|
HC W SCREW 2.7X24 CORT LP
|
Facility
OP
|
$861.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604846
|
|
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 2.7X24 CORT LP
|
Facility
IP
|
$861.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604846
|
|
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 2.7X26 CORT LP
|
Facility
IP
|
$861.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604847
|
|
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 2.7X26 CORT LP
|
Facility
OP
|
$861.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604847
|
|
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 2.7X28 CORT LP
|
Facility
OP
|
$861.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604848
|
|
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 2.7X28 CORT LP
|
Facility
IP
|
$861.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604848
|
|
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 2.7X30 CORT LP
|
Facility
IP
|
$861.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604849
|
|
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 2.7X30 CORT LP
|
Facility
OP
|
$861.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604849
|
|
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 3.0X12 HDLS
|
Facility
OP
|
$1,340.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606120
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$442.20 |
| Max. Negotiated Rate |
$1,246.20 |
| Rate for Payer: Aetna Commercial |
$1,130.96
|
| Rate for Payer: Aetna Medicare |
$442.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$442.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$769.56
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$837.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$508.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$486.42
|
| Rate for Payer: Cash Price |
$830.80
|
| Rate for Payer: Cash Price |
$830.80
|
| Rate for Payer: Centivo All Commercial |
$683.40
|
| Rate for Payer: Cigna All Commercial |
$1,156.42
|
| Rate for Payer: CORVEL All Commercial |
$1,246.20
|
| Rate for Payer: Coventry All Commercial |
$1,179.20
|
| Rate for Payer: Encore All Commercial |
$1,233.47
|
| Rate for Payer: Frontpath All Commercial |
$1,232.80
|
| Rate for Payer: Humana ChoiceCare |
$1,157.36
|
| Rate for Payer: Humana Medicare |
$683.40
|
| Rate for Payer: Lucent All Commercial |
$683.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,206.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,005.00
|
| Rate for Payer: PHP All Commercial |
$1,016.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$522.60
|
| Rate for Payer: Sagamore Health Network All Products |
$1,034.48
|
| Rate for Payer: Signature Care EPO |
$1,112.20
|
| Rate for Payer: Signature Care PPO |
$1,179.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,139.00
|
| Rate for Payer: United Healthcare Commercial |
$1,055.92
|
| Rate for Payer: United Healthcare Medicare |
$442.20
|
|
|
HC W SCREW 3.0X12 HDLS
|
Facility
IP
|
$1,340.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606120
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,005.00 |
| Max. Negotiated Rate |
$1,246.20 |
| Rate for Payer: Aetna Commercial |
$1,157.76
|
| Rate for Payer: Cash Price |
$830.80
|
| Rate for Payer: Cigna All Commercial |
$1,156.42
|
| Rate for Payer: CORVEL All Commercial |
$1,246.20
|
| Rate for Payer: Coventry All Commercial |
$1,179.20
|
| Rate for Payer: Encore All Commercial |
$1,233.47
|
| Rate for Payer: Frontpath All Commercial |
$1,232.80
|
| Rate for Payer: Humana ChoiceCare |
$1,157.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,206.00
|
| Rate for Payer: PHCS All Commercial |
$1,005.00
|
| Rate for Payer: PHP All Commercial |
$1,016.26
|
| Rate for Payer: Sagamore Health Network All Products |
$1,034.48
|
| Rate for Payer: Signature Care EPO |
$1,112.20
|
| Rate for Payer: Signature Care PPO |
$1,179.20
|
| Rate for Payer: United Healthcare Commercial |
$1,055.92
|
|
|
HC W SCREW 3.0X14 HDLS
|
Facility
IP
|
$1,340.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,005.00 |
| Max. Negotiated Rate |
$1,246.20 |
| Rate for Payer: Aetna Commercial |
$1,157.76
|
| Rate for Payer: Cash Price |
$830.80
|
| Rate for Payer: Cigna All Commercial |
$1,156.42
|
| Rate for Payer: CORVEL All Commercial |
$1,246.20
|
| Rate for Payer: Coventry All Commercial |
$1,179.20
|
| Rate for Payer: Encore All Commercial |
$1,233.47
|
| Rate for Payer: Frontpath All Commercial |
$1,232.80
|
| Rate for Payer: Humana ChoiceCare |
$1,157.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,206.00
|
| Rate for Payer: PHCS All Commercial |
$1,005.00
|
| Rate for Payer: PHP All Commercial |
$1,016.26
|
| Rate for Payer: Sagamore Health Network All Products |
$1,034.48
|
| Rate for Payer: Signature Care EPO |
$1,112.20
|
| Rate for Payer: Signature Care PPO |
$1,179.20
|
| Rate for Payer: United Healthcare Commercial |
$1,055.92
|
|
|
HC W SCREW 3.0X14 HDLS
|
Facility
OP
|
$1,340.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$442.20 |
| Max. Negotiated Rate |
$1,246.20 |
| Rate for Payer: Aetna Commercial |
$1,130.96
|
| Rate for Payer: Aetna Medicare |
$442.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$442.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$769.56
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$837.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$508.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$486.42
|
| Rate for Payer: Cash Price |
$830.80
|
| Rate for Payer: Cash Price |
$830.80
|
| Rate for Payer: Centivo All Commercial |
$683.40
|
| Rate for Payer: Cigna All Commercial |
$1,156.42
|
| Rate for Payer: CORVEL All Commercial |
$1,246.20
|
| Rate for Payer: Coventry All Commercial |
$1,179.20
|
| Rate for Payer: Encore All Commercial |
$1,233.47
|
| Rate for Payer: Frontpath All Commercial |
$1,232.80
|
| Rate for Payer: Humana ChoiceCare |
$1,157.36
|
| Rate for Payer: Humana Medicare |
$683.40
|
| Rate for Payer: Lucent All Commercial |
$683.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,206.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,005.00
|
| Rate for Payer: PHP All Commercial |
$1,016.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$522.60
|
| Rate for Payer: Sagamore Health Network All Products |
$1,034.48
|
| Rate for Payer: Signature Care EPO |
$1,112.20
|
| Rate for Payer: Signature Care PPO |
$1,179.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,139.00
|
| Rate for Payer: United Healthcare Commercial |
$1,055.92
|
| Rate for Payer: United Healthcare Medicare |
$442.20
|
|
|
HC W SCREW 3.0X16 HDLS
|
Facility
OP
|
$1,340.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$442.20 |
| Max. Negotiated Rate |
$1,246.20 |
| Rate for Payer: Aetna Commercial |
$1,130.96
|
| Rate for Payer: Aetna Medicare |
$442.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$442.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$769.56
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$837.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$508.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$486.42
|
| Rate for Payer: Cash Price |
$830.80
|
| Rate for Payer: Cash Price |
$830.80
|
| Rate for Payer: Centivo All Commercial |
$683.40
|
| Rate for Payer: Cigna All Commercial |
$1,156.42
|
| Rate for Payer: CORVEL All Commercial |
$1,246.20
|
| Rate for Payer: Coventry All Commercial |
$1,179.20
|
| Rate for Payer: Encore All Commercial |
$1,233.47
|
| Rate for Payer: Frontpath All Commercial |
$1,232.80
|
| Rate for Payer: Humana ChoiceCare |
$1,157.36
|
| Rate for Payer: Humana Medicare |
$683.40
|
| Rate for Payer: Lucent All Commercial |
$683.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,206.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,005.00
|
| Rate for Payer: PHP All Commercial |
$1,016.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$522.60
|
| Rate for Payer: Sagamore Health Network All Products |
$1,034.48
|
| Rate for Payer: Signature Care EPO |
$1,112.20
|
| Rate for Payer: Signature Care PPO |
$1,179.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,139.00
|
| Rate for Payer: United Healthcare Commercial |
$1,055.92
|
| Rate for Payer: United Healthcare Medicare |
$442.20
|
|
|
HC W SCREW 3.0X16 HDLS
|
Facility
IP
|
$1,340.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,005.00 |
| Max. Negotiated Rate |
$1,246.20 |
| Rate for Payer: Aetna Commercial |
$1,157.76
|
| Rate for Payer: Cash Price |
$830.80
|
| Rate for Payer: Cigna All Commercial |
$1,156.42
|
| Rate for Payer: CORVEL All Commercial |
$1,246.20
|
| Rate for Payer: Coventry All Commercial |
$1,179.20
|
| Rate for Payer: Encore All Commercial |
$1,233.47
|
| Rate for Payer: Frontpath All Commercial |
$1,232.80
|
| Rate for Payer: Humana ChoiceCare |
$1,157.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,206.00
|
| Rate for Payer: PHCS All Commercial |
$1,005.00
|
| Rate for Payer: PHP All Commercial |
$1,016.26
|
| Rate for Payer: Sagamore Health Network All Products |
$1,034.48
|
| Rate for Payer: Signature Care EPO |
$1,112.20
|
| Rate for Payer: Signature Care PPO |
$1,179.20
|
| Rate for Payer: United Healthcare Commercial |
$1,055.92
|
|
|
HC W SCREW 3.0X18 HD
|
Facility
OP
|
$1,000.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607017
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$330.00 |
| Max. Negotiated Rate |
$930.00 |
| Rate for Payer: Aetna Commercial |
$844.00
|
| Rate for Payer: Aetna Medicare |
$330.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$330.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$574.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$625.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$379.50
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$363.00
|
| Rate for Payer: Cash Price |
$620.00
|
| Rate for Payer: Cash Price |
$620.00
|
| Rate for Payer: Centivo All Commercial |
$510.00
|
| Rate for Payer: Cigna All Commercial |
$863.00
|
| Rate for Payer: CORVEL All Commercial |
$930.00
|
| Rate for Payer: Coventry All Commercial |
$880.00
|
| Rate for Payer: Encore All Commercial |
$920.50
|
| Rate for Payer: Frontpath All Commercial |
$920.00
|
| Rate for Payer: Humana ChoiceCare |
$863.70
|
| Rate for Payer: Humana Medicare |
$510.00
|
| Rate for Payer: Lucent All Commercial |
$510.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$900.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$750.00
|
| Rate for Payer: PHP All Commercial |
$758.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$390.00
|
| Rate for Payer: Sagamore Health Network All Products |
$772.00
|
| Rate for Payer: Signature Care EPO |
$830.00
|
| Rate for Payer: Signature Care PPO |
$880.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$850.00
|
| Rate for Payer: United Healthcare Commercial |
$788.00
|
| Rate for Payer: United Healthcare Medicare |
$330.00
|
|
|
HC W SCREW 3.0X18 HD
|
Facility
IP
|
$1,000.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607017
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$750.00 |
| Max. Negotiated Rate |
$930.00 |
| Rate for Payer: Aetna Commercial |
$864.00
|
| Rate for Payer: Cash Price |
$620.00
|
| Rate for Payer: Cigna All Commercial |
$863.00
|
| Rate for Payer: CORVEL All Commercial |
$930.00
|
| Rate for Payer: Coventry All Commercial |
$880.00
|
| Rate for Payer: Encore All Commercial |
$920.50
|
| Rate for Payer: Frontpath All Commercial |
$920.00
|
| Rate for Payer: Humana ChoiceCare |
$863.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$900.00
|
| Rate for Payer: PHCS All Commercial |
$750.00
|
| Rate for Payer: PHP All Commercial |
$758.40
|
| Rate for Payer: Sagamore Health Network All Products |
$772.00
|
| Rate for Payer: Signature Care EPO |
$830.00
|
| Rate for Payer: Signature Care PPO |
$880.00
|
| Rate for Payer: United Healthcare Commercial |
$788.00
|
|
|
HC W SCREW 3.0X18 HDLS
|
Facility
IP
|
$1,340.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606246
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,005.00 |
| Max. Negotiated Rate |
$1,246.20 |
| Rate for Payer: Aetna Commercial |
$1,157.76
|
| Rate for Payer: Cash Price |
$830.80
|
| Rate for Payer: Cigna All Commercial |
$1,156.42
|
| Rate for Payer: CORVEL All Commercial |
$1,246.20
|
| Rate for Payer: Coventry All Commercial |
$1,179.20
|
| Rate for Payer: Encore All Commercial |
$1,233.47
|
| Rate for Payer: Frontpath All Commercial |
$1,232.80
|
| Rate for Payer: Humana ChoiceCare |
$1,157.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,206.00
|
| Rate for Payer: PHCS All Commercial |
$1,005.00
|
| Rate for Payer: PHP All Commercial |
$1,016.26
|
| Rate for Payer: Sagamore Health Network All Products |
$1,034.48
|
| Rate for Payer: Signature Care EPO |
$1,112.20
|
| Rate for Payer: Signature Care PPO |
$1,179.20
|
| Rate for Payer: United Healthcare Commercial |
$1,055.92
|
|
|
HC W SCREW 3.0X18 HDLS
|
Facility
OP
|
$1,340.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606246
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$442.20 |
| Max. Negotiated Rate |
$1,246.20 |
| Rate for Payer: Aetna Commercial |
$1,130.96
|
| Rate for Payer: Aetna Medicare |
$442.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$442.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$769.56
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$837.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$508.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$486.42
|
| Rate for Payer: Cash Price |
$830.80
|
| Rate for Payer: Cash Price |
$830.80
|
| Rate for Payer: Centivo All Commercial |
$683.40
|
| Rate for Payer: Cigna All Commercial |
$1,156.42
|
| Rate for Payer: CORVEL All Commercial |
$1,246.20
|
| Rate for Payer: Coventry All Commercial |
$1,179.20
|
| Rate for Payer: Encore All Commercial |
$1,233.47
|
| Rate for Payer: Frontpath All Commercial |
$1,232.80
|
| Rate for Payer: Humana ChoiceCare |
$1,157.36
|
| Rate for Payer: Humana Medicare |
$683.40
|
| Rate for Payer: Lucent All Commercial |
$683.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,206.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,005.00
|
| Rate for Payer: PHP All Commercial |
$1,016.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$522.60
|
| Rate for Payer: Sagamore Health Network All Products |
$1,034.48
|
| Rate for Payer: Signature Care EPO |
$1,112.20
|
| Rate for Payer: Signature Care PPO |
$1,179.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,139.00
|
| Rate for Payer: United Healthcare Commercial |
$1,055.92
|
| Rate for Payer: United Healthcare Medicare |
$442.20
|
|
|
HC W SCREW 3.0X28 HD
|
Facility
IP
|
$1,000.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607014
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$750.00 |
| Max. Negotiated Rate |
$930.00 |
| Rate for Payer: Aetna Commercial |
$864.00
|
| Rate for Payer: Cash Price |
$620.00
|
| Rate for Payer: Cigna All Commercial |
$863.00
|
| Rate for Payer: CORVEL All Commercial |
$930.00
|
| Rate for Payer: Coventry All Commercial |
$880.00
|
| Rate for Payer: Encore All Commercial |
$920.50
|
| Rate for Payer: Frontpath All Commercial |
$920.00
|
| Rate for Payer: Humana ChoiceCare |
$863.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$900.00
|
| Rate for Payer: PHCS All Commercial |
$750.00
|
| Rate for Payer: PHP All Commercial |
$758.40
|
| Rate for Payer: Sagamore Health Network All Products |
$772.00
|
| Rate for Payer: Signature Care EPO |
$830.00
|
| Rate for Payer: Signature Care PPO |
$880.00
|
| Rate for Payer: United Healthcare Commercial |
$788.00
|
|
|
HC W SCREW 3.0X28 HD
|
Facility
OP
|
$1,000.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607014
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$330.00 |
| Max. Negotiated Rate |
$930.00 |
| Rate for Payer: Aetna Commercial |
$844.00
|
| Rate for Payer: Aetna Medicare |
$330.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$330.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$574.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$625.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$379.50
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$363.00
|
| Rate for Payer: Cash Price |
$620.00
|
| Rate for Payer: Cash Price |
$620.00
|
| Rate for Payer: Centivo All Commercial |
$510.00
|
| Rate for Payer: Cigna All Commercial |
$863.00
|
| Rate for Payer: CORVEL All Commercial |
$930.00
|
| Rate for Payer: Coventry All Commercial |
$880.00
|
| Rate for Payer: Encore All Commercial |
$920.50
|
| Rate for Payer: Frontpath All Commercial |
$920.00
|
| Rate for Payer: Humana ChoiceCare |
$863.70
|
| Rate for Payer: Humana Medicare |
$510.00
|
| Rate for Payer: Lucent All Commercial |
$510.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$900.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$750.00
|
| Rate for Payer: PHP All Commercial |
$758.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$390.00
|
| Rate for Payer: Sagamore Health Network All Products |
$772.00
|
| Rate for Payer: Signature Care EPO |
$830.00
|
| Rate for Payer: Signature Care PPO |
$880.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$850.00
|
| Rate for Payer: United Healthcare Commercial |
$788.00
|
| Rate for Payer: United Healthcare Medicare |
$330.00
|
|
|
HC W SCREW 3.0X30
|
Facility
IP
|
$1,340.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606529
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,005.00 |
| Max. Negotiated Rate |
$1,246.20 |
| Rate for Payer: Aetna Commercial |
$1,157.76
|
| Rate for Payer: Cash Price |
$830.80
|
| Rate for Payer: Cigna All Commercial |
$1,156.42
|
| Rate for Payer: CORVEL All Commercial |
$1,246.20
|
| Rate for Payer: Coventry All Commercial |
$1,179.20
|
| Rate for Payer: Encore All Commercial |
$1,233.47
|
| Rate for Payer: Frontpath All Commercial |
$1,232.80
|
| Rate for Payer: Humana ChoiceCare |
$1,157.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,206.00
|
| Rate for Payer: PHCS All Commercial |
$1,005.00
|
| Rate for Payer: PHP All Commercial |
$1,016.26
|
| Rate for Payer: Sagamore Health Network All Products |
$1,034.48
|
| Rate for Payer: Signature Care EPO |
$1,112.20
|
| Rate for Payer: Signature Care PPO |
$1,179.20
|
| Rate for Payer: United Healthcare Commercial |
$1,055.92
|
|
|
HC W SCREW 3.0X30
|
Facility
OP
|
$1,340.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606529
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$442.20 |
| Max. Negotiated Rate |
$1,246.20 |
| Rate for Payer: Aetna Commercial |
$1,130.96
|
| Rate for Payer: Aetna Medicare |
$442.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$442.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$769.56
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$837.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$508.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$486.42
|
| Rate for Payer: Cash Price |
$830.80
|
| Rate for Payer: Cash Price |
$830.80
|
| Rate for Payer: Centivo All Commercial |
$683.40
|
| Rate for Payer: Cigna All Commercial |
$1,156.42
|
| Rate for Payer: CORVEL All Commercial |
$1,246.20
|
| Rate for Payer: Coventry All Commercial |
$1,179.20
|
| Rate for Payer: Encore All Commercial |
$1,233.47
|
| Rate for Payer: Frontpath All Commercial |
$1,232.80
|
| Rate for Payer: Humana ChoiceCare |
$1,157.36
|
| Rate for Payer: Humana Medicare |
$683.40
|
| Rate for Payer: Lucent All Commercial |
$683.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,206.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,005.00
|
| Rate for Payer: PHP All Commercial |
$1,016.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$522.60
|
| Rate for Payer: Sagamore Health Network All Products |
$1,034.48
|
| Rate for Payer: Signature Care EPO |
$1,112.20
|
| Rate for Payer: Signature Care PPO |
$1,179.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,139.00
|
| Rate for Payer: United Healthcare Commercial |
$1,055.92
|
| Rate for Payer: United Healthcare Medicare |
$442.20
|
|
|
HC W SCREW 3.0X32 HD
|
Facility
IP
|
$1,000.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607717
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$750.00 |
| Max. Negotiated Rate |
$930.00 |
| Rate for Payer: Aetna Commercial |
$864.00
|
| Rate for Payer: Cash Price |
$620.00
|
| Rate for Payer: Cigna All Commercial |
$863.00
|
| Rate for Payer: CORVEL All Commercial |
$930.00
|
| Rate for Payer: Coventry All Commercial |
$880.00
|
| Rate for Payer: Encore All Commercial |
$920.50
|
| Rate for Payer: Frontpath All Commercial |
$920.00
|
| Rate for Payer: Humana ChoiceCare |
$863.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$900.00
|
| Rate for Payer: PHCS All Commercial |
$750.00
|
| Rate for Payer: PHP All Commercial |
$758.40
|
| Rate for Payer: Sagamore Health Network All Products |
$772.00
|
| Rate for Payer: Signature Care EPO |
$830.00
|
| Rate for Payer: Signature Care PPO |
$880.00
|
| Rate for Payer: United Healthcare Commercial |
$788.00
|
|
|
HC W SCREW 3.0X32 HD
|
Facility
OP
|
$1,000.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607717
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$330.00 |
| Max. Negotiated Rate |
$930.00 |
| Rate for Payer: Aetna Commercial |
$844.00
|
| Rate for Payer: Aetna Medicare |
$330.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$330.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$574.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$625.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$379.50
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$363.00
|
| Rate for Payer: Cash Price |
$620.00
|
| Rate for Payer: Cash Price |
$620.00
|
| Rate for Payer: Centivo All Commercial |
$510.00
|
| Rate for Payer: Cigna All Commercial |
$863.00
|
| Rate for Payer: CORVEL All Commercial |
$930.00
|
| Rate for Payer: Coventry All Commercial |
$880.00
|
| Rate for Payer: Encore All Commercial |
$920.50
|
| Rate for Payer: Frontpath All Commercial |
$920.00
|
| Rate for Payer: Humana ChoiceCare |
$863.70
|
| Rate for Payer: Humana Medicare |
$510.00
|
| Rate for Payer: Lucent All Commercial |
$510.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$900.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$750.00
|
| Rate for Payer: PHP All Commercial |
$758.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$390.00
|
| Rate for Payer: Sagamore Health Network All Products |
$772.00
|
| Rate for Payer: Signature Care EPO |
$830.00
|
| Rate for Payer: Signature Care PPO |
$880.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$850.00
|
| Rate for Payer: United Healthcare Commercial |
$788.00
|
| Rate for Payer: United Healthcare Medicare |
$330.00
|
|
|
HC W SCREW 3.0X34
|
Facility
IP
|
$1,460.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604663
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,095.00 |
| Max. Negotiated Rate |
$1,357.80 |
| Rate for Payer: Aetna Commercial |
$1,261.44
|
| Rate for Payer: Cash Price |
$905.20
|
| Rate for Payer: Cigna All Commercial |
$1,259.98
|
| Rate for Payer: CORVEL All Commercial |
$1,357.80
|
| Rate for Payer: Coventry All Commercial |
$1,284.80
|
| Rate for Payer: Encore All Commercial |
$1,343.93
|
| Rate for Payer: Frontpath All Commercial |
$1,343.20
|
| Rate for Payer: Humana ChoiceCare |
$1,261.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,314.00
|
| Rate for Payer: PHCS All Commercial |
$1,095.00
|
| Rate for Payer: PHP All Commercial |
$1,107.26
|
| Rate for Payer: Sagamore Health Network All Products |
$1,127.12
|
| Rate for Payer: Signature Care EPO |
$1,211.80
|
| Rate for Payer: Signature Care PPO |
$1,284.80
|
| Rate for Payer: United Healthcare Commercial |
$1,150.48
|
|
