|
HC W SCREW 6.5X75X16
|
Facility
OP
|
$2,330.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605785
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,166.90 |
| Rate for Payer: Aetna Commercial |
$1,966.52
|
| Rate for Payer: Aetna Medicare |
$768.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$768.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,338.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,456.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$884.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$845.79
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Centivo All Commercial |
$1,188.30
|
| Rate for Payer: Cigna All Commercial |
$2,010.79
|
| Rate for Payer: CORVEL All Commercial |
$2,166.90
|
| Rate for Payer: Coventry All Commercial |
$2,050.40
|
| Rate for Payer: Encore All Commercial |
$2,144.76
|
| Rate for Payer: Frontpath All Commercial |
$2,143.60
|
| Rate for Payer: Humana ChoiceCare |
$2,012.42
|
| Rate for Payer: Humana Medicare |
$1,188.30
|
| Rate for Payer: Lucent All Commercial |
$1,188.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,097.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,747.50
|
| Rate for Payer: PHP All Commercial |
$1,767.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$908.70
|
| Rate for Payer: Sagamore Health Network All Products |
$1,798.76
|
| Rate for Payer: Signature Care EPO |
$1,933.90
|
| Rate for Payer: Signature Care PPO |
$2,050.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,980.50
|
| Rate for Payer: United Healthcare Commercial |
$1,836.04
|
| Rate for Payer: United Healthcare Medicare |
$768.90
|
|
|
HC W SCREW 6.5X75X32
|
Facility
IP
|
$2,330.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605784
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,747.50 |
| Max. Negotiated Rate |
$2,166.90 |
| Rate for Payer: Aetna Commercial |
$2,013.12
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Cigna All Commercial |
$2,010.79
|
| Rate for Payer: CORVEL All Commercial |
$2,166.90
|
| Rate for Payer: Coventry All Commercial |
$2,050.40
|
| Rate for Payer: Encore All Commercial |
$2,144.76
|
| Rate for Payer: Frontpath All Commercial |
$2,143.60
|
| Rate for Payer: Humana ChoiceCare |
$2,012.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,097.00
|
| Rate for Payer: PHCS All Commercial |
$1,747.50
|
| Rate for Payer: PHP All Commercial |
$1,767.07
|
| Rate for Payer: Sagamore Health Network All Products |
$1,798.76
|
| Rate for Payer: Signature Care EPO |
$1,933.90
|
| Rate for Payer: Signature Care PPO |
$2,050.40
|
| Rate for Payer: United Healthcare Commercial |
$1,836.04
|
|
|
HC W SCREW 6.5X75X32
|
Facility
OP
|
$2,330.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605784
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,166.90 |
| Rate for Payer: Aetna Commercial |
$1,966.52
|
| Rate for Payer: Aetna Medicare |
$768.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$768.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,338.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,456.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$884.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$845.79
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Centivo All Commercial |
$1,188.30
|
| Rate for Payer: Cigna All Commercial |
$2,010.79
|
| Rate for Payer: CORVEL All Commercial |
$2,166.90
|
| Rate for Payer: Coventry All Commercial |
$2,050.40
|
| Rate for Payer: Encore All Commercial |
$2,144.76
|
| Rate for Payer: Frontpath All Commercial |
$2,143.60
|
| Rate for Payer: Humana ChoiceCare |
$2,012.42
|
| Rate for Payer: Humana Medicare |
$1,188.30
|
| Rate for Payer: Lucent All Commercial |
$1,188.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,097.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,747.50
|
| Rate for Payer: PHP All Commercial |
$1,767.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$908.70
|
| Rate for Payer: Sagamore Health Network All Products |
$1,798.76
|
| Rate for Payer: Signature Care EPO |
$1,933.90
|
| Rate for Payer: Signature Care PPO |
$2,050.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,980.50
|
| Rate for Payer: United Healthcare Commercial |
$1,836.04
|
| Rate for Payer: United Healthcare Medicare |
$768.90
|
|
|
HC W SCREW 6.5X80X16
|
Facility
IP
|
$2,330.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605787
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,747.50 |
| Max. Negotiated Rate |
$2,166.90 |
| Rate for Payer: Aetna Commercial |
$2,013.12
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Cigna All Commercial |
$2,010.79
|
| Rate for Payer: CORVEL All Commercial |
$2,166.90
|
| Rate for Payer: Coventry All Commercial |
$2,050.40
|
| Rate for Payer: Encore All Commercial |
$2,144.76
|
| Rate for Payer: Frontpath All Commercial |
$2,143.60
|
| Rate for Payer: Humana ChoiceCare |
$2,012.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,097.00
|
| Rate for Payer: PHCS All Commercial |
$1,747.50
|
| Rate for Payer: PHP All Commercial |
$1,767.07
|
| Rate for Payer: Sagamore Health Network All Products |
$1,798.76
|
| Rate for Payer: Signature Care EPO |
$1,933.90
|
| Rate for Payer: Signature Care PPO |
$2,050.40
|
| Rate for Payer: United Healthcare Commercial |
$1,836.04
|
|
|
HC W SCREW 6.5X80X16
|
Facility
OP
|
$2,330.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605787
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,166.90 |
| Rate for Payer: Aetna Commercial |
$1,966.52
|
| Rate for Payer: Aetna Medicare |
$768.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$768.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,338.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,456.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$884.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$845.79
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Centivo All Commercial |
$1,188.30
|
| Rate for Payer: Cigna All Commercial |
$2,010.79
|
| Rate for Payer: CORVEL All Commercial |
$2,166.90
|
| Rate for Payer: Coventry All Commercial |
$2,050.40
|
| Rate for Payer: Encore All Commercial |
$2,144.76
|
| Rate for Payer: Frontpath All Commercial |
$2,143.60
|
| Rate for Payer: Humana ChoiceCare |
$2,012.42
|
| Rate for Payer: Humana Medicare |
$1,188.30
|
| Rate for Payer: Lucent All Commercial |
$1,188.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,097.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,747.50
|
| Rate for Payer: PHP All Commercial |
$1,767.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$908.70
|
| Rate for Payer: Sagamore Health Network All Products |
$1,798.76
|
| Rate for Payer: Signature Care EPO |
$1,933.90
|
| Rate for Payer: Signature Care PPO |
$2,050.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,980.50
|
| Rate for Payer: United Healthcare Commercial |
$1,836.04
|
| Rate for Payer: United Healthcare Medicare |
$768.90
|
|
|
HC W SCREW 6.5X80X32
|
Facility
IP
|
$2,330.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605786
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,747.50 |
| Max. Negotiated Rate |
$2,166.90 |
| Rate for Payer: Aetna Commercial |
$2,013.12
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Cigna All Commercial |
$2,010.79
|
| Rate for Payer: CORVEL All Commercial |
$2,166.90
|
| Rate for Payer: Coventry All Commercial |
$2,050.40
|
| Rate for Payer: Encore All Commercial |
$2,144.76
|
| Rate for Payer: Frontpath All Commercial |
$2,143.60
|
| Rate for Payer: Humana ChoiceCare |
$2,012.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,097.00
|
| Rate for Payer: PHCS All Commercial |
$1,747.50
|
| Rate for Payer: PHP All Commercial |
$1,767.07
|
| Rate for Payer: Sagamore Health Network All Products |
$1,798.76
|
| Rate for Payer: Signature Care EPO |
$1,933.90
|
| Rate for Payer: Signature Care PPO |
$2,050.40
|
| Rate for Payer: United Healthcare Commercial |
$1,836.04
|
|
|
HC W SCREW 6.5X80X32
|
Facility
OP
|
$2,330.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605786
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,166.90 |
| Rate for Payer: Aetna Commercial |
$1,966.52
|
| Rate for Payer: Aetna Medicare |
$768.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$768.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,338.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,456.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$884.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$845.79
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Centivo All Commercial |
$1,188.30
|
| Rate for Payer: Cigna All Commercial |
$2,010.79
|
| Rate for Payer: CORVEL All Commercial |
$2,166.90
|
| Rate for Payer: Coventry All Commercial |
$2,050.40
|
| Rate for Payer: Encore All Commercial |
$2,144.76
|
| Rate for Payer: Frontpath All Commercial |
$2,143.60
|
| Rate for Payer: Humana ChoiceCare |
$2,012.42
|
| Rate for Payer: Humana Medicare |
$1,188.30
|
| Rate for Payer: Lucent All Commercial |
$1,188.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,097.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,747.50
|
| Rate for Payer: PHP All Commercial |
$1,767.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$908.70
|
| Rate for Payer: Sagamore Health Network All Products |
$1,798.76
|
| Rate for Payer: Signature Care EPO |
$1,933.90
|
| Rate for Payer: Signature Care PPO |
$2,050.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,980.50
|
| Rate for Payer: United Healthcare Commercial |
$1,836.04
|
| Rate for Payer: United Healthcare Medicare |
$768.90
|
|
|
HC W SCREW 6.5X85X16
|
Facility
IP
|
$2,330.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605789
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,747.50 |
| Max. Negotiated Rate |
$2,166.90 |
| Rate for Payer: Aetna Commercial |
$2,013.12
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Cigna All Commercial |
$2,010.79
|
| Rate for Payer: CORVEL All Commercial |
$2,166.90
|
| Rate for Payer: Coventry All Commercial |
$2,050.40
|
| Rate for Payer: Encore All Commercial |
$2,144.76
|
| Rate for Payer: Frontpath All Commercial |
$2,143.60
|
| Rate for Payer: Humana ChoiceCare |
$2,012.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,097.00
|
| Rate for Payer: PHCS All Commercial |
$1,747.50
|
| Rate for Payer: PHP All Commercial |
$1,767.07
|
| Rate for Payer: Sagamore Health Network All Products |
$1,798.76
|
| Rate for Payer: Signature Care EPO |
$1,933.90
|
| Rate for Payer: Signature Care PPO |
$2,050.40
|
| Rate for Payer: United Healthcare Commercial |
$1,836.04
|
|
|
HC W SCREW 6.5X85X16
|
Facility
OP
|
$2,330.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605789
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,166.90 |
| Rate for Payer: Aetna Commercial |
$1,966.52
|
| Rate for Payer: Aetna Medicare |
$768.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$768.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,338.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,456.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$884.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$845.79
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Centivo All Commercial |
$1,188.30
|
| Rate for Payer: Cigna All Commercial |
$2,010.79
|
| Rate for Payer: CORVEL All Commercial |
$2,166.90
|
| Rate for Payer: Coventry All Commercial |
$2,050.40
|
| Rate for Payer: Encore All Commercial |
$2,144.76
|
| Rate for Payer: Frontpath All Commercial |
$2,143.60
|
| Rate for Payer: Humana ChoiceCare |
$2,012.42
|
| Rate for Payer: Humana Medicare |
$1,188.30
|
| Rate for Payer: Lucent All Commercial |
$1,188.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,097.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,747.50
|
| Rate for Payer: PHP All Commercial |
$1,767.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$908.70
|
| Rate for Payer: Sagamore Health Network All Products |
$1,798.76
|
| Rate for Payer: Signature Care EPO |
$1,933.90
|
| Rate for Payer: Signature Care PPO |
$2,050.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,980.50
|
| Rate for Payer: United Healthcare Commercial |
$1,836.04
|
| Rate for Payer: United Healthcare Medicare |
$768.90
|
|
|
HC W SCREW 6.5X85X32
|
Facility
IP
|
$2,330.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605788
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,747.50 |
| Max. Negotiated Rate |
$2,166.90 |
| Rate for Payer: Aetna Commercial |
$2,013.12
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Cigna All Commercial |
$2,010.79
|
| Rate for Payer: CORVEL All Commercial |
$2,166.90
|
| Rate for Payer: Coventry All Commercial |
$2,050.40
|
| Rate for Payer: Encore All Commercial |
$2,144.76
|
| Rate for Payer: Frontpath All Commercial |
$2,143.60
|
| Rate for Payer: Humana ChoiceCare |
$2,012.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,097.00
|
| Rate for Payer: PHCS All Commercial |
$1,747.50
|
| Rate for Payer: PHP All Commercial |
$1,767.07
|
| Rate for Payer: Sagamore Health Network All Products |
$1,798.76
|
| Rate for Payer: Signature Care EPO |
$1,933.90
|
| Rate for Payer: Signature Care PPO |
$2,050.40
|
| Rate for Payer: United Healthcare Commercial |
$1,836.04
|
|
|
HC W SCREW 6.5X85X32
|
Facility
OP
|
$2,330.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605788
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,166.90 |
| Rate for Payer: Aetna Commercial |
$1,966.52
|
| Rate for Payer: Aetna Medicare |
$768.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$768.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,338.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,456.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$884.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$845.79
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Centivo All Commercial |
$1,188.30
|
| Rate for Payer: Cigna All Commercial |
$2,010.79
|
| Rate for Payer: CORVEL All Commercial |
$2,166.90
|
| Rate for Payer: Coventry All Commercial |
$2,050.40
|
| Rate for Payer: Encore All Commercial |
$2,144.76
|
| Rate for Payer: Frontpath All Commercial |
$2,143.60
|
| Rate for Payer: Humana ChoiceCare |
$2,012.42
|
| Rate for Payer: Humana Medicare |
$1,188.30
|
| Rate for Payer: Lucent All Commercial |
$1,188.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,097.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,747.50
|
| Rate for Payer: PHP All Commercial |
$1,767.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$908.70
|
| Rate for Payer: Sagamore Health Network All Products |
$1,798.76
|
| Rate for Payer: Signature Care EPO |
$1,933.90
|
| Rate for Payer: Signature Care PPO |
$2,050.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,980.50
|
| Rate for Payer: United Healthcare Commercial |
$1,836.04
|
| Rate for Payer: United Healthcare Medicare |
$768.90
|
|
|
HC W SCREW 6.5X90X16
|
Facility
IP
|
$2,330.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605791
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,747.50 |
| Max. Negotiated Rate |
$2,166.90 |
| Rate for Payer: Aetna Commercial |
$2,013.12
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Cigna All Commercial |
$2,010.79
|
| Rate for Payer: CORVEL All Commercial |
$2,166.90
|
| Rate for Payer: Coventry All Commercial |
$2,050.40
|
| Rate for Payer: Encore All Commercial |
$2,144.76
|
| Rate for Payer: Frontpath All Commercial |
$2,143.60
|
| Rate for Payer: Humana ChoiceCare |
$2,012.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,097.00
|
| Rate for Payer: PHCS All Commercial |
$1,747.50
|
| Rate for Payer: PHP All Commercial |
$1,767.07
|
| Rate for Payer: Sagamore Health Network All Products |
$1,798.76
|
| Rate for Payer: Signature Care EPO |
$1,933.90
|
| Rate for Payer: Signature Care PPO |
$2,050.40
|
| Rate for Payer: United Healthcare Commercial |
$1,836.04
|
|
|
HC W SCREW 6.5X90X16
|
Facility
OP
|
$2,330.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605791
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,166.90 |
| Rate for Payer: Aetna Commercial |
$1,966.52
|
| Rate for Payer: Aetna Medicare |
$768.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$768.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,338.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,456.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$884.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$845.79
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Centivo All Commercial |
$1,188.30
|
| Rate for Payer: Cigna All Commercial |
$2,010.79
|
| Rate for Payer: CORVEL All Commercial |
$2,166.90
|
| Rate for Payer: Coventry All Commercial |
$2,050.40
|
| Rate for Payer: Encore All Commercial |
$2,144.76
|
| Rate for Payer: Frontpath All Commercial |
$2,143.60
|
| Rate for Payer: Humana ChoiceCare |
$2,012.42
|
| Rate for Payer: Humana Medicare |
$1,188.30
|
| Rate for Payer: Lucent All Commercial |
$1,188.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,097.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,747.50
|
| Rate for Payer: PHP All Commercial |
$1,767.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$908.70
|
| Rate for Payer: Sagamore Health Network All Products |
$1,798.76
|
| Rate for Payer: Signature Care EPO |
$1,933.90
|
| Rate for Payer: Signature Care PPO |
$2,050.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,980.50
|
| Rate for Payer: United Healthcare Commercial |
$1,836.04
|
| Rate for Payer: United Healthcare Medicare |
$768.90
|
|
|
HC W SCREW 6.5X90X32
|
Facility
OP
|
$2,330.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605790
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,166.90 |
| Rate for Payer: Aetna Commercial |
$1,966.52
|
| Rate for Payer: Aetna Medicare |
$768.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$768.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,338.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,456.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$884.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$845.79
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Centivo All Commercial |
$1,188.30
|
| Rate for Payer: Cigna All Commercial |
$2,010.79
|
| Rate for Payer: CORVEL All Commercial |
$2,166.90
|
| Rate for Payer: Coventry All Commercial |
$2,050.40
|
| Rate for Payer: Encore All Commercial |
$2,144.76
|
| Rate for Payer: Frontpath All Commercial |
$2,143.60
|
| Rate for Payer: Humana ChoiceCare |
$2,012.42
|
| Rate for Payer: Humana Medicare |
$1,188.30
|
| Rate for Payer: Lucent All Commercial |
$1,188.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,097.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,747.50
|
| Rate for Payer: PHP All Commercial |
$1,767.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$908.70
|
| Rate for Payer: Sagamore Health Network All Products |
$1,798.76
|
| Rate for Payer: Signature Care EPO |
$1,933.90
|
| Rate for Payer: Signature Care PPO |
$2,050.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,980.50
|
| Rate for Payer: United Healthcare Commercial |
$1,836.04
|
| Rate for Payer: United Healthcare Medicare |
$768.90
|
|
|
HC W SCREW 6.5X90X32
|
Facility
IP
|
$2,330.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605790
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,747.50 |
| Max. Negotiated Rate |
$2,166.90 |
| Rate for Payer: Aetna Commercial |
$2,013.12
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Cigna All Commercial |
$2,010.79
|
| Rate for Payer: CORVEL All Commercial |
$2,166.90
|
| Rate for Payer: Coventry All Commercial |
$2,050.40
|
| Rate for Payer: Encore All Commercial |
$2,144.76
|
| Rate for Payer: Frontpath All Commercial |
$2,143.60
|
| Rate for Payer: Humana ChoiceCare |
$2,012.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,097.00
|
| Rate for Payer: PHCS All Commercial |
$1,747.50
|
| Rate for Payer: PHP All Commercial |
$1,767.07
|
| Rate for Payer: Sagamore Health Network All Products |
$1,798.76
|
| Rate for Payer: Signature Care EPO |
$1,933.90
|
| Rate for Payer: Signature Care PPO |
$2,050.40
|
| Rate for Payer: United Healthcare Commercial |
$1,836.04
|
|
|
HC W SCREW 6.5X95X16
|
Facility
IP
|
$2,330.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605793
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,747.50 |
| Max. Negotiated Rate |
$2,166.90 |
| Rate for Payer: Aetna Commercial |
$2,013.12
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Cigna All Commercial |
$2,010.79
|
| Rate for Payer: CORVEL All Commercial |
$2,166.90
|
| Rate for Payer: Coventry All Commercial |
$2,050.40
|
| Rate for Payer: Encore All Commercial |
$2,144.76
|
| Rate for Payer: Frontpath All Commercial |
$2,143.60
|
| Rate for Payer: Humana ChoiceCare |
$2,012.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,097.00
|
| Rate for Payer: PHCS All Commercial |
$1,747.50
|
| Rate for Payer: PHP All Commercial |
$1,767.07
|
| Rate for Payer: Sagamore Health Network All Products |
$1,798.76
|
| Rate for Payer: Signature Care EPO |
$1,933.90
|
| Rate for Payer: Signature Care PPO |
$2,050.40
|
| Rate for Payer: United Healthcare Commercial |
$1,836.04
|
|
|
HC W SCREW 6.5X95X16
|
Facility
OP
|
$2,330.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605793
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,166.90 |
| Rate for Payer: Aetna Commercial |
$1,966.52
|
| Rate for Payer: Aetna Medicare |
$768.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$768.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,338.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,456.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$884.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$845.79
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Centivo All Commercial |
$1,188.30
|
| Rate for Payer: Cigna All Commercial |
$2,010.79
|
| Rate for Payer: CORVEL All Commercial |
$2,166.90
|
| Rate for Payer: Coventry All Commercial |
$2,050.40
|
| Rate for Payer: Encore All Commercial |
$2,144.76
|
| Rate for Payer: Frontpath All Commercial |
$2,143.60
|
| Rate for Payer: Humana ChoiceCare |
$2,012.42
|
| Rate for Payer: Humana Medicare |
$1,188.30
|
| Rate for Payer: Lucent All Commercial |
$1,188.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,097.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,747.50
|
| Rate for Payer: PHP All Commercial |
$1,767.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$908.70
|
| Rate for Payer: Sagamore Health Network All Products |
$1,798.76
|
| Rate for Payer: Signature Care EPO |
$1,933.90
|
| Rate for Payer: Signature Care PPO |
$2,050.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,980.50
|
| Rate for Payer: United Healthcare Commercial |
$1,836.04
|
| Rate for Payer: United Healthcare Medicare |
$768.90
|
|
|
HC W SCREW 6.5X95X32
|
Facility
OP
|
$2,330.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605792
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,166.90 |
| Rate for Payer: Aetna Commercial |
$1,966.52
|
| Rate for Payer: Aetna Medicare |
$768.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$768.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,338.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,456.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$884.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$845.79
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Centivo All Commercial |
$1,188.30
|
| Rate for Payer: Cigna All Commercial |
$2,010.79
|
| Rate for Payer: CORVEL All Commercial |
$2,166.90
|
| Rate for Payer: Coventry All Commercial |
$2,050.40
|
| Rate for Payer: Encore All Commercial |
$2,144.76
|
| Rate for Payer: Frontpath All Commercial |
$2,143.60
|
| Rate for Payer: Humana ChoiceCare |
$2,012.42
|
| Rate for Payer: Humana Medicare |
$1,188.30
|
| Rate for Payer: Lucent All Commercial |
$1,188.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,097.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,747.50
|
| Rate for Payer: PHP All Commercial |
$1,767.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$908.70
|
| Rate for Payer: Sagamore Health Network All Products |
$1,798.76
|
| Rate for Payer: Signature Care EPO |
$1,933.90
|
| Rate for Payer: Signature Care PPO |
$2,050.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,980.50
|
| Rate for Payer: United Healthcare Commercial |
$1,836.04
|
| Rate for Payer: United Healthcare Medicare |
$768.90
|
|
|
HC W SCREW 6.5X95X32
|
Facility
IP
|
$2,330.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605792
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,747.50 |
| Max. Negotiated Rate |
$2,166.90 |
| Rate for Payer: Aetna Commercial |
$2,013.12
|
| Rate for Payer: Cash Price |
$1,444.60
|
| Rate for Payer: Cigna All Commercial |
$2,010.79
|
| Rate for Payer: CORVEL All Commercial |
$2,166.90
|
| Rate for Payer: Coventry All Commercial |
$2,050.40
|
| Rate for Payer: Encore All Commercial |
$2,144.76
|
| Rate for Payer: Frontpath All Commercial |
$2,143.60
|
| Rate for Payer: Humana ChoiceCare |
$2,012.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,097.00
|
| Rate for Payer: PHCS All Commercial |
$1,747.50
|
| Rate for Payer: PHP All Commercial |
$1,767.07
|
| Rate for Payer: Sagamore Health Network All Products |
$1,798.76
|
| Rate for Payer: Signature Care EPO |
$1,933.90
|
| Rate for Payer: Signature Care PPO |
$2,050.40
|
| Rate for Payer: United Healthcare Commercial |
$1,836.04
|
|
|
HC W SCREW 7.5X50 CANN
|
Facility
OP
|
$1,810.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606213
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,684.04 |
| Rate for Payer: Aetna Commercial |
$1,528.32
|
| Rate for Payer: Aetna Medicare |
$597.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$597.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,039.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,131.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$687.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$657.32
|
| Rate for Payer: Cash Price |
$1,122.70
|
| Rate for Payer: Cash Price |
$1,122.70
|
| Rate for Payer: Centivo All Commercial |
$923.51
|
| Rate for Payer: Cigna All Commercial |
$1,562.72
|
| Rate for Payer: CORVEL All Commercial |
$1,684.04
|
| Rate for Payer: Coventry All Commercial |
$1,593.50
|
| Rate for Payer: Encore All Commercial |
$1,666.84
|
| Rate for Payer: Frontpath All Commercial |
$1,665.94
|
| Rate for Payer: Humana ChoiceCare |
$1,563.99
|
| Rate for Payer: Humana Medicare |
$923.51
|
| Rate for Payer: Lucent All Commercial |
$923.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,629.72
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,358.10
|
| Rate for Payer: PHP All Commercial |
$1,373.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$706.21
|
| Rate for Payer: Sagamore Health Network All Products |
$1,397.94
|
| Rate for Payer: Signature Care EPO |
$1,502.96
|
| Rate for Payer: Signature Care PPO |
$1,593.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,539.18
|
| Rate for Payer: United Healthcare Commercial |
$1,426.91
|
| Rate for Payer: United Healthcare Medicare |
$597.56
|
|
|
HC W SCREW 7.5X50 CANN
|
Facility
IP
|
$1,810.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606213
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,358.10 |
| Max. Negotiated Rate |
$1,684.04 |
| Rate for Payer: Aetna Commercial |
$1,564.53
|
| Rate for Payer: Cash Price |
$1,122.70
|
| Rate for Payer: Cigna All Commercial |
$1,562.72
|
| Rate for Payer: CORVEL All Commercial |
$1,684.04
|
| Rate for Payer: Coventry All Commercial |
$1,593.50
|
| Rate for Payer: Encore All Commercial |
$1,666.84
|
| Rate for Payer: Frontpath All Commercial |
$1,665.94
|
| Rate for Payer: Humana ChoiceCare |
$1,563.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,629.72
|
| Rate for Payer: PHCS All Commercial |
$1,358.10
|
| Rate for Payer: PHP All Commercial |
$1,373.31
|
| Rate for Payer: Sagamore Health Network All Products |
$1,397.94
|
| Rate for Payer: Signature Care EPO |
$1,502.96
|
| Rate for Payer: Signature Care PPO |
$1,593.50
|
| Rate for Payer: United Healthcare Commercial |
$1,426.91
|
|
|
HC W SCREW 7.5X55 CANN
|
Facility
IP
|
$1,810.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606214
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,358.10 |
| Max. Negotiated Rate |
$1,684.04 |
| Rate for Payer: Aetna Commercial |
$1,564.53
|
| Rate for Payer: Cash Price |
$1,122.70
|
| Rate for Payer: Cigna All Commercial |
$1,562.72
|
| Rate for Payer: CORVEL All Commercial |
$1,684.04
|
| Rate for Payer: Coventry All Commercial |
$1,593.50
|
| Rate for Payer: Encore All Commercial |
$1,666.84
|
| Rate for Payer: Frontpath All Commercial |
$1,665.94
|
| Rate for Payer: Humana ChoiceCare |
$1,563.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,629.72
|
| Rate for Payer: PHCS All Commercial |
$1,358.10
|
| Rate for Payer: PHP All Commercial |
$1,373.31
|
| Rate for Payer: Sagamore Health Network All Products |
$1,397.94
|
| Rate for Payer: Signature Care EPO |
$1,502.96
|
| Rate for Payer: Signature Care PPO |
$1,593.50
|
| Rate for Payer: United Healthcare Commercial |
$1,426.91
|
|
|
HC W SCREW 7.5X55 CANN
|
Facility
OP
|
$1,810.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606214
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,684.04 |
| Rate for Payer: Aetna Commercial |
$1,528.32
|
| Rate for Payer: Aetna Medicare |
$597.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$597.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,039.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,131.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$687.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$657.32
|
| Rate for Payer: Cash Price |
$1,122.70
|
| Rate for Payer: Cash Price |
$1,122.70
|
| Rate for Payer: Centivo All Commercial |
$923.51
|
| Rate for Payer: Cigna All Commercial |
$1,562.72
|
| Rate for Payer: CORVEL All Commercial |
$1,684.04
|
| Rate for Payer: Coventry All Commercial |
$1,593.50
|
| Rate for Payer: Encore All Commercial |
$1,666.84
|
| Rate for Payer: Frontpath All Commercial |
$1,665.94
|
| Rate for Payer: Humana ChoiceCare |
$1,563.99
|
| Rate for Payer: Humana Medicare |
$923.51
|
| Rate for Payer: Lucent All Commercial |
$923.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,629.72
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,358.10
|
| Rate for Payer: PHP All Commercial |
$1,373.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$706.21
|
| Rate for Payer: Sagamore Health Network All Products |
$1,397.94
|
| Rate for Payer: Signature Care EPO |
$1,502.96
|
| Rate for Payer: Signature Care PPO |
$1,593.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,539.18
|
| Rate for Payer: United Healthcare Commercial |
$1,426.91
|
| Rate for Payer: United Healthcare Medicare |
$597.56
|
|
|
HC W SCREW 7X45 CANN
|
Facility
IP
|
$1,635.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606911
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,226.25 |
| Max. Negotiated Rate |
$1,520.55 |
| Rate for Payer: Aetna Commercial |
$1,412.64
|
| Rate for Payer: Cash Price |
$1,013.70
|
| Rate for Payer: Cigna All Commercial |
$1,411.00
|
| Rate for Payer: CORVEL All Commercial |
$1,520.55
|
| Rate for Payer: Coventry All Commercial |
$1,438.80
|
| Rate for Payer: Encore All Commercial |
$1,505.02
|
| Rate for Payer: Frontpath All Commercial |
$1,504.20
|
| Rate for Payer: Humana ChoiceCare |
$1,412.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,471.50
|
| Rate for Payer: PHCS All Commercial |
$1,226.25
|
| Rate for Payer: PHP All Commercial |
$1,239.98
|
| Rate for Payer: Sagamore Health Network All Products |
$1,262.22
|
| Rate for Payer: Signature Care EPO |
$1,357.05
|
| Rate for Payer: Signature Care PPO |
$1,438.80
|
| Rate for Payer: United Healthcare Commercial |
$1,288.38
|
|
|
HC W SCREW 7X45 CANN
|
Facility
OP
|
$1,635.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606911
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,520.55 |
| Rate for Payer: Aetna Commercial |
$1,379.94
|
| Rate for Payer: Aetna Medicare |
$539.55
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$539.55
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$938.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,022.04
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$620.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$593.50
|
| Rate for Payer: Cash Price |
$1,013.70
|
| Rate for Payer: Cash Price |
$1,013.70
|
| Rate for Payer: Centivo All Commercial |
$833.85
|
| Rate for Payer: Cigna All Commercial |
$1,411.00
|
| Rate for Payer: CORVEL All Commercial |
$1,520.55
|
| Rate for Payer: Coventry All Commercial |
$1,438.80
|
| Rate for Payer: Encore All Commercial |
$1,505.02
|
| Rate for Payer: Frontpath All Commercial |
$1,504.20
|
| Rate for Payer: Humana ChoiceCare |
$1,412.15
|
| Rate for Payer: Humana Medicare |
$833.85
|
| Rate for Payer: Lucent All Commercial |
$833.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,471.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,226.25
|
| Rate for Payer: PHP All Commercial |
$1,239.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$637.65
|
| Rate for Payer: Sagamore Health Network All Products |
$1,262.22
|
| Rate for Payer: Signature Care EPO |
$1,357.05
|
| Rate for Payer: Signature Care PPO |
$1,438.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,389.75
|
| Rate for Payer: United Healthcare Commercial |
$1,288.38
|
| Rate for Payer: United Healthcare Medicare |
$539.55
|
|
