|
HC Z DRILL 4.0 MD
|
Facility
IP
|
$885.50
|
|
| Hospital Charge Code |
41607495
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$664.12 |
| Max. Negotiated Rate |
$823.52 |
| Rate for Payer: Aetna Commercial |
$765.07
|
| Rate for Payer: Cash Price |
$549.01
|
| Rate for Payer: Cigna All Commercial |
$764.19
|
| Rate for Payer: CORVEL All Commercial |
$823.52
|
| Rate for Payer: Coventry All Commercial |
$779.24
|
| Rate for Payer: Encore All Commercial |
$815.10
|
| Rate for Payer: Frontpath All Commercial |
$814.66
|
| Rate for Payer: Humana ChoiceCare |
$764.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$796.95
|
| Rate for Payer: PHCS All Commercial |
$664.12
|
| Rate for Payer: PHP All Commercial |
$671.56
|
| Rate for Payer: Sagamore Health Network All Products |
$683.61
|
| Rate for Payer: Signature Care EPO |
$734.96
|
| Rate for Payer: Signature Care PPO |
$779.24
|
| Rate for Payer: United Healthcare Commercial |
$697.77
|
|
|
HC Z DRILL 4.2X130 FH
|
Facility
IP
|
$1,739.50
|
|
| Hospital Charge Code |
41607924
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,304.62 |
| Max. Negotiated Rate |
$1,617.74 |
| Rate for Payer: Aetna Commercial |
$1,502.93
|
| Rate for Payer: Cash Price |
$1,078.49
|
| Rate for Payer: Cigna All Commercial |
$1,501.19
|
| Rate for Payer: CORVEL All Commercial |
$1,617.74
|
| Rate for Payer: Coventry All Commercial |
$1,530.76
|
| Rate for Payer: Encore All Commercial |
$1,601.21
|
| Rate for Payer: Frontpath All Commercial |
$1,600.34
|
| Rate for Payer: Humana ChoiceCare |
$1,502.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,565.55
|
| Rate for Payer: PHCS All Commercial |
$1,304.62
|
| Rate for Payer: PHP All Commercial |
$1,319.24
|
| Rate for Payer: Sagamore Health Network All Products |
$1,342.89
|
| Rate for Payer: Signature Care EPO |
$1,443.78
|
| Rate for Payer: Signature Care PPO |
$1,530.76
|
| Rate for Payer: United Healthcare Commercial |
$1,370.73
|
|
|
HC Z DRILL 4.2X130 FH
|
Facility
OP
|
$1,739.50
|
|
| Hospital Charge Code |
41607924
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,617.74 |
| Rate for Payer: Aetna Commercial |
$1,468.14
|
| Rate for Payer: Aetna Medicare |
$574.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$574.04
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$998.99
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,087.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$660.14
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$631.44
|
| Rate for Payer: Cash Price |
$1,078.49
|
| Rate for Payer: Cash Price |
$1,078.49
|
| Rate for Payer: Centivo All Commercial |
$887.14
|
| Rate for Payer: Cigna All Commercial |
$1,501.19
|
| Rate for Payer: CORVEL All Commercial |
$1,617.74
|
| Rate for Payer: Coventry All Commercial |
$1,530.76
|
| Rate for Payer: Encore All Commercial |
$1,601.21
|
| Rate for Payer: Frontpath All Commercial |
$1,600.34
|
| Rate for Payer: Humana ChoiceCare |
$1,502.41
|
| Rate for Payer: Humana Medicare |
$887.14
|
| Rate for Payer: Lucent All Commercial |
$887.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,565.55
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,304.62
|
| Rate for Payer: PHP All Commercial |
$1,319.24
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$678.40
|
| Rate for Payer: Sagamore Health Network All Products |
$1,342.89
|
| Rate for Payer: Signature Care EPO |
$1,443.78
|
| Rate for Payer: Signature Care PPO |
$1,530.76
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,478.58
|
| Rate for Payer: United Healthcare Commercial |
$1,370.73
|
| Rate for Payer: United Healthcare Medicare |
$574.04
|
|
|
HC Z DRILL 4.2X185 FH
|
Facility
OP
|
$1,739.50
|
|
| Hospital Charge Code |
41607925
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,617.74 |
| Rate for Payer: Aetna Commercial |
$1,468.14
|
| Rate for Payer: Aetna Medicare |
$574.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$574.04
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$998.99
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,087.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$660.14
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$631.44
|
| Rate for Payer: Cash Price |
$1,078.49
|
| Rate for Payer: Cash Price |
$1,078.49
|
| Rate for Payer: Centivo All Commercial |
$887.14
|
| Rate for Payer: Cigna All Commercial |
$1,501.19
|
| Rate for Payer: CORVEL All Commercial |
$1,617.74
|
| Rate for Payer: Coventry All Commercial |
$1,530.76
|
| Rate for Payer: Encore All Commercial |
$1,601.21
|
| Rate for Payer: Frontpath All Commercial |
$1,600.34
|
| Rate for Payer: Humana ChoiceCare |
$1,502.41
|
| Rate for Payer: Humana Medicare |
$887.14
|
| Rate for Payer: Lucent All Commercial |
$887.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,565.55
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,304.62
|
| Rate for Payer: PHP All Commercial |
$1,319.24
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$678.40
|
| Rate for Payer: Sagamore Health Network All Products |
$1,342.89
|
| Rate for Payer: Signature Care EPO |
$1,443.78
|
| Rate for Payer: Signature Care PPO |
$1,530.76
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,478.58
|
| Rate for Payer: United Healthcare Commercial |
$1,370.73
|
| Rate for Payer: United Healthcare Medicare |
$574.04
|
|
|
HC Z DRILL 4.2X185 FH
|
Facility
IP
|
$1,739.50
|
|
| Hospital Charge Code |
41607925
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,304.62 |
| Max. Negotiated Rate |
$1,617.74 |
| Rate for Payer: Aetna Commercial |
$1,502.93
|
| Rate for Payer: Cash Price |
$1,078.49
|
| Rate for Payer: Cigna All Commercial |
$1,501.19
|
| Rate for Payer: CORVEL All Commercial |
$1,617.74
|
| Rate for Payer: Coventry All Commercial |
$1,530.76
|
| Rate for Payer: Encore All Commercial |
$1,601.21
|
| Rate for Payer: Frontpath All Commercial |
$1,600.34
|
| Rate for Payer: Humana ChoiceCare |
$1,502.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,565.55
|
| Rate for Payer: PHCS All Commercial |
$1,304.62
|
| Rate for Payer: PHP All Commercial |
$1,319.24
|
| Rate for Payer: Sagamore Health Network All Products |
$1,342.89
|
| Rate for Payer: Signature Care EPO |
$1,443.78
|
| Rate for Payer: Signature Care PPO |
$1,530.76
|
| Rate for Payer: United Healthcare Commercial |
$1,370.73
|
|
|
HC Z DRILL 4.2X360 LOCK
|
Facility
OP
|
$1,739.50
|
|
| Hospital Charge Code |
41607926
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,617.74 |
| Rate for Payer: Aetna Commercial |
$1,468.14
|
| Rate for Payer: Aetna Medicare |
$574.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$574.04
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$998.99
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,087.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$660.14
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$631.44
|
| Rate for Payer: Cash Price |
$1,078.49
|
| Rate for Payer: Cash Price |
$1,078.49
|
| Rate for Payer: Centivo All Commercial |
$887.14
|
| Rate for Payer: Cigna All Commercial |
$1,501.19
|
| Rate for Payer: CORVEL All Commercial |
$1,617.74
|
| Rate for Payer: Coventry All Commercial |
$1,530.76
|
| Rate for Payer: Encore All Commercial |
$1,601.21
|
| Rate for Payer: Frontpath All Commercial |
$1,600.34
|
| Rate for Payer: Humana ChoiceCare |
$1,502.41
|
| Rate for Payer: Humana Medicare |
$887.14
|
| Rate for Payer: Lucent All Commercial |
$887.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,565.55
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,304.62
|
| Rate for Payer: PHP All Commercial |
$1,319.24
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$678.40
|
| Rate for Payer: Sagamore Health Network All Products |
$1,342.89
|
| Rate for Payer: Signature Care EPO |
$1,443.78
|
| Rate for Payer: Signature Care PPO |
$1,530.76
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,478.58
|
| Rate for Payer: United Healthcare Commercial |
$1,370.73
|
| Rate for Payer: United Healthcare Medicare |
$574.04
|
|
|
HC Z DRILL 4.2X360 LOCK
|
Facility
IP
|
$1,739.50
|
|
| Hospital Charge Code |
41607926
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,304.62 |
| Max. Negotiated Rate |
$1,617.74 |
| Rate for Payer: Aetna Commercial |
$1,502.93
|
| Rate for Payer: Cash Price |
$1,078.49
|
| Rate for Payer: Cigna All Commercial |
$1,501.19
|
| Rate for Payer: CORVEL All Commercial |
$1,617.74
|
| Rate for Payer: Coventry All Commercial |
$1,530.76
|
| Rate for Payer: Encore All Commercial |
$1,601.21
|
| Rate for Payer: Frontpath All Commercial |
$1,600.34
|
| Rate for Payer: Humana ChoiceCare |
$1,502.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,565.55
|
| Rate for Payer: PHCS All Commercial |
$1,304.62
|
| Rate for Payer: PHP All Commercial |
$1,319.24
|
| Rate for Payer: Sagamore Health Network All Products |
$1,342.89
|
| Rate for Payer: Signature Care EPO |
$1,443.78
|
| Rate for Payer: Signature Care PPO |
$1,530.76
|
| Rate for Payer: United Healthcare Commercial |
$1,370.73
|
|
|
HC Z DRILL 4.3 DISTAL GRAD
|
Facility
IP
|
$1,191.80
|
|
| Hospital Charge Code |
41606240
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$893.85 |
| Max. Negotiated Rate |
$1,108.37 |
| Rate for Payer: Aetna Commercial |
$1,029.72
|
| Rate for Payer: Cash Price |
$738.92
|
| Rate for Payer: Cigna All Commercial |
$1,028.52
|
| Rate for Payer: CORVEL All Commercial |
$1,108.37
|
| Rate for Payer: Coventry All Commercial |
$1,048.78
|
| Rate for Payer: Encore All Commercial |
$1,097.05
|
| Rate for Payer: Frontpath All Commercial |
$1,096.46
|
| Rate for Payer: Humana ChoiceCare |
$1,029.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,072.62
|
| Rate for Payer: PHCS All Commercial |
$893.85
|
| Rate for Payer: PHP All Commercial |
$903.86
|
| Rate for Payer: Sagamore Health Network All Products |
$920.07
|
| Rate for Payer: Signature Care EPO |
$989.19
|
| Rate for Payer: Signature Care PPO |
$1,048.78
|
| Rate for Payer: United Healthcare Commercial |
$939.14
|
|
|
HC Z DRILL 4.3 DISTAL GRAD
|
Facility
OP
|
$1,191.80
|
|
| Hospital Charge Code |
41606240
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,108.37 |
| Rate for Payer: Aetna Commercial |
$1,005.88
|
| Rate for Payer: Aetna Medicare |
$393.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$393.29
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$684.45
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$744.99
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$452.29
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$432.62
|
| Rate for Payer: Cash Price |
$738.92
|
| Rate for Payer: Cash Price |
$738.92
|
| Rate for Payer: Centivo All Commercial |
$607.82
|
| Rate for Payer: Cigna All Commercial |
$1,028.52
|
| Rate for Payer: CORVEL All Commercial |
$1,108.37
|
| Rate for Payer: Coventry All Commercial |
$1,048.78
|
| Rate for Payer: Encore All Commercial |
$1,097.05
|
| Rate for Payer: Frontpath All Commercial |
$1,096.46
|
| Rate for Payer: Humana ChoiceCare |
$1,029.36
|
| Rate for Payer: Humana Medicare |
$607.82
|
| Rate for Payer: Lucent All Commercial |
$607.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,072.62
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$893.85
|
| Rate for Payer: PHP All Commercial |
$903.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$464.80
|
| Rate for Payer: Sagamore Health Network All Products |
$920.07
|
| Rate for Payer: Signature Care EPO |
$989.19
|
| Rate for Payer: Signature Care PPO |
$1,048.78
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,013.03
|
| Rate for Payer: United Healthcare Commercial |
$939.14
|
| Rate for Payer: United Healthcare Medicare |
$393.29
|
|
|
HC Z DRILL 4.3 DISTAL GRAD SHRT
|
Facility
IP
|
$1,191.80
|
|
| Hospital Charge Code |
41606656
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$893.85 |
| Max. Negotiated Rate |
$1,108.37 |
| Rate for Payer: Aetna Commercial |
$1,029.72
|
| Rate for Payer: Cash Price |
$738.92
|
| Rate for Payer: Cigna All Commercial |
$1,028.52
|
| Rate for Payer: CORVEL All Commercial |
$1,108.37
|
| Rate for Payer: Coventry All Commercial |
$1,048.78
|
| Rate for Payer: Encore All Commercial |
$1,097.05
|
| Rate for Payer: Frontpath All Commercial |
$1,096.46
|
| Rate for Payer: Humana ChoiceCare |
$1,029.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,072.62
|
| Rate for Payer: PHCS All Commercial |
$893.85
|
| Rate for Payer: PHP All Commercial |
$903.86
|
| Rate for Payer: Sagamore Health Network All Products |
$920.07
|
| Rate for Payer: Signature Care EPO |
$989.19
|
| Rate for Payer: Signature Care PPO |
$1,048.78
|
| Rate for Payer: United Healthcare Commercial |
$939.14
|
|
|
HC Z DRILL 4.3 DISTAL GRAD SHRT
|
Facility
OP
|
$1,191.80
|
|
| Hospital Charge Code |
41606656
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,108.37 |
| Rate for Payer: Aetna Commercial |
$1,005.88
|
| Rate for Payer: Aetna Medicare |
$393.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$393.29
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$684.45
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$744.99
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$452.29
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$432.62
|
| Rate for Payer: Cash Price |
$738.92
|
| Rate for Payer: Cash Price |
$738.92
|
| Rate for Payer: Centivo All Commercial |
$607.82
|
| Rate for Payer: Cigna All Commercial |
$1,028.52
|
| Rate for Payer: CORVEL All Commercial |
$1,108.37
|
| Rate for Payer: Coventry All Commercial |
$1,048.78
|
| Rate for Payer: Encore All Commercial |
$1,097.05
|
| Rate for Payer: Frontpath All Commercial |
$1,096.46
|
| Rate for Payer: Humana ChoiceCare |
$1,029.36
|
| Rate for Payer: Humana Medicare |
$607.82
|
| Rate for Payer: Lucent All Commercial |
$607.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,072.62
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$893.85
|
| Rate for Payer: PHP All Commercial |
$903.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$464.80
|
| Rate for Payer: Sagamore Health Network All Products |
$920.07
|
| Rate for Payer: Signature Care EPO |
$989.19
|
| Rate for Payer: Signature Care PPO |
$1,048.78
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,013.03
|
| Rate for Payer: United Healthcare Commercial |
$939.14
|
| Rate for Payer: United Healthcare Medicare |
$393.29
|
|
|
HC Z DRILL 4.3 GRAD DIST LONG
|
Facility
OP
|
$1,560.00
|
|
| Hospital Charge Code |
41606518
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,450.80 |
| Rate for Payer: Aetna Commercial |
$1,316.64
|
| Rate for Payer: Aetna Medicare |
$514.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$514.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$895.91
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$975.16
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$592.02
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$566.28
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Centivo All Commercial |
$795.60
|
| Rate for Payer: Cigna All Commercial |
$1,346.28
|
| Rate for Payer: CORVEL All Commercial |
$1,450.80
|
| Rate for Payer: Coventry All Commercial |
$1,372.80
|
| Rate for Payer: Encore All Commercial |
$1,435.98
|
| Rate for Payer: Frontpath All Commercial |
$1,435.20
|
| Rate for Payer: Humana ChoiceCare |
$1,347.37
|
| Rate for Payer: Humana Medicare |
$795.60
|
| Rate for Payer: Lucent All Commercial |
$795.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,404.00
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,170.00
|
| Rate for Payer: PHP All Commercial |
$1,183.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$608.40
|
| Rate for Payer: Sagamore Health Network All Products |
$1,204.32
|
| Rate for Payer: Signature Care EPO |
$1,294.80
|
| Rate for Payer: Signature Care PPO |
$1,372.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,326.00
|
| Rate for Payer: United Healthcare Commercial |
$1,229.28
|
| Rate for Payer: United Healthcare Medicare |
$514.80
|
|
|
HC Z DRILL 4.3 GRAD DIST LONG
|
Facility
IP
|
$1,560.00
|
|
| Hospital Charge Code |
41606518
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,170.00 |
| Max. Negotiated Rate |
$1,450.80 |
| Rate for Payer: Aetna Commercial |
$1,347.84
|
| Rate for Payer: Cash Price |
$967.20
|
| Rate for Payer: Cigna All Commercial |
$1,346.28
|
| Rate for Payer: CORVEL All Commercial |
$1,450.80
|
| Rate for Payer: Coventry All Commercial |
$1,372.80
|
| Rate for Payer: Encore All Commercial |
$1,435.98
|
| Rate for Payer: Frontpath All Commercial |
$1,435.20
|
| Rate for Payer: Humana ChoiceCare |
$1,347.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,404.00
|
| Rate for Payer: PHCS All Commercial |
$1,170.00
|
| Rate for Payer: PHP All Commercial |
$1,183.10
|
| Rate for Payer: Sagamore Health Network All Products |
$1,204.32
|
| Rate for Payer: Signature Care EPO |
$1,294.80
|
| Rate for Payer: Signature Care PPO |
$1,372.80
|
| Rate for Payer: United Healthcare Commercial |
$1,229.28
|
|
|
HC Z DRILL 4.7 CANN
|
Facility
IP
|
$898.85
|
|
| Hospital Charge Code |
41606947
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$674.14 |
| Max. Negotiated Rate |
$835.93 |
| Rate for Payer: Aetna Commercial |
$776.61
|
| Rate for Payer: Cash Price |
$557.29
|
| Rate for Payer: Cigna All Commercial |
$775.71
|
| Rate for Payer: CORVEL All Commercial |
$835.93
|
| Rate for Payer: Coventry All Commercial |
$790.99
|
| Rate for Payer: Encore All Commercial |
$827.39
|
| Rate for Payer: Frontpath All Commercial |
$826.94
|
| Rate for Payer: Humana ChoiceCare |
$776.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$808.96
|
| Rate for Payer: PHCS All Commercial |
$674.14
|
| Rate for Payer: PHP All Commercial |
$681.69
|
| Rate for Payer: Sagamore Health Network All Products |
$693.91
|
| Rate for Payer: Signature Care EPO |
$746.05
|
| Rate for Payer: Signature Care PPO |
$790.99
|
| Rate for Payer: United Healthcare Commercial |
$708.29
|
|
|
HC Z DRILL 4.7 CANN
|
Facility
OP
|
$898.85
|
|
| Hospital Charge Code |
41606947
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$835.93 |
| Rate for Payer: Aetna Commercial |
$758.63
|
| Rate for Payer: Aetna Medicare |
$296.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$296.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$516.21
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$561.87
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$341.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$326.28
|
| Rate for Payer: Cash Price |
$557.29
|
| Rate for Payer: Cash Price |
$557.29
|
| Rate for Payer: Centivo All Commercial |
$458.41
|
| Rate for Payer: Cigna All Commercial |
$775.71
|
| Rate for Payer: CORVEL All Commercial |
$835.93
|
| Rate for Payer: Coventry All Commercial |
$790.99
|
| Rate for Payer: Encore All Commercial |
$827.39
|
| Rate for Payer: Frontpath All Commercial |
$826.94
|
| Rate for Payer: Humana ChoiceCare |
$776.34
|
| Rate for Payer: Humana Medicare |
$458.41
|
| Rate for Payer: Lucent All Commercial |
$458.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$808.96
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$674.14
|
| Rate for Payer: PHP All Commercial |
$681.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$350.55
|
| Rate for Payer: Sagamore Health Network All Products |
$693.91
|
| Rate for Payer: Signature Care EPO |
$746.05
|
| Rate for Payer: Signature Care PPO |
$790.99
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$764.02
|
| Rate for Payer: United Healthcare Commercial |
$708.29
|
| Rate for Payer: United Healthcare Medicare |
$296.62
|
|
|
HC Z DRILL AUG 2.7
|
Facility
OP
|
$754.40
|
|
| Hospital Charge Code |
41606609
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$701.59 |
| Rate for Payer: Aetna Commercial |
$636.71
|
| Rate for Payer: Aetna Medicare |
$248.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$248.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$433.25
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$471.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$286.29
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$273.85
|
| Rate for Payer: Cash Price |
$467.73
|
| Rate for Payer: Cash Price |
$467.73
|
| Rate for Payer: Centivo All Commercial |
$384.74
|
| Rate for Payer: Cigna All Commercial |
$651.05
|
| Rate for Payer: CORVEL All Commercial |
$701.59
|
| Rate for Payer: Coventry All Commercial |
$663.87
|
| Rate for Payer: Encore All Commercial |
$694.43
|
| Rate for Payer: Frontpath All Commercial |
$694.05
|
| Rate for Payer: Humana ChoiceCare |
$651.58
|
| Rate for Payer: Humana Medicare |
$384.74
|
| Rate for Payer: Lucent All Commercial |
$384.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$678.96
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$565.80
|
| Rate for Payer: PHP All Commercial |
$572.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$294.22
|
| Rate for Payer: Sagamore Health Network All Products |
$582.40
|
| Rate for Payer: Signature Care EPO |
$626.15
|
| Rate for Payer: Signature Care PPO |
$663.87
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$641.24
|
| Rate for Payer: United Healthcare Commercial |
$594.47
|
| Rate for Payer: United Healthcare Medicare |
$248.95
|
|
|
HC Z DRILL AUG 2.7
|
Facility
IP
|
$754.40
|
|
| Hospital Charge Code |
41606609
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$565.80 |
| Max. Negotiated Rate |
$701.59 |
| Rate for Payer: Aetna Commercial |
$651.80
|
| Rate for Payer: Cash Price |
$467.73
|
| Rate for Payer: Cigna All Commercial |
$651.05
|
| Rate for Payer: CORVEL All Commercial |
$701.59
|
| Rate for Payer: Coventry All Commercial |
$663.87
|
| Rate for Payer: Encore All Commercial |
$694.43
|
| Rate for Payer: Frontpath All Commercial |
$694.05
|
| Rate for Payer: Humana ChoiceCare |
$651.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$678.96
|
| Rate for Payer: PHCS All Commercial |
$565.80
|
| Rate for Payer: PHP All Commercial |
$572.14
|
| Rate for Payer: Sagamore Health Network All Products |
$582.40
|
| Rate for Payer: Signature Care EPO |
$626.15
|
| Rate for Payer: Signature Care PPO |
$663.87
|
| Rate for Payer: United Healthcare Commercial |
$594.47
|
|
|
HC Z DRILL BIT 100
|
Facility
OP
|
$735.28
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607761
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$242.64 |
| Max. Negotiated Rate |
$683.81 |
| Rate for Payer: Aetna Commercial |
$620.58
|
| Rate for Payer: Aetna Medicare |
$242.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$242.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$422.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$459.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$279.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$266.91
|
| Rate for Payer: Cash Price |
$455.87
|
| Rate for Payer: Cash Price |
$455.87
|
| Rate for Payer: Centivo All Commercial |
$374.99
|
| Rate for Payer: Cigna All Commercial |
$634.55
|
| Rate for Payer: CORVEL All Commercial |
$683.81
|
| Rate for Payer: Coventry All Commercial |
$647.05
|
| Rate for Payer: Encore All Commercial |
$676.83
|
| Rate for Payer: Frontpath All Commercial |
$676.46
|
| Rate for Payer: Humana ChoiceCare |
$635.06
|
| Rate for Payer: Humana Medicare |
$374.99
|
| Rate for Payer: Lucent All Commercial |
$374.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$661.75
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$551.46
|
| Rate for Payer: PHP All Commercial |
$557.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$286.76
|
| Rate for Payer: Sagamore Health Network All Products |
$567.64
|
| Rate for Payer: Signature Care EPO |
$610.28
|
| Rate for Payer: Signature Care PPO |
$647.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$624.99
|
| Rate for Payer: United Healthcare Commercial |
$579.40
|
| Rate for Payer: United Healthcare Medicare |
$242.64
|
|
|
HC Z DRILL BIT 100
|
Facility
IP
|
$735.28
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607761
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$551.46 |
| Max. Negotiated Rate |
$683.81 |
| Rate for Payer: Aetna Commercial |
$635.28
|
| Rate for Payer: Cash Price |
$455.87
|
| Rate for Payer: Cigna All Commercial |
$634.55
|
| Rate for Payer: CORVEL All Commercial |
$683.81
|
| Rate for Payer: Coventry All Commercial |
$647.05
|
| Rate for Payer: Encore All Commercial |
$676.83
|
| Rate for Payer: Frontpath All Commercial |
$676.46
|
| Rate for Payer: Humana ChoiceCare |
$635.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$661.75
|
| Rate for Payer: PHCS All Commercial |
$551.46
|
| Rate for Payer: PHP All Commercial |
$557.64
|
| Rate for Payer: Sagamore Health Network All Products |
$567.64
|
| Rate for Payer: Signature Care EPO |
$610.28
|
| Rate for Payer: Signature Care PPO |
$647.05
|
| Rate for Payer: United Healthcare Commercial |
$579.40
|
|
|
HC Z DRILL BIT 1.0 MINI
|
Facility
OP
|
$346.43
|
|
| Hospital Charge Code |
41606327
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$114.32 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$292.39
|
| Rate for Payer: Aetna Medicare |
$114.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$114.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$198.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$216.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$131.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$125.75
|
| Rate for Payer: Cash Price |
$214.79
|
| Rate for Payer: Cash Price |
$214.79
|
| Rate for Payer: Centivo All Commercial |
$176.68
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Humana Medicare |
$176.68
|
| Rate for Payer: Lucent All Commercial |
$176.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$135.11
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$294.47
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
| Rate for Payer: United Healthcare Medicare |
$114.32
|
|
|
HC Z DRILL BIT 1.0 MINI
|
Facility
IP
|
$346.43
|
|
| Hospital Charge Code |
41606327
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$259.82 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$299.32
|
| Rate for Payer: Cash Price |
$214.79
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
|
|
HC Z DRILL BIT 1.1 60 QC
|
Facility
OP
|
$489.37
|
|
| Hospital Charge Code |
41604259
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$455.11 |
| Rate for Payer: Aetna Commercial |
$413.03
|
| Rate for Payer: Aetna Medicare |
$161.49
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$161.49
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$281.05
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$305.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$185.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$177.64
|
| Rate for Payer: Cash Price |
$303.41
|
| Rate for Payer: Cash Price |
$303.41
|
| Rate for Payer: Centivo All Commercial |
$249.58
|
| Rate for Payer: Cigna All Commercial |
$422.33
|
| Rate for Payer: CORVEL All Commercial |
$455.11
|
| Rate for Payer: Coventry All Commercial |
$430.65
|
| Rate for Payer: Encore All Commercial |
$450.47
|
| Rate for Payer: Frontpath All Commercial |
$450.22
|
| Rate for Payer: Humana ChoiceCare |
$422.67
|
| Rate for Payer: Humana Medicare |
$249.58
|
| Rate for Payer: Lucent All Commercial |
$249.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$440.43
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$367.03
|
| Rate for Payer: PHP All Commercial |
$371.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$190.85
|
| Rate for Payer: Sagamore Health Network All Products |
$377.79
|
| Rate for Payer: Signature Care EPO |
$406.18
|
| Rate for Payer: Signature Care PPO |
$430.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$415.96
|
| Rate for Payer: United Healthcare Commercial |
$385.62
|
| Rate for Payer: United Healthcare Medicare |
$161.49
|
|
|
HC Z DRILL BIT 1.1 60 QC
|
Facility
IP
|
$489.37
|
|
| Hospital Charge Code |
41604259
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$367.03 |
| Max. Negotiated Rate |
$455.11 |
| Rate for Payer: Aetna Commercial |
$422.82
|
| Rate for Payer: Cash Price |
$303.41
|
| Rate for Payer: Cigna All Commercial |
$422.33
|
| Rate for Payer: CORVEL All Commercial |
$455.11
|
| Rate for Payer: Coventry All Commercial |
$430.65
|
| Rate for Payer: Encore All Commercial |
$450.47
|
| Rate for Payer: Frontpath All Commercial |
$450.22
|
| Rate for Payer: Humana ChoiceCare |
$422.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$440.43
|
| Rate for Payer: PHCS All Commercial |
$367.03
|
| Rate for Payer: PHP All Commercial |
$371.14
|
| Rate for Payer: Sagamore Health Network All Products |
$377.79
|
| Rate for Payer: Signature Care EPO |
$406.18
|
| Rate for Payer: Signature Care PPO |
$430.65
|
| Rate for Payer: United Healthcare Commercial |
$385.62
|
|
|
HC Z DRILL BIT 1.1MM FAST
|
Facility
OP
|
$346.43
|
|
| Hospital Charge Code |
41605894
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$114.32 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$292.39
|
| Rate for Payer: Aetna Medicare |
$114.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$114.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$198.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$216.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$131.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$125.75
|
| Rate for Payer: Cash Price |
$214.79
|
| Rate for Payer: Cash Price |
$214.79
|
| Rate for Payer: Centivo All Commercial |
$176.68
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Humana Medicare |
$176.68
|
| Rate for Payer: Lucent All Commercial |
$176.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$135.11
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$294.47
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
| Rate for Payer: United Healthcare Medicare |
$114.32
|
|
|
HC Z DRILL BIT 1.1MM FAST
|
Facility
IP
|
$346.43
|
|
| Hospital Charge Code |
41605894
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$259.82 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$299.32
|
| Rate for Payer: Cash Price |
$214.79
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
|
