|
HC W SCREW 2.4X10 LOCK TM
|
Facility
IP
|
$1,295.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604897
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$971.25 |
| Max. Negotiated Rate |
$1,204.35 |
| Rate for Payer: Aetna Commercial |
$1,118.88
|
| Rate for Payer: Cash Price |
$802.90
|
| Rate for Payer: Cigna All Commercial |
$1,117.58
|
| Rate for Payer: CORVEL All Commercial |
$1,204.35
|
| Rate for Payer: Coventry All Commercial |
$1,139.60
|
| Rate for Payer: Encore All Commercial |
$1,192.05
|
| Rate for Payer: Frontpath All Commercial |
$1,191.40
|
| Rate for Payer: Humana ChoiceCare |
$1,118.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,165.50
|
| Rate for Payer: PHCS All Commercial |
$971.25
|
| Rate for Payer: PHP All Commercial |
$982.13
|
| Rate for Payer: Sagamore Health Network All Products |
$999.74
|
| Rate for Payer: Signature Care EPO |
$1,074.85
|
| Rate for Payer: Signature Care PPO |
$1,139.60
|
| Rate for Payer: United Healthcare Commercial |
$1,020.46
|
|
|
HC W SCREW 2.4X10 LOCK TM
|
Facility
OP
|
$1,295.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604897
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$427.35 |
| Max. Negotiated Rate |
$1,204.35 |
| Rate for Payer: Aetna Commercial |
$1,092.98
|
| Rate for Payer: Aetna Medicare |
$427.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$427.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$743.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$809.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$491.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$470.08
|
| Rate for Payer: Cash Price |
$802.90
|
| Rate for Payer: Cash Price |
$802.90
|
| Rate for Payer: Centivo All Commercial |
$660.45
|
| Rate for Payer: Cigna All Commercial |
$1,117.58
|
| Rate for Payer: CORVEL All Commercial |
$1,204.35
|
| Rate for Payer: Coventry All Commercial |
$1,139.60
|
| Rate for Payer: Encore All Commercial |
$1,192.05
|
| Rate for Payer: Frontpath All Commercial |
$1,191.40
|
| Rate for Payer: Humana ChoiceCare |
$1,118.49
|
| Rate for Payer: Humana Medicare |
$660.45
|
| Rate for Payer: Lucent All Commercial |
$660.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,165.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$971.25
|
| Rate for Payer: PHP All Commercial |
$982.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$505.05
|
| Rate for Payer: Sagamore Health Network All Products |
$999.74
|
| Rate for Payer: Signature Care EPO |
$1,074.85
|
| Rate for Payer: Signature Care PPO |
$1,139.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,100.75
|
| Rate for Payer: United Healthcare Commercial |
$1,020.46
|
| Rate for Payer: United Healthcare Medicare |
$427.35
|
|
|
HC W SCREW 2.4X10 NON LOCK TM
|
Facility
OP
|
$763.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604909
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$251.79 |
| Max. Negotiated Rate |
$709.59 |
| Rate for Payer: Aetna Commercial |
$643.97
|
| Rate for Payer: Aetna Medicare |
$251.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$251.79
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$438.19
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$476.95
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$289.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$276.97
|
| Rate for Payer: Cash Price |
$473.06
|
| Rate for Payer: Cash Price |
$473.06
|
| Rate for Payer: Centivo All Commercial |
$389.13
|
| Rate for Payer: Cigna All Commercial |
$658.47
|
| Rate for Payer: CORVEL All Commercial |
$709.59
|
| Rate for Payer: Coventry All Commercial |
$671.44
|
| Rate for Payer: Encore All Commercial |
$702.34
|
| Rate for Payer: Frontpath All Commercial |
$701.96
|
| Rate for Payer: Humana ChoiceCare |
$659.00
|
| Rate for Payer: Humana Medicare |
$389.13
|
| Rate for Payer: Lucent All Commercial |
$389.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$686.70
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$572.25
|
| Rate for Payer: PHP All Commercial |
$578.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$297.57
|
| Rate for Payer: Sagamore Health Network All Products |
$589.04
|
| Rate for Payer: Signature Care EPO |
$633.29
|
| Rate for Payer: Signature Care PPO |
$671.44
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$648.55
|
| Rate for Payer: United Healthcare Commercial |
$601.24
|
| Rate for Payer: United Healthcare Medicare |
$251.79
|
|
|
HC W SCREW 2.4X10 NON LOCK TM
|
Facility
IP
|
$763.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604909
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$572.25 |
| Max. Negotiated Rate |
$709.59 |
| Rate for Payer: Aetna Commercial |
$659.23
|
| Rate for Payer: Cash Price |
$473.06
|
| Rate for Payer: Cigna All Commercial |
$658.47
|
| Rate for Payer: CORVEL All Commercial |
$709.59
|
| Rate for Payer: Coventry All Commercial |
$671.44
|
| Rate for Payer: Encore All Commercial |
$702.34
|
| Rate for Payer: Frontpath All Commercial |
$701.96
|
| Rate for Payer: Humana ChoiceCare |
$659.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$686.70
|
| Rate for Payer: PHCS All Commercial |
$572.25
|
| Rate for Payer: PHP All Commercial |
$578.66
|
| Rate for Payer: Sagamore Health Network All Products |
$589.04
|
| Rate for Payer: Signature Care EPO |
$633.29
|
| Rate for Payer: Signature Care PPO |
$671.44
|
| Rate for Payer: United Healthcare Commercial |
$601.24
|
|
|
HC W SCREW 2.4X12 LOCK TM
|
Facility
OP
|
$1,295.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604898
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$427.35 |
| Max. Negotiated Rate |
$1,204.35 |
| Rate for Payer: Aetna Commercial |
$1,092.98
|
| Rate for Payer: Aetna Medicare |
$427.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$427.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$743.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$809.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$491.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$470.08
|
| Rate for Payer: Cash Price |
$802.90
|
| Rate for Payer: Cash Price |
$802.90
|
| Rate for Payer: Centivo All Commercial |
$660.45
|
| Rate for Payer: Cigna All Commercial |
$1,117.58
|
| Rate for Payer: CORVEL All Commercial |
$1,204.35
|
| Rate for Payer: Coventry All Commercial |
$1,139.60
|
| Rate for Payer: Encore All Commercial |
$1,192.05
|
| Rate for Payer: Frontpath All Commercial |
$1,191.40
|
| Rate for Payer: Humana ChoiceCare |
$1,118.49
|
| Rate for Payer: Humana Medicare |
$660.45
|
| Rate for Payer: Lucent All Commercial |
$660.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,165.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$971.25
|
| Rate for Payer: PHP All Commercial |
$982.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$505.05
|
| Rate for Payer: Sagamore Health Network All Products |
$999.74
|
| Rate for Payer: Signature Care EPO |
$1,074.85
|
| Rate for Payer: Signature Care PPO |
$1,139.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,100.75
|
| Rate for Payer: United Healthcare Commercial |
$1,020.46
|
| Rate for Payer: United Healthcare Medicare |
$427.35
|
|
|
HC W SCREW 2.4X12 LOCK TM
|
Facility
IP
|
$1,295.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604898
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$971.25 |
| Max. Negotiated Rate |
$1,204.35 |
| Rate for Payer: Aetna Commercial |
$1,118.88
|
| Rate for Payer: Cash Price |
$802.90
|
| Rate for Payer: Cigna All Commercial |
$1,117.58
|
| Rate for Payer: CORVEL All Commercial |
$1,204.35
|
| Rate for Payer: Coventry All Commercial |
$1,139.60
|
| Rate for Payer: Encore All Commercial |
$1,192.05
|
| Rate for Payer: Frontpath All Commercial |
$1,191.40
|
| Rate for Payer: Humana ChoiceCare |
$1,118.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,165.50
|
| Rate for Payer: PHCS All Commercial |
$971.25
|
| Rate for Payer: PHP All Commercial |
$982.13
|
| Rate for Payer: Sagamore Health Network All Products |
$999.74
|
| Rate for Payer: Signature Care EPO |
$1,074.85
|
| Rate for Payer: Signature Care PPO |
$1,139.60
|
| Rate for Payer: United Healthcare Commercial |
$1,020.46
|
|
|
HC W SCREW 2.4X12 NON LOCK TM
|
Facility
IP
|
$763.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604910
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$572.25 |
| Max. Negotiated Rate |
$709.59 |
| Rate for Payer: Aetna Commercial |
$659.23
|
| Rate for Payer: Cash Price |
$473.06
|
| Rate for Payer: Cigna All Commercial |
$658.47
|
| Rate for Payer: CORVEL All Commercial |
$709.59
|
| Rate for Payer: Coventry All Commercial |
$671.44
|
| Rate for Payer: Encore All Commercial |
$702.34
|
| Rate for Payer: Frontpath All Commercial |
$701.96
|
| Rate for Payer: Humana ChoiceCare |
$659.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$686.70
|
| Rate for Payer: PHCS All Commercial |
$572.25
|
| Rate for Payer: PHP All Commercial |
$578.66
|
| Rate for Payer: Sagamore Health Network All Products |
$589.04
|
| Rate for Payer: Signature Care EPO |
$633.29
|
| Rate for Payer: Signature Care PPO |
$671.44
|
| Rate for Payer: United Healthcare Commercial |
$601.24
|
|
|
HC W SCREW 2.4X12 NON LOCK TM
|
Facility
OP
|
$763.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604910
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$251.79 |
| Max. Negotiated Rate |
$709.59 |
| Rate for Payer: Aetna Commercial |
$643.97
|
| Rate for Payer: Aetna Medicare |
$251.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$251.79
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$438.19
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$476.95
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$289.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$276.97
|
| Rate for Payer: Cash Price |
$473.06
|
| Rate for Payer: Cash Price |
$473.06
|
| Rate for Payer: Centivo All Commercial |
$389.13
|
| Rate for Payer: Cigna All Commercial |
$658.47
|
| Rate for Payer: CORVEL All Commercial |
$709.59
|
| Rate for Payer: Coventry All Commercial |
$671.44
|
| Rate for Payer: Encore All Commercial |
$702.34
|
| Rate for Payer: Frontpath All Commercial |
$701.96
|
| Rate for Payer: Humana ChoiceCare |
$659.00
|
| Rate for Payer: Humana Medicare |
$389.13
|
| Rate for Payer: Lucent All Commercial |
$389.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$686.70
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$572.25
|
| Rate for Payer: PHP All Commercial |
$578.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$297.57
|
| Rate for Payer: Sagamore Health Network All Products |
$589.04
|
| Rate for Payer: Signature Care EPO |
$633.29
|
| Rate for Payer: Signature Care PPO |
$671.44
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$648.55
|
| Rate for Payer: United Healthcare Commercial |
$601.24
|
| Rate for Payer: United Healthcare Medicare |
$251.79
|
|
|
HC W SCREW 2.4X14 LOCK TM
|
Facility
IP
|
$1,295.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604899
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$971.25 |
| Max. Negotiated Rate |
$1,204.35 |
| Rate for Payer: Aetna Commercial |
$1,118.88
|
| Rate for Payer: Cash Price |
$802.90
|
| Rate for Payer: Cigna All Commercial |
$1,117.58
|
| Rate for Payer: CORVEL All Commercial |
$1,204.35
|
| Rate for Payer: Coventry All Commercial |
$1,139.60
|
| Rate for Payer: Encore All Commercial |
$1,192.05
|
| Rate for Payer: Frontpath All Commercial |
$1,191.40
|
| Rate for Payer: Humana ChoiceCare |
$1,118.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,165.50
|
| Rate for Payer: PHCS All Commercial |
$971.25
|
| Rate for Payer: PHP All Commercial |
$982.13
|
| Rate for Payer: Sagamore Health Network All Products |
$999.74
|
| Rate for Payer: Signature Care EPO |
$1,074.85
|
| Rate for Payer: Signature Care PPO |
$1,139.60
|
| Rate for Payer: United Healthcare Commercial |
$1,020.46
|
|
|
HC W SCREW 2.4X14 LOCK TM
|
Facility
OP
|
$1,295.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604899
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$427.35 |
| Max. Negotiated Rate |
$1,204.35 |
| Rate for Payer: Aetna Commercial |
$1,092.98
|
| Rate for Payer: Aetna Medicare |
$427.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$427.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$743.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$809.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$491.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$470.08
|
| Rate for Payer: Cash Price |
$802.90
|
| Rate for Payer: Cash Price |
$802.90
|
| Rate for Payer: Centivo All Commercial |
$660.45
|
| Rate for Payer: Cigna All Commercial |
$1,117.58
|
| Rate for Payer: CORVEL All Commercial |
$1,204.35
|
| Rate for Payer: Coventry All Commercial |
$1,139.60
|
| Rate for Payer: Encore All Commercial |
$1,192.05
|
| Rate for Payer: Frontpath All Commercial |
$1,191.40
|
| Rate for Payer: Humana ChoiceCare |
$1,118.49
|
| Rate for Payer: Humana Medicare |
$660.45
|
| Rate for Payer: Lucent All Commercial |
$660.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,165.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$971.25
|
| Rate for Payer: PHP All Commercial |
$982.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$505.05
|
| Rate for Payer: Sagamore Health Network All Products |
$999.74
|
| Rate for Payer: Signature Care EPO |
$1,074.85
|
| Rate for Payer: Signature Care PPO |
$1,139.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,100.75
|
| Rate for Payer: United Healthcare Commercial |
$1,020.46
|
| Rate for Payer: United Healthcare Medicare |
$427.35
|
|
|
HC W SCREW 2.4X14 NON LOCK TM
|
Facility
OP
|
$763.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604911
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$251.79 |
| Max. Negotiated Rate |
$709.59 |
| Rate for Payer: Aetna Commercial |
$643.97
|
| Rate for Payer: Aetna Medicare |
$251.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$251.79
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$438.19
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$476.95
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$289.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$276.97
|
| Rate for Payer: Cash Price |
$473.06
|
| Rate for Payer: Cash Price |
$473.06
|
| Rate for Payer: Centivo All Commercial |
$389.13
|
| Rate for Payer: Cigna All Commercial |
$658.47
|
| Rate for Payer: CORVEL All Commercial |
$709.59
|
| Rate for Payer: Coventry All Commercial |
$671.44
|
| Rate for Payer: Encore All Commercial |
$702.34
|
| Rate for Payer: Frontpath All Commercial |
$701.96
|
| Rate for Payer: Humana ChoiceCare |
$659.00
|
| Rate for Payer: Humana Medicare |
$389.13
|
| Rate for Payer: Lucent All Commercial |
$389.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$686.70
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$572.25
|
| Rate for Payer: PHP All Commercial |
$578.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$297.57
|
| Rate for Payer: Sagamore Health Network All Products |
$589.04
|
| Rate for Payer: Signature Care EPO |
$633.29
|
| Rate for Payer: Signature Care PPO |
$671.44
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$648.55
|
| Rate for Payer: United Healthcare Commercial |
$601.24
|
| Rate for Payer: United Healthcare Medicare |
$251.79
|
|
|
HC W SCREW 2.4X14 NON LOCK TM
|
Facility
IP
|
$763.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604911
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$572.25 |
| Max. Negotiated Rate |
$709.59 |
| Rate for Payer: Aetna Commercial |
$659.23
|
| Rate for Payer: Cash Price |
$473.06
|
| Rate for Payer: Cigna All Commercial |
$658.47
|
| Rate for Payer: CORVEL All Commercial |
$709.59
|
| Rate for Payer: Coventry All Commercial |
$671.44
|
| Rate for Payer: Encore All Commercial |
$702.34
|
| Rate for Payer: Frontpath All Commercial |
$701.96
|
| Rate for Payer: Humana ChoiceCare |
$659.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$686.70
|
| Rate for Payer: PHCS All Commercial |
$572.25
|
| Rate for Payer: PHP All Commercial |
$578.66
|
| Rate for Payer: Sagamore Health Network All Products |
$589.04
|
| Rate for Payer: Signature Care EPO |
$633.29
|
| Rate for Payer: Signature Care PPO |
$671.44
|
| Rate for Payer: United Healthcare Commercial |
$601.24
|
|
|
HC W SCREW 2.4X16 LOCK TM
|
Facility
OP
|
$1,295.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604900
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$427.35 |
| Max. Negotiated Rate |
$1,204.35 |
| Rate for Payer: Aetna Commercial |
$1,092.98
|
| Rate for Payer: Aetna Medicare |
$427.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$427.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$743.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$809.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$491.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$470.08
|
| Rate for Payer: Cash Price |
$802.90
|
| Rate for Payer: Cash Price |
$802.90
|
| Rate for Payer: Centivo All Commercial |
$660.45
|
| Rate for Payer: Cigna All Commercial |
$1,117.58
|
| Rate for Payer: CORVEL All Commercial |
$1,204.35
|
| Rate for Payer: Coventry All Commercial |
$1,139.60
|
| Rate for Payer: Encore All Commercial |
$1,192.05
|
| Rate for Payer: Frontpath All Commercial |
$1,191.40
|
| Rate for Payer: Humana ChoiceCare |
$1,118.49
|
| Rate for Payer: Humana Medicare |
$660.45
|
| Rate for Payer: Lucent All Commercial |
$660.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,165.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$971.25
|
| Rate for Payer: PHP All Commercial |
$982.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$505.05
|
| Rate for Payer: Sagamore Health Network All Products |
$999.74
|
| Rate for Payer: Signature Care EPO |
$1,074.85
|
| Rate for Payer: Signature Care PPO |
$1,139.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,100.75
|
| Rate for Payer: United Healthcare Commercial |
$1,020.46
|
| Rate for Payer: United Healthcare Medicare |
$427.35
|
|
|
HC W SCREW 2.4X16 LOCK TM
|
Facility
IP
|
$1,295.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604900
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$971.25 |
| Max. Negotiated Rate |
$1,204.35 |
| Rate for Payer: Aetna Commercial |
$1,118.88
|
| Rate for Payer: Cash Price |
$802.90
|
| Rate for Payer: Cigna All Commercial |
$1,117.58
|
| Rate for Payer: CORVEL All Commercial |
$1,204.35
|
| Rate for Payer: Coventry All Commercial |
$1,139.60
|
| Rate for Payer: Encore All Commercial |
$1,192.05
|
| Rate for Payer: Frontpath All Commercial |
$1,191.40
|
| Rate for Payer: Humana ChoiceCare |
$1,118.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,165.50
|
| Rate for Payer: PHCS All Commercial |
$971.25
|
| Rate for Payer: PHP All Commercial |
$982.13
|
| Rate for Payer: Sagamore Health Network All Products |
$999.74
|
| Rate for Payer: Signature Care EPO |
$1,074.85
|
| Rate for Payer: Signature Care PPO |
$1,139.60
|
| Rate for Payer: United Healthcare Commercial |
$1,020.46
|
|
|
HC W SCREW 2.4X16 NON LOCK TM
|
Facility
IP
|
$763.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604912
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$572.25 |
| Max. Negotiated Rate |
$709.59 |
| Rate for Payer: Aetna Commercial |
$659.23
|
| Rate for Payer: Cash Price |
$473.06
|
| Rate for Payer: Cigna All Commercial |
$658.47
|
| Rate for Payer: CORVEL All Commercial |
$709.59
|
| Rate for Payer: Coventry All Commercial |
$671.44
|
| Rate for Payer: Encore All Commercial |
$702.34
|
| Rate for Payer: Frontpath All Commercial |
$701.96
|
| Rate for Payer: Humana ChoiceCare |
$659.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$686.70
|
| Rate for Payer: PHCS All Commercial |
$572.25
|
| Rate for Payer: PHP All Commercial |
$578.66
|
| Rate for Payer: Sagamore Health Network All Products |
$589.04
|
| Rate for Payer: Signature Care EPO |
$633.29
|
| Rate for Payer: Signature Care PPO |
$671.44
|
| Rate for Payer: United Healthcare Commercial |
$601.24
|
|
|
HC W SCREW 2.4X16 NON LOCK TM
|
Facility
OP
|
$763.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604912
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$251.79 |
| Max. Negotiated Rate |
$709.59 |
| Rate for Payer: Aetna Commercial |
$643.97
|
| Rate for Payer: Aetna Medicare |
$251.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$251.79
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$438.19
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$476.95
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$289.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$276.97
|
| Rate for Payer: Cash Price |
$473.06
|
| Rate for Payer: Cash Price |
$473.06
|
| Rate for Payer: Centivo All Commercial |
$389.13
|
| Rate for Payer: Cigna All Commercial |
$658.47
|
| Rate for Payer: CORVEL All Commercial |
$709.59
|
| Rate for Payer: Coventry All Commercial |
$671.44
|
| Rate for Payer: Encore All Commercial |
$702.34
|
| Rate for Payer: Frontpath All Commercial |
$701.96
|
| Rate for Payer: Humana ChoiceCare |
$659.00
|
| Rate for Payer: Humana Medicare |
$389.13
|
| Rate for Payer: Lucent All Commercial |
$389.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$686.70
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$572.25
|
| Rate for Payer: PHP All Commercial |
$578.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$297.57
|
| Rate for Payer: Sagamore Health Network All Products |
$589.04
|
| Rate for Payer: Signature Care EPO |
$633.29
|
| Rate for Payer: Signature Care PPO |
$671.44
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$648.55
|
| Rate for Payer: United Healthcare Commercial |
$601.24
|
| Rate for Payer: United Healthcare Medicare |
$251.79
|
|
|
HC W SCREW 2.4X18 LOCK TM
|
Facility
IP
|
$1,295.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604901
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$971.25 |
| Max. Negotiated Rate |
$1,204.35 |
| Rate for Payer: Aetna Commercial |
$1,118.88
|
| Rate for Payer: Cash Price |
$802.90
|
| Rate for Payer: Cigna All Commercial |
$1,117.58
|
| Rate for Payer: CORVEL All Commercial |
$1,204.35
|
| Rate for Payer: Coventry All Commercial |
$1,139.60
|
| Rate for Payer: Encore All Commercial |
$1,192.05
|
| Rate for Payer: Frontpath All Commercial |
$1,191.40
|
| Rate for Payer: Humana ChoiceCare |
$1,118.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,165.50
|
| Rate for Payer: PHCS All Commercial |
$971.25
|
| Rate for Payer: PHP All Commercial |
$982.13
|
| Rate for Payer: Sagamore Health Network All Products |
$999.74
|
| Rate for Payer: Signature Care EPO |
$1,074.85
|
| Rate for Payer: Signature Care PPO |
$1,139.60
|
| Rate for Payer: United Healthcare Commercial |
$1,020.46
|
|
|
HC W SCREW 2.4X18 LOCK TM
|
Facility
OP
|
$1,295.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604901
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$427.35 |
| Max. Negotiated Rate |
$1,204.35 |
| Rate for Payer: Aetna Commercial |
$1,092.98
|
| Rate for Payer: Aetna Medicare |
$427.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$427.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$743.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$809.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$491.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$470.08
|
| Rate for Payer: Cash Price |
$802.90
|
| Rate for Payer: Cash Price |
$802.90
|
| Rate for Payer: Centivo All Commercial |
$660.45
|
| Rate for Payer: Cigna All Commercial |
$1,117.58
|
| Rate for Payer: CORVEL All Commercial |
$1,204.35
|
| Rate for Payer: Coventry All Commercial |
$1,139.60
|
| Rate for Payer: Encore All Commercial |
$1,192.05
|
| Rate for Payer: Frontpath All Commercial |
$1,191.40
|
| Rate for Payer: Humana ChoiceCare |
$1,118.49
|
| Rate for Payer: Humana Medicare |
$660.45
|
| Rate for Payer: Lucent All Commercial |
$660.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,165.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$971.25
|
| Rate for Payer: PHP All Commercial |
$982.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$505.05
|
| Rate for Payer: Sagamore Health Network All Products |
$999.74
|
| Rate for Payer: Signature Care EPO |
$1,074.85
|
| Rate for Payer: Signature Care PPO |
$1,139.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,100.75
|
| Rate for Payer: United Healthcare Commercial |
$1,020.46
|
| Rate for Payer: United Healthcare Medicare |
$427.35
|
|
|
HC W SCREW 2.4X18 NON LOCK TM
|
Facility
OP
|
$763.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604913
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$251.79 |
| Max. Negotiated Rate |
$709.59 |
| Rate for Payer: Aetna Commercial |
$643.97
|
| Rate for Payer: Aetna Medicare |
$251.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$251.79
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$438.19
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$476.95
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$289.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$276.97
|
| Rate for Payer: Cash Price |
$473.06
|
| Rate for Payer: Cash Price |
$473.06
|
| Rate for Payer: Centivo All Commercial |
$389.13
|
| Rate for Payer: Cigna All Commercial |
$658.47
|
| Rate for Payer: CORVEL All Commercial |
$709.59
|
| Rate for Payer: Coventry All Commercial |
$671.44
|
| Rate for Payer: Encore All Commercial |
$702.34
|
| Rate for Payer: Frontpath All Commercial |
$701.96
|
| Rate for Payer: Humana ChoiceCare |
$659.00
|
| Rate for Payer: Humana Medicare |
$389.13
|
| Rate for Payer: Lucent All Commercial |
$389.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$686.70
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$572.25
|
| Rate for Payer: PHP All Commercial |
$578.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$297.57
|
| Rate for Payer: Sagamore Health Network All Products |
$589.04
|
| Rate for Payer: Signature Care EPO |
$633.29
|
| Rate for Payer: Signature Care PPO |
$671.44
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$648.55
|
| Rate for Payer: United Healthcare Commercial |
$601.24
|
| Rate for Payer: United Healthcare Medicare |
$251.79
|
|
|
HC W SCREW 2.4X18 NON LOCK TM
|
Facility
IP
|
$763.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604913
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$572.25 |
| Max. Negotiated Rate |
$709.59 |
| Rate for Payer: Aetna Commercial |
$659.23
|
| Rate for Payer: Cash Price |
$473.06
|
| Rate for Payer: Cigna All Commercial |
$658.47
|
| Rate for Payer: CORVEL All Commercial |
$709.59
|
| Rate for Payer: Coventry All Commercial |
$671.44
|
| Rate for Payer: Encore All Commercial |
$702.34
|
| Rate for Payer: Frontpath All Commercial |
$701.96
|
| Rate for Payer: Humana ChoiceCare |
$659.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$686.70
|
| Rate for Payer: PHCS All Commercial |
$572.25
|
| Rate for Payer: PHP All Commercial |
$578.66
|
| Rate for Payer: Sagamore Health Network All Products |
$589.04
|
| Rate for Payer: Signature Care EPO |
$633.29
|
| Rate for Payer: Signature Care PPO |
$671.44
|
| Rate for Payer: United Healthcare Commercial |
$601.24
|
|
|
HC W SCREW 2.4X20 LOCK TM
|
Facility
OP
|
$1,295.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604902
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$427.35 |
| Max. Negotiated Rate |
$1,204.35 |
| Rate for Payer: Aetna Commercial |
$1,092.98
|
| Rate for Payer: Aetna Medicare |
$427.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$427.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$743.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$809.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$491.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$470.08
|
| Rate for Payer: Cash Price |
$802.90
|
| Rate for Payer: Cash Price |
$802.90
|
| Rate for Payer: Centivo All Commercial |
$660.45
|
| Rate for Payer: Cigna All Commercial |
$1,117.58
|
| Rate for Payer: CORVEL All Commercial |
$1,204.35
|
| Rate for Payer: Coventry All Commercial |
$1,139.60
|
| Rate for Payer: Encore All Commercial |
$1,192.05
|
| Rate for Payer: Frontpath All Commercial |
$1,191.40
|
| Rate for Payer: Humana ChoiceCare |
$1,118.49
|
| Rate for Payer: Humana Medicare |
$660.45
|
| Rate for Payer: Lucent All Commercial |
$660.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,165.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$971.25
|
| Rate for Payer: PHP All Commercial |
$982.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$505.05
|
| Rate for Payer: Sagamore Health Network All Products |
$999.74
|
| Rate for Payer: Signature Care EPO |
$1,074.85
|
| Rate for Payer: Signature Care PPO |
$1,139.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,100.75
|
| Rate for Payer: United Healthcare Commercial |
$1,020.46
|
| Rate for Payer: United Healthcare Medicare |
$427.35
|
|
|
HC W SCREW 2.4X20 LOCK TM
|
Facility
IP
|
$1,295.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604902
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$971.25 |
| Max. Negotiated Rate |
$1,204.35 |
| Rate for Payer: Aetna Commercial |
$1,118.88
|
| Rate for Payer: Cash Price |
$802.90
|
| Rate for Payer: Cigna All Commercial |
$1,117.58
|
| Rate for Payer: CORVEL All Commercial |
$1,204.35
|
| Rate for Payer: Coventry All Commercial |
$1,139.60
|
| Rate for Payer: Encore All Commercial |
$1,192.05
|
| Rate for Payer: Frontpath All Commercial |
$1,191.40
|
| Rate for Payer: Humana ChoiceCare |
$1,118.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,165.50
|
| Rate for Payer: PHCS All Commercial |
$971.25
|
| Rate for Payer: PHP All Commercial |
$982.13
|
| Rate for Payer: Sagamore Health Network All Products |
$999.74
|
| Rate for Payer: Signature Care EPO |
$1,074.85
|
| Rate for Payer: Signature Care PPO |
$1,139.60
|
| Rate for Payer: United Healthcare Commercial |
$1,020.46
|
|
|
HC W SCREW 2.4X20 NON LOCK TM
|
Facility
OP
|
$763.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604914
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$251.79 |
| Max. Negotiated Rate |
$709.59 |
| Rate for Payer: Aetna Commercial |
$643.97
|
| Rate for Payer: Aetna Medicare |
$251.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$251.79
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$438.19
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$476.95
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$289.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$276.97
|
| Rate for Payer: Cash Price |
$473.06
|
| Rate for Payer: Cash Price |
$473.06
|
| Rate for Payer: Centivo All Commercial |
$389.13
|
| Rate for Payer: Cigna All Commercial |
$658.47
|
| Rate for Payer: CORVEL All Commercial |
$709.59
|
| Rate for Payer: Coventry All Commercial |
$671.44
|
| Rate for Payer: Encore All Commercial |
$702.34
|
| Rate for Payer: Frontpath All Commercial |
$701.96
|
| Rate for Payer: Humana ChoiceCare |
$659.00
|
| Rate for Payer: Humana Medicare |
$389.13
|
| Rate for Payer: Lucent All Commercial |
$389.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$686.70
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$572.25
|
| Rate for Payer: PHP All Commercial |
$578.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$297.57
|
| Rate for Payer: Sagamore Health Network All Products |
$589.04
|
| Rate for Payer: Signature Care EPO |
$633.29
|
| Rate for Payer: Signature Care PPO |
$671.44
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$648.55
|
| Rate for Payer: United Healthcare Commercial |
$601.24
|
| Rate for Payer: United Healthcare Medicare |
$251.79
|
|
|
HC W SCREW 2.4X20 NON LOCK TM
|
Facility
IP
|
$763.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604914
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$572.25 |
| Max. Negotiated Rate |
$709.59 |
| Rate for Payer: Aetna Commercial |
$659.23
|
| Rate for Payer: Cash Price |
$473.06
|
| Rate for Payer: Cigna All Commercial |
$658.47
|
| Rate for Payer: CORVEL All Commercial |
$709.59
|
| Rate for Payer: Coventry All Commercial |
$671.44
|
| Rate for Payer: Encore All Commercial |
$702.34
|
| Rate for Payer: Frontpath All Commercial |
$701.96
|
| Rate for Payer: Humana ChoiceCare |
$659.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$686.70
|
| Rate for Payer: PHCS All Commercial |
$572.25
|
| Rate for Payer: PHP All Commercial |
$578.66
|
| Rate for Payer: Sagamore Health Network All Products |
$589.04
|
| Rate for Payer: Signature Care EPO |
$633.29
|
| Rate for Payer: Signature Care PPO |
$671.44
|
| Rate for Payer: United Healthcare Commercial |
$601.24
|
|
|
HC W SCREW 2.4X22 LOCK TM
|
Facility
OP
|
$1,295.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604903
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$427.35 |
| Max. Negotiated Rate |
$1,204.35 |
| Rate for Payer: Aetna Commercial |
$1,092.98
|
| Rate for Payer: Aetna Medicare |
$427.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$427.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$743.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$809.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$491.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$470.08
|
| Rate for Payer: Cash Price |
$802.90
|
| Rate for Payer: Cash Price |
$802.90
|
| Rate for Payer: Centivo All Commercial |
$660.45
|
| Rate for Payer: Cigna All Commercial |
$1,117.58
|
| Rate for Payer: CORVEL All Commercial |
$1,204.35
|
| Rate for Payer: Coventry All Commercial |
$1,139.60
|
| Rate for Payer: Encore All Commercial |
$1,192.05
|
| Rate for Payer: Frontpath All Commercial |
$1,191.40
|
| Rate for Payer: Humana ChoiceCare |
$1,118.49
|
| Rate for Payer: Humana Medicare |
$660.45
|
| Rate for Payer: Lucent All Commercial |
$660.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,165.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$971.25
|
| Rate for Payer: PHP All Commercial |
$982.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$505.05
|
| Rate for Payer: Sagamore Health Network All Products |
$999.74
|
| Rate for Payer: Signature Care EPO |
$1,074.85
|
| Rate for Payer: Signature Care PPO |
$1,139.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,100.75
|
| Rate for Payer: United Healthcare Commercial |
$1,020.46
|
| Rate for Payer: United Healthcare Medicare |
$427.35
|
|
