195.30
|
| Rate for Payer: Coventry All Commercial |
$184.80
|
| Rate for Payer: Encore All Commercial |
$193.30
|
| Rate for Payer: Frontpath All Commercial |
$193.20
|
| Rate for Payer: Humana ChoiceCare |
$181.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$189.00
|
| Rate for Payer: PHCS All Commercial |
$157.50
|
| Rate for Payer: PHP All Commercial |
$159.26
|
| Rate for Payer: Sagamore Health Network All Products |
$162.12
|
| Rate for Payer: Signature Care EPO |
$174.30
|
| Rate for Payer: Signature Care PPO |
$184.80
|
| Rate for Payer: United Healthcare Commercial |
$165.48
|
|
|
HC W KWIRE 1.9
|
Facility
|
OP
|
$126.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606913
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.58 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$106.34
|
| Rate for Payer: Aetna Medicare |
$41.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$41.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$72.36
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$78.76
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$47.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$45.74
|
| Rate for Payer: Cash Price |
$78.12
|
| Rate for Payer: Cash Price |
$78.12
|
| Rate for Payer: Centivo All Commercial |
$64.26
|
| Rate for Payer: Cigna All Commercial |
$108.74
|
| Rate for Payer: CORVEL All Commercial |
$117.18
|
| Rate for Payer: Coventry All Commercial |
$110.88
|
| Rate for Payer: Encore All Commercial |
$115.98
|
| Rate for Payer: Frontpath All Commercial |
$115.92
|
| Rate for Payer: Humana ChoiceCare |
$108.83
|
| Rate for Payer: Humana Medicare |
$64.26
|
| Rate for Payer: Lucent All Commercial |
$64.26
|
| Rate for Payer: Lutheran Preferred All Commercial |
$113.40
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$94.50
|
| Rate for Payer: PHP All Commercial |
$95.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$49.14
|
| Rate for Payer: Sagamore Health Network All Products |
$97.27
|
| Rate for Payer: Signature Care EPO |
$104.58
|
| Rate for Payer: Signature Care PPO |
$110.88
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$107.10
|
| Rate for Payer: United Healthcare Commercial |
$99.29
|
| Rate for Payer: United Healthcare Medicare |
$41.58
|
|
|
HC W KWIRE 1.9
|
Facility
|
IP
|
$126.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606913
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$94.50 |
| Max. Negotiated Rate |
$117.18 |
| Rate for Payer: Aetna Commercial |
$108.86
|
| Rate for Payer: Cash Price |
$78.12
|
| Rate for Payer: Cigna All Commercial |
$108.74
|
| Rate for Payer: CORVEL All Commercial |
$117.18
|
| Rate for Payer: Coventry All Commercial |
$110.88
|
| Rate for Payer: Encore All Commercial |
$115.98
|
| Rate for Payer: Frontpath All Commercial |
$115.92
|
| Rate for Payer: Humana ChoiceCare |
$108.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$113.40
|
| Rate for Payer: PHCS All Commercial |
$94.50
|
| Rate for Payer: PHP All Commercial |
$95.56
|
| Rate for Payer: Sagamore Health Network All Products |
$97.27
|
| Rate for Payer: Signature Care EPO |
$104.58
|
| Rate for Payer: Signature Care PPO |
$110.88
|
| Rate for Payer: United Healthcare Commercial |
$99.29
|
|
|
HC W K-WIRE 2.0X228
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606217
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$157.50 |
| Max. Negotiated Rate |
$195.30 |
| Rate for Payer: Aetna Commercial |
$181.44
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Cigna All Commercial |
$181.23
|
| Rate for Payer: CORVEL All Commercial |
$195.30
|
| Rate for Payer: Coventry All Commercial |
$184.80
|
| Rate for Payer: Encore All Commercial |
$193.30
|
| Rate for Payer: Frontpath All Commercial |
$193.20
|
| Rate for Payer: Humana ChoiceCare |
$181.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$189.00
|
| Rate for Payer: PHCS All Commercial |
$157.50
|
| Rate for Payer: PHP All Commercial |
$159.26
|
| Rate for Payer: Sagamore Health Network All Products |
$162.12
|
| Rate for Payer: Signature Care EPO |
$174.30
|
| Rate for Payer: Signature Care PPO |
$184.80
|
| Rate for Payer: United Healthcare Commercial |
$165.48
|
|
|
HC W K-WIRE 2.0X228
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606217
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.30 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$177.24
|
| Rate for Payer: Aetna Medicare |
$69.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$69.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$120.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$131.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$79.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$76.23
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Centivo All Commercial |
$107.10
|
| Rate for Payer: Cigna All Commercial |
$181.23
|
| Rate for Payer: CORVEL All Commercial |
$195.30
|
| Rate for Payer: Coventry All Commercial |
$184.80
|
| Rate for Payer: Encore All Commercial |
$193.30
|
| Rate for Payer: Frontpath All Commercial |
$193.20
|
| Rate for Payer: Humana ChoiceCare |
$181.38
|
| Rate for Payer: Humana Medicare |
$107.10
|
| Rate for Payer: Lucent All Commercial |
$107.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$189.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$157.50
|
| Rate for Payer: PHP All Commercial |
$159.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$81.90
|
| Rate for Payer: Sagamore Health Network All Products |
$162.12
|
| Rate for Payer: Signature Care EPO |
$174.30
|
| Rate for Payer: Signature Care PPO |
$184.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$178.50
|
| Rate for Payer: United Healthcare Commercial |
$165.48
|
| Rate for Payer: United Healthcare Medicare |
$69.30
|
|
|
HC W KWIRE 2.3
|
Facility
|
IP
|
$217.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606914
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$162.75 |
| Max. Negotiated Rate |
$201.81 |
| Rate for Payer: Aetna Commercial |
$187.49
|
| Rate for Payer: Cash Price |
$134.54
|
| Rate for Payer: Cigna All Commercial |
$187.27
|
| Rate for Payer: CORVEL All Commercial |
$201.81
|
| Rate for Payer: Coventry All Commercial |
$190.96
|
| Rate for Payer: Encore All Commercial |
$199.75
|
| Rate for Payer: Frontpath All Commercial |
$199.64
|
| Rate for Payer: Humana ChoiceCare |
$187.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$195.30
|
| Rate for Payer: PHCS All Commercial |
$162.75
|
| Rate for Payer: PHP All Commercial |
$164.57
|
| Rate for Payer: Sagamore Health Network All Products |
$167.52
|
| Rate for Payer: Signature Care EPO |
$180.11
|
| Rate for Payer: Signature Care PPO |
$190.96
|
| Rate for Payer: United Healthcare Commercial |
$171.00
|
|
|
HC W KWIRE 2.3
|
Facility
|
OP
|
$217.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606914
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$71.61 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$183.15
|
| Rate for Payer: Aetna Medicare |
$71.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$71.61
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$124.62
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$135.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$82.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$78.77
|
| Rate for Payer: Cash Price |
$134.54
|
| Rate for Payer: Cash Price |
$134.54
|
| Rate for Payer: Centivo All Commercial |
$110.67
|
| Rate for Payer: Cigna All Commercial |
$187.27
|
| Rate for Payer: CORVEL All Commercial |
$201.81
|
| Rate for Payer: Coventry All Commercial |
$190.96
|
| Rate for Payer: Encore All Commercial |
$199.75
|
| Rate for Payer: Frontpath All Commercial |
$199.64
|
| Rate for Payer: Humana ChoiceCare |
$187.42
|
| Rate for Payer: Humana Medicare |
$110.67
|
| Rate for Payer: Lucent All Commercial |
$110.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$195.30
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$162.75
|
| Rate for Payer: PHP All Commercial |
$164.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$84.63
|
| Rate for Payer: Sagamore Health Network All Products |
$167.52
|
| Rate for Payer: Signature Care EPO |
$180.11
|
| Rate for Payer: Signature Care PPO |
$190.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$184.45
|
| Rate for Payer: United Healthcare Commercial |
$171.00
|
| Rate for Payer: United Healthcare Medicare |
$71.61
|
|
|
HC W K-WIRE 2.5X150
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604345
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$157.50 |
| Max. Negotiated Rate |
$195.30 |
| Rate for Payer: Aetna Commercial |
$181.44
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Cigna All Commercial |
$181.23
|
| Rate for Payer: CORVEL All Commercial |
$195.30
|
| Rate for Payer: Coventry All Commercial |
$184.80
|
| Rate for Payer: Encore All Commercial |
$193.30
|
| Rate for Payer: Frontpath All Commercial |
$193.20
|
| Rate for Payer: Humana ChoiceCare |
$181.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$189.00
|
| Rate for Payer: PHCS All Commercial |
$157.50
|
| Rate for Payer: PHP All Commercial |
$159.26
|
| Rate for Payer: Sagamore Health Network All Products |
$162.12
|
| Rate for Payer: Signature Care EPO |
$174.30
|
| Rate for Payer: Signature Care PPO |
$184.80
|
| Rate for Payer: United Healthcare Commercial |
$165.48
|
|
|
HC W K-WIRE 2.5X150
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604345
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.30 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$177.24
|
| Rate for Payer: Aetna Medicare |
$69.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$69.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$120.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$131.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$79.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$76.23
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Centivo All Commercial |
$107.10
|
| Rate for Payer: Cigna All Commercial |
$181.23
|
| Rate for Payer: CORVEL All Commercial |
$195.30
|
| Rate for Payer: Coventry All Commercial |
$184.80
|
| Rate for Payer: Encore All Commercial |
$193.30
|
| Rate for Payer: Frontpath All Commercial |
$193.20
|
| Rate for Payer: Humana ChoiceCare |
$181.38
|
| Rate for Payer: Humana Medicare |
$107.10
|
| Rate for Payer: Lucent All Commercial |
$107.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$189.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$157.50
|
| Rate for Payer: PHP All Commercial |
$159.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$81.90
|
| Rate for Payer: Sagamore Health Network All Products |
$162.12
|
| Rate for Payer: Signature Care EPO |
$174.30
|
| Rate for Payer: Signature Care PPO |
$184.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$178.50
|
| Rate for Payer: United Healthcare Commercial |
$165.48
|
| Rate for Payer: United Healthcare Medicare |
$69.30
|
|
|
HC W K-WIRE 2.5X270 02527
|
Facility
|
IP
|
$658.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605808
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$493.50 |
| Max. Negotiated Rate |
$611.94 |
| Rate for Payer: Aetna Commercial |
$568.51
|
| Rate for Payer: Cash Price |
$407.96
|
| Rate for Payer: Cigna All Commercial |
$567.85
|
| Rate for Payer: CORVEL All Commercial |
$611.94
|
| Rate for Payer: Coventry All Commercial |
$579.04
|
| Rate for Payer: Encore All Commercial |
$605.69
|
| Rate for Payer: Frontpath All Commercial |
$605.36
|
| Rate for Payer: Humana ChoiceCare |
$568.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$592.20
|
| Rate for Payer: PHCS All Commercial |
$493.50
|
| Rate for Payer: PHP All Commercial |
$499.03
|
| Rate for Payer: Sagamore Health Network All Products |
$507.98
|
| Rate for Payer: Signature Care EPO |
$546.14
|
| Rate for Payer: Signature Care PPO |
$579.04
|
| Rate for Payer: United Healthcare Commercial |
$518.50
|
|
|
HC W K-WIRE 2.5X270 02527
|
Facility
|
OP
|
$658.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605808
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$217.14 |
| Max. Negotiated Rate |
$611.94 |
| Rate for Payer: Aetna Commercial |
$555.35
|
| Rate for Payer: Aetna Medicare |
$217.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$217.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$377.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$411.32
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$249.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$238.85
|
| Rate for Payer: Cash Price |
$407.96
|
| Rate for Payer: Cash Price |
$407.96
|
| Rate for Payer: Centivo All Commercial |
$335.58
|
| Rate for Payer: Cigna All Commercial |
$567.85
|
| Rate for Payer: CORVEL All Commercial |
$611.94
|
| Rate for Payer: Coventry All Commercial |
$579.04
|
| Rate for Payer: Encore All Commercial |
$605.69
|
| Rate for Payer: Frontpath All Commercial |
$605.36
|
| Rate for Payer: Humana ChoiceCare |
$568.31
|
| Rate for Payer: Humana Medicare |
$335.58
|
| Rate for Payer: Lucent All Commercial |
$335.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$592.20
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$493.50
|
| Rate for Payer: PHP All Commercial |
$499.03
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$256.62
|
| Rate for Payer: Sagamore Health Network All Products |
$507.98
|
| Rate for Payer: Signature Care EPO |
$546.14
|
| Rate for Payer: Signature Care PPO |
$579.04
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$559.30
|
| Rate for Payer: United Healthcare Commercial |
$518.50
|
| Rate for Payer: United Healthcare Medicare |
$217.14
|
|
|
HC W K-WIRE 2.5X270 2502
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605796
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$157.50 |
| Max. Negotiated Rate |
$195.30 |
| Rate for Payer: Aetna Commercial |
$181.44
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Cigna All Commercial |
$181.23
|
| Rate for Payer: CORVEL All Commercial |
$195.30
|
| Rate for Payer: Coventry All Commercial |
$184.80
|
| Rate for Payer: Encore All Commercial |
$193.30
|
| Rate for Payer: Frontpath All Commercial |
$193.20
|
| Rate for Payer: Humana ChoiceCare |
$181.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$189.00
|
| Rate for Payer: PHCS All Commercial |
$157.50
|
| Rate for Payer: PHP All Commercial |
$159.26
|
| Rate for Payer: Sagamore Health Network All Products |
$162.12
|
| Rate for Payer: Signature Care EPO |
$174.30
|
| Rate for Payer: Signature Care PPO |
$184.80
|
| Rate for Payer: United Healthcare Commercial |
$165.48
|
|
|
HC W K-WIRE 2.5X270 2502
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605796
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.30 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$177.24
|
| Rate for Payer: Aetna Medicare |
$69.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$69.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$120.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$131.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$79.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$76.23
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Centivo All Commercial |
$107.10
|
| Rate for Payer: Cigna All Commercial |
$181.23
|
| Rate for Payer: CORVEL All Commercial |
$195.30
|
| Rate for Payer: Coventry All Commercial |
$184.80
|
| Rate for Payer: Encore All Commercial |
$193.30
|
| Rate for Payer: Frontpath All Commercial |
$193.20
|
| Rate for Payer: Humana ChoiceCare |
$181.38
|
| Rate for Payer: Humana Medicare |
$107.10
|
| Rate for Payer: Lucent All Commercial |
$107.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$189.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$157.50
|
| Rate for Payer: PHP All Commercial |
$159.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$81.90
|
| Rate for Payer: Sagamore Health Network All Products |
$162.12
|
| Rate for Payer: Signature Care EPO |
$174.30
|
| Rate for Payer: Signature Care PPO |
$184.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$178.50
|
| Rate for Payer: United Healthcare Commercial |
$165.48
|
| Rate for Payer: United Healthcare Medicare |
$69.30
|
|
|
HC W K-WIRE 2.5X270 2503
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605797
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.30 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$177.24
|
| Rate for Payer: Aetna Medicare |
$69.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$69.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$120.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$131.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$79.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$76.23
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Centivo All Commercial |
$107.10
|
| Rate for Payer: Cigna All Commercial |
$181.23
|
| Rate for Payer: CORVEL All Commercial |
$195.30
|
| Rate for Payer: Coventry All Commercial |
$184.80
|
| Rate for Payer: Encore All Commercial |
$193.30
|
| Rate for Payer: Frontpath All Commercial |
$193.20
|
| Rate for Payer: Humana ChoiceCare |
$181.38
|
| Rate for Payer: Humana Medicare |
$107.10
|
| Rate for Payer: Lucent All Commercial |
$107.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$189.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$157.50
|
| Rate for Payer: PHP All Commercial |
$159.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$81.90
|
| Rate for Payer: Sagamore Health Network All Products |
$162.12
|
| Rate for Payer: Signature Care EPO |
$174.30
|
| Rate for Payer: Signature Care PPO |
$184.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$178.50
|
| Rate for Payer: United Healthcare Commercial |
$165.48
|
| Rate for Payer: United Healthcare Medicare |
$69.30
|
|
|
HC W K-WIRE 2.5X270 2503
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605797
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$157.50 |
| Max. Negotiated Rate |
$195.30 |
| Rate for Payer: Aetna Commercial |
$181.44
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Cigna All Commercial |
$181.23
|
| Rate for Payer: CORVEL All Commercial |
$195.30
|
| Rate for Payer: Coventry All Commercial |
$184.80
|
| Rate for Payer: Encore All Commercial |
$193.30
|
| Rate for Payer: Frontpath All Commercial |
$193.20
|
| Rate for Payer: Humana ChoiceCare |
$181.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$189.00
|
| Rate for Payer: PHCS All Commercial |
$157.50
|
| Rate for Payer: PHP All Commercial |
$159.26
|
| Rate for Payer: Sagamore Health Network All Products |
$162.12
|
| Rate for Payer: Signature Care EPO |
$174.30
|
| Rate for Payer: Signature Care PPO |
$184.80
|
| Rate for Payer: United Healthcare Commercial |
$165.48
|
|
|
HC W K-WIRE 2.5X270 2527
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605802
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$157.50 |
| Max. Negotiated Rate |
$195.30 |
| Rate for Payer: Aetna Commercial |
$181.44
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Cigna All Commercial |
$181.23
|
| Rate for Payer: CORVEL All Commercial |
$195.30
|
| Rate for Payer: Coventry All Commercial |
$184.80
|
| Rate for Payer: Encore All Commercial |
$193.30
|
| Rate for Payer: Frontpath All Commercial |
$193.20
|
| Rate for Payer: Humana ChoiceCare |
$181.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$189.00
|
| Rate for Payer: PHCS All Commercial |
$157.50
|
| Rate for Payer: PHP All Commercial |
$159.26
|
| Rate for Payer: Sagamore Health Network All Products |
$162.12
|
| Rate for Payer: Signature Care EPO |
$174.30
|
| Rate for Payer: Signature Care PPO |
$184.80
|
| Rate for Payer: United Healthcare Commercial |
$165.48
|
|
|
HC W K-WIRE 2.5X270 2527
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605802
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.30 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$177.24
|
| Rate for Payer: Aetna Medicare |
$69.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$69.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$120.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$131.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$79.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$76.23
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Centivo All Commercial |
$107.10
|
| Rate for Payer: Cigna All Commercial |
$181.23
|
| Rate for Payer: CORVEL All Commercial |
$195.30
|
| Rate for Payer: Coventry All Commercial |
$184.80
|
| Rate for Payer: Encore All Commercial |
$193.30
|
| Rate for Payer: Frontpath All Commercial |
$193.20
|
| Rate for Payer: Humana ChoiceCare |
$181.38
|
| Rate for Payer: Humana Medicare |
$107.10
|
| Rate for Payer: Lucent All Commercial |
$107.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$189.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$157.50
|
| Rate for Payer: PHP All Commercial |
$159.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$81.90
|
| Rate for Payer: Sagamore Health Network All Products |
$162.12
|
| Rate for Payer: Signature Care EPO |
$174.30
|
| Rate for Payer: Signature Care PPO |
$184.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$178.50
|
| Rate for Payer: United Healthcare Commercial |
$165.48
|
| Rate for Payer: United Healthcare Medicare |
$69.30
|
|
|
HC W K-WIRE 2.5X270 LG 02527
|
Facility
|
IP
|
$658.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605810
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$493.50 |
| Max. Negotiated Rate |
$611.94 |
| Rate for Payer: Aetna Commercial |
$568.51
|
| Rate for Payer: Cash Price |
$407.96
|
| Rate for Payer: Cigna All Commercial |
$567.85
|
| Rate for Payer: CORVEL All Commercial |
$611.94
|
| Rate for Payer: Coventry All Commercial |
$579.04
|
| Rate for Payer: Encore All Commercial |
$605.69
|
| Rate for Payer: Frontpath All Commercial |
$605.36
|
| Rate for Payer: Humana ChoiceCare |
$568.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$592.20
|
| Rate for Payer: PHCS All Commercial |
$493.50
|
| Rate for Payer: PHP All Commercial |
$499.03
|
| Rate for Payer: Sagamore Health Network All Products |
$507.98
|
| Rate for Payer: Signature Care EPO |
$546.14
|
| Rate for Payer: Signature Care PPO |
$579.04
|
| Rate for Payer: United Healthcare Commercial |
$518.50
|
|
|
HC W K-WIRE 2.5X270 LG 02527
|
Facility
|
OP
|
$658.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605810
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$217.14 |
| Max. Negotiated Rate |
$611.94 |
| Rate for Payer: Aetna Commercial |
$555.35
|
| Rate for Payer: Aetna Medicare |
$217.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$217.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$377.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$411.32
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$249.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$238.85
|
| Rate for Payer: Cash Price |
$407.96
|
| Rate for Payer: Cash Price |
$407.96
|
| Rate for Payer: Centivo All Commercial |
$335.58
|
| Rate for Payer: Cigna All Commercial |
$567.85
|
| Rate for Payer: CORVEL All Commercial |
$611.94
|
| Rate for Payer: Coventry All Commercial |
$579.04
|
| Rate for Payer: Encore All Commercial |
$605.69
|
| Rate for Payer: Frontpath All Commercial |
$605.36
|
| Rate for Payer: Humana ChoiceCare |
$568.31
|
| Rate for Payer: Humana Medicare |
$335.58
|
| Rate for Payer: Lucent All Commercial |
$335.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$592.20
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$493.50
|
| Rate for Payer: PHP All Commercial |
$499.03
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$256.62
|
| Rate for Payer: Sagamore Health Network All Products |
$507.98
|
| Rate for Payer: Signature Care EPO |
$546.14
|
| Rate for Payer: Signature Care PPO |
$579.04
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$559.30
|
| Rate for Payer: United Healthcare Commercial |
$518.50
|
| Rate for Payer: United Healthcare Medicare |
$217.14
|
|
