|
HC W SCREW 2.7X12 CORT LP
|
Facility
IP
|
$861.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604844
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$645.75 |
| Max. Negotiated Rate |
$800.73 |
| Rate for Payer: Aetna Commercial |
$743.90
|
| Rate for Payer: Cash Price |
$533.82
|
| Rate for Payer: Cigna All Commercial |
$743.04
|
| Rate for Payer: CORVEL All Commercial |
$800.73
|
| Rate for Payer: Coventry All Commercial |
$757.68
|
| Rate for Payer: Encore All Commercial |
$792.55
|
| Rate for Payer: Frontpath All Commercial |
$792.12
|
| Rate for Payer: Humana ChoiceCare |
$743.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$774.90
|
| Rate for Payer: PHCS All Commercial |
$645.75
|
| Rate for Payer: PHP All Commercial |
$652.98
|
| Rate for Payer: Sagamore Health Network All Products |
$664.69
|
| Rate for Payer: Signature Care EPO |
$714.63
|
| Rate for Payer: Signature Care PPO |
$757.68
|
| Rate for Payer: United Healthcare Commercial |
$678.47
|
|
|
HC W SCREW 2.7X12 LOCK
|
Facility
IP
|
$1,210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604771
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$907.50 |
| Max. Negotiated Rate |
$1,125.30 |
| Rate for Payer: Aetna Commercial |
$1,045.44
|
| Rate for Payer: Cash Price |
$750.20
|
| Rate for Payer: Cigna All Commercial |
$1,044.23
|
| Rate for Payer: CORVEL All Commercial |
$1,125.30
|
| Rate for Payer: Coventry All Commercial |
$1,064.80
|
| Rate for Payer: Encore All Commercial |
$1,113.80
|
| Rate for Payer: Frontpath All Commercial |
$1,113.20
|
| Rate for Payer: Humana ChoiceCare |
$1,045.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,089.00
|
| Rate for Payer: PHCS All Commercial |
$907.50
|
| Rate for Payer: PHP All Commercial |
$917.66
|
| Rate for Payer: Sagamore Health Network All Products |
$934.12
|
| Rate for Payer: Signature Care EPO |
$1,004.30
|
| Rate for Payer: Signature Care PPO |
$1,064.80
|
| Rate for Payer: United Healthcare Commercial |
$953.48
|
|
|
HC W SCREW 2.7X12 LOCK
|
Facility
OP
|
$1,210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604771
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$399.30 |
| Max. Negotiated Rate |
$1,125.30 |
| Rate for Payer: Aetna Commercial |
$1,021.24
|
| Rate for Payer: Aetna Medicare |
$399.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$399.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$694.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$756.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$459.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$439.23
|
| Rate for Payer: Cash Price |
$750.20
|
| Rate for Payer: Cash Price |
$750.20
|
| Rate for Payer: Centivo All Commercial |
$617.10
|
| Rate for Payer: Cigna All Commercial |
$1,044.23
|
| Rate for Payer: CORVEL All Commercial |
$1,125.30
|
| Rate for Payer: Coventry All Commercial |
$1,064.80
|
| Rate for Payer: Encore All Commercial |
$1,113.80
|
| Rate for Payer: Frontpath All Commercial |
$1,113.20
|
| Rate for Payer: Humana ChoiceCare |
$1,045.08
|
| Rate for Payer: Humana Medicare |
$617.10
|
| Rate for Payer: Lucent All Commercial |
$617.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,089.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$907.50
|
| Rate for Payer: PHP All Commercial |
$917.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$471.90
|
| Rate for Payer: Sagamore Health Network All Products |
$934.12
|
| Rate for Payer: Signature Care EPO |
$1,004.30
|
| Rate for Payer: Signature Care PPO |
$1,064.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,028.50
|
| Rate for Payer: United Healthcare Commercial |
$953.48
|
| Rate for Payer: United Healthcare Medicare |
$399.30
|
|
|
HC W SCREW 2.7X14 CORT LP
|
Facility
IP
|
$861.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605846
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$645.75 |
| Max. Negotiated Rate |
$800.73 |
| Rate for Payer: Aetna Commercial |
$743.90
|
| Rate for Payer: Cash Price |
$533.82
|
| Rate for Payer: Cigna All Commercial |
$743.04
|
| Rate for Payer: CORVEL All Commercial |
$800.73
|
| Rate for Payer: Coventry All Commercial |
$757.68
|
| Rate for Payer: Encore All Commercial |
$792.55
|
| Rate for Payer: Frontpath All Commercial |
$792.12
|
| Rate for Payer: Humana ChoiceCare |
$743.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$774.90
|
| Rate for Payer: PHCS All Commercial |
$645.75
|
| Rate for Payer: PHP All Commercial |
$652.98
|
| Rate for Payer: Sagamore Health Network All Products |
$664.69
|
| Rate for Payer: Signature Care EPO |
$714.63
|
| Rate for Payer: Signature Care PPO |
$757.68
|
| Rate for Payer: United Healthcare Commercial |
$678.47
|
|
|
HC W SCREW 2.7X14 CORT LP
|
Facility
OP
|
$861.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605846
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$284.13 |
| Max. Negotiated Rate |
$800.73 |
| Rate for Payer: Aetna Commercial |
$726.68
|
| Rate for Payer: Aetna Medicare |
$284.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$284.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$494.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$538.21
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$326.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$312.54
|
| Rate for Payer: Cash Price |
$533.82
|
| Rate for Payer: Cash Price |
$533.82
|
| Rate for Payer: Centivo All Commercial |
$439.11
|
| Rate for Payer: Cigna All Commercial |
$743.04
|
| Rate for Payer: CORVEL All Commercial |
$800.73
|
| Rate for Payer: Coventry All Commercial |
$757.68
|
| Rate for Payer: Encore All Commercial |
$792.55
|
| Rate for Payer: Frontpath All Commercial |
$792.12
|
| Rate for Payer: Humana ChoiceCare |
$743.65
|
| Rate for Payer: Humana Medicare |
$439.11
|
| Rate for Payer: Lucent All Commercial |
$439.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$774.90
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$645.75
|
| Rate for Payer: PHP All Commercial |
$652.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$335.79
|
| Rate for Payer: Sagamore Health Network All Products |
$664.69
|
| Rate for Payer: Signature Care EPO |
$714.63
|
| Rate for Payer: Signature Care PPO |
$757.68
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$731.85
|
| Rate for Payer: United Healthcare Commercial |
$678.47
|
| Rate for Payer: United Healthcare Medicare |
$284.13
|
|
|
HC W SCREW 2.7X14 LOCK
|
Facility
OP
|
$900.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604772
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$297.00 |
| Max. Negotiated Rate |
$837.00 |
| Rate for Payer: Aetna Commercial |
$759.60
|
| Rate for Payer: Aetna Medicare |
$297.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$297.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$516.87
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$562.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$341.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$326.70
|
| Rate for Payer: Cash Price |
$558.00
|
| Rate for Payer: Cash Price |
$558.00
|
| Rate for Payer: Centivo All Commercial |
$459.00
|
| Rate for Payer: Cigna All Commercial |
$776.70
|
| Rate for Payer: CORVEL All Commercial |
$837.00
|
| Rate for Payer: Coventry All Commercial |
$792.00
|
| Rate for Payer: Encore All Commercial |
$828.45
|
| Rate for Payer: Frontpath All Commercial |
$828.00
|
| Rate for Payer: Humana ChoiceCare |
$777.33
|
| Rate for Payer: Humana Medicare |
$459.00
|
| Rate for Payer: Lucent All Commercial |
$459.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$810.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$675.00
|
| Rate for Payer: PHP All Commercial |
$682.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$351.00
|
| Rate for Payer: Sagamore Health Network All Products |
$694.80
|
| Rate for Payer: Signature Care EPO |
$747.00
|
| Rate for Payer: Signature Care PPO |
$792.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$765.00
|
| Rate for Payer: United Healthcare Commercial |
$709.20
|
| Rate for Payer: United Healthcare Medicare |
$297.00
|
|
|
HC W SCREW 2.7X14 LOCK
|
Facility
IP
|
$900.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604772
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$675.00 |
| Max. Negotiated Rate |
$837.00 |
| Rate for Payer: Aetna Commercial |
$777.60
|
| Rate for Payer: Cash Price |
$558.00
|
| Rate for Payer: Cigna All Commercial |
$776.70
|
| Rate for Payer: CORVEL All Commercial |
$837.00
|
| Rate for Payer: Coventry All Commercial |
$792.00
|
| Rate for Payer: Encore All Commercial |
$828.45
|
| Rate for Payer: Frontpath All Commercial |
$828.00
|
| Rate for Payer: Humana ChoiceCare |
$777.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$810.00
|
| Rate for Payer: PHCS All Commercial |
$675.00
|
| Rate for Payer: PHP All Commercial |
$682.56
|
| Rate for Payer: Sagamore Health Network All Products |
$694.80
|
| Rate for Payer: Signature Care EPO |
$747.00
|
| Rate for Payer: Signature Care PPO |
$792.00
|
| Rate for Payer: United Healthcare Commercial |
$709.20
|
|
|
HC W SCREW 2.7X14 LOCK HD
|
Facility
OP
|
$1,210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606319
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$399.30 |
| Max. Negotiated Rate |
$1,125.30 |
| Rate for Payer: Aetna Commercial |
$1,021.24
|
| Rate for Payer: Aetna Medicare |
$399.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$399.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$694.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$756.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$459.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$439.23
|
| Rate for Payer: Cash Price |
$750.20
|
| Rate for Payer: Cash Price |
$750.20
|
| Rate for Payer: Centivo All Commercial |
$617.10
|
| Rate for Payer: Cigna All Commercial |
$1,044.23
|
| Rate for Payer: CORVEL All Commercial |
$1,125.30
|
| Rate for Payer: Coventry All Commercial |
$1,064.80
|
| Rate for Payer: Encore All Commercial |
$1,113.80
|
| Rate for Payer: Frontpath All Commercial |
$1,113.20
|
| Rate for Payer: Humana ChoiceCare |
$1,045.08
|
| Rate for Payer: Humana Medicare |
$617.10
|
| Rate for Payer: Lucent All Commercial |
$617.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,089.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$907.50
|
| Rate for Payer: PHP All Commercial |
$917.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$471.90
|
| Rate for Payer: Sagamore Health Network All Products |
$934.12
|
| Rate for Payer: Signature Care EPO |
$1,004.30
|
| Rate for Payer: Signature Care PPO |
$1,064.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,028.50
|
| Rate for Payer: United Healthcare Commercial |
$953.48
|
| Rate for Payer: United Healthcare Medicare |
$399.30
|
|
|
HC W SCREW 2.7X14 LOCK HD
|
Facility
IP
|
$1,210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606319
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$907.50 |
| Max. Negotiated Rate |
$1,125.30 |
| Rate for Payer: Aetna Commercial |
$1,045.44
|
| Rate for Payer: Cash Price |
$750.20
|
| Rate for Payer: Cigna All Commercial |
$1,044.23
|
| Rate for Payer: CORVEL All Commercial |
$1,125.30
|
| Rate for Payer: Coventry All Commercial |
$1,064.80
|
| Rate for Payer: Encore All Commercial |
$1,113.80
|
| Rate for Payer: Frontpath All Commercial |
$1,113.20
|
| Rate for Payer: Humana ChoiceCare |
$1,045.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,089.00
|
| Rate for Payer: PHCS All Commercial |
$907.50
|
| Rate for Payer: PHP All Commercial |
$917.66
|
| Rate for Payer: Sagamore Health Network All Products |
$934.12
|
| Rate for Payer: Signature Care EPO |
$1,004.30
|
| Rate for Payer: Signature Care PPO |
$1,064.80
|
| Rate for Payer: United Healthcare Commercial |
$953.48
|
|
|
HC W SCREW 2.7X16 CORT LP
|
Facility
OP
|
$861.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604373
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$284.13 |
| Max. Negotiated Rate |
$800.73 |
| Rate for Payer: Aetna Commercial |
$726.68
|
| Rate for Payer: Aetna Medicare |
$284.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$284.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$494.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$538.21
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$326.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$312.54
|
| Rate for Payer: Cash Price |
$533.82
|
| Rate for Payer: Cash Price |
$533.82
|
| Rate for Payer: Centivo All Commercial |
$439.11
|
| Rate for Payer: Cigna All Commercial |
$743.04
|
| Rate for Payer: CORVEL All Commercial |
$800.73
|
| Rate for Payer: Coventry All Commercial |
$757.68
|
| Rate for Payer: Encore All Commercial |
$792.55
|
| Rate for Payer: Frontpath All Commercial |
$792.12
|
| Rate for Payer: Humana ChoiceCare |
$743.65
|
| Rate for Payer: Humana Medicare |
$439.11
|
| Rate for Payer: Lucent All Commercial |
$439.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$774.90
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$645.75
|
| Rate for Payer: PHP All Commercial |
$652.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$335.79
|
| Rate for Payer: Sagamore Health Network All Products |
$664.69
|
| Rate for Payer: Signature Care EPO |
$714.63
|
| Rate for Payer: Signature Care PPO |
$757.68
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$731.85
|
| Rate for Payer: United Healthcare Commercial |
$678.47
|
| Rate for Payer: United Healthcare Medicare |
$284.13
|
|
|
HC W SCREW 2.7X16 CORT LP
|
Facility
IP
|
$861.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604373
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$645.75 |
| Max. Negotiated Rate |
$800.73 |
| Rate for Payer: Aetna Commercial |
$743.90
|
| Rate for Payer: Cash Price |
$533.82
|
| Rate for Payer: Cigna All Commercial |
$743.04
|
| Rate for Payer: CORVEL All Commercial |
$800.73
|
| Rate for Payer: Coventry All Commercial |
$757.68
|
| Rate for Payer: Encore All Commercial |
$792.55
|
| Rate for Payer: Frontpath All Commercial |
$792.12
|
| Rate for Payer: Humana ChoiceCare |
$743.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$774.90
|
| Rate for Payer: PHCS All Commercial |
$645.75
|
| Rate for Payer: PHP All Commercial |
$652.98
|
| Rate for Payer: Sagamore Health Network All Products |
$664.69
|
| Rate for Payer: Signature Care EPO |
$714.63
|
| Rate for Payer: Signature Care PPO |
$757.68
|
| Rate for Payer: United Healthcare Commercial |
$678.47
|
|
|
HC W SCREW 2.7X16 LOCK
|
Facility
OP
|
$1,210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604359
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$399.30 |
| Max. Negotiated Rate |
$1,125.30 |
| Rate for Payer: Aetna Commercial |
$1,021.24
|
| Rate for Payer: Aetna Medicare |
$399.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$399.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$694.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$756.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$459.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$439.23
|
| Rate for Payer: Cash Price |
$750.20
|
| Rate for Payer: Cash Price |
$750.20
|
| Rate for Payer: Centivo All Commercial |
$617.10
|
| Rate for Payer: Cigna All Commercial |
$1,044.23
|
| Rate for Payer: CORVEL All Commercial |
$1,125.30
|
| Rate for Payer: Coventry All Commercial |
$1,064.80
|
| Rate for Payer: Encore All Commercial |
$1,113.80
|
| Rate for Payer: Frontpath All Commercial |
$1,113.20
|
| Rate for Payer: Humana ChoiceCare |
$1,045.08
|
| Rate for Payer: Humana Medicare |
$617.10
|
| Rate for Payer: Lucent All Commercial |
$617.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,089.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$907.50
|
| Rate for Payer: PHP All Commercial |
$917.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$471.90
|
| Rate for Payer: Sagamore Health Network All Products |
$934.12
|
| Rate for Payer: Signature Care EPO |
$1,004.30
|
| Rate for Payer: Signature Care PPO |
$1,064.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,028.50
|
| Rate for Payer: United Healthcare Commercial |
$953.48
|
| Rate for Payer: United Healthcare Medicare |
$399.30
|
|
|
HC W SCREW 2.7X16 LOCK
|
Facility
IP
|
$1,210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604359
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$907.50 |
| Max. Negotiated Rate |
$1,125.30 |
| Rate for Payer: Aetna Commercial |
$1,045.44
|
| Rate for Payer: Cash Price |
$750.20
|
| Rate for Payer: Cigna All Commercial |
$1,044.23
|
| Rate for Payer: CORVEL All Commercial |
$1,125.30
|
| Rate for Payer: Coventry All Commercial |
$1,064.80
|
| Rate for Payer: Encore All Commercial |
$1,113.80
|
| Rate for Payer: Frontpath All Commercial |
$1,113.20
|
| Rate for Payer: Humana ChoiceCare |
$1,045.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,089.00
|
| Rate for Payer: PHCS All Commercial |
$907.50
|
| Rate for Payer: PHP All Commercial |
$917.66
|
| Rate for Payer: Sagamore Health Network All Products |
$934.12
|
| Rate for Payer: Signature Care EPO |
$1,004.30
|
| Rate for Payer: Signature Care PPO |
$1,064.80
|
| Rate for Payer: United Healthcare Commercial |
$953.48
|
|
|
HC W SCREW 2.7X18 CORT LP
|
Facility
OP
|
$861.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604358
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$284.13 |
| Max. Negotiated Rate |
$800.73 |
| Rate for Payer: Aetna Commercial |
$726.68
|
| Rate for Payer: Aetna Medicare |
$284.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$284.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$494.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$538.21
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$326.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$312.54
|
| Rate for Payer: Cash Price |
$533.82
|
| Rate for Payer: Cash Price |
$533.82
|
| Rate for Payer: Centivo All Commercial |
$439.11
|
| Rate for Payer: Cigna All Commercial |
$743.04
|
| Rate for Payer: CORVEL All Commercial |
$800.73
|
| Rate for Payer: Coventry All Commercial |
$757.68
|
| Rate for Payer: Encore All Commercial |
$792.55
|
| Rate for Payer: Frontpath All Commercial |
$792.12
|
| Rate for Payer: Humana ChoiceCare |
$743.65
|
| Rate for Payer: Humana Medicare |
$439.11
|
| Rate for Payer: Lucent All Commercial |
$439.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$774.90
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$645.75
|
| Rate for Payer: PHP All Commercial |
$652.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$335.79
|
| Rate for Payer: Sagamore Health Network All Products |
$664.69
|
| Rate for Payer: Signature Care EPO |
$714.63
|
| Rate for Payer: Signature Care PPO |
$757.68
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$731.85
|
| Rate for Payer: United Healthcare Commercial |
$678.47
|
| Rate for Payer: United Healthcare Medicare |
$284.13
|
|
|
HC W SCREW 2.7X18 CORT LP
|
Facility
IP
|
$861.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604358
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$645.75 |
| Max. Negotiated Rate |
$800.73 |
| Rate for Payer: Aetna Commercial |
$743.90
|
| Rate for Payer: Cash Price |
$533.82
|
| Rate for Payer: Cigna All Commercial |
$743.04
|
| Rate for Payer: CORVEL All Commercial |
$800.73
|
| Rate for Payer: Coventry All Commercial |
$757.68
|
| Rate for Payer: Encore All Commercial |
$792.55
|
| Rate for Payer: Frontpath All Commercial |
$792.12
|
| Rate for Payer: Humana ChoiceCare |
$743.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$774.90
|
| Rate for Payer: PHCS All Commercial |
$645.75
|
| Rate for Payer: PHP All Commercial |
$652.98
|
| Rate for Payer: Sagamore Health Network All Products |
$664.69
|
| Rate for Payer: Signature Care EPO |
$714.63
|
| Rate for Payer: Signature Care PPO |
$757.68
|
| Rate for Payer: United Healthcare Commercial |
$678.47
|
|
|
HC W SCREW 2.7X18 LOCK
|
Facility
OP
|
$1,210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603573
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$399.30 |
| Max. Negotiated Rate |
$1,125.30 |
| Rate for Payer: Aetna Commercial |
$1,021.24
|
| Rate for Payer: Aetna Medicare |
$399.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$399.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$694.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$756.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$459.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$439.23
|
| Rate for Payer: Cash Price |
$750.20
|
| Rate for Payer: Cash Price |
$750.20
|
| Rate for Payer: Centivo All Commercial |
$617.10
|
| Rate for Payer: Cigna All Commercial |
$1,044.23
|
| Rate for Payer: CORVEL All Commercial |
$1,125.30
|
| Rate for Payer: Coventry All Commercial |
$1,064.80
|
| Rate for Payer: Encore All Commercial |
$1,113.80
|
| Rate for Payer: Frontpath All Commercial |
$1,113.20
|
| Rate for Payer: Humana ChoiceCare |
$1,045.08
|
| Rate for Payer: Humana Medicare |
$617.10
|
| Rate for Payer: Lucent All Commercial |
$617.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,089.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$907.50
|
| Rate for Payer: PHP All Commercial |
$917.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$471.90
|
| Rate for Payer: Sagamore Health Network All Products |
$934.12
|
| Rate for Payer: Signature Care EPO |
$1,004.30
|
| Rate for Payer: Signature Care PPO |
$1,064.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,028.50
|
| Rate for Payer: United Healthcare Commercial |
$953.48
|
| Rate for Payer: United Healthcare Medicare |
$399.30
|
|
|
HC W SCREW 2.7X18 LOCK
|
Facility
IP
|
$1,210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603573
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$907.50 |
| Max. Negotiated Rate |
$1,125.30 |
| Rate for Payer: Aetna Commercial |
$1,045.44
|
| Rate for Payer: Cash Price |
$750.20
|
| Rate for Payer: Cigna All Commercial |
$1,044.23
|
| Rate for Payer: CORVEL All Commercial |
$1,125.30
|
| Rate for Payer: Coventry All Commercial |
$1,064.80
|
| Rate for Payer: Encore All Commercial |
$1,113.80
|
| Rate for Payer: Frontpath All Commercial |
$1,113.20
|
| Rate for Payer: Humana ChoiceCare |
$1,045.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,089.00
|
| Rate for Payer: PHCS All Commercial |
$907.50
|
| Rate for Payer: PHP All Commercial |
$917.66
|
| Rate for Payer: Sagamore Health Network All Products |
$934.12
|
| Rate for Payer: Signature Care EPO |
$1,004.30
|
| Rate for Payer: Signature Care PPO |
$1,064.80
|
| Rate for Payer: United Healthcare Commercial |
$953.48
|
|
|
HC W SCREW 2.7X20 CORT LP
|
Facility
IP
|
$861.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604626
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$645.75 |
| Max. Negotiated Rate |
$800.73 |
| Rate for Payer: Aetna Commercial |
$743.90
|
| Rate for Payer: Cash Price |
$533.82
|
| Rate for Payer: Cigna All Commercial |
$743.04
|
| Rate for Payer: CORVEL All Commercial |
$800.73
|
| Rate for Payer: Coventry All Commercial |
$757.68
|
| Rate for Payer: Encore All Commercial |
$792.55
|
| Rate for Payer: Frontpath All Commercial |
$792.12
|
| Rate for Payer: Humana ChoiceCare |
$743.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$774.90
|
| Rate for Payer: PHCS All Commercial |
$645.75
|
| Rate for Payer: PHP All Commercial |
$652.98
|
| Rate for Payer: Sagamore Health Network All Products |
$664.69
|
| Rate for Payer: Signature Care EPO |
$714.63
|
| Rate for Payer: Signature Care PPO |
$757.68
|
| Rate for Payer: United Healthcare Commercial |
$678.47
|
|
|
HC W SCREW 2.7X20 CORT LP
|
Facility
OP
|
$861.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604626
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$284.13 |
| Max. Negotiated Rate |
$800.73 |
| Rate for Payer: Aetna Commercial |
$726.68
|
| Rate for Payer: Aetna Medicare |
$284.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$284.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$494.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$538.21
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$326.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$312.54
|
| Rate for Payer: Cash Price |
$533.82
|
| Rate for Payer: Cash Price |
$533.82
|
| Rate for Payer: Centivo All Commercial |
$439.11
|
| Rate for Payer: Cigna All Commercial |
$743.04
|
| Rate for Payer: CORVEL All Commercial |
$800.73
|
| Rate for Payer: Coventry All Commercial |
$757.68
|
| Rate for Payer: Encore All Commercial |
$792.55
|
| Rate for Payer: Frontpath All Commercial |
$792.12
|
| Rate for Payer: Humana ChoiceCare |
$743.65
|
| Rate for Payer: Humana Medicare |
$439.11
|
| Rate for Payer: Lucent All Commercial |
$439.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$774.90
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$645.75
|
| Rate for Payer: PHP All Commercial |
$652.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$335.79
|
| Rate for Payer: Sagamore Health Network All Products |
$664.69
|
| Rate for Payer: Signature Care EPO |
$714.63
|
| Rate for Payer: Signature Care PPO |
$757.68
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$731.85
|
| Rate for Payer: United Healthcare Commercial |
$678.47
|
| Rate for Payer: United Healthcare Medicare |
$284.13
|
|
|
HC W SCREW 2.7X20 LOCK
|
Facility
IP
|
$1,210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603574
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$907.50 |
| Max. Negotiated Rate |
$1,125.30 |
| Rate for Payer: Aetna Commercial |
$1,045.44
|
| Rate for Payer: Cash Price |
$750.20
|
| Rate for Payer: Cigna All Commercial |
$1,044.23
|
| Rate for Payer: CORVEL All Commercial |
$1,125.30
|
| Rate for Payer: Coventry All Commercial |
$1,064.80
|
| Rate for Payer: Encore All Commercial |
$1,113.80
|
| Rate for Payer: Frontpath All Commercial |
$1,113.20
|
| Rate for Payer: Humana ChoiceCare |
$1,045.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,089.00
|
| Rate for Payer: PHCS All Commercial |
$907.50
|
| Rate for Payer: PHP All Commercial |
$917.66
|
| Rate for Payer: Sagamore Health Network All Products |
$934.12
|
| Rate for Payer: Signature Care EPO |
$1,004.30
|
| Rate for Payer: Signature Care PPO |
$1,064.80
|
| Rate for Payer: United Healthcare Commercial |
$953.48
|
|
|
HC W SCREW 2.7X20 LOCK
|
Facility
OP
|
$1,210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603574
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$399.30 |
| Max. Negotiated Rate |
$1,125.30 |
| Rate for Payer: Aetna Commercial |
$1,021.24
|
| Rate for Payer: Aetna Medicare |
$399.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$399.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$694.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$756.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$459.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$439.23
|
| Rate for Payer: Cash Price |
$750.20
|
| Rate for Payer: Cash Price |
$750.20
|
| Rate for Payer: Centivo All Commercial |
$617.10
|
| Rate for Payer: Cigna All Commercial |
$1,044.23
|
| Rate for Payer: CORVEL All Commercial |
$1,125.30
|
| Rate for Payer: Coventry All Commercial |
$1,064.80
|
| Rate for Payer: Encore All Commercial |
$1,113.80
|
| Rate for Payer: Frontpath All Commercial |
$1,113.20
|
| Rate for Payer: Humana ChoiceCare |
$1,045.08
|
| Rate for Payer: Humana Medicare |
$617.10
|
| Rate for Payer: Lucent All Commercial |
$617.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,089.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$907.50
|
| Rate for Payer: PHP All Commercial |
$917.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$471.90
|
| Rate for Payer: Sagamore Health Network All Products |
$934.12
|
| Rate for Payer: Signature Care EPO |
$1,004.30
|
| Rate for Payer: Signature Care PPO |
$1,064.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,028.50
|
| Rate for Payer: United Healthcare Commercial |
$953.48
|
| Rate for Payer: United Healthcare Medicare |
$399.30
|
|
|
HC W SCREW 2.7X22 CORT LP
|
Facility
OP
|
$861.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604845
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$284.13 |
| Max. Negotiated Rate |
$800.73 |
| Rate for Payer: Aetna Commercial |
$726.68
|
| Rate for Payer: Aetna Medicare |
$284.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$284.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$494.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$538.21
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$326.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$312.54
|
| Rate for Payer: Cash Price |
$533.82
|
| Rate for Payer: Cash Price |
$533.82
|
| Rate for Payer: Centivo All Commercial |
$439.11
|
| Rate for Payer: Cigna All Commercial |
$743.04
|
| Rate for Payer: CORVEL All Commercial |
$800.73
|
| Rate for Payer: Coventry All Commercial |
$757.68
|
| Rate for Payer: Encore All Commercial |
$792.55
|
| Rate for Payer: Frontpath All Commercial |
$792.12
|
| Rate for Payer: Humana ChoiceCare |
$743.65
|
| Rate for Payer: Humana Medicare |
$439.11
|
| Rate for Payer: Lucent All Commercial |
$439.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$774.90
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$645.75
|
| Rate for Payer: PHP All Commercial |
$652.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$335.79
|
| Rate for Payer: Sagamore Health Network All Products |
$664.69
|
| Rate for Payer: Signature Care EPO |
$714.63
|
| Rate for Payer: Signature Care PPO |
$757.68
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$731.85
|
| Rate for Payer: United Healthcare Commercial |
$678.47
|
| Rate for Payer: United Healthcare Medicare |
$284.13
|
|
|
HC W SCREW 2.7X22 CORT LP
|
Facility
IP
|
$861.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604845
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$645.75 |
| Max. Negotiated Rate |
$800.73 |
| Rate for Payer: Aetna Commercial |
$743.90
|
| Rate for Payer: Cash Price |
$533.82
|
| Rate for Payer: Cigna All Commercial |
$743.04
|
| Rate for Payer: CORVEL All Commercial |
$800.73
|
| Rate for Payer: Coventry All Commercial |
$757.68
|
| Rate for Payer: Encore All Commercial |
$792.55
|
| Rate for Payer: Frontpath All Commercial |
$792.12
|
| Rate for Payer: Humana ChoiceCare |
$743.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$774.90
|
| Rate for Payer: PHCS All Commercial |
$645.75
|
| Rate for Payer: PHP All Commercial |
$652.98
|
| Rate for Payer: Sagamore Health Network All Products |
$664.69
|
| Rate for Payer: Signature Care EPO |
$714.63
|
| Rate for Payer: Signature Care PPO |
$757.68
|
| Rate for Payer: United Healthcare Commercial |
$678.47
|
|
|
HC W SCREW 2.7X22 LOCK
|
Facility
IP
|
$1,210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603575
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$907.50 |
| Max. Negotiated Rate |
$1,125.30 |
| Rate for Payer: Aetna Commercial |
$1,045.44
|
| Rate for Payer: Cash Price |
$750.20
|
| Rate for Payer: Cigna All Commercial |
$1,044.23
|
| Rate for Payer: CORVEL All Commercial |
$1,125.30
|
| Rate for Payer: Coventry All Commercial |
$1,064.80
|
| Rate for Payer: Encore All Commercial |
$1,113.80
|
| Rate for Payer: Frontpath All Commercial |
$1,113.20
|
| Rate for Payer: Humana ChoiceCare |
$1,045.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,089.00
|
| Rate for Payer: PHCS All Commercial |
$907.50
|
| Rate for Payer: PHP All Commercial |
$917.66
|
| Rate for Payer: Sagamore Health Network All Products |
$934.12
|
| Rate for Payer: Signature Care EPO |
$1,004.30
|
| Rate for Payer: Signature Care PPO |
$1,064.80
|
| Rate for Payer: United Healthcare Commercial |
$953.48
|
|
|
HC W SCREW 2.7X22 LOCK
|
Facility
OP
|
$1,210.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603575
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$399.30 |
| Max. Negotiated Rate |
$1,125.30 |
| Rate for Payer: Aetna Commercial |
$1,021.24
|
| Rate for Payer: Aetna Medicare |
$399.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$399.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$694.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$756.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$459.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$439.23
|
| Rate for Payer: Cash Price |
$750.20
|
| Rate for Payer: Cash Price |
$750.20
|
| Rate for Payer: Centivo All Commercial |
$617.10
|
| Rate for Payer: Cigna All Commercial |
$1,044.23
|
| Rate for Payer: CORVEL All Commercial |
$1,125.30
|
| Rate for Payer: Coventry All Commercial |
$1,064.80
|
| Rate for Payer: Encore All Commercial |
$1,113.80
|
| Rate for Payer: Frontpath All Commercial |
$1,113.20
|
| Rate for Payer: Humana ChoiceCare |
$1,045.08
|
| Rate for Payer: Humana Medicare |
$617.10
|
| Rate for Payer: Lucent All Commercial |
$617.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,089.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$907.50
|
| Rate for Payer: PHP All Commercial |
$917.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$471.90
|
| Rate for Payer: Sagamore Health Network All Products |
$934.12
|
| Rate for Payer: Signature Care EPO |
$1,004.30
|
| Rate for Payer: Signature Care PPO |
$1,064.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,028.50
|
| Rate for Payer: United Healthcare Commercial |
$953.48
|
| Rate for Payer: United Healthcare Medicare |
$399.30
|
|
