|
HC Z DRILL GUIDE 2.5/3.5
|
Facility
IP
|
$1,222.10
|
|
| Hospital Charge Code |
41606899
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$916.58 |
| Max. Negotiated Rate |
$1,136.55 |
| Rate for Payer: Aetna Commercial |
$1,055.89
|
| Rate for Payer: Cash Price |
$757.70
|
| Rate for Payer: Cigna All Commercial |
$1,054.67
|
| Rate for Payer: CORVEL All Commercial |
$1,136.55
|
| Rate for Payer: Coventry All Commercial |
$1,075.45
|
| Rate for Payer: Encore All Commercial |
$1,124.94
|
| Rate for Payer: Frontpath All Commercial |
$1,124.33
|
| Rate for Payer: Humana ChoiceCare |
$1,055.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,099.89
|
| Rate for Payer: PHCS All Commercial |
$916.58
|
| Rate for Payer: PHP All Commercial |
$926.84
|
| Rate for Payer: Sagamore Health Network All Products |
$943.46
|
| Rate for Payer: Signature Care EPO |
$1,014.34
|
| Rate for Payer: Signature Care PPO |
$1,075.45
|
| Rate for Payer: United Healthcare Commercial |
$963.01
|
|
|
HC Z DRILL GUIDE 2.5/3.5
|
Facility
OP
|
$1,222.10
|
|
| Hospital Charge Code |
41606899
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,136.55 |
| Rate for Payer: Aetna Commercial |
$1,031.45
|
| Rate for Payer: Aetna Medicare |
$403.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$403.29
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$701.85
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$763.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$463.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$443.62
|
| Rate for Payer: Cash Price |
$757.70
|
| Rate for Payer: Cash Price |
$757.70
|
| Rate for Payer: Centivo All Commercial |
$623.27
|
| Rate for Payer: Cigna All Commercial |
$1,054.67
|
| Rate for Payer: CORVEL All Commercial |
$1,136.55
|
| Rate for Payer: Coventry All Commercial |
$1,075.45
|
| Rate for Payer: Encore All Commercial |
$1,124.94
|
| Rate for Payer: Frontpath All Commercial |
$1,124.33
|
| Rate for Payer: Humana ChoiceCare |
$1,055.53
|
| Rate for Payer: Humana Medicare |
$623.27
|
| Rate for Payer: Lucent All Commercial |
$623.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,099.89
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$916.58
|
| Rate for Payer: PHP All Commercial |
$926.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$476.62
|
| Rate for Payer: Sagamore Health Network All Products |
$943.46
|
| Rate for Payer: Signature Care EPO |
$1,014.34
|
| Rate for Payer: Signature Care PPO |
$1,075.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,038.78
|
| Rate for Payer: United Healthcare Commercial |
$963.01
|
| Rate for Payer: United Healthcare Medicare |
$403.29
|
|
|
HC Z DRILL GUIDE 2.7/2.0
|
Facility
OP
|
$1,400.00
|
|
| Hospital Charge Code |
41606894
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,302.00 |
| Rate for Payer: Aetna Commercial |
$1,181.60
|
| Rate for Payer: Aetna Medicare |
$462.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$462.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$804.02
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$875.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$531.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$508.20
|
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Centivo All Commercial |
$714.00
|
| Rate for Payer: Cigna All Commercial |
$1,208.20
|
| Rate for Payer: CORVEL All Commercial |
$1,302.00
|
| Rate for Payer: Coventry All Commercial |
$1,232.00
|
| Rate for Payer: Encore All Commercial |
$1,288.70
|
| Rate for Payer: Frontpath All Commercial |
$1,288.00
|
| Rate for Payer: Humana ChoiceCare |
$1,209.18
|
| Rate for Payer: Humana Medicare |
$714.00
|
| Rate for Payer: Lucent All Commercial |
$714.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,260.00
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,050.00
|
| Rate for Payer: PHP All Commercial |
$1,061.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$546.00
|
| Rate for Payer: Sagamore Health Network All Products |
$1,080.80
|
| Rate for Payer: Signature Care EPO |
$1,162.00
|
| Rate for Payer: Signature Care PPO |
$1,232.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,190.00
|
| Rate for Payer: United Healthcare Commercial |
$1,103.20
|
| Rate for Payer: United Healthcare Medicare |
$462.00
|
|
|
HC Z DRILL GUIDE 2.7/2.0
|
Facility
IP
|
$1,400.00
|
|
| Hospital Charge Code |
41606894
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,050.00 |
| Max. Negotiated Rate |
$1,302.00 |
| Rate for Payer: Aetna Commercial |
$1,209.60
|
| Rate for Payer: Cash Price |
$868.00
|
| Rate for Payer: Cigna All Commercial |
$1,208.20
|
| Rate for Payer: CORVEL All Commercial |
$1,302.00
|
| Rate for Payer: Coventry All Commercial |
$1,232.00
|
| Rate for Payer: Encore All Commercial |
$1,288.70
|
| Rate for Payer: Frontpath All Commercial |
$1,288.00
|
| Rate for Payer: Humana ChoiceCare |
$1,209.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,260.00
|
| Rate for Payer: PHCS All Commercial |
$1,050.00
|
| Rate for Payer: PHP All Commercial |
$1,061.76
|
| Rate for Payer: Sagamore Health Network All Products |
$1,080.80
|
| Rate for Payer: Signature Care EPO |
$1,162.00
|
| Rate for Payer: Signature Care PPO |
$1,232.00
|
| Rate for Payer: United Healthcare Commercial |
$1,103.20
|
|
|
HC Z DRILL GUIDE 2.7 LOCK
|
Facility
IP
|
$1,302.90
|
|
| Hospital Charge Code |
41606897
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$977.18 |
| Max. Negotiated Rate |
$1,211.70 |
| Rate for Payer: Aetna Commercial |
$1,125.71
|
| Rate for Payer: Cash Price |
$807.80
|
| Rate for Payer: Cigna All Commercial |
$1,124.40
|
| Rate for Payer: CORVEL All Commercial |
$1,211.70
|
| Rate for Payer: Coventry All Commercial |
$1,146.55
|
| Rate for Payer: Encore All Commercial |
$1,199.32
|
| Rate for Payer: Frontpath All Commercial |
$1,198.67
|
| Rate for Payer: Humana ChoiceCare |
$1,125.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,172.61
|
| Rate for Payer: PHCS All Commercial |
$977.18
|
| Rate for Payer: PHP All Commercial |
$988.12
|
| Rate for Payer: Sagamore Health Network All Products |
$1,005.84
|
| Rate for Payer: Signature Care EPO |
$1,081.41
|
| Rate for Payer: Signature Care PPO |
$1,146.55
|
| Rate for Payer: United Healthcare Commercial |
$1,026.69
|
|
|
HC Z DRILL GUIDE 2.7 LOCK
|
Facility
OP
|
$1,302.90
|
|
| Hospital Charge Code |
41606897
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,211.70 |
| Rate for Payer: Aetna Commercial |
$1,099.65
|
| Rate for Payer: Aetna Medicare |
$429.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$429.96
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$748.26
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$814.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$494.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$472.95
|
| Rate for Payer: Cash Price |
$807.80
|
| Rate for Payer: Cash Price |
$807.80
|
| Rate for Payer: Centivo All Commercial |
$664.48
|
| Rate for Payer: Cigna All Commercial |
$1,124.40
|
| Rate for Payer: CORVEL All Commercial |
$1,211.70
|
| Rate for Payer: Coventry All Commercial |
$1,146.55
|
| Rate for Payer: Encore All Commercial |
$1,199.32
|
| Rate for Payer: Frontpath All Commercial |
$1,198.67
|
| Rate for Payer: Humana ChoiceCare |
$1,125.31
|
| Rate for Payer: Humana Medicare |
$664.48
|
| Rate for Payer: Lucent All Commercial |
$664.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,172.61
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$977.18
|
| Rate for Payer: PHP All Commercial |
$988.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$508.13
|
| Rate for Payer: Sagamore Health Network All Products |
$1,005.84
|
| Rate for Payer: Signature Care EPO |
$1,081.41
|
| Rate for Payer: Signature Care PPO |
$1,146.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,107.46
|
| Rate for Payer: United Healthcare Commercial |
$1,026.69
|
| Rate for Payer: United Healthcare Medicare |
$429.96
|
|
|
HC Z DRILL GUIDE 2.9/4.0
|
Facility
OP
|
$2,240.00
|
|
| Hospital Charge Code |
41606896
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$2,083.20 |
| Rate for Payer: Aetna Commercial |
$1,890.56
|
| Rate for Payer: Aetna Medicare |
$739.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$739.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,286.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,400.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$850.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$813.12
|
| Rate for Payer: Cash Price |
$1,388.80
|
| Rate for Payer: Cash Price |
$1,388.80
|
| Rate for Payer: Centivo All Commercial |
$1,142.40
|
| Rate for Payer: Cigna All Commercial |
$1,933.12
|
| Rate for Payer: CORVEL All Commercial |
$2,083.20
|
| Rate for Payer: Coventry All Commercial |
$1,971.20
|
| Rate for Payer: Encore All Commercial |
$2,061.92
|
| Rate for Payer: Frontpath All Commercial |
$2,060.80
|
| Rate for Payer: Humana ChoiceCare |
$1,934.69
|
| Rate for Payer: Humana Medicare |
$1,142.40
|
| Rate for Payer: Lucent All Commercial |
$1,142.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,016.00
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,680.00
|
| Rate for Payer: PHP All Commercial |
$1,698.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$873.60
|
| Rate for Payer: Sagamore Health Network All Products |
$1,729.28
|
| Rate for Payer: Signature Care EPO |
$1,859.20
|
| Rate for Payer: Signature Care PPO |
$1,971.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,904.00
|
| Rate for Payer: United Healthcare Commercial |
$1,765.12
|
| Rate for Payer: United Healthcare Medicare |
$739.20
|
|
|
HC Z DRILL GUIDE 2.9/4.0
|
Facility
IP
|
$2,240.00
|
|
| Hospital Charge Code |
41606896
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,680.00 |
| Max. Negotiated Rate |
$2,083.20 |
| Rate for Payer: Aetna Commercial |
$1,935.36
|
| Rate for Payer: Cash Price |
$1,388.80
|
| Rate for Payer: Cigna All Commercial |
$1,933.12
|
| Rate for Payer: CORVEL All Commercial |
$2,083.20
|
| Rate for Payer: Coventry All Commercial |
$1,971.20
|
| Rate for Payer: Encore All Commercial |
$2,061.92
|
| Rate for Payer: Frontpath All Commercial |
$2,060.80
|
| Rate for Payer: Humana ChoiceCare |
$1,934.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,016.00
|
| Rate for Payer: PHCS All Commercial |
$1,680.00
|
| Rate for Payer: PHP All Commercial |
$1,698.82
|
| Rate for Payer: Sagamore Health Network All Products |
$1,729.28
|
| Rate for Payer: Signature Care EPO |
$1,859.20
|
| Rate for Payer: Signature Care PPO |
$1,971.20
|
| Rate for Payer: United Healthcare Commercial |
$1,765.12
|
|
|
HC Z DRILL JGRKNT 2.9
|
Facility
OP
|
$931.00
|
|
| Hospital Charge Code |
41607788
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$865.83 |
| Rate for Payer: Aetna Commercial |
$785.76
|
| Rate for Payer: Aetna Medicare |
$307.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$307.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$534.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$581.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$353.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$337.95
|
| Rate for Payer: Cash Price |
$577.22
|
| Rate for Payer: Cash Price |
$577.22
|
| Rate for Payer: Centivo All Commercial |
$474.81
|
| Rate for Payer: Cigna All Commercial |
$803.45
|
| Rate for Payer: CORVEL All Commercial |
$865.83
|
| Rate for Payer: Coventry All Commercial |
$819.28
|
| Rate for Payer: Encore All Commercial |
$856.99
|
| Rate for Payer: Frontpath All Commercial |
$856.52
|
| Rate for Payer: Humana ChoiceCare |
$804.10
|
| Rate for Payer: Humana Medicare |
$474.81
|
| Rate for Payer: Lucent All Commercial |
$474.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$837.90
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$698.25
|
| Rate for Payer: PHP All Commercial |
$706.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$363.09
|
| Rate for Payer: Sagamore Health Network All Products |
$718.73
|
| Rate for Payer: Signature Care EPO |
$772.73
|
| Rate for Payer: Signature Care PPO |
$819.28
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$791.35
|
| Rate for Payer: United Healthcare Commercial |
$733.63
|
| Rate for Payer: United Healthcare Medicare |
$307.23
|
|
|
HC Z DRILL JGRKNT 2.9
|
Facility
IP
|
$931.00
|
|
| Hospital Charge Code |
41607788
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$698.25 |
| Max. Negotiated Rate |
$865.83 |
| Rate for Payer: Aetna Commercial |
$804.38
|
| Rate for Payer: Cash Price |
$577.22
|
| Rate for Payer: Cigna All Commercial |
$803.45
|
| Rate for Payer: CORVEL All Commercial |
$865.83
|
| Rate for Payer: Coventry All Commercial |
$819.28
|
| Rate for Payer: Encore All Commercial |
$856.99
|
| Rate for Payer: Frontpath All Commercial |
$856.52
|
| Rate for Payer: Humana ChoiceCare |
$804.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$837.90
|
| Rate for Payer: PHCS All Commercial |
$698.25
|
| Rate for Payer: PHP All Commercial |
$706.07
|
| Rate for Payer: Sagamore Health Network All Products |
$718.73
|
| Rate for Payer: Signature Care EPO |
$772.73
|
| Rate for Payer: Signature Care PPO |
$819.28
|
| Rate for Payer: United Healthcare Commercial |
$733.63
|
|
|
HC Z DRILL LAG SCREW
|
Facility
IP
|
$3,417.84
|
|
| Hospital Charge Code |
41606241
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,563.38 |
| Max. Negotiated Rate |
$3,178.59 |
| Rate for Payer: Aetna Commercial |
$2,953.01
|
| Rate for Payer: Cash Price |
$2,119.06
|
| Rate for Payer: Cigna All Commercial |
$2,949.60
|
| Rate for Payer: CORVEL All Commercial |
$3,178.59
|
| Rate for Payer: Coventry All Commercial |
$3,007.70
|
| Rate for Payer: Encore All Commercial |
$3,146.12
|
| Rate for Payer: Frontpath All Commercial |
$3,144.41
|
| Rate for Payer: Humana ChoiceCare |
$2,951.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,076.06
|
| Rate for Payer: PHCS All Commercial |
$2,563.38
|
| Rate for Payer: PHP All Commercial |
$2,592.09
|
| Rate for Payer: Sagamore Health Network All Products |
$2,638.57
|
| Rate for Payer: Signature Care EPO |
$2,836.81
|
| Rate for Payer: Signature Care PPO |
$3,007.70
|
| Rate for Payer: United Healthcare Commercial |
$2,693.26
|
|
|
HC Z DRILL LAG SCREW
|
Facility
OP
|
$3,417.84
|
|
| Hospital Charge Code |
41606241
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$3,178.59 |
| Rate for Payer: Aetna Commercial |
$2,884.66
|
| Rate for Payer: Aetna Medicare |
$1,127.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,127.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,962.87
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,136.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,297.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,240.68
|
| Rate for Payer: Cash Price |
$2,119.06
|
| Rate for Payer: Cash Price |
$2,119.06
|
| Rate for Payer: Centivo All Commercial |
$1,743.10
|
| Rate for Payer: Cigna All Commercial |
$2,949.60
|
| Rate for Payer: CORVEL All Commercial |
$3,178.59
|
| Rate for Payer: Coventry All Commercial |
$3,007.70
|
| Rate for Payer: Encore All Commercial |
$3,146.12
|
| Rate for Payer: Frontpath All Commercial |
$3,144.41
|
| Rate for Payer: Humana ChoiceCare |
$2,951.99
|
| Rate for Payer: Humana Medicare |
$1,743.10
|
| Rate for Payer: Lucent All Commercial |
$1,743.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,076.06
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$2,563.38
|
| Rate for Payer: PHP All Commercial |
$2,592.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,332.96
|
| Rate for Payer: Sagamore Health Network All Products |
$2,638.57
|
| Rate for Payer: Signature Care EPO |
$2,836.81
|
| Rate for Payer: Signature Care PPO |
$3,007.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,905.16
|
| Rate for Payer: United Healthcare Commercial |
$2,693.26
|
| Rate for Payer: United Healthcare Medicare |
$1,127.89
|
|
|
HC Z DRILL SLEEVE
|
Facility
OP
|
$829.78
|
|
| Hospital Charge Code |
41606745
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$771.70 |
| Rate for Payer: Aetna Commercial |
$700.33
|
| Rate for Payer: Aetna Medicare |
$273.83
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$273.83
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$476.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$518.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$314.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$301.21
|
| Rate for Payer: Cash Price |
$514.46
|
| Rate for Payer: Cash Price |
$514.46
|
| Rate for Payer: Centivo All Commercial |
$423.19
|
| Rate for Payer: Cigna All Commercial |
$716.10
|
| Rate for Payer: CORVEL All Commercial |
$771.70
|
| Rate for Payer: Coventry All Commercial |
$730.21
|
| Rate for Payer: Encore All Commercial |
$763.81
|
| Rate for Payer: Frontpath All Commercial |
$763.40
|
| Rate for Payer: Humana ChoiceCare |
$716.68
|
| Rate for Payer: Humana Medicare |
$423.19
|
| Rate for Payer: Lucent All Commercial |
$423.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$746.80
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$622.34
|
| Rate for Payer: PHP All Commercial |
$629.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$323.61
|
| Rate for Payer: Sagamore Health Network All Products |
$640.59
|
| Rate for Payer: Signature Care EPO |
$688.72
|
| Rate for Payer: Signature Care PPO |
$730.21
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$705.31
|
| Rate for Payer: United Healthcare Commercial |
$653.87
|
| Rate for Payer: United Healthcare Medicare |
$273.83
|
|
|
HC Z DRILL SLEEVE
|
Facility
IP
|
$829.78
|
|
| Hospital Charge Code |
41606745
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$622.34 |
| Max. Negotiated Rate |
$771.70 |
| Rate for Payer: Aetna Commercial |
$716.93
|
| Rate for Payer: Cash Price |
$514.46
|
| Rate for Payer: Cigna All Commercial |
$716.10
|
| Rate for Payer: CORVEL All Commercial |
$771.70
|
| Rate for Payer: Coventry All Commercial |
$730.21
|
| Rate for Payer: Encore All Commercial |
$763.81
|
| Rate for Payer: Frontpath All Commercial |
$763.40
|
| Rate for Payer: Humana ChoiceCare |
$716.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$746.80
|
| Rate for Payer: PHCS All Commercial |
$622.34
|
| Rate for Payer: PHP All Commercial |
$629.31
|
| Rate for Payer: Sagamore Health Network All Products |
$640.59
|
| Rate for Payer: Signature Care EPO |
$688.72
|
| Rate for Payer: Signature Care PPO |
$730.21
|
| Rate for Payer: United Healthcare Commercial |
$653.87
|
|
|
HC Z DRILL SLEEVE 100 MM
|
Facility
OP
|
$1,333.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607760
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$439.96 |
| Max. Negotiated Rate |
$1,239.88 |
| Rate for Payer: Aetna Commercial |
$1,125.22
|
| Rate for Payer: Aetna Medicare |
$439.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$439.96
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$765.66
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$833.38
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$505.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$483.95
|
| Rate for Payer: Cash Price |
$826.58
|
| Rate for Payer: Cash Price |
$826.58
|
| Rate for Payer: Centivo All Commercial |
$679.93
|
| Rate for Payer: Cigna All Commercial |
$1,150.55
|
| Rate for Payer: CORVEL All Commercial |
$1,239.88
|
| Rate for Payer: Coventry All Commercial |
$1,173.22
|
| Rate for Payer: Encore All Commercial |
$1,227.21
|
| Rate for Payer: Frontpath All Commercial |
$1,226.54
|
| Rate for Payer: Humana ChoiceCare |
$1,151.48
|
| Rate for Payer: Humana Medicare |
$679.93
|
| Rate for Payer: Lucent All Commercial |
$679.93
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,199.88
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$999.90
|
| Rate for Payer: PHP All Commercial |
$1,011.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$519.95
|
| Rate for Payer: Sagamore Health Network All Products |
$1,029.23
|
| Rate for Payer: Signature Care EPO |
$1,106.56
|
| Rate for Payer: Signature Care PPO |
$1,173.22
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,133.22
|
| Rate for Payer: United Healthcare Commercial |
$1,050.56
|
| Rate for Payer: United Healthcare Medicare |
$439.96
|
|
|
HC Z DRILL SLEEVE 100 MM
|
Facility
IP
|
$1,333.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607760
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$999.90 |
| Max. Negotiated Rate |
$1,239.88 |
| Rate for Payer: Aetna Commercial |
$1,151.88
|
| Rate for Payer: Cash Price |
$826.58
|
| Rate for Payer: Cigna All Commercial |
$1,150.55
|
| Rate for Payer: CORVEL All Commercial |
$1,239.88
|
| Rate for Payer: Coventry All Commercial |
$1,173.22
|
| Rate for Payer: Encore All Commercial |
$1,227.21
|
| Rate for Payer: Frontpath All Commercial |
$1,226.54
|
| Rate for Payer: Humana ChoiceCare |
$1,151.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,199.88
|
| Rate for Payer: PHCS All Commercial |
$999.90
|
| Rate for Payer: PHP All Commercial |
$1,011.10
|
| Rate for Payer: Sagamore Health Network All Products |
$1,029.23
|
| Rate for Payer: Signature Care EPO |
$1,106.56
|
| Rate for Payer: Signature Care PPO |
$1,173.22
|
| Rate for Payer: United Healthcare Commercial |
$1,050.56
|
|
|
HC Z DRILL STOP
|
Facility
OP
|
$190.89
|
|
| Hospital Charge Code |
41607821
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$62.99 |
| Max. Negotiated Rate |
$177.53 |
| Rate for Payer: Aetna Commercial |
$161.11
|
| Rate for Payer: Aetna Medicare |
$62.99
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$62.99
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$109.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$119.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$72.44
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$69.29
|
| Rate for Payer: Cash Price |
$118.35
|
| Rate for Payer: Cash Price |
$118.35
|
| Rate for Payer: Centivo All Commercial |
$97.35
|
| Rate for Payer: Cigna All Commercial |
$164.74
|
| Rate for Payer: CORVEL All Commercial |
$177.53
|
| Rate for Payer: Coventry All Commercial |
$167.98
|
| Rate for Payer: Encore All Commercial |
$175.71
|
| Rate for Payer: Frontpath All Commercial |
$175.62
|
| Rate for Payer: Humana ChoiceCare |
$164.87
|
| Rate for Payer: Humana Medicare |
$97.35
|
| Rate for Payer: Lucent All Commercial |
$97.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$171.80
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$143.17
|
| Rate for Payer: PHP All Commercial |
$144.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$74.45
|
| Rate for Payer: Sagamore Health Network All Products |
$147.37
|
| Rate for Payer: Signature Care EPO |
$158.44
|
| Rate for Payer: Signature Care PPO |
$167.98
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$162.26
|
| Rate for Payer: United Healthcare Commercial |
$150.42
|
| Rate for Payer: United Healthcare Medicare |
$62.99
|
|
|
HC Z DRILL STOP
|
Facility
IP
|
$190.89
|
|
| Hospital Charge Code |
41607821
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$143.17 |
| Max. Negotiated Rate |
$177.53 |
| Rate for Payer: Aetna Commercial |
$164.93
|
| Rate for Payer: Cash Price |
$118.35
|
| Rate for Payer: Cigna All Commercial |
$164.74
|
| Rate for Payer: CORVEL All Commercial |
$177.53
|
| Rate for Payer: Coventry All Commercial |
$167.98
|
| Rate for Payer: Encore All Commercial |
$175.71
|
| Rate for Payer: Frontpath All Commercial |
$175.62
|
| Rate for Payer: Humana ChoiceCare |
$164.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$171.80
|
| Rate for Payer: PHCS All Commercial |
$143.17
|
| Rate for Payer: PHP All Commercial |
$144.77
|
| Rate for Payer: Sagamore Health Network All Products |
$147.37
|
| Rate for Payer: Signature Care EPO |
$158.44
|
| Rate for Payer: Signature Care PPO |
$167.98
|
| Rate for Payer: United Healthcare Commercial |
$150.42
|
|
|
HC Z DRILL TWIST SCP 3.5X70
|
Facility
OP
|
$735.28
|
|
| Hospital Charge Code |
41606743
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| 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 |
$121.68
|
| 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 |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| 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 TWIST SCP 3.5X70
|
Facility
IP
|
$735.28
|
|
| Hospital Charge Code |
41606743
|
|
Hospital Revenue Code
|
272
|
| 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 DRIVER 1.3 SQ
|
Facility
IP
|
$735.28
|
|
| Hospital Charge Code |
41606742
|
|
Hospital Revenue Code
|
272
|
| 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 DRIVER 1.3 SQ
|
Facility
OP
|
$735.28
|
|
| Hospital Charge Code |
41606742
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| 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 |
$121.68
|
| 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 |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| 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 DRIVER 2.0 CANN HEX
|
Facility
OP
|
$862.15
|
|
| Hospital Charge Code |
41608007
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$801.80 |
| Rate for Payer: Aetna Commercial |
$727.65
|
| Rate for Payer: Aetna Medicare |
$284.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$284.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$495.13
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$538.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$327.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$312.96
|
| Rate for Payer: Cash Price |
$534.53
|
| Rate for Payer: Cash Price |
$534.53
|
| Rate for Payer: Centivo All Commercial |
$439.70
|
| Rate for Payer: Cigna All Commercial |
$744.04
|
| Rate for Payer: CORVEL All Commercial |
$801.80
|
| Rate for Payer: Coventry All Commercial |
$758.69
|
| Rate for Payer: Encore All Commercial |
$793.61
|
| Rate for Payer: Frontpath All Commercial |
$793.18
|
| Rate for Payer: Humana ChoiceCare |
$744.64
|
| Rate for Payer: Humana Medicare |
$439.70
|
| Rate for Payer: Lucent All Commercial |
$439.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$775.94
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$646.61
|
| Rate for Payer: PHP All Commercial |
$653.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$336.24
|
| Rate for Payer: Sagamore Health Network All Products |
$665.58
|
| Rate for Payer: Signature Care EPO |
$715.58
|
| Rate for Payer: Signature Care PPO |
$758.69
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$732.83
|
| Rate for Payer: United Healthcare Commercial |
$679.37
|
| Rate for Payer: United Healthcare Medicare |
$284.51
|
|
|
HC Z DRIVER 2.0 CANN HEX
|
Facility
IP
|
$862.15
|
|
| Hospital Charge Code |
41608007
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$646.61 |
| Max. Negotiated Rate |
$801.80 |
| Rate for Payer: Aetna Commercial |
$744.90
|
| Rate for Payer: Cash Price |
$534.53
|
| Rate for Payer: Cigna All Commercial |
$744.04
|
| Rate for Payer: CORVEL All Commercial |
$801.80
|
| Rate for Payer: Coventry All Commercial |
$758.69
|
| Rate for Payer: Encore All Commercial |
$793.61
|
| Rate for Payer: Frontpath All Commercial |
$793.18
|
| Rate for Payer: Humana ChoiceCare |
$744.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$775.94
|
| Rate for Payer: PHCS All Commercial |
$646.61
|
| Rate for Payer: PHP All Commercial |
$653.85
|
| Rate for Payer: Sagamore Health Network All Products |
$665.58
|
| Rate for Payer: Signature Care EPO |
$715.58
|
| Rate for Payer: Signature Care PPO |
$758.69
|
| Rate for Payer: United Healthcare Commercial |
$679.37
|
|
|
HC Z DRIVER 2.2 SQ
|
Facility
OP
|
$754.39
|
|
| Hospital Charge Code |
41606746
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$701.58 |
| 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 |
$471.57
|
| 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 |
$273.84
|
| Rate for Payer: Cash Price |
$467.72
|
| Rate for Payer: Cash Price |
$467.72
|
| Rate for Payer: Centivo All Commercial |
$384.74
|
| Rate for Payer: Cigna All Commercial |
$651.04
|
| Rate for Payer: CORVEL All Commercial |
$701.58
|
| Rate for Payer: Coventry All Commercial |
$663.86
|
| Rate for Payer: Encore All Commercial |
$694.42
|
| Rate for Payer: Frontpath All Commercial |
$694.04
|
| Rate for Payer: Humana ChoiceCare |
$651.57
|
| Rate for Payer: Humana Medicare |
$384.74
|
| Rate for Payer: Lucent All Commercial |
$384.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$678.95
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$565.79
|
| Rate for Payer: PHP All Commercial |
$572.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$294.21
|
| Rate for Payer: Sagamore Health Network All Products |
$582.39
|
| Rate for Payer: Signature Care EPO |
$626.14
|
| Rate for Payer: Signature Care PPO |
$663.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$641.23
|
| Rate for Payer: United Healthcare Commercial |
$594.46
|
| Rate for Payer: United Healthcare Medicare |
$248.95
|
|
