|
HC Z DRILL BIT 5.0 CANN
|
Facility
OP
|
$2,488.65
|
|
| Hospital Charge Code |
41604085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$2,314.44 |
| Rate for Payer: Aetna Commercial |
$2,100.42
|
| Rate for Payer: Aetna Medicare |
$821.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$821.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,429.23
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,555.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$944.44
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$903.38
|
| Rate for Payer: Cash Price |
$1,542.96
|
| Rate for Payer: Cash Price |
$1,542.96
|
| Rate for Payer: Centivo All Commercial |
$1,269.21
|
| Rate for Payer: Cigna All Commercial |
$2,147.70
|
| Rate for Payer: CORVEL All Commercial |
$2,314.44
|
| Rate for Payer: Coventry All Commercial |
$2,190.01
|
| Rate for Payer: Encore All Commercial |
$2,290.80
|
| Rate for Payer: Frontpath All Commercial |
$2,289.56
|
| Rate for Payer: Humana ChoiceCare |
$2,149.45
|
| Rate for Payer: Humana Medicare |
$1,269.21
|
| Rate for Payer: Lucent All Commercial |
$1,269.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,239.78
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,866.49
|
| Rate for Payer: PHP All Commercial |
$1,887.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$970.57
|
| Rate for Payer: Sagamore Health Network All Products |
$1,921.24
|
| Rate for Payer: Signature Care EPO |
$2,065.58
|
| Rate for Payer: Signature Care PPO |
$2,190.01
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,115.35
|
| Rate for Payer: United Healthcare Commercial |
$1,961.06
|
| Rate for Payer: United Healthcare Medicare |
$821.25
|
|
|
HC Z DRILL BIT G7 POLY
|
Facility
OP
|
$2,175.80
|
|
| Hospital Charge Code |
41606584
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$2,023.49 |
| Rate for Payer: Aetna Commercial |
$1,836.38
|
| Rate for Payer: Aetna Medicare |
$718.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$718.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,249.56
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,360.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$825.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$789.82
|
| Rate for Payer: Cash Price |
$1,349.00
|
| Rate for Payer: Cash Price |
$1,349.00
|
| Rate for Payer: Centivo All Commercial |
$1,109.66
|
| Rate for Payer: Cigna All Commercial |
$1,877.72
|
| Rate for Payer: CORVEL All Commercial |
$2,023.49
|
| Rate for Payer: Coventry All Commercial |
$1,914.70
|
| Rate for Payer: Encore All Commercial |
$2,002.82
|
| Rate for Payer: Frontpath All Commercial |
$2,001.74
|
| Rate for Payer: Humana ChoiceCare |
$1,879.24
|
| Rate for Payer: Humana Medicare |
$1,109.66
|
| Rate for Payer: Lucent All Commercial |
$1,109.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,958.22
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,631.85
|
| Rate for Payer: PHP All Commercial |
$1,650.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$848.56
|
| Rate for Payer: Sagamore Health Network All Products |
$1,679.72
|
| Rate for Payer: Signature Care EPO |
$1,805.91
|
| Rate for Payer: Signature Care PPO |
$1,914.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,849.43
|
| Rate for Payer: United Healthcare Commercial |
$1,714.53
|
| Rate for Payer: United Healthcare Medicare |
$718.01
|
|
|
HC Z DRILL BIT G7 POLY
|
Facility
IP
|
$2,175.80
|
|
| Hospital Charge Code |
41606584
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,631.85 |
| Max. Negotiated Rate |
$2,023.49 |
| Rate for Payer: Aetna Commercial |
$1,879.89
|
| Rate for Payer: Cash Price |
$1,349.00
|
| Rate for Payer: Cigna All Commercial |
$1,877.72
|
| Rate for Payer: CORVEL All Commercial |
$2,023.49
|
| Rate for Payer: Coventry All Commercial |
$1,914.70
|
| Rate for Payer: Encore All Commercial |
$2,002.82
|
| Rate for Payer: Frontpath All Commercial |
$2,001.74
|
| Rate for Payer: Humana ChoiceCare |
$1,879.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,958.22
|
| Rate for Payer: PHCS All Commercial |
$1,631.85
|
| Rate for Payer: PHP All Commercial |
$1,650.13
|
| Rate for Payer: Sagamore Health Network All Products |
$1,679.72
|
| Rate for Payer: Signature Care EPO |
$1,805.91
|
| Rate for Payer: Signature Care PPO |
$1,914.70
|
| Rate for Payer: United Healthcare Commercial |
$1,714.53
|
|
|
HC Z DRILL BIT QR 15/64
|
Facility
OP
|
$962.78
|
|
| Hospital Charge Code |
41605692
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$895.39 |
| Rate for Payer: Aetna Commercial |
$812.59
|
| Rate for Payer: Aetna Medicare |
$317.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$317.72
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$552.92
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$601.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$365.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$349.49
|
| Rate for Payer: Cash Price |
$596.92
|
| Rate for Payer: Cash Price |
$596.92
|
| Rate for Payer: Centivo All Commercial |
$491.02
|
| Rate for Payer: Cigna All Commercial |
$830.88
|
| Rate for Payer: CORVEL All Commercial |
$895.39
|
| Rate for Payer: Coventry All Commercial |
$847.25
|
| Rate for Payer: Encore All Commercial |
$886.24
|
| Rate for Payer: Frontpath All Commercial |
$885.76
|
| Rate for Payer: Humana ChoiceCare |
$831.55
|
| Rate for Payer: Humana Medicare |
$491.02
|
| Rate for Payer: Lucent All Commercial |
$491.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$866.50
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$722.08
|
| Rate for Payer: PHP All Commercial |
$730.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$375.48
|
| Rate for Payer: Sagamore Health Network All Products |
$743.27
|
| Rate for Payer: Signature Care EPO |
$799.11
|
| Rate for Payer: Signature Care PPO |
$847.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$818.36
|
| Rate for Payer: United Healthcare Commercial |
$758.67
|
| Rate for Payer: United Healthcare Medicare |
$317.72
|
|
|
HC Z DRILL BIT QR 15/64
|
Facility
IP
|
$962.78
|
|
| Hospital Charge Code |
41605692
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$722.08 |
| Max. Negotiated Rate |
$895.39 |
| Rate for Payer: Aetna Commercial |
$831.84
|
| Rate for Payer: Cash Price |
$596.92
|
| Rate for Payer: Cigna All Commercial |
$830.88
|
| Rate for Payer: CORVEL All Commercial |
$895.39
|
| Rate for Payer: Coventry All Commercial |
$847.25
|
| Rate for Payer: Encore All Commercial |
$886.24
|
| Rate for Payer: Frontpath All Commercial |
$885.76
|
| Rate for Payer: Humana ChoiceCare |
$831.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$866.50
|
| Rate for Payer: PHCS All Commercial |
$722.08
|
| Rate for Payer: PHP All Commercial |
$730.17
|
| Rate for Payer: Sagamore Health Network All Products |
$743.27
|
| Rate for Payer: Signature Care EPO |
$799.11
|
| Rate for Payer: Signature Care PPO |
$847.25
|
| Rate for Payer: United Healthcare Commercial |
$758.67
|
|
|
HC Z DRILL BIT VPC 1.8 CANN
|
Facility
IP
|
$1,023.80
|
|
| Hospital Charge Code |
41604543
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$767.85 |
| Max. Negotiated Rate |
$952.13 |
| Rate for Payer: Aetna Commercial |
$884.56
|
| Rate for Payer: Cash Price |
$634.76
|
| Rate for Payer: Cigna All Commercial |
$883.54
|
| Rate for Payer: CORVEL All Commercial |
$952.13
|
| Rate for Payer: Coventry All Commercial |
$900.94
|
| Rate for Payer: Encore All Commercial |
$942.41
|
| Rate for Payer: Frontpath All Commercial |
$941.90
|
| Rate for Payer: Humana ChoiceCare |
$884.26
|
| Rate for Payer: Lutheran Preferred All Commercial |
$921.42
|
| Rate for Payer: PHCS All Commercial |
$767.85
|
| Rate for Payer: PHP All Commercial |
$776.45
|
| Rate for Payer: Sagamore Health Network All Products |
$790.37
|
| Rate for Payer: Signature Care EPO |
$849.75
|
| Rate for Payer: Signature Care PPO |
$900.94
|
| Rate for Payer: United Healthcare Commercial |
$806.75
|
|
|
HC Z DRILL BIT VPC 1.8 CANN
|
Facility
OP
|
$1,023.80
|
|
| Hospital Charge Code |
41604543
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$952.13 |
| Rate for Payer: Aetna Commercial |
$864.09
|
| Rate for Payer: Aetna Medicare |
$337.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$337.85
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$587.97
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$639.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$388.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$371.64
|
| Rate for Payer: Cash Price |
$634.76
|
| Rate for Payer: Cash Price |
$634.76
|
| Rate for Payer: Centivo All Commercial |
$522.14
|
| Rate for Payer: Cigna All Commercial |
$883.54
|
| Rate for Payer: CORVEL All Commercial |
$952.13
|
| Rate for Payer: Coventry All Commercial |
$900.94
|
| Rate for Payer: Encore All Commercial |
$942.41
|
| Rate for Payer: Frontpath All Commercial |
$941.90
|
| Rate for Payer: Humana ChoiceCare |
$884.26
|
| Rate for Payer: Humana Medicare |
$522.14
|
| Rate for Payer: Lucent All Commercial |
$522.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$921.42
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$767.85
|
| Rate for Payer: PHP All Commercial |
$776.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$399.28
|
| Rate for Payer: Sagamore Health Network All Products |
$790.37
|
| Rate for Payer: Signature Care EPO |
$849.75
|
| Rate for Payer: Signature Care PPO |
$900.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$870.23
|
| Rate for Payer: United Healthcare Commercial |
$806.75
|
| Rate for Payer: United Healthcare Medicare |
$337.85
|
|
|
HC Z DRILL BIT VPC 2.4 CANN
|
Facility
IP
|
$1,023.80
|
|
| Hospital Charge Code |
41604544
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$767.85 |
| Max. Negotiated Rate |
$952.13 |
| Rate for Payer: Aetna Commercial |
$884.56
|
| Rate for Payer: Cash Price |
$634.76
|
| Rate for Payer: Cigna All Commercial |
$883.54
|
| Rate for Payer: CORVEL All Commercial |
$952.13
|
| Rate for Payer: Coventry All Commercial |
$900.94
|
| Rate for Payer: Encore All Commercial |
$942.41
|
| Rate for Payer: Frontpath All Commercial |
$941.90
|
| Rate for Payer: Humana ChoiceCare |
$884.26
|
| Rate for Payer: Lutheran Preferred All Commercial |
$921.42
|
| Rate for Payer: PHCS All Commercial |
$767.85
|
| Rate for Payer: PHP All Commercial |
$776.45
|
| Rate for Payer: Sagamore Health Network All Products |
$790.37
|
| Rate for Payer: Signature Care EPO |
$849.75
|
| Rate for Payer: Signature Care PPO |
$900.94
|
| Rate for Payer: United Healthcare Commercial |
$806.75
|
|
|
HC Z DRILL BIT VPC 2.4 CANN
|
Facility
OP
|
$1,023.80
|
|
| Hospital Charge Code |
41604544
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$952.13 |
| Rate for Payer: Aetna Commercial |
$864.09
|
| Rate for Payer: Aetna Medicare |
$337.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$337.85
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$587.97
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$639.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$388.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$371.64
|
| Rate for Payer: Cash Price |
$634.76
|
| Rate for Payer: Cash Price |
$634.76
|
| Rate for Payer: Centivo All Commercial |
$522.14
|
| Rate for Payer: Cigna All Commercial |
$883.54
|
| Rate for Payer: CORVEL All Commercial |
$952.13
|
| Rate for Payer: Coventry All Commercial |
$900.94
|
| Rate for Payer: Encore All Commercial |
$942.41
|
| Rate for Payer: Frontpath All Commercial |
$941.90
|
| Rate for Payer: Humana ChoiceCare |
$884.26
|
| Rate for Payer: Humana Medicare |
$522.14
|
| Rate for Payer: Lucent All Commercial |
$522.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$921.42
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$767.85
|
| Rate for Payer: PHP All Commercial |
$776.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$399.28
|
| Rate for Payer: Sagamore Health Network All Products |
$790.37
|
| Rate for Payer: Signature Care EPO |
$849.75
|
| Rate for Payer: Signature Care PPO |
$900.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$870.23
|
| Rate for Payer: United Healthcare Commercial |
$806.75
|
| Rate for Payer: United Healthcare Medicare |
$337.85
|
|
|
HC Z DRILL BIT VPC 3.2 CANN
|
Facility
IP
|
$1,023.80
|
|
| Hospital Charge Code |
41603702
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$767.85 |
| Max. Negotiated Rate |
$952.13 |
| Rate for Payer: Aetna Commercial |
$884.56
|
| Rate for Payer: Cash Price |
$634.76
|
| Rate for Payer: Cigna All Commercial |
$883.54
|
| Rate for Payer: CORVEL All Commercial |
$952.13
|
| Rate for Payer: Coventry All Commercial |
$900.94
|
| Rate for Payer: Encore All Commercial |
$942.41
|
| Rate for Payer: Frontpath All Commercial |
$941.90
|
| Rate for Payer: Humana ChoiceCare |
$884.26
|
| Rate for Payer: Lutheran Preferred All Commercial |
$921.42
|
| Rate for Payer: PHCS All Commercial |
$767.85
|
| Rate for Payer: PHP All Commercial |
$776.45
|
| Rate for Payer: Sagamore Health Network All Products |
$790.37
|
| Rate for Payer: Signature Care EPO |
$849.75
|
| Rate for Payer: Signature Care PPO |
$900.94
|
| Rate for Payer: United Healthcare Commercial |
$806.75
|
|
|
HC Z DRILL BIT VPC 3.2 CANN
|
Facility
OP
|
$1,023.80
|
|
| Hospital Charge Code |
41603702
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$952.13 |
| Rate for Payer: Aetna Commercial |
$864.09
|
| Rate for Payer: Aetna Medicare |
$337.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$337.85
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$587.97
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$639.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$388.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$371.64
|
| Rate for Payer: Cash Price |
$634.76
|
| Rate for Payer: Cash Price |
$634.76
|
| Rate for Payer: Centivo All Commercial |
$522.14
|
| Rate for Payer: Cigna All Commercial |
$883.54
|
| Rate for Payer: CORVEL All Commercial |
$952.13
|
| Rate for Payer: Coventry All Commercial |
$900.94
|
| Rate for Payer: Encore All Commercial |
$942.41
|
| Rate for Payer: Frontpath All Commercial |
$941.90
|
| Rate for Payer: Humana ChoiceCare |
$884.26
|
| Rate for Payer: Humana Medicare |
$522.14
|
| Rate for Payer: Lucent All Commercial |
$522.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$921.42
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$767.85
|
| Rate for Payer: PHP All Commercial |
$776.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$399.28
|
| Rate for Payer: Sagamore Health Network All Products |
$790.37
|
| Rate for Payer: Signature Care EPO |
$849.75
|
| Rate for Payer: Signature Care PPO |
$900.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$870.23
|
| Rate for Payer: United Healthcare Commercial |
$806.75
|
| Rate for Payer: United Healthcare Medicare |
$337.85
|
|
|
HC Z DRILL CALB TIB 4.3
|
Facility
IP
|
$1,032.00
|
|
| Hospital Charge Code |
41603899
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$774.00 |
| Max. Negotiated Rate |
$959.76 |
| Rate for Payer: Aetna Commercial |
$891.65
|
| Rate for Payer: Cash Price |
$639.84
|
| Rate for Payer: Cigna All Commercial |
$890.62
|
| Rate for Payer: CORVEL All Commercial |
$959.76
|
| Rate for Payer: Coventry All Commercial |
$908.16
|
| Rate for Payer: Encore All Commercial |
$949.96
|
| Rate for Payer: Frontpath All Commercial |
$949.44
|
| Rate for Payer: Humana ChoiceCare |
$891.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$928.80
|
| Rate for Payer: PHCS All Commercial |
$774.00
|
| Rate for Payer: PHP All Commercial |
$782.67
|
| Rate for Payer: Sagamore Health Network All Products |
$796.70
|
| Rate for Payer: Signature Care EPO |
$856.56
|
| Rate for Payer: Signature Care PPO |
$908.16
|
| Rate for Payer: United Healthcare Commercial |
$813.22
|
|
|
HC Z DRILL CALB TIB 4.3
|
Facility
OP
|
$1,032.00
|
|
| Hospital Charge Code |
41603899
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$959.76 |
| Rate for Payer: Aetna Commercial |
$871.01
|
| Rate for Payer: Aetna Medicare |
$340.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$340.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$592.68
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$645.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$391.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$374.62
|
| Rate for Payer: Cash Price |
$639.84
|
| Rate for Payer: Cash Price |
$639.84
|
| Rate for Payer: Centivo All Commercial |
$526.32
|
| Rate for Payer: Cigna All Commercial |
$890.62
|
| Rate for Payer: CORVEL All Commercial |
$959.76
|
| Rate for Payer: Coventry All Commercial |
$908.16
|
| Rate for Payer: Encore All Commercial |
$949.96
|
| Rate for Payer: Frontpath All Commercial |
$949.44
|
| Rate for Payer: Humana ChoiceCare |
$891.34
|
| Rate for Payer: Humana Medicare |
$526.32
|
| Rate for Payer: Lucent All Commercial |
$526.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$928.80
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$774.00
|
| Rate for Payer: PHP All Commercial |
$782.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$402.48
|
| Rate for Payer: Sagamore Health Network All Products |
$796.70
|
| Rate for Payer: Signature Care EPO |
$856.56
|
| Rate for Payer: Signature Care PPO |
$908.16
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$877.20
|
| Rate for Payer: United Healthcare Commercial |
$813.22
|
| Rate for Payer: United Healthcare Medicare |
$340.56
|
|
|
HC Z DRILL CALIBRATED 4.3 LONG
|
Facility
IP
|
$722.40
|
|
| Hospital Charge Code |
41602574
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$541.80 |
| Max. Negotiated Rate |
$671.83 |
| Rate for Payer: Aetna Commercial |
$624.15
|
| Rate for Payer: Cash Price |
$447.89
|
| Rate for Payer: Cigna All Commercial |
$623.43
|
| Rate for Payer: CORVEL All Commercial |
$671.83
|
| Rate for Payer: Coventry All Commercial |
$635.71
|
| Rate for Payer: Encore All Commercial |
$664.97
|
| Rate for Payer: Frontpath All Commercial |
$664.61
|
| Rate for Payer: Humana ChoiceCare |
$623.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$650.16
|
| Rate for Payer: PHCS All Commercial |
$541.80
|
| Rate for Payer: PHP All Commercial |
$547.87
|
| Rate for Payer: Sagamore Health Network All Products |
$557.69
|
| Rate for Payer: Signature Care EPO |
$599.59
|
| Rate for Payer: Signature Care PPO |
$635.71
|
| Rate for Payer: United Healthcare Commercial |
$569.25
|
|
|
HC Z DRILL CALIBRATED 4.3 LONG
|
Facility
OP
|
$722.40
|
|
| Hospital Charge Code |
41602574
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$671.83 |
| Rate for Payer: Aetna Commercial |
$609.71
|
| Rate for Payer: Aetna Medicare |
$238.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$238.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$414.87
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$451.57
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$274.15
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$262.23
|
| Rate for Payer: Cash Price |
$447.89
|
| Rate for Payer: Cash Price |
$447.89
|
| Rate for Payer: Centivo All Commercial |
$368.42
|
| Rate for Payer: Cigna All Commercial |
$623.43
|
| Rate for Payer: CORVEL All Commercial |
$671.83
|
| Rate for Payer: Coventry All Commercial |
$635.71
|
| Rate for Payer: Encore All Commercial |
$664.97
|
| Rate for Payer: Frontpath All Commercial |
$664.61
|
| Rate for Payer: Humana ChoiceCare |
$623.94
|
| Rate for Payer: Humana Medicare |
$368.42
|
| Rate for Payer: Lucent All Commercial |
$368.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$650.16
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$541.80
|
| Rate for Payer: PHP All Commercial |
$547.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$281.74
|
| Rate for Payer: Sagamore Health Network All Products |
$557.69
|
| Rate for Payer: Signature Care EPO |
$599.59
|
| Rate for Payer: Signature Care PPO |
$635.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$614.04
|
| Rate for Payer: United Healthcare Commercial |
$569.25
|
| Rate for Payer: United Healthcare Medicare |
$238.39
|
|
|
HC Z DRILL CALIBRATED 4.9 RF
|
Facility
OP
|
$1,964.10
|
|
| Hospital Charge Code |
41603454
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,826.61 |
| Rate for Payer: Aetna Commercial |
$1,657.70
|
| Rate for Payer: Aetna Medicare |
$648.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$648.15
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,127.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,227.76
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$745.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$712.97
|
| Rate for Payer: Cash Price |
$1,217.74
|
| Rate for Payer: Cash Price |
$1,217.74
|
| Rate for Payer: Centivo All Commercial |
$1,001.69
|
| Rate for Payer: Cigna All Commercial |
$1,695.02
|
| Rate for Payer: CORVEL All Commercial |
$1,826.61
|
| Rate for Payer: Coventry All Commercial |
$1,728.41
|
| Rate for Payer: Encore All Commercial |
$1,807.95
|
| Rate for Payer: Frontpath All Commercial |
$1,806.97
|
| Rate for Payer: Humana ChoiceCare |
$1,696.39
|
| Rate for Payer: Humana Medicare |
$1,001.69
|
| Rate for Payer: Lucent All Commercial |
$1,001.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,767.69
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,473.08
|
| Rate for Payer: PHP All Commercial |
$1,489.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$766.00
|
| Rate for Payer: Sagamore Health Network All Products |
$1,516.29
|
| Rate for Payer: Signature Care EPO |
$1,630.20
|
| Rate for Payer: Signature Care PPO |
$1,728.41
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,669.48
|
| Rate for Payer: United Healthcare Commercial |
$1,547.71
|
| Rate for Payer: United Healthcare Medicare |
$648.15
|
|
|
HC Z DRILL CALIBRATED 4.9 RF
|
Facility
IP
|
$1,964.10
|
|
| Hospital Charge Code |
41603454
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,473.08 |
| Max. Negotiated Rate |
$1,826.61 |
| Rate for Payer: Aetna Commercial |
$1,696.98
|
| Rate for Payer: Cash Price |
$1,217.74
|
| Rate for Payer: Cigna All Commercial |
$1,695.02
|
| Rate for Payer: CORVEL All Commercial |
$1,826.61
|
| Rate for Payer: Coventry All Commercial |
$1,728.41
|
| Rate for Payer: Encore All Commercial |
$1,807.95
|
| Rate for Payer: Frontpath All Commercial |
$1,806.97
|
| Rate for Payer: Humana ChoiceCare |
$1,696.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,767.69
|
| Rate for Payer: PHCS All Commercial |
$1,473.08
|
| Rate for Payer: PHP All Commercial |
$1,489.57
|
| Rate for Payer: Sagamore Health Network All Products |
$1,516.29
|
| Rate for Payer: Signature Care EPO |
$1,630.20
|
| Rate for Payer: Signature Care PPO |
$1,728.41
|
| Rate for Payer: United Healthcare Commercial |
$1,547.71
|
|
|
HC Z DRILL FREE HAND 4.3, 152.5
|
Facility
IP
|
$675.85
|
|
| Hospital Charge Code |
41603441
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$506.89 |
| Max. Negotiated Rate |
$628.54 |
| Rate for Payer: Aetna Commercial |
$583.93
|
| Rate for Payer: Cash Price |
$419.03
|
| Rate for Payer: Cigna All Commercial |
$583.26
|
| Rate for Payer: CORVEL All Commercial |
$628.54
|
| Rate for Payer: Coventry All Commercial |
$594.75
|
| Rate for Payer: Encore All Commercial |
$622.12
|
| Rate for Payer: Frontpath All Commercial |
$621.78
|
| Rate for Payer: Humana ChoiceCare |
$583.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$608.26
|
| Rate for Payer: PHCS All Commercial |
$506.89
|
| Rate for Payer: PHP All Commercial |
$512.56
|
| Rate for Payer: Sagamore Health Network All Products |
$521.76
|
| Rate for Payer: Signature Care EPO |
$560.96
|
| Rate for Payer: Signature Care PPO |
$594.75
|
| Rate for Payer: United Healthcare Commercial |
$532.57
|
|
|
HC Z DRILL FREE HAND 4.3, 152.5
|
Facility
OP
|
$675.85
|
|
| Hospital Charge Code |
41603441
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$628.54 |
| Rate for Payer: Aetna Commercial |
$570.42
|
| Rate for Payer: Aetna Medicare |
$223.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$223.03
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$388.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$422.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$256.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$245.33
|
| Rate for Payer: Cash Price |
$419.03
|
| Rate for Payer: Cash Price |
$419.03
|
| Rate for Payer: Centivo All Commercial |
$344.68
|
| Rate for Payer: Cigna All Commercial |
$583.26
|
| Rate for Payer: CORVEL All Commercial |
$628.54
|
| Rate for Payer: Coventry All Commercial |
$594.75
|
| Rate for Payer: Encore All Commercial |
$622.12
|
| Rate for Payer: Frontpath All Commercial |
$621.78
|
| Rate for Payer: Humana ChoiceCare |
$583.73
|
| Rate for Payer: Humana Medicare |
$344.68
|
| Rate for Payer: Lucent All Commercial |
$344.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$608.26
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$506.89
|
| Rate for Payer: PHP All Commercial |
$512.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$263.58
|
| Rate for Payer: Sagamore Health Network All Products |
$521.76
|
| Rate for Payer: Signature Care EPO |
$560.96
|
| Rate for Payer: Signature Care PPO |
$594.75
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$574.47
|
| Rate for Payer: United Healthcare Commercial |
$532.57
|
| Rate for Payer: United Healthcare Medicare |
$223.03
|
|
|
HC Z DRILL FREE HAND TARG 3.3
|
Facility
OP
|
$848.90
|
|
| Hospital Charge Code |
41603897
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$789.48 |
| Rate for Payer: Aetna Commercial |
$716.47
|
| Rate for Payer: Aetna Medicare |
$280.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$280.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$487.52
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$530.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$322.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$308.15
|
| Rate for Payer: Cash Price |
$526.32
|
| Rate for Payer: Cash Price |
$526.32
|
| Rate for Payer: Centivo All Commercial |
$432.94
|
| Rate for Payer: Cigna All Commercial |
$732.60
|
| Rate for Payer: CORVEL All Commercial |
$789.48
|
| Rate for Payer: Coventry All Commercial |
$747.03
|
| Rate for Payer: Encore All Commercial |
$781.41
|
| Rate for Payer: Frontpath All Commercial |
$780.99
|
| Rate for Payer: Humana ChoiceCare |
$733.19
|
| Rate for Payer: Humana Medicare |
$432.94
|
| Rate for Payer: Lucent All Commercial |
$432.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$764.01
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$636.68
|
| Rate for Payer: PHP All Commercial |
$643.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$331.07
|
| Rate for Payer: Sagamore Health Network All Products |
$655.35
|
| Rate for Payer: Signature Care EPO |
$704.59
|
| Rate for Payer: Signature Care PPO |
$747.03
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$721.56
|
| Rate for Payer: United Healthcare Commercial |
$668.93
|
| Rate for Payer: United Healthcare Medicare |
$280.14
|
|
|
HC Z DRILL FREE HAND TARG 3.3
|
Facility
IP
|
$848.90
|
|
| Hospital Charge Code |
41603897
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$636.68 |
| Max. Negotiated Rate |
$789.48 |
| Rate for Payer: Aetna Commercial |
$733.45
|
| Rate for Payer: Cash Price |
$526.32
|
| Rate for Payer: Cigna All Commercial |
$732.60
|
| Rate for Payer: CORVEL All Commercial |
$789.48
|
| Rate for Payer: Coventry All Commercial |
$747.03
|
| Rate for Payer: Encore All Commercial |
$781.41
|
| Rate for Payer: Frontpath All Commercial |
$780.99
|
| Rate for Payer: Humana ChoiceCare |
$733.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$764.01
|
| Rate for Payer: PHCS All Commercial |
$636.68
|
| Rate for Payer: PHP All Commercial |
$643.81
|
| Rate for Payer: Sagamore Health Network All Products |
$655.35
|
| Rate for Payer: Signature Care EPO |
$704.59
|
| Rate for Payer: Signature Care PPO |
$747.03
|
| Rate for Payer: United Healthcare Commercial |
$668.93
|
|
|
HC Z DRILL FREE HAND TARG 4.3
|
Facility
OP
|
$629.23
|
|
| Hospital Charge Code |
41603456
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$585.18 |
| Rate for Payer: Aetna Commercial |
$531.07
|
| Rate for Payer: Aetna Medicare |
$207.65
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$207.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$361.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$393.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$238.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$228.41
|
| Rate for Payer: Cash Price |
$390.12
|
| Rate for Payer: Cash Price |
$390.12
|
| Rate for Payer: Centivo All Commercial |
$320.91
|
| Rate for Payer: Cigna All Commercial |
$543.03
|
| Rate for Payer: CORVEL All Commercial |
$585.18
|
| Rate for Payer: Coventry All Commercial |
$553.72
|
| Rate for Payer: Encore All Commercial |
$579.21
|
| Rate for Payer: Frontpath All Commercial |
$578.89
|
| Rate for Payer: Humana ChoiceCare |
$543.47
|
| Rate for Payer: Humana Medicare |
$320.91
|
| Rate for Payer: Lucent All Commercial |
$320.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$566.31
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$471.92
|
| Rate for Payer: PHP All Commercial |
$477.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$245.40
|
| Rate for Payer: Sagamore Health Network All Products |
$485.77
|
| Rate for Payer: Signature Care EPO |
$522.26
|
| Rate for Payer: Signature Care PPO |
$553.72
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$534.85
|
| Rate for Payer: United Healthcare Commercial |
$495.83
|
| Rate for Payer: United Healthcare Medicare |
$207.65
|
|
|
HC Z DRILL FREE HAND TARG 4.3
|
Facility
IP
|
$629.23
|
|
| Hospital Charge Code |
41603456
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$471.92 |
| Max. Negotiated Rate |
$585.18 |
| Rate for Payer: Aetna Commercial |
$543.65
|
| Rate for Payer: Cash Price |
$390.12
|
| Rate for Payer: Cigna All Commercial |
$543.03
|
| Rate for Payer: CORVEL All Commercial |
$585.18
|
| Rate for Payer: Coventry All Commercial |
$553.72
|
| Rate for Payer: Encore All Commercial |
$579.21
|
| Rate for Payer: Frontpath All Commercial |
$578.89
|
| Rate for Payer: Humana ChoiceCare |
$543.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$566.31
|
| Rate for Payer: PHCS All Commercial |
$471.92
|
| Rate for Payer: PHP All Commercial |
$477.21
|
| Rate for Payer: Sagamore Health Network All Products |
$485.77
|
| Rate for Payer: Signature Care EPO |
$522.26
|
| Rate for Payer: Signature Care PPO |
$553.72
|
| Rate for Payer: United Healthcare Commercial |
$495.83
|
|
|
HC Z DRILL GUIDE 1.6/2.9
|
Facility
OP
|
$1,247.35
|
|
| Hospital Charge Code |
41606898
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,160.04 |
| Rate for Payer: Aetna Commercial |
$1,052.76
|
| Rate for Payer: Aetna Medicare |
$411.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$411.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$716.35
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$779.72
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$473.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$452.79
|
| Rate for Payer: Cash Price |
$773.36
|
| Rate for Payer: Cash Price |
$773.36
|
| Rate for Payer: Centivo All Commercial |
$636.15
|
| Rate for Payer: Cigna All Commercial |
$1,076.46
|
| Rate for Payer: CORVEL All Commercial |
$1,160.04
|
| Rate for Payer: Coventry All Commercial |
$1,097.67
|
| Rate for Payer: Encore All Commercial |
$1,148.19
|
| Rate for Payer: Frontpath All Commercial |
$1,147.56
|
| Rate for Payer: Humana ChoiceCare |
$1,077.34
|
| Rate for Payer: Humana Medicare |
$636.15
|
| Rate for Payer: Lucent All Commercial |
$636.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,122.62
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$935.51
|
| Rate for Payer: PHP All Commercial |
$945.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$486.47
|
| Rate for Payer: Sagamore Health Network All Products |
$962.95
|
| Rate for Payer: Signature Care EPO |
$1,035.30
|
| Rate for Payer: Signature Care PPO |
$1,097.67
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,060.25
|
| Rate for Payer: United Healthcare Commercial |
$982.91
|
| Rate for Payer: United Healthcare Medicare |
$411.63
|
|
|
HC Z DRILL GUIDE 1.6/2.9
|
Facility
IP
|
$1,247.35
|
|
| Hospital Charge Code |
41606898
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$935.51 |
| Max. Negotiated Rate |
$1,160.04 |
| Rate for Payer: Aetna Commercial |
$1,077.71
|
| Rate for Payer: Cash Price |
$773.36
|
| Rate for Payer: Cigna All Commercial |
$1,076.46
|
| Rate for Payer: CORVEL All Commercial |
$1,160.04
|
| Rate for Payer: Coventry All Commercial |
$1,097.67
|
| Rate for Payer: Encore All Commercial |
$1,148.19
|
| Rate for Payer: Frontpath All Commercial |
$1,147.56
|
| Rate for Payer: Humana ChoiceCare |
$1,077.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,122.62
|
| Rate for Payer: PHCS All Commercial |
$935.51
|
| Rate for Payer: PHP All Commercial |
$945.99
|
| Rate for Payer: Sagamore Health Network All Products |
$962.95
|
| Rate for Payer: Signature Care EPO |
$1,035.30
|
| Rate for Payer: Signature Care PPO |
$1,097.67
|
| Rate for Payer: United Healthcare Commercial |
$982.91
|
|
