|
HC W SCREW 4.5X60
|
Facility
IP
|
$1,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605762
|
|
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 4.5X60
|
Facility
OP
|
$1,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605762
|
|
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 4.5X60 CORT
|
Facility
IP
|
$742.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604820
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$556.50 |
| Max. Negotiated Rate |
$690.06 |
| Rate for Payer: Aetna Commercial |
$641.09
|
| Rate for Payer: Cash Price |
$460.04
|
| Rate for Payer: Cigna All Commercial |
$640.35
|
| Rate for Payer: CORVEL All Commercial |
$690.06
|
| Rate for Payer: Coventry All Commercial |
$652.96
|
| Rate for Payer: Encore All Commercial |
$683.01
|
| Rate for Payer: Frontpath All Commercial |
$682.64
|
| Rate for Payer: Humana ChoiceCare |
$640.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$667.80
|
| Rate for Payer: PHCS All Commercial |
$556.50
|
| Rate for Payer: PHP All Commercial |
$562.73
|
| Rate for Payer: Sagamore Health Network All Products |
$572.82
|
| Rate for Payer: Signature Care EPO |
$615.86
|
| Rate for Payer: Signature Care PPO |
$652.96
|
| Rate for Payer: United Healthcare Commercial |
$584.70
|
|
|
HC W SCREW 4.5X60 CORT
|
Facility
OP
|
$742.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604820
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$244.86 |
| Max. Negotiated Rate |
$690.06 |
| Rate for Payer: Aetna Commercial |
$626.25
|
| Rate for Payer: Aetna Medicare |
$244.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$244.86
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$426.13
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$463.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$281.59
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$269.35
|
| Rate for Payer: Cash Price |
$460.04
|
| Rate for Payer: Cash Price |
$460.04
|
| Rate for Payer: Centivo All Commercial |
$378.42
|
| Rate for Payer: Cigna All Commercial |
$640.35
|
| Rate for Payer: CORVEL All Commercial |
$690.06
|
| Rate for Payer: Coventry All Commercial |
$652.96
|
| Rate for Payer: Encore All Commercial |
$683.01
|
| Rate for Payer: Frontpath All Commercial |
$682.64
|
| Rate for Payer: Humana ChoiceCare |
$640.87
|
| Rate for Payer: Humana Medicare |
$378.42
|
| Rate for Payer: Lucent All Commercial |
$378.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$667.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$556.50
|
| Rate for Payer: PHP All Commercial |
$562.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$289.38
|
| Rate for Payer: Sagamore Health Network All Products |
$572.82
|
| Rate for Payer: Signature Care EPO |
$615.86
|
| Rate for Payer: Signature Care PPO |
$652.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$630.70
|
| Rate for Payer: United Healthcare Commercial |
$584.70
|
| Rate for Payer: United Healthcare Medicare |
$244.86
|
|
|
HC W SCREW 4.5X60 LG
|
Facility
IP
|
$1,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605763
|
|
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 4.5X60 LG
|
Facility
OP
|
$1,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605763
|
|
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 4.5X60 LOCK
|
Facility
OP
|
$1,255.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604790
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$414.15 |
| Max. Negotiated Rate |
$1,167.15 |
| Rate for Payer: Aetna Commercial |
$1,059.22
|
| Rate for Payer: Aetna Medicare |
$414.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$414.15
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$720.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$784.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$476.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$455.56
|
| Rate for Payer: Cash Price |
$778.10
|
| Rate for Payer: Cash Price |
$778.10
|
| Rate for Payer: Centivo All Commercial |
$640.05
|
| Rate for Payer: Cigna All Commercial |
$1,083.06
|
| Rate for Payer: CORVEL All Commercial |
$1,167.15
|
| Rate for Payer: Coventry All Commercial |
$1,104.40
|
| Rate for Payer: Encore All Commercial |
$1,155.23
|
| Rate for Payer: Frontpath All Commercial |
$1,154.60
|
| Rate for Payer: Humana ChoiceCare |
$1,083.94
|
| Rate for Payer: Humana Medicare |
$640.05
|
| Rate for Payer: Lucent All Commercial |
$640.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,129.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$941.25
|
| Rate for Payer: PHP All Commercial |
$951.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$489.45
|
| Rate for Payer: Sagamore Health Network All Products |
$968.86
|
| Rate for Payer: Signature Care EPO |
$1,041.65
|
| Rate for Payer: Signature Care PPO |
$1,104.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,066.75
|
| Rate for Payer: United Healthcare Commercial |
$988.94
|
| Rate for Payer: United Healthcare Medicare |
$414.15
|
|
|
HC W SCREW 4.5X60 LOCK
|
Facility
IP
|
$1,255.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604790
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$941.25 |
| Max. Negotiated Rate |
$1,167.15 |
| Rate for Payer: Aetna Commercial |
$1,084.32
|
| Rate for Payer: Cash Price |
$778.10
|
| Rate for Payer: Cigna All Commercial |
$1,083.06
|
| Rate for Payer: CORVEL All Commercial |
$1,167.15
|
| Rate for Payer: Coventry All Commercial |
$1,104.40
|
| Rate for Payer: Encore All Commercial |
$1,155.23
|
| Rate for Payer: Frontpath All Commercial |
$1,154.60
|
| Rate for Payer: Humana ChoiceCare |
$1,083.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,129.50
|
| Rate for Payer: PHCS All Commercial |
$941.25
|
| Rate for Payer: PHP All Commercial |
$951.79
|
| Rate for Payer: Sagamore Health Network All Products |
$968.86
|
| Rate for Payer: Signature Care EPO |
$1,041.65
|
| Rate for Payer: Signature Care PPO |
$1,104.40
|
| Rate for Payer: United Healthcare Commercial |
$988.94
|
|
|
HC W SCREW 4.5X60 SHRT
|
Facility
OP
|
$1,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605764
|
|
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 4.5X60 SHRT
|
Facility
IP
|
$1,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605764
|
|
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 4X10 TENODESIS INT
|
Facility
OP
|
$2,345.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607128
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,180.85 |
| Rate for Payer: Aetna Commercial |
$1,979.18
|
| Rate for Payer: Aetna Medicare |
$773.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$773.85
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,346.73
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,465.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$889.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$851.24
|
| Rate for Payer: Cash Price |
$1,453.90
|
| Rate for Payer: Cash Price |
$1,453.90
|
| Rate for Payer: Centivo All Commercial |
$1,195.95
|
| Rate for Payer: Cigna All Commercial |
$2,023.74
|
| Rate for Payer: CORVEL All Commercial |
$2,180.85
|
| Rate for Payer: Coventry All Commercial |
$2,063.60
|
| Rate for Payer: Encore All Commercial |
$2,158.57
|
| Rate for Payer: Frontpath All Commercial |
$2,157.40
|
| Rate for Payer: Humana ChoiceCare |
$2,025.38
|
| Rate for Payer: Humana Medicare |
$1,195.95
|
| Rate for Payer: Lucent All Commercial |
$1,195.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,110.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,758.75
|
| Rate for Payer: PHP All Commercial |
$1,778.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$914.55
|
| Rate for Payer: Sagamore Health Network All Products |
$1,810.34
|
| Rate for Payer: Signature Care EPO |
$1,946.35
|
| Rate for Payer: Signature Care PPO |
$2,063.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,993.25
|
| Rate for Payer: United Healthcare Commercial |
$1,847.86
|
| Rate for Payer: United Healthcare Medicare |
$773.85
|
|
|
HC W SCREW 4X10 TENODESIS INT
|
Facility
IP
|
$2,345.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607128
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,758.75 |
| Max. Negotiated Rate |
$2,180.85 |
| Rate for Payer: Aetna Commercial |
$2,026.08
|
| Rate for Payer: Cash Price |
$1,453.90
|
| Rate for Payer: Cigna All Commercial |
$2,023.74
|
| Rate for Payer: CORVEL All Commercial |
$2,180.85
|
| Rate for Payer: Coventry All Commercial |
$2,063.60
|
| Rate for Payer: Encore All Commercial |
$2,158.57
|
| Rate for Payer: Frontpath All Commercial |
$2,157.40
|
| Rate for Payer: Humana ChoiceCare |
$2,025.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,110.50
|
| Rate for Payer: PHCS All Commercial |
$1,758.75
|
| Rate for Payer: PHP All Commercial |
$1,778.45
|
| Rate for Payer: Sagamore Health Network All Products |
$1,810.34
|
| Rate for Payer: Signature Care EPO |
$1,946.35
|
| Rate for Payer: Signature Care PPO |
$2,063.60
|
| Rate for Payer: United Healthcare Commercial |
$1,847.86
|
|
|
HC W SCREW 5.5X20 CORT
|
Facility
IP
|
$742.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604821
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$556.50 |
| Max. Negotiated Rate |
$690.06 |
| Rate for Payer: Aetna Commercial |
$641.09
|
| Rate for Payer: Cash Price |
$460.04
|
| Rate for Payer: Cigna All Commercial |
$640.35
|
| Rate for Payer: CORVEL All Commercial |
$690.06
|
| Rate for Payer: Coventry All Commercial |
$652.96
|
| Rate for Payer: Encore All Commercial |
$683.01
|
| Rate for Payer: Frontpath All Commercial |
$682.64
|
| Rate for Payer: Humana ChoiceCare |
$640.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$667.80
|
| Rate for Payer: PHCS All Commercial |
$556.50
|
| Rate for Payer: PHP All Commercial |
$562.73
|
| Rate for Payer: Sagamore Health Network All Products |
$572.82
|
| Rate for Payer: Signature Care EPO |
$615.86
|
| Rate for Payer: Signature Care PPO |
$652.96
|
| Rate for Payer: United Healthcare Commercial |
$584.70
|
|
|
HC W SCREW 5.5X20 CORT
|
Facility
OP
|
$742.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604821
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$244.86 |
| Max. Negotiated Rate |
$690.06 |
| Rate for Payer: Aetna Commercial |
$626.25
|
| Rate for Payer: Aetna Medicare |
$244.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$244.86
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$426.13
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$463.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$281.59
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$269.35
|
| Rate for Payer: Cash Price |
$460.04
|
| Rate for Payer: Cash Price |
$460.04
|
| Rate for Payer: Centivo All Commercial |
$378.42
|
| Rate for Payer: Cigna All Commercial |
$640.35
|
| Rate for Payer: CORVEL All Commercial |
$690.06
|
| Rate for Payer: Coventry All Commercial |
$652.96
|
| Rate for Payer: Encore All Commercial |
$683.01
|
| Rate for Payer: Frontpath All Commercial |
$682.64
|
| Rate for Payer: Humana ChoiceCare |
$640.87
|
| Rate for Payer: Humana Medicare |
$378.42
|
| Rate for Payer: Lucent All Commercial |
$378.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$667.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$556.50
|
| Rate for Payer: PHP All Commercial |
$562.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$289.38
|
| Rate for Payer: Sagamore Health Network All Products |
$572.82
|
| Rate for Payer: Signature Care EPO |
$615.86
|
| Rate for Payer: Signature Care PPO |
$652.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$630.70
|
| Rate for Payer: United Healthcare Commercial |
$584.70
|
| Rate for Payer: United Healthcare Medicare |
$244.86
|
|
|
HC W SCREW 5.5X20 LOCK
|
Facility
IP
|
$1,255.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604791
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$941.25 |
| Max. Negotiated Rate |
$1,167.15 |
| Rate for Payer: Aetna Commercial |
$1,084.32
|
| Rate for Payer: Cash Price |
$778.10
|
| Rate for Payer: Cigna All Commercial |
$1,083.06
|
| Rate for Payer: CORVEL All Commercial |
$1,167.15
|
| Rate for Payer: Coventry All Commercial |
$1,104.40
|
| Rate for Payer: Encore All Commercial |
$1,155.23
|
| Rate for Payer: Frontpath All Commercial |
$1,154.60
|
| Rate for Payer: Humana ChoiceCare |
$1,083.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,129.50
|
| Rate for Payer: PHCS All Commercial |
$941.25
|
| Rate for Payer: PHP All Commercial |
$951.79
|
| Rate for Payer: Sagamore Health Network All Products |
$968.86
|
| Rate for Payer: Signature Care EPO |
$1,041.65
|
| Rate for Payer: Signature Care PPO |
$1,104.40
|
| Rate for Payer: United Healthcare Commercial |
$988.94
|
|
|
HC W SCREW 5.5X20 LOCK
|
Facility
OP
|
$1,255.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604791
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$414.15 |
| Max. Negotiated Rate |
$1,167.15 |
| Rate for Payer: Aetna Commercial |
$1,059.22
|
| Rate for Payer: Aetna Medicare |
$414.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$414.15
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$720.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$784.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$476.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$455.56
|
| Rate for Payer: Cash Price |
$778.10
|
| Rate for Payer: Cash Price |
$778.10
|
| Rate for Payer: Centivo All Commercial |
$640.05
|
| Rate for Payer: Cigna All Commercial |
$1,083.06
|
| Rate for Payer: CORVEL All Commercial |
$1,167.15
|
| Rate for Payer: Coventry All Commercial |
$1,104.40
|
| Rate for Payer: Encore All Commercial |
$1,155.23
|
| Rate for Payer: Frontpath All Commercial |
$1,154.60
|
| Rate for Payer: Humana ChoiceCare |
$1,083.94
|
| Rate for Payer: Humana Medicare |
$640.05
|
| Rate for Payer: Lucent All Commercial |
$640.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,129.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$941.25
|
| Rate for Payer: PHP All Commercial |
$951.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$489.45
|
| Rate for Payer: Sagamore Health Network All Products |
$968.86
|
| Rate for Payer: Signature Care EPO |
$1,041.65
|
| Rate for Payer: Signature Care PPO |
$1,104.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,066.75
|
| Rate for Payer: United Healthcare Commercial |
$988.94
|
| Rate for Payer: United Healthcare Medicare |
$414.15
|
|
|
HC W SCREW 5.5X22 CORT
|
Facility
OP
|
$742.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604822
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$244.86 |
| Max. Negotiated Rate |
$690.06 |
| Rate for Payer: Aetna Commercial |
$626.25
|
| Rate for Payer: Aetna Medicare |
$244.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$244.86
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$426.13
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$463.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$281.59
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$269.35
|
| Rate for Payer: Cash Price |
$460.04
|
| Rate for Payer: Cash Price |
$460.04
|
| Rate for Payer: Centivo All Commercial |
$378.42
|
| Rate for Payer: Cigna All Commercial |
$640.35
|
| Rate for Payer: CORVEL All Commercial |
$690.06
|
| Rate for Payer: Coventry All Commercial |
$652.96
|
| Rate for Payer: Encore All Commercial |
$683.01
|
| Rate for Payer: Frontpath All Commercial |
$682.64
|
| Rate for Payer: Humana ChoiceCare |
$640.87
|
| Rate for Payer: Humana Medicare |
$378.42
|
| Rate for Payer: Lucent All Commercial |
$378.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$667.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$556.50
|
| Rate for Payer: PHP All Commercial |
$562.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$289.38
|
| Rate for Payer: Sagamore Health Network All Products |
$572.82
|
| Rate for Payer: Signature Care EPO |
$615.86
|
| Rate for Payer: Signature Care PPO |
$652.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$630.70
|
| Rate for Payer: United Healthcare Commercial |
$584.70
|
| Rate for Payer: United Healthcare Medicare |
$244.86
|
|
|
HC W SCREW 5.5X22 CORT
|
Facility
IP
|
$742.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604822
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$556.50 |
| Max. Negotiated Rate |
$690.06 |
| Rate for Payer: Aetna Commercial |
$641.09
|
| Rate for Payer: Cash Price |
$460.04
|
| Rate for Payer: Cigna All Commercial |
$640.35
|
| Rate for Payer: CORVEL All Commercial |
$690.06
|
| Rate for Payer: Coventry All Commercial |
$652.96
|
| Rate for Payer: Encore All Commercial |
$683.01
|
| Rate for Payer: Frontpath All Commercial |
$682.64
|
| Rate for Payer: Humana ChoiceCare |
$640.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$667.80
|
| Rate for Payer: PHCS All Commercial |
$556.50
|
| Rate for Payer: PHP All Commercial |
$562.73
|
| Rate for Payer: Sagamore Health Network All Products |
$572.82
|
| Rate for Payer: Signature Care EPO |
$615.86
|
| Rate for Payer: Signature Care PPO |
$652.96
|
| Rate for Payer: United Healthcare Commercial |
$584.70
|
|
|
HC W SCREW 5.5X22 LOCK
|
Facility
IP
|
$1,255.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604792
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$941.25 |
| Max. Negotiated Rate |
$1,167.15 |
| Rate for Payer: Aetna Commercial |
$1,084.32
|
| Rate for Payer: Cash Price |
$778.10
|
| Rate for Payer: Cigna All Commercial |
$1,083.06
|
| Rate for Payer: CORVEL All Commercial |
$1,167.15
|
| Rate for Payer: Coventry All Commercial |
$1,104.40
|
| Rate for Payer: Encore All Commercial |
$1,155.23
|
| Rate for Payer: Frontpath All Commercial |
$1,154.60
|
| Rate for Payer: Humana ChoiceCare |
$1,083.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,129.50
|
| Rate for Payer: PHCS All Commercial |
$941.25
|
| Rate for Payer: PHP All Commercial |
$951.79
|
| Rate for Payer: Sagamore Health Network All Products |
$968.86
|
| Rate for Payer: Signature Care EPO |
$1,041.65
|
| Rate for Payer: Signature Care PPO |
$1,104.40
|
| Rate for Payer: United Healthcare Commercial |
$988.94
|
|
|
HC W SCREW 5.5X22 LOCK
|
Facility
OP
|
$1,255.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604792
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$414.15 |
| Max. Negotiated Rate |
$1,167.15 |
| Rate for Payer: Aetna Commercial |
$1,059.22
|
| Rate for Payer: Aetna Medicare |
$414.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$414.15
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$720.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$784.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$476.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$455.56
|
| Rate for Payer: Cash Price |
$778.10
|
| Rate for Payer: Cash Price |
$778.10
|
| Rate for Payer: Centivo All Commercial |
$640.05
|
| Rate for Payer: Cigna All Commercial |
$1,083.06
|
| Rate for Payer: CORVEL All Commercial |
$1,167.15
|
| Rate for Payer: Coventry All Commercial |
$1,104.40
|
| Rate for Payer: Encore All Commercial |
$1,155.23
|
| Rate for Payer: Frontpath All Commercial |
$1,154.60
|
| Rate for Payer: Humana ChoiceCare |
$1,083.94
|
| Rate for Payer: Humana Medicare |
$640.05
|
| Rate for Payer: Lucent All Commercial |
$640.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,129.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$941.25
|
| Rate for Payer: PHP All Commercial |
$951.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$489.45
|
| Rate for Payer: Sagamore Health Network All Products |
$968.86
|
| Rate for Payer: Signature Care EPO |
$1,041.65
|
| Rate for Payer: Signature Care PPO |
$1,104.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,066.75
|
| Rate for Payer: United Healthcare Commercial |
$988.94
|
| Rate for Payer: United Healthcare Medicare |
$414.15
|
|
|
HC W SCREW 5.5X24 CORT
|
Facility
IP
|
$742.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604823
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$556.50 |
| Max. Negotiated Rate |
$690.06 |
| Rate for Payer: Aetna Commercial |
$641.09
|
| Rate for Payer: Cash Price |
$460.04
|
| Rate for Payer: Cigna All Commercial |
$640.35
|
| Rate for Payer: CORVEL All Commercial |
$690.06
|
| Rate for Payer: Coventry All Commercial |
$652.96
|
| Rate for Payer: Encore All Commercial |
$683.01
|
| Rate for Payer: Frontpath All Commercial |
$682.64
|
| Rate for Payer: Humana ChoiceCare |
$640.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$667.80
|
| Rate for Payer: PHCS All Commercial |
$556.50
|
| Rate for Payer: PHP All Commercial |
$562.73
|
| Rate for Payer: Sagamore Health Network All Products |
$572.82
|
| Rate for Payer: Signature Care EPO |
$615.86
|
| Rate for Payer: Signature Care PPO |
$652.96
|
| Rate for Payer: United Healthcare Commercial |
$584.70
|
|
|
HC W SCREW 5.5X24 CORT
|
Facility
OP
|
$742.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604823
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$244.86 |
| Max. Negotiated Rate |
$690.06 |
| Rate for Payer: Aetna Commercial |
$626.25
|
| Rate for Payer: Aetna Medicare |
$244.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$244.86
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$426.13
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$463.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$281.59
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$269.35
|
| Rate for Payer: Cash Price |
$460.04
|
| Rate for Payer: Cash Price |
$460.04
|
| Rate for Payer: Centivo All Commercial |
$378.42
|
| Rate for Payer: Cigna All Commercial |
$640.35
|
| Rate for Payer: CORVEL All Commercial |
$690.06
|
| Rate for Payer: Coventry All Commercial |
$652.96
|
| Rate for Payer: Encore All Commercial |
$683.01
|
| Rate for Payer: Frontpath All Commercial |
$682.64
|
| Rate for Payer: Humana ChoiceCare |
$640.87
|
| Rate for Payer: Humana Medicare |
$378.42
|
| Rate for Payer: Lucent All Commercial |
$378.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$667.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$556.50
|
| Rate for Payer: PHP All Commercial |
$562.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$289.38
|
| Rate for Payer: Sagamore Health Network All Products |
$572.82
|
| Rate for Payer: Signature Care EPO |
$615.86
|
| Rate for Payer: Signature Care PPO |
$652.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$630.70
|
| Rate for Payer: United Healthcare Commercial |
$584.70
|
| Rate for Payer: United Healthcare Medicare |
$244.86
|
|
|
HC W SCREW 5.5X24 LOCK
|
Facility
IP
|
$1,255.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604793
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$941.25 |
| Max. Negotiated Rate |
$1,167.15 |
| Rate for Payer: Aetna Commercial |
$1,084.32
|
| Rate for Payer: Cash Price |
$778.10
|
| Rate for Payer: Cigna All Commercial |
$1,083.06
|
| Rate for Payer: CORVEL All Commercial |
$1,167.15
|
| Rate for Payer: Coventry All Commercial |
$1,104.40
|
| Rate for Payer: Encore All Commercial |
$1,155.23
|
| Rate for Payer: Frontpath All Commercial |
$1,154.60
|
| Rate for Payer: Humana ChoiceCare |
$1,083.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,129.50
|
| Rate for Payer: PHCS All Commercial |
$941.25
|
| Rate for Payer: PHP All Commercial |
$951.79
|
| Rate for Payer: Sagamore Health Network All Products |
$968.86
|
| Rate for Payer: Signature Care EPO |
$1,041.65
|
| Rate for Payer: Signature Care PPO |
$1,104.40
|
| Rate for Payer: United Healthcare Commercial |
$988.94
|
|
|
HC W SCREW 5.5X24 LOCK
|
Facility
OP
|
$1,255.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604793
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$414.15 |
| Max. Negotiated Rate |
$1,167.15 |
| Rate for Payer: Aetna Commercial |
$1,059.22
|
| Rate for Payer: Aetna Medicare |
$414.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$414.15
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$720.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$784.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$476.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$455.56
|
| Rate for Payer: Cash Price |
$778.10
|
| Rate for Payer: Cash Price |
$778.10
|
| Rate for Payer: Centivo All Commercial |
$640.05
|
| Rate for Payer: Cigna All Commercial |
$1,083.06
|
| Rate for Payer: CORVEL All Commercial |
$1,167.15
|
| Rate for Payer: Coventry All Commercial |
$1,104.40
|
| Rate for Payer: Encore All Commercial |
$1,155.23
|
| Rate for Payer: Frontpath All Commercial |
$1,154.60
|
| Rate for Payer: Humana ChoiceCare |
$1,083.94
|
| Rate for Payer: Humana Medicare |
$640.05
|
| Rate for Payer: Lucent All Commercial |
$640.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,129.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$941.25
|
| Rate for Payer: PHP All Commercial |
$951.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$489.45
|
| Rate for Payer: Sagamore Health Network All Products |
$968.86
|
| Rate for Payer: Signature Care EPO |
$1,041.65
|
| Rate for Payer: Signature Care PPO |
$1,104.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,066.75
|
| Rate for Payer: United Healthcare Commercial |
$988.94
|
| Rate for Payer: United Healthcare Medicare |
$414.15
|
|
|
HC W SCREW 5.5X26 CORT
|
Facility
IP
|
$742.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604824
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$556.50 |
| Max. Negotiated Rate |
$690.06 |
| Rate for Payer: Aetna Commercial |
$641.09
|
| Rate for Payer: Cash Price |
$460.04
|
| Rate for Payer: Cigna All Commercial |
$640.35
|
| Rate for Payer: CORVEL All Commercial |
$690.06
|
| Rate for Payer: Coventry All Commercial |
$652.96
|
| Rate for Payer: Encore All Commercial |
$683.01
|
| Rate for Payer: Frontpath All Commercial |
$682.64
|
| Rate for Payer: Humana ChoiceCare |
$640.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$667.80
|
| Rate for Payer: PHCS All Commercial |
$556.50
|
| Rate for Payer: PHP All Commercial |
$562.73
|
| Rate for Payer: Sagamore Health Network All Products |
$572.82
|
| Rate for Payer: Signature Care EPO |
$615.86
|
| Rate for Payer: Signature Care PPO |
$652.96
|
| Rate for Payer: United Healthcare Commercial |
$584.70
|
|
