|
HC W SCREW 4.0X60 PT CANC
|
Facility
OP
|
$861.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604673
|
|
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 4.0X60 PT CANC
|
Facility
IP
|
$861.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604673
|
|
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 4.3X42 HDLS SHRT
|
Facility
OP
|
$1,790.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607130
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,664.70 |
| Rate for Payer: Aetna Commercial |
$1,510.76
|
| Rate for Payer: Aetna Medicare |
$590.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$590.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,028.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,118.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$679.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$649.77
|
| Rate for Payer: Cash Price |
$1,109.80
|
| Rate for Payer: Cash Price |
$1,109.80
|
| Rate for Payer: Centivo All Commercial |
$912.90
|
| Rate for Payer: Cigna All Commercial |
$1,544.77
|
| Rate for Payer: CORVEL All Commercial |
$1,664.70
|
| Rate for Payer: Coventry All Commercial |
$1,575.20
|
| Rate for Payer: Encore All Commercial |
$1,647.70
|
| Rate for Payer: Frontpath All Commercial |
$1,646.80
|
| Rate for Payer: Humana ChoiceCare |
$1,546.02
|
| Rate for Payer: Humana Medicare |
$912.90
|
| Rate for Payer: Lucent All Commercial |
$912.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,611.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,342.50
|
| Rate for Payer: PHP All Commercial |
$1,357.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$698.10
|
| Rate for Payer: Sagamore Health Network All Products |
$1,381.88
|
| Rate for Payer: Signature Care EPO |
$1,485.70
|
| Rate for Payer: Signature Care PPO |
$1,575.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,521.50
|
| Rate for Payer: United Healthcare Commercial |
$1,410.52
|
| Rate for Payer: United Healthcare Medicare |
$590.70
|
|
|
HC W SCREW 4.3X42 HDLS SHRT
|
Facility
IP
|
$1,790.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607130
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,342.50 |
| Max. Negotiated Rate |
$1,664.70 |
| Rate for Payer: Aetna Commercial |
$1,546.56
|
| Rate for Payer: Cash Price |
$1,109.80
|
| Rate for Payer: Cigna All Commercial |
$1,544.77
|
| Rate for Payer: CORVEL All Commercial |
$1,664.70
|
| Rate for Payer: Coventry All Commercial |
$1,575.20
|
| Rate for Payer: Encore All Commercial |
$1,647.70
|
| Rate for Payer: Frontpath All Commercial |
$1,646.80
|
| Rate for Payer: Humana ChoiceCare |
$1,546.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,611.00
|
| Rate for Payer: PHCS All Commercial |
$1,342.50
|
| Rate for Payer: PHP All Commercial |
$1,357.54
|
| Rate for Payer: Sagamore Health Network All Products |
$1,381.88
|
| Rate for Payer: Signature Care EPO |
$1,485.70
|
| Rate for Payer: Signature Care PPO |
$1,575.20
|
| Rate for Payer: United Healthcare Commercial |
$1,410.52
|
|
|
HC W SCREW 4.3X44 HDLS SHRT
|
Facility
IP
|
$1,790.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,342.50 |
| Max. Negotiated Rate |
$1,664.70 |
| Rate for Payer: Aetna Commercial |
$1,546.56
|
| Rate for Payer: Cash Price |
$1,109.80
|
| Rate for Payer: Cigna All Commercial |
$1,544.77
|
| Rate for Payer: CORVEL All Commercial |
$1,664.70
|
| Rate for Payer: Coventry All Commercial |
$1,575.20
|
| Rate for Payer: Encore All Commercial |
$1,647.70
|
| Rate for Payer: Frontpath All Commercial |
$1,646.80
|
| Rate for Payer: Humana ChoiceCare |
$1,546.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,611.00
|
| Rate for Payer: PHCS All Commercial |
$1,342.50
|
| Rate for Payer: PHP All Commercial |
$1,357.54
|
| Rate for Payer: Sagamore Health Network All Products |
$1,381.88
|
| Rate for Payer: Signature Care EPO |
$1,485.70
|
| Rate for Payer: Signature Care PPO |
$1,575.20
|
| Rate for Payer: United Healthcare Commercial |
$1,410.52
|
|
|
HC W SCREW 4.3X44 HDLS SHRT
|
Facility
OP
|
$1,790.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,664.70 |
| Rate for Payer: Aetna Commercial |
$1,510.76
|
| Rate for Payer: Aetna Medicare |
$590.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$590.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,028.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,118.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$679.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$649.77
|
| Rate for Payer: Cash Price |
$1,109.80
|
| Rate for Payer: Cash Price |
$1,109.80
|
| Rate for Payer: Centivo All Commercial |
$912.90
|
| Rate for Payer: Cigna All Commercial |
$1,544.77
|
| Rate for Payer: CORVEL All Commercial |
$1,664.70
|
| Rate for Payer: Coventry All Commercial |
$1,575.20
|
| Rate for Payer: Encore All Commercial |
$1,647.70
|
| Rate for Payer: Frontpath All Commercial |
$1,646.80
|
| Rate for Payer: Humana ChoiceCare |
$1,546.02
|
| Rate for Payer: Humana Medicare |
$912.90
|
| Rate for Payer: Lucent All Commercial |
$912.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,611.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,342.50
|
| Rate for Payer: PHP All Commercial |
$1,357.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$698.10
|
| Rate for Payer: Sagamore Health Network All Products |
$1,381.88
|
| Rate for Payer: Signature Care EPO |
$1,485.70
|
| Rate for Payer: Signature Care PPO |
$1,575.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,521.50
|
| Rate for Payer: United Healthcare Commercial |
$1,410.52
|
| Rate for Payer: United Healthcare Medicare |
$590.70
|
|
|
HC W SCREW 4.3X46 HDLS SHRT
|
Facility
OP
|
$1,790.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604370
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,664.70 |
| Rate for Payer: Aetna Commercial |
$1,510.76
|
| Rate for Payer: Aetna Medicare |
$590.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$590.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,028.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,118.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$679.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$649.77
|
| Rate for Payer: Cash Price |
$1,109.80
|
| Rate for Payer: Cash Price |
$1,109.80
|
| Rate for Payer: Centivo All Commercial |
$912.90
|
| Rate for Payer: Cigna All Commercial |
$1,544.77
|
| Rate for Payer: CORVEL All Commercial |
$1,664.70
|
| Rate for Payer: Coventry All Commercial |
$1,575.20
|
| Rate for Payer: Encore All Commercial |
$1,647.70
|
| Rate for Payer: Frontpath All Commercial |
$1,646.80
|
| Rate for Payer: Humana ChoiceCare |
$1,546.02
|
| Rate for Payer: Humana Medicare |
$912.90
|
| Rate for Payer: Lucent All Commercial |
$912.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,611.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,342.50
|
| Rate for Payer: PHP All Commercial |
$1,357.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$698.10
|
| Rate for Payer: Sagamore Health Network All Products |
$1,381.88
|
| Rate for Payer: Signature Care EPO |
$1,485.70
|
| Rate for Payer: Signature Care PPO |
$1,575.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,521.50
|
| Rate for Payer: United Healthcare Commercial |
$1,410.52
|
| Rate for Payer: United Healthcare Medicare |
$590.70
|
|
|
HC W SCREW 4.3X46 HDLS SHRT
|
Facility
IP
|
$1,790.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604370
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,342.50 |
| Max. Negotiated Rate |
$1,664.70 |
| Rate for Payer: Aetna Commercial |
$1,546.56
|
| Rate for Payer: Cash Price |
$1,109.80
|
| Rate for Payer: Cigna All Commercial |
$1,544.77
|
| Rate for Payer: CORVEL All Commercial |
$1,664.70
|
| Rate for Payer: Coventry All Commercial |
$1,575.20
|
| Rate for Payer: Encore All Commercial |
$1,647.70
|
| Rate for Payer: Frontpath All Commercial |
$1,646.80
|
| Rate for Payer: Humana ChoiceCare |
$1,546.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,611.00
|
| Rate for Payer: PHCS All Commercial |
$1,342.50
|
| Rate for Payer: PHP All Commercial |
$1,357.54
|
| Rate for Payer: Sagamore Health Network All Products |
$1,381.88
|
| Rate for Payer: Signature Care EPO |
$1,485.70
|
| Rate for Payer: Signature Care PPO |
$1,575.20
|
| Rate for Payer: United Healthcare Commercial |
$1,410.52
|
|
|
HC W SCREW 4.3X48 HDLS SHRT
|
Facility
OP
|
$1,790.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607131
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,664.70 |
| Rate for Payer: Aetna Commercial |
$1,510.76
|
| Rate for Payer: Aetna Medicare |
$590.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$590.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,028.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,118.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$679.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$649.77
|
| Rate for Payer: Cash Price |
$1,109.80
|
| Rate for Payer: Cash Price |
$1,109.80
|
| Rate for Payer: Centivo All Commercial |
$912.90
|
| Rate for Payer: Cigna All Commercial |
$1,544.77
|
| Rate for Payer: CORVEL All Commercial |
$1,664.70
|
| Rate for Payer: Coventry All Commercial |
$1,575.20
|
| Rate for Payer: Encore All Commercial |
$1,647.70
|
| Rate for Payer: Frontpath All Commercial |
$1,646.80
|
| Rate for Payer: Humana ChoiceCare |
$1,546.02
|
| Rate for Payer: Humana Medicare |
$912.90
|
| Rate for Payer: Lucent All Commercial |
$912.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,611.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,342.50
|
| Rate for Payer: PHP All Commercial |
$1,357.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$698.10
|
| Rate for Payer: Sagamore Health Network All Products |
$1,381.88
|
| Rate for Payer: Signature Care EPO |
$1,485.70
|
| Rate for Payer: Signature Care PPO |
$1,575.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,521.50
|
| Rate for Payer: United Healthcare Commercial |
$1,410.52
|
| Rate for Payer: United Healthcare Medicare |
$590.70
|
|
|
HC W SCREW 4.3X48 HDLS SHRT
|
Facility
IP
|
$1,790.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607131
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,342.50 |
| Max. Negotiated Rate |
$1,664.70 |
| Rate for Payer: Aetna Commercial |
$1,546.56
|
| Rate for Payer: Cash Price |
$1,109.80
|
| Rate for Payer: Cigna All Commercial |
$1,544.77
|
| Rate for Payer: CORVEL All Commercial |
$1,664.70
|
| Rate for Payer: Coventry All Commercial |
$1,575.20
|
| Rate for Payer: Encore All Commercial |
$1,647.70
|
| Rate for Payer: Frontpath All Commercial |
$1,646.80
|
| Rate for Payer: Humana ChoiceCare |
$1,546.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,611.00
|
| Rate for Payer: PHCS All Commercial |
$1,342.50
|
| Rate for Payer: PHP All Commercial |
$1,357.54
|
| Rate for Payer: Sagamore Health Network All Products |
$1,381.88
|
| Rate for Payer: Signature Care EPO |
$1,485.70
|
| Rate for Payer: Signature Care PPO |
$1,575.20
|
| Rate for Payer: United Healthcare Commercial |
$1,410.52
|
|
|
HC W SCREW 4.5X12
|
Facility
OP
|
$1,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605699
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.50 |
| Max. Negotiated Rate |
$1,441.50 |
| Rate for Payer: Aetna Commercial |
$1,308.20
|
| Rate for Payer: Aetna Medicare |
$511.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$511.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$890.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$968.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$588.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$562.65
|
| Rate for Payer: Cash Price |
$961.00
|
| Rate for Payer: Cash Price |
$961.00
|
| Rate for Payer: Centivo All Commercial |
$790.50
|
| Rate for Payer: Cigna All Commercial |
$1,337.65
|
| Rate for Payer: CORVEL All Commercial |
$1,441.50
|
| Rate for Payer: Coventry All Commercial |
$1,364.00
|
| Rate for Payer: Encore All Commercial |
$1,426.78
|
| Rate for Payer: Frontpath All Commercial |
$1,426.00
|
| Rate for Payer: Humana ChoiceCare |
$1,338.74
|
| Rate for Payer: Humana Medicare |
$790.50
|
| Rate for Payer: Lucent All Commercial |
$790.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,395.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,162.50
|
| Rate for Payer: PHP All Commercial |
$1,175.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$604.50
|
| Rate for Payer: Sagamore Health Network All Products |
$1,196.60
|
| Rate for Payer: Signature Care EPO |
$1,286.50
|
| Rate for Payer: Signature Care PPO |
$1,364.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,317.50
|
| Rate for Payer: United Healthcare Commercial |
$1,221.40
|
| Rate for Payer: United Healthcare Medicare |
$511.50
|
|
|
HC W SCREW 4.5X12
|
Facility
IP
|
$1,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605699
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,162.50 |
| Max. Negotiated Rate |
$1,441.50 |
| Rate for Payer: Aetna Commercial |
$1,339.20
|
| Rate for Payer: Cash Price |
$961.00
|
| Rate for Payer: Cigna All Commercial |
$1,337.65
|
| Rate for Payer: CORVEL All Commercial |
$1,441.50
|
| Rate for Payer: Coventry All Commercial |
$1,364.00
|
| Rate for Payer: Encore All Commercial |
$1,426.78
|
| Rate for Payer: Frontpath All Commercial |
$1,426.00
|
| Rate for Payer: Humana ChoiceCare |
$1,338.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,395.00
|
| Rate for Payer: PHCS All Commercial |
$1,162.50
|
| Rate for Payer: PHP All Commercial |
$1,175.52
|
| Rate for Payer: Sagamore Health Network All Products |
$1,196.60
|
| Rate for Payer: Signature Care EPO |
$1,286.50
|
| Rate for Payer: Signature Care PPO |
$1,364.00
|
| Rate for Payer: United Healthcare Commercial |
$1,221.40
|
|
|
HC W SCREW 4.5X12 LG
|
Facility
IP
|
$1,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605700
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,162.50 |
| Max. Negotiated Rate |
$1,441.50 |
| Rate for Payer: Aetna Commercial |
$1,339.20
|
| Rate for Payer: Cash Price |
$961.00
|
| Rate for Payer: Cigna All Commercial |
$1,337.65
|
| Rate for Payer: CORVEL All Commercial |
$1,441.50
|
| Rate for Payer: Coventry All Commercial |
$1,364.00
|
| Rate for Payer: Encore All Commercial |
$1,426.78
|
| Rate for Payer: Frontpath All Commercial |
$1,426.00
|
| Rate for Payer: Humana ChoiceCare |
$1,338.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,395.00
|
| Rate for Payer: PHCS All Commercial |
$1,162.50
|
| Rate for Payer: PHP All Commercial |
$1,175.52
|
| Rate for Payer: Sagamore Health Network All Products |
$1,196.60
|
| Rate for Payer: Signature Care EPO |
$1,286.50
|
| Rate for Payer: Signature Care PPO |
$1,364.00
|
| Rate for Payer: United Healthcare Commercial |
$1,221.40
|
|
|
HC W SCREW 4.5X12 LG
|
Facility
OP
|
$1,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605700
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.50 |
| Max. Negotiated Rate |
$1,441.50 |
| Rate for Payer: Aetna Commercial |
$1,308.20
|
| Rate for Payer: Aetna Medicare |
$511.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$511.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$890.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$968.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$588.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$562.65
|
| Rate for Payer: Cash Price |
$961.00
|
| Rate for Payer: Cash Price |
$961.00
|
| Rate for Payer: Centivo All Commercial |
$790.50
|
| Rate for Payer: Cigna All Commercial |
$1,337.65
|
| Rate for Payer: CORVEL All Commercial |
$1,441.50
|
| Rate for Payer: Coventry All Commercial |
$1,364.00
|
| Rate for Payer: Encore All Commercial |
$1,426.78
|
| Rate for Payer: Frontpath All Commercial |
$1,426.00
|
| Rate for Payer: Humana ChoiceCare |
$1,338.74
|
| Rate for Payer: Humana Medicare |
$790.50
|
| Rate for Payer: Lucent All Commercial |
$790.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,395.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,162.50
|
| Rate for Payer: PHP All Commercial |
$1,175.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$604.50
|
| Rate for Payer: Sagamore Health Network All Products |
$1,196.60
|
| Rate for Payer: Signature Care EPO |
$1,286.50
|
| Rate for Payer: Signature Care PPO |
$1,364.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,317.50
|
| Rate for Payer: United Healthcare Commercial |
$1,221.40
|
| Rate for Payer: United Healthcare Medicare |
$511.50
|
|
|
HC W SCREW 4.5X12 SHRT
|
Facility
IP
|
$1,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605701
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,162.50 |
| Max. Negotiated Rate |
$1,441.50 |
| Rate for Payer: Aetna Commercial |
$1,339.20
|
| Rate for Payer: Cash Price |
$961.00
|
| Rate for Payer: Cigna All Commercial |
$1,337.65
|
| Rate for Payer: CORVEL All Commercial |
$1,441.50
|
| Rate for Payer: Coventry All Commercial |
$1,364.00
|
| Rate for Payer: Encore All Commercial |
$1,426.78
|
| Rate for Payer: Frontpath All Commercial |
$1,426.00
|
| Rate for Payer: Humana ChoiceCare |
$1,338.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,395.00
|
| Rate for Payer: PHCS All Commercial |
$1,162.50
|
| Rate for Payer: PHP All Commercial |
$1,175.52
|
| Rate for Payer: Sagamore Health Network All Products |
$1,196.60
|
| Rate for Payer: Signature Care EPO |
$1,286.50
|
| Rate for Payer: Signature Care PPO |
$1,364.00
|
| Rate for Payer: United Healthcare Commercial |
$1,221.40
|
|
|
HC W SCREW 4.5X12 SHRT
|
Facility
OP
|
$1,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605701
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.50 |
| Max. Negotiated Rate |
$1,441.50 |
| Rate for Payer: Aetna Commercial |
$1,308.20
|
| Rate for Payer: Aetna Medicare |
$511.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$511.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$890.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$968.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$588.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$562.65
|
| Rate for Payer: Cash Price |
$961.00
|
| Rate for Payer: Cash Price |
$961.00
|
| Rate for Payer: Centivo All Commercial |
$790.50
|
| Rate for Payer: Cigna All Commercial |
$1,337.65
|
| Rate for Payer: CORVEL All Commercial |
$1,441.50
|
| Rate for Payer: Coventry All Commercial |
$1,364.00
|
| Rate for Payer: Encore All Commercial |
$1,426.78
|
| Rate for Payer: Frontpath All Commercial |
$1,426.00
|
| Rate for Payer: Humana ChoiceCare |
$1,338.74
|
| Rate for Payer: Humana Medicare |
$790.50
|
| Rate for Payer: Lucent All Commercial |
$790.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,395.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,162.50
|
| Rate for Payer: PHP All Commercial |
$1,175.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$604.50
|
| Rate for Payer: Sagamore Health Network All Products |
$1,196.60
|
| Rate for Payer: Signature Care EPO |
$1,286.50
|
| Rate for Payer: Signature Care PPO |
$1,364.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,317.50
|
| Rate for Payer: United Healthcare Commercial |
$1,221.40
|
| Rate for Payer: United Healthcare Medicare |
$511.50
|
|
|
HC W SCREW 4.5X14
|
Facility
IP
|
$1,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605702
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,162.50 |
| Max. Negotiated Rate |
$1,441.50 |
| Rate for Payer: Aetna Commercial |
$1,339.20
|
| Rate for Payer: Cash Price |
$961.00
|
| Rate for Payer: Cigna All Commercial |
$1,337.65
|
| Rate for Payer: CORVEL All Commercial |
$1,441.50
|
| Rate for Payer: Coventry All Commercial |
$1,364.00
|
| Rate for Payer: Encore All Commercial |
$1,426.78
|
| Rate for Payer: Frontpath All Commercial |
$1,426.00
|
| Rate for Payer: Humana ChoiceCare |
$1,338.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,395.00
|
| Rate for Payer: PHCS All Commercial |
$1,162.50
|
| Rate for Payer: PHP All Commercial |
$1,175.52
|
| Rate for Payer: Sagamore Health Network All Products |
$1,196.60
|
| Rate for Payer: Signature Care EPO |
$1,286.50
|
| Rate for Payer: Signature Care PPO |
$1,364.00
|
| Rate for Payer: United Healthcare Commercial |
$1,221.40
|
|
|
HC W SCREW 4.5X14
|
Facility
OP
|
$1,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605702
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.50 |
| Max. Negotiated Rate |
$1,441.50 |
| Rate for Payer: Aetna Commercial |
$1,308.20
|
| Rate for Payer: Aetna Medicare |
$511.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$511.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$890.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$968.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$588.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$562.65
|
| Rate for Payer: Cash Price |
$961.00
|
| Rate for Payer: Cash Price |
$961.00
|
| Rate for Payer: Centivo All Commercial |
$790.50
|
| Rate for Payer: Cigna All Commercial |
$1,337.65
|
| Rate for Payer: CORVEL All Commercial |
$1,441.50
|
| Rate for Payer: Coventry All Commercial |
$1,364.00
|
| Rate for Payer: Encore All Commercial |
$1,426.78
|
| Rate for Payer: Frontpath All Commercial |
$1,426.00
|
| Rate for Payer: Humana ChoiceCare |
$1,338.74
|
| Rate for Payer: Humana Medicare |
$790.50
|
| Rate for Payer: Lucent All Commercial |
$790.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,395.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,162.50
|
| Rate for Payer: PHP All Commercial |
$1,175.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$604.50
|
| Rate for Payer: Sagamore Health Network All Products |
$1,196.60
|
| Rate for Payer: Signature Care EPO |
$1,286.50
|
| Rate for Payer: Signature Care PPO |
$1,364.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,317.50
|
| Rate for Payer: United Healthcare Commercial |
$1,221.40
|
| Rate for Payer: United Healthcare Medicare |
$511.50
|
|
|
HC W SCREW 4.5X14 LG
|
Facility
OP
|
$1,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605703
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.50 |
| Max. Negotiated Rate |
$1,441.50 |
| Rate for Payer: Aetna Commercial |
$1,308.20
|
| Rate for Payer: Aetna Medicare |
$511.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$511.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$890.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$968.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$588.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$562.65
|
| Rate for Payer: Cash Price |
$961.00
|
| Rate for Payer: Cash Price |
$961.00
|
| Rate for Payer: Centivo All Commercial |
$790.50
|
| Rate for Payer: Cigna All Commercial |
$1,337.65
|
| Rate for Payer: CORVEL All Commercial |
$1,441.50
|
| Rate for Payer: Coventry All Commercial |
$1,364.00
|
| Rate for Payer: Encore All Commercial |
$1,426.78
|
| Rate for Payer: Frontpath All Commercial |
$1,426.00
|
| Rate for Payer: Humana ChoiceCare |
$1,338.74
|
| Rate for Payer: Humana Medicare |
$790.50
|
| Rate for Payer: Lucent All Commercial |
$790.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,395.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,162.50
|
| Rate for Payer: PHP All Commercial |
$1,175.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$604.50
|
| Rate for Payer: Sagamore Health Network All Products |
$1,196.60
|
| Rate for Payer: Signature Care EPO |
$1,286.50
|
| Rate for Payer: Signature Care PPO |
$1,364.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,317.50
|
| Rate for Payer: United Healthcare Commercial |
$1,221.40
|
| Rate for Payer: United Healthcare Medicare |
$511.50
|
|
|
HC W SCREW 4.5X14 LG
|
Facility
IP
|
$1,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605703
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,162.50 |
| Max. Negotiated Rate |
$1,441.50 |
| Rate for Payer: Aetna Commercial |
$1,339.20
|
| Rate for Payer: Cash Price |
$961.00
|
| Rate for Payer: Cigna All Commercial |
$1,337.65
|
| Rate for Payer: CORVEL All Commercial |
$1,441.50
|
| Rate for Payer: Coventry All Commercial |
$1,364.00
|
| Rate for Payer: Encore All Commercial |
$1,426.78
|
| Rate for Payer: Frontpath All Commercial |
$1,426.00
|
| Rate for Payer: Humana ChoiceCare |
$1,338.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,395.00
|
| Rate for Payer: PHCS All Commercial |
$1,162.50
|
| Rate for Payer: PHP All Commercial |
$1,175.52
|
| Rate for Payer: Sagamore Health Network All Products |
$1,196.60
|
| Rate for Payer: Signature Care EPO |
$1,286.50
|
| Rate for Payer: Signature Care PPO |
$1,364.00
|
| Rate for Payer: United Healthcare Commercial |
$1,221.40
|
|
|
HC W SCREW 4.5X14 SHRT
|
Facility
IP
|
$1,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605704
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,162.50 |
| Max. Negotiated Rate |
$1,441.50 |
| Rate for Payer: Aetna Commercial |
$1,339.20
|
| Rate for Payer: Cash Price |
$961.00
|
| Rate for Payer: Cigna All Commercial |
$1,337.65
|
| Rate for Payer: CORVEL All Commercial |
$1,441.50
|
| Rate for Payer: Coventry All Commercial |
$1,364.00
|
| Rate for Payer: Encore All Commercial |
$1,426.78
|
| Rate for Payer: Frontpath All Commercial |
$1,426.00
|
| Rate for Payer: Humana ChoiceCare |
$1,338.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,395.00
|
| Rate for Payer: PHCS All Commercial |
$1,162.50
|
| Rate for Payer: PHP All Commercial |
$1,175.52
|
| Rate for Payer: Sagamore Health Network All Products |
$1,196.60
|
| Rate for Payer: Signature Care EPO |
$1,286.50
|
| Rate for Payer: Signature Care PPO |
$1,364.00
|
| Rate for Payer: United Healthcare Commercial |
$1,221.40
|
|
|
HC W SCREW 4.5X14 SHRT
|
Facility
OP
|
$1,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605704
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.50 |
| Max. Negotiated Rate |
$1,441.50 |
| Rate for Payer: Aetna Commercial |
$1,308.20
|
| Rate for Payer: Aetna Medicare |
$511.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$511.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$890.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$968.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$588.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$562.65
|
| Rate for Payer: Cash Price |
$961.00
|
| Rate for Payer: Cash Price |
$961.00
|
| Rate for Payer: Centivo All Commercial |
$790.50
|
| Rate for Payer: Cigna All Commercial |
$1,337.65
|
| Rate for Payer: CORVEL All Commercial |
$1,441.50
|
| Rate for Payer: Coventry All Commercial |
$1,364.00
|
| Rate for Payer: Encore All Commercial |
$1,426.78
|
| Rate for Payer: Frontpath All Commercial |
$1,426.00
|
| Rate for Payer: Humana ChoiceCare |
$1,338.74
|
| Rate for Payer: Humana Medicare |
$790.50
|
| Rate for Payer: Lucent All Commercial |
$790.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,395.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,162.50
|
| Rate for Payer: PHP All Commercial |
$1,175.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$604.50
|
| Rate for Payer: Sagamore Health Network All Products |
$1,196.60
|
| Rate for Payer: Signature Care EPO |
$1,286.50
|
| Rate for Payer: Signature Care PPO |
$1,364.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,317.50
|
| Rate for Payer: United Healthcare Commercial |
$1,221.40
|
| Rate for Payer: United Healthcare Medicare |
$511.50
|
|
|
HC W SCREW 4.5X16
|
Facility
OP
|
$1,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605705
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$511.50 |
| Max. Negotiated Rate |
$1,441.50 |
| Rate for Payer: Aetna Commercial |
$1,308.20
|
| Rate for Payer: Aetna Medicare |
$511.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$511.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$890.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$968.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$588.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$562.65
|
| Rate for Payer: Cash Price |
$961.00
|
| Rate for Payer: Cash Price |
$961.00
|
| Rate for Payer: Centivo All Commercial |
$790.50
|
| Rate for Payer: Cigna All Commercial |
$1,337.65
|
| Rate for Payer: CORVEL All Commercial |
$1,441.50
|
| Rate for Payer: Coventry All Commercial |
$1,364.00
|
| Rate for Payer: Encore All Commercial |
$1,426.78
|
| Rate for Payer: Frontpath All Commercial |
$1,426.00
|
| Rate for Payer: Humana ChoiceCare |
$1,338.74
|
| Rate for Payer: Humana Medicare |
$790.50
|
| Rate for Payer: Lucent All Commercial |
$790.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,395.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,162.50
|
| Rate for Payer: PHP All Commercial |
$1,175.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$604.50
|
| Rate for Payer: Sagamore Health Network All Products |
$1,196.60
|
| Rate for Payer: Signature Care EPO |
$1,286.50
|
| Rate for Payer: Signature Care PPO |
$1,364.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,317.50
|
| Rate for Payer: United Healthcare Commercial |
$1,221.40
|
| Rate for Payer: United Healthcare Medicare |
$511.50
|
|
|
HC W SCREW 4.5X16
|
Facility
IP
|
$1,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605705
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,162.50 |
| Max. Negotiated Rate |
$1,441.50 |
| Rate for Payer: Aetna Commercial |
$1,339.20
|
| Rate for Payer: Cash Price |
$961.00
|
| Rate for Payer: Cigna All Commercial |
$1,337.65
|
| Rate for Payer: CORVEL All Commercial |
$1,441.50
|
| Rate for Payer: Coventry All Commercial |
$1,364.00
|
| Rate for Payer: Encore All Commercial |
$1,426.78
|
| Rate for Payer: Frontpath All Commercial |
$1,426.00
|
| Rate for Payer: Humana ChoiceCare |
$1,338.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,395.00
|
| Rate for Payer: PHCS All Commercial |
$1,162.50
|
| Rate for Payer: PHP All Commercial |
$1,175.52
|
| Rate for Payer: Sagamore Health Network All Products |
$1,196.60
|
| Rate for Payer: Signature Care EPO |
$1,286.50
|
| Rate for Payer: Signature Care PPO |
$1,364.00
|
| Rate for Payer: United Healthcare Commercial |
$1,221.40
|
|
|
HC W SCREW 4.5X16 LG
|
Facility
IP
|
$1,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605706
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,162.50 |
| Max. Negotiated Rate |
$1,441.50 |
| Rate for Payer: Aetna Commercial |
$1,339.20
|
| Rate for Payer: Cash Price |
$961.00
|
| Rate for Payer: Cigna All Commercial |
$1,337.65
|
| Rate for Payer: CORVEL All Commercial |
$1,441.50
|
| Rate for Payer: Coventry All Commercial |
$1,364.00
|
| Rate for Payer: Encore All Commercial |
$1,426.78
|
| Rate for Payer: Frontpath All Commercial |
$1,426.00
|
| Rate for Payer: Humana ChoiceCare |
$1,338.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,395.00
|
| Rate for Payer: PHCS All Commercial |
$1,162.50
|
| Rate for Payer: PHP All Commercial |
$1,175.52
|
| Rate for Payer: Sagamore Health Network All Products |
$1,196.60
|
| Rate for Payer: Signature Care EPO |
$1,286.50
|
| Rate for Payer: Signature Care PPO |
$1,364.00
|
| Rate for Payer: United Healthcare Commercial |
$1,221.40
|
|
