|
HC Z JUGSTITCH SUTURE CUTTER
|
Facility
IP
|
$1,190.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608284
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$892.50 |
| Max. Negotiated Rate |
$1,106.70 |
| Rate for Payer: Aetna Commercial |
$1,028.16
|
| Rate for Payer: Cash Price |
$737.80
|
| Rate for Payer: Cigna All Commercial |
$1,026.97
|
| Rate for Payer: CORVEL All Commercial |
$1,106.70
|
| Rate for Payer: Coventry All Commercial |
$1,047.20
|
| Rate for Payer: Encore All Commercial |
$1,095.40
|
| Rate for Payer: Frontpath All Commercial |
$1,094.80
|
| Rate for Payer: Humana ChoiceCare |
$1,027.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,071.00
|
| Rate for Payer: PHCS All Commercial |
$892.50
|
| Rate for Payer: PHP All Commercial |
$902.50
|
| Rate for Payer: Sagamore Health Network All Products |
$918.68
|
| Rate for Payer: Signature Care EPO |
$987.70
|
| Rate for Payer: Signature Care PPO |
$1,047.20
|
| Rate for Payer: United Healthcare Commercial |
$937.72
|
|
|
HC Z KIT FEM CEMENT PREP
|
Facility
OP
|
$868.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603721
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$286.44 |
| Max. Negotiated Rate |
$807.24 |
| Rate for Payer: Aetna Commercial |
$732.59
|
| Rate for Payer: Aetna Medicare |
$286.44
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$286.44
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$498.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$542.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$329.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$315.08
|
| Rate for Payer: Cash Price |
$538.16
|
| Rate for Payer: Cash Price |
$538.16
|
| Rate for Payer: Centivo All Commercial |
$442.68
|
| Rate for Payer: Cigna All Commercial |
$749.08
|
| Rate for Payer: CORVEL All Commercial |
$807.24
|
| Rate for Payer: Coventry All Commercial |
$763.84
|
| Rate for Payer: Encore All Commercial |
$798.99
|
| Rate for Payer: Frontpath All Commercial |
$798.56
|
| Rate for Payer: Humana ChoiceCare |
$749.69
|
| Rate for Payer: Humana Medicare |
$442.68
|
| Rate for Payer: Lucent All Commercial |
$442.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$781.20
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$651.00
|
| Rate for Payer: PHP All Commercial |
$658.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$338.52
|
| Rate for Payer: Sagamore Health Network All Products |
$670.10
|
| Rate for Payer: Signature Care EPO |
$720.44
|
| Rate for Payer: Signature Care PPO |
$763.84
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$737.80
|
| Rate for Payer: United Healthcare Commercial |
$683.98
|
| Rate for Payer: United Healthcare Medicare |
$286.44
|
|
|
HC Z KIT FEM CEMENT PREP
|
Facility
IP
|
$868.00
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41603721
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$651.00 |
| Max. Negotiated Rate |
$807.24 |
| Rate for Payer: Aetna Commercial |
$749.95
|
| Rate for Payer: Cash Price |
$538.16
|
| Rate for Payer: Cigna All Commercial |
$749.08
|
| Rate for Payer: CORVEL All Commercial |
$807.24
|
| Rate for Payer: Coventry All Commercial |
$763.84
|
| Rate for Payer: Encore All Commercial |
$798.99
|
| Rate for Payer: Frontpath All Commercial |
$798.56
|
| Rate for Payer: Humana ChoiceCare |
$749.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$781.20
|
| Rate for Payer: PHCS All Commercial |
$651.00
|
| Rate for Payer: PHP All Commercial |
$658.29
|
| Rate for Payer: Sagamore Health Network All Products |
$670.10
|
| Rate for Payer: Signature Care EPO |
$720.44
|
| Rate for Payer: Signature Care PPO |
$763.84
|
| Rate for Payer: United Healthcare Commercial |
$683.98
|
|
|
HC Z KNEE PRESS KNOZZLE
|
Facility
IP
|
$756.00
|
|
| Hospital Charge Code |
41607739
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$567.00 |
| Max. Negotiated Rate |
$703.08 |
| Rate for Payer: Aetna Commercial |
$653.18
|
| Rate for Payer: Cash Price |
$468.72
|
| Rate for Payer: Cigna All Commercial |
$652.43
|
| Rate for Payer: CORVEL All Commercial |
$703.08
|
| Rate for Payer: Coventry All Commercial |
$665.28
|
| Rate for Payer: Encore All Commercial |
$695.90
|
| Rate for Payer: Frontpath All Commercial |
$695.52
|
| Rate for Payer: Humana ChoiceCare |
$652.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$680.40
|
| Rate for Payer: PHCS All Commercial |
$567.00
|
| Rate for Payer: PHP All Commercial |
$573.35
|
| Rate for Payer: Sagamore Health Network All Products |
$583.63
|
| Rate for Payer: Signature Care EPO |
$627.48
|
| Rate for Payer: Signature Care PPO |
$665.28
|
| Rate for Payer: United Healthcare Commercial |
$595.73
|
|
|
HC Z KNEE PRESS KNOZZLE
|
Facility
OP
|
$756.00
|
|
| Hospital Charge Code |
41607739
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$703.08 |
| Rate for Payer: Aetna Commercial |
$638.06
|
| Rate for Payer: Aetna Medicare |
$249.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$249.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$434.17
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$472.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$286.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$274.43
|
| Rate for Payer: Cash Price |
$468.72
|
| Rate for Payer: Cash Price |
$468.72
|
| Rate for Payer: Centivo All Commercial |
$385.56
|
| Rate for Payer: Cigna All Commercial |
$652.43
|
| Rate for Payer: CORVEL All Commercial |
$703.08
|
| Rate for Payer: Coventry All Commercial |
$665.28
|
| Rate for Payer: Encore All Commercial |
$695.90
|
| Rate for Payer: Frontpath All Commercial |
$695.52
|
| Rate for Payer: Humana ChoiceCare |
$652.96
|
| Rate for Payer: Humana Medicare |
$385.56
|
| Rate for Payer: Lucent All Commercial |
$385.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$680.40
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$567.00
|
| Rate for Payer: PHP All Commercial |
$573.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$294.84
|
| Rate for Payer: Sagamore Health Network All Products |
$583.63
|
| Rate for Payer: Signature Care EPO |
$627.48
|
| Rate for Payer: Signature Care PPO |
$665.28
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$642.60
|
| Rate for Payer: United Healthcare Commercial |
$595.73
|
| Rate for Payer: United Healthcare Medicare |
$249.48
|
|
|
HC Z K WIRE .035 .90MM
|
Facility
IP
|
$53.57
|
|
| Hospital Charge Code |
41602496
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.18 |
| Max. Negotiated Rate |
$49.82 |
| Rate for Payer: Aetna Commercial |
$46.28
|
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Cigna All Commercial |
$46.23
|
| Rate for Payer: CORVEL All Commercial |
$49.82
|
| Rate for Payer: Coventry All Commercial |
$47.14
|
| Rate for Payer: Encore All Commercial |
$49.31
|
| Rate for Payer: Frontpath All Commercial |
$49.28
|
| Rate for Payer: Humana ChoiceCare |
$46.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$48.21
|
| Rate for Payer: PHCS All Commercial |
$40.18
|
| Rate for Payer: PHP All Commercial |
$40.63
|
| Rate for Payer: Sagamore Health Network All Products |
$41.36
|
| Rate for Payer: Signature Care EPO |
$44.46
|
| Rate for Payer: Signature Care PPO |
$47.14
|
| Rate for Payer: United Healthcare Commercial |
$42.21
|
|
|
HC Z K WIRE .035 .90MM
|
Facility
OP
|
$53.57
|
|
| Hospital Charge Code |
41602496
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.68 |
| Max. Negotiated Rate |
$121.68 |
| Rate for Payer: Aetna Commercial |
$45.21
|
| Rate for Payer: Aetna Medicare |
$17.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$17.68
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$30.77
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$33.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$20.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$19.45
|
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Centivo All Commercial |
$27.32
|
| Rate for Payer: Cigna All Commercial |
$46.23
|
| Rate for Payer: CORVEL All Commercial |
$49.82
|
| Rate for Payer: Coventry All Commercial |
$47.14
|
| Rate for Payer: Encore All Commercial |
$49.31
|
| Rate for Payer: Frontpath All Commercial |
$49.28
|
| Rate for Payer: Humana ChoiceCare |
$46.27
|
| Rate for Payer: Humana Medicare |
$27.32
|
| Rate for Payer: Lucent All Commercial |
$27.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$48.21
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$40.18
|
| Rate for Payer: PHP All Commercial |
$40.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$20.89
|
| Rate for Payer: Sagamore Health Network All Products |
$41.36
|
| Rate for Payer: Signature Care EPO |
$44.46
|
| Rate for Payer: Signature Care PPO |
$47.14
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$45.53
|
| Rate for Payer: United Healthcare Commercial |
$42.21
|
| Rate for Payer: United Healthcare Medicare |
$17.68
|
|
|
HC Z K WIRE .035 9IN
|
Facility
OP
|
$53.57
|
|
| Hospital Charge Code |
41602113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.68 |
| Max. Negotiated Rate |
$121.68 |
| Rate for Payer: Aetna Commercial |
$45.21
|
| Rate for Payer: Aetna Medicare |
$17.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$17.68
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$30.77
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$33.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$20.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$19.45
|
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Centivo All Commercial |
$27.32
|
| Rate for Payer: Cigna All Commercial |
$46.23
|
| Rate for Payer: CORVEL All Commercial |
$49.82
|
| Rate for Payer: Coventry All Commercial |
$47.14
|
| Rate for Payer: Encore All Commercial |
$49.31
|
| Rate for Payer: Frontpath All Commercial |
$49.28
|
| Rate for Payer: Humana ChoiceCare |
$46.27
|
| Rate for Payer: Humana Medicare |
$27.32
|
| Rate for Payer: Lucent All Commercial |
$27.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$48.21
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$40.18
|
| Rate for Payer: PHP All Commercial |
$40.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$20.89
|
| Rate for Payer: Sagamore Health Network All Products |
$41.36
|
| Rate for Payer: Signature Care EPO |
$44.46
|
| Rate for Payer: Signature Care PPO |
$47.14
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$45.53
|
| Rate for Payer: United Healthcare Commercial |
$42.21
|
| Rate for Payer: United Healthcare Medicare |
$17.68
|
|
|
HC Z K WIRE .035 9IN
|
Facility
IP
|
$53.57
|
|
| Hospital Charge Code |
41602113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.18 |
| Max. Negotiated Rate |
$49.82 |
| Rate for Payer: Aetna Commercial |
$46.28
|
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Cigna All Commercial |
$46.23
|
| Rate for Payer: CORVEL All Commercial |
$49.82
|
| Rate for Payer: Coventry All Commercial |
$47.14
|
| Rate for Payer: Encore All Commercial |
$49.31
|
| Rate for Payer: Frontpath All Commercial |
$49.28
|
| Rate for Payer: Humana ChoiceCare |
$46.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$48.21
|
| Rate for Payer: PHCS All Commercial |
$40.18
|
| Rate for Payer: PHP All Commercial |
$40.63
|
| Rate for Payer: Sagamore Health Network All Products |
$41.36
|
| Rate for Payer: Signature Care EPO |
$44.46
|
| Rate for Payer: Signature Care PPO |
$47.14
|
| Rate for Payer: United Healthcare Commercial |
$42.21
|
|
|
HC Z K-WIRE .045 4IN TROC TIP
|
Facility
OP
|
$301.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603532
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.58 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$254.69
|
| Rate for Payer: Aetna Medicare |
$99.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$99.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$173.31
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$188.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$114.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$109.54
|
| Rate for Payer: Cash Price |
$187.10
|
| Rate for Payer: Cash Price |
$187.10
|
| Rate for Payer: Centivo All Commercial |
$153.90
|
| Rate for Payer: Cigna All Commercial |
$260.43
|
| Rate for Payer: CORVEL All Commercial |
$280.65
|
| Rate for Payer: Coventry All Commercial |
$265.56
|
| Rate for Payer: Encore All Commercial |
$277.78
|
| Rate for Payer: Frontpath All Commercial |
$277.63
|
| Rate for Payer: Humana ChoiceCare |
$260.64
|
| Rate for Payer: Humana Medicare |
$153.90
|
| Rate for Payer: Lucent All Commercial |
$153.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$271.59
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$226.33
|
| Rate for Payer: PHP All Commercial |
$228.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$117.69
|
| Rate for Payer: Sagamore Health Network All Products |
$232.97
|
| Rate for Payer: Signature Care EPO |
$250.47
|
| Rate for Payer: Signature Care PPO |
$265.56
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$256.50
|
| Rate for Payer: United Healthcare Commercial |
$237.79
|
| Rate for Payer: United Healthcare Medicare |
$99.58
|
|
|
HC Z K-WIRE .045 4IN TROC TIP
|
Facility
IP
|
$301.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603532
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$226.33 |
| Max. Negotiated Rate |
$280.65 |
| Rate for Payer: Aetna Commercial |
$260.73
|
| Rate for Payer: Cash Price |
$187.10
|
| Rate for Payer: Cigna All Commercial |
$260.43
|
| Rate for Payer: CORVEL All Commercial |
$280.65
|
| Rate for Payer: Coventry All Commercial |
$265.56
|
| Rate for Payer: Encore All Commercial |
$277.78
|
| Rate for Payer: Frontpath All Commercial |
$277.63
|
| Rate for Payer: Humana ChoiceCare |
$260.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$271.59
|
| Rate for Payer: PHCS All Commercial |
$226.33
|
| Rate for Payer: PHP All Commercial |
$228.86
|
| Rate for Payer: Sagamore Health Network All Products |
$232.97
|
| Rate for Payer: Signature Care EPO |
$250.47
|
| Rate for Payer: Signature Care PPO |
$265.56
|
| Rate for Payer: United Healthcare Commercial |
$237.79
|
|
|
HC Z K-WIRE .045 6IN
|
Facility
IP
|
$298.27
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603535
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$223.70 |
| Max. Negotiated Rate |
$277.39 |
| Rate for Payer: Aetna Commercial |
$257.71
|
| Rate for Payer: Cash Price |
$184.93
|
| Rate for Payer: Cigna All Commercial |
$257.41
|
| Rate for Payer: CORVEL All Commercial |
$277.39
|
| Rate for Payer: Coventry All Commercial |
$262.48
|
| Rate for Payer: Encore All Commercial |
$274.56
|
| Rate for Payer: Frontpath All Commercial |
$274.41
|
| Rate for Payer: Humana ChoiceCare |
$257.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$268.44
|
| Rate for Payer: PHCS All Commercial |
$223.70
|
| Rate for Payer: PHP All Commercial |
$226.21
|
| Rate for Payer: Sagamore Health Network All Products |
$230.26
|
| Rate for Payer: Signature Care EPO |
$247.56
|
| Rate for Payer: Signature Care PPO |
$262.48
|
| Rate for Payer: United Healthcare Commercial |
$235.04
|
|
|
HC Z K-WIRE .045 6IN
|
Facility
OP
|
$298.27
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603535
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$98.43 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$251.74
|
| Rate for Payer: Aetna Medicare |
$98.43
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$98.43
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$171.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$186.45
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$113.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$108.27
|
| Rate for Payer: Cash Price |
$184.93
|
| Rate for Payer: Cash Price |
$184.93
|
| Rate for Payer: Centivo All Commercial |
$152.12
|
| Rate for Payer: Cigna All Commercial |
$257.41
|
| Rate for Payer: CORVEL All Commercial |
$277.39
|
| Rate for Payer: Coventry All Commercial |
$262.48
|
| Rate for Payer: Encore All Commercial |
$274.56
|
| Rate for Payer: Frontpath All Commercial |
$274.41
|
| Rate for Payer: Humana ChoiceCare |
$257.62
|
| Rate for Payer: Humana Medicare |
$152.12
|
| Rate for Payer: Lucent All Commercial |
$152.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$268.44
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$223.70
|
| Rate for Payer: PHP All Commercial |
$226.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$116.33
|
| Rate for Payer: Sagamore Health Network All Products |
$230.26
|
| Rate for Payer: Signature Care EPO |
$247.56
|
| Rate for Payer: Signature Care PPO |
$262.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$253.53
|
| Rate for Payer: United Healthcare Commercial |
$235.04
|
| Rate for Payer: United Healthcare Medicare |
$98.43
|
|
|
HC Z K-WIRE .045 6IN TROC TIP
|
Facility
OP
|
$486.92
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603584
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$160.68 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$410.96
|
| Rate for Payer: Aetna Medicare |
$160.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$160.68
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$279.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$304.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$184.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$176.75
|
| Rate for Payer: Cash Price |
$301.89
|
| Rate for Payer: Cash Price |
$301.89
|
| Rate for Payer: Centivo All Commercial |
$248.33
|
| Rate for Payer: Cigna All Commercial |
$420.21
|
| Rate for Payer: CORVEL All Commercial |
$452.84
|
| Rate for Payer: Coventry All Commercial |
$428.49
|
| Rate for Payer: Encore All Commercial |
$448.21
|
| Rate for Payer: Frontpath All Commercial |
$447.97
|
| Rate for Payer: Humana ChoiceCare |
$420.55
|
| Rate for Payer: Humana Medicare |
$248.33
|
| Rate for Payer: Lucent All Commercial |
$248.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$438.23
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$365.19
|
| Rate for Payer: PHP All Commercial |
$369.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$189.90
|
| Rate for Payer: Sagamore Health Network All Products |
$375.90
|
| Rate for Payer: Signature Care EPO |
$404.14
|
| Rate for Payer: Signature Care PPO |
$428.49
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$413.88
|
| Rate for Payer: United Healthcare Commercial |
$383.69
|
| Rate for Payer: United Healthcare Medicare |
$160.68
|
|
|
HC Z K-WIRE .045 6IN TROC TIP
|
Facility
IP
|
$486.92
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603584
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$365.19 |
| Max. Negotiated Rate |
$452.84 |
| Rate for Payer: Aetna Commercial |
$420.70
|
| Rate for Payer: Cash Price |
$301.89
|
| Rate for Payer: Cigna All Commercial |
$420.21
|
| Rate for Payer: CORVEL All Commercial |
$452.84
|
| Rate for Payer: Coventry All Commercial |
$428.49
|
| Rate for Payer: Encore All Commercial |
$448.21
|
| Rate for Payer: Frontpath All Commercial |
$447.97
|
| Rate for Payer: Humana ChoiceCare |
$420.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$438.23
|
| Rate for Payer: PHCS All Commercial |
$365.19
|
| Rate for Payer: PHP All Commercial |
$369.28
|
| Rate for Payer: Sagamore Health Network All Products |
$375.90
|
| Rate for Payer: Signature Care EPO |
$404.14
|
| Rate for Payer: Signature Care PPO |
$428.49
|
| Rate for Payer: United Healthcare Commercial |
$383.69
|
|
|
HC Z K WIRE .045 9IN
|
Facility
OP
|
$74.67
|
|
| Hospital Charge Code |
41602112
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.64 |
| Max. Negotiated Rate |
$121.68 |
| Rate for Payer: Aetna Commercial |
$63.02
|
| Rate for Payer: Aetna Medicare |
$24.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$24.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$42.88
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$46.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$28.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$27.11
|
| Rate for Payer: Cash Price |
$46.30
|
| Rate for Payer: Cash Price |
$46.30
|
| Rate for Payer: Centivo All Commercial |
$38.08
|
| Rate for Payer: Cigna All Commercial |
$64.44
|
| Rate for Payer: CORVEL All Commercial |
$69.44
|
| Rate for Payer: Coventry All Commercial |
$65.71
|
| Rate for Payer: Encore All Commercial |
$68.73
|
| Rate for Payer: Frontpath All Commercial |
$68.70
|
| Rate for Payer: Humana ChoiceCare |
$64.49
|
| Rate for Payer: Humana Medicare |
$38.08
|
| Rate for Payer: Lucent All Commercial |
$38.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$67.20
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$56.00
|
| Rate for Payer: PHP All Commercial |
$56.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$29.12
|
| Rate for Payer: Sagamore Health Network All Products |
$57.65
|
| Rate for Payer: Signature Care EPO |
$61.98
|
| Rate for Payer: Signature Care PPO |
$65.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$63.47
|
| Rate for Payer: United Healthcare Commercial |
$58.84
|
| Rate for Payer: United Healthcare Medicare |
$24.64
|
|
|
HC Z K WIRE .045 9IN
|
Facility
IP
|
$74.67
|
|
| Hospital Charge Code |
41602112
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$56.00 |
| Max. Negotiated Rate |
$69.44 |
| Rate for Payer: Aetna Commercial |
$64.51
|
| Rate for Payer: Cash Price |
$46.30
|
| Rate for Payer: Cigna All Commercial |
$64.44
|
| Rate for Payer: CORVEL All Commercial |
$69.44
|
| Rate for Payer: Coventry All Commercial |
$65.71
|
| Rate for Payer: Encore All Commercial |
$68.73
|
| Rate for Payer: Frontpath All Commercial |
$68.70
|
| Rate for Payer: Humana ChoiceCare |
$64.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$67.20
|
| Rate for Payer: PHCS All Commercial |
$56.00
|
| Rate for Payer: PHP All Commercial |
$56.63
|
| Rate for Payer: Sagamore Health Network All Products |
$57.65
|
| Rate for Payer: Signature Care EPO |
$61.98
|
| Rate for Payer: Signature Care PPO |
$65.71
|
| Rate for Payer: United Healthcare Commercial |
$58.84
|
|
|
HC Z KWIRE .045X120
|
Facility
OP
|
$1,800.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607771
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,674.00 |
| Rate for Payer: Aetna Commercial |
$1,519.20
|
| Rate for Payer: Aetna Medicare |
$594.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$594.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,033.74
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,125.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$683.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$653.40
|
| Rate for Payer: Cash Price |
$1,116.00
|
| Rate for Payer: Cash Price |
$1,116.00
|
| Rate for Payer: Centivo All Commercial |
$918.00
|
| Rate for Payer: Cigna All Commercial |
$1,553.40
|
| Rate for Payer: CORVEL All Commercial |
$1,674.00
|
| Rate for Payer: Coventry All Commercial |
$1,584.00
|
| Rate for Payer: Encore All Commercial |
$1,656.90
|
| Rate for Payer: Frontpath All Commercial |
$1,656.00
|
| Rate for Payer: Humana ChoiceCare |
$1,554.66
|
| Rate for Payer: Humana Medicare |
$918.00
|
| Rate for Payer: Lucent All Commercial |
$918.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,620.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,350.00
|
| Rate for Payer: PHP All Commercial |
$1,365.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$702.00
|
| Rate for Payer: Sagamore Health Network All Products |
$1,389.60
|
| Rate for Payer: Signature Care EPO |
$1,494.00
|
| Rate for Payer: Signature Care PPO |
$1,584.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,530.00
|
| Rate for Payer: United Healthcare Commercial |
$1,418.40
|
| Rate for Payer: United Healthcare Medicare |
$594.00
|
|
|
HC Z KWIRE .045X120
|
Facility
IP
|
$1,800.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607771
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,350.00 |
| Max. Negotiated Rate |
$1,674.00 |
| Rate for Payer: Aetna Commercial |
$1,555.20
|
| Rate for Payer: Cash Price |
$1,116.00
|
| Rate for Payer: Cigna All Commercial |
$1,553.40
|
| Rate for Payer: CORVEL All Commercial |
$1,674.00
|
| Rate for Payer: Coventry All Commercial |
$1,584.00
|
| Rate for Payer: Encore All Commercial |
$1,656.90
|
| Rate for Payer: Frontpath All Commercial |
$1,656.00
|
| Rate for Payer: Humana ChoiceCare |
$1,554.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,620.00
|
| Rate for Payer: PHCS All Commercial |
$1,350.00
|
| Rate for Payer: PHP All Commercial |
$1,365.12
|
| Rate for Payer: Sagamore Health Network All Products |
$1,389.60
|
| Rate for Payer: Signature Care EPO |
$1,494.00
|
| Rate for Payer: Signature Care PPO |
$1,584.00
|
| Rate for Payer: United Healthcare Commercial |
$1,418.40
|
|
|
HC Z K-WIRE .054 4IN TROC TIP
|
Facility
OP
|
$301.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603533
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$99.58 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$254.69
|
| Rate for Payer: Aetna Medicare |
$99.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$99.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$173.31
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$188.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$114.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$109.54
|
| Rate for Payer: Cash Price |
$187.10
|
| Rate for Payer: Cash Price |
$187.10
|
| Rate for Payer: Centivo All Commercial |
$153.90
|
| Rate for Payer: Cigna All Commercial |
$260.43
|
| Rate for Payer: CORVEL All Commercial |
$280.65
|
| Rate for Payer: Coventry All Commercial |
$265.56
|
| Rate for Payer: Encore All Commercial |
$277.78
|
| Rate for Payer: Frontpath All Commercial |
$277.63
|
| Rate for Payer: Humana ChoiceCare |
$260.64
|
| Rate for Payer: Humana Medicare |
$153.90
|
| Rate for Payer: Lucent All Commercial |
$153.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$271.59
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$226.33
|
| Rate for Payer: PHP All Commercial |
$228.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$117.69
|
| Rate for Payer: Sagamore Health Network All Products |
$232.97
|
| Rate for Payer: Signature Care EPO |
$250.47
|
| Rate for Payer: Signature Care PPO |
$265.56
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$256.50
|
| Rate for Payer: United Healthcare Commercial |
$237.79
|
| Rate for Payer: United Healthcare Medicare |
$99.58
|
|
|
HC Z K-WIRE .054 4IN TROC TIP
|
Facility
IP
|
$301.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603533
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$226.33 |
| Max. Negotiated Rate |
$280.65 |
| Rate for Payer: Aetna Commercial |
$260.73
|
| Rate for Payer: Cash Price |
$187.10
|
| Rate for Payer: Cigna All Commercial |
$260.43
|
| Rate for Payer: CORVEL All Commercial |
$280.65
|
| Rate for Payer: Coventry All Commercial |
$265.56
|
| Rate for Payer: Encore All Commercial |
$277.78
|
| Rate for Payer: Frontpath All Commercial |
$277.63
|
| Rate for Payer: Humana ChoiceCare |
$260.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$271.59
|
| Rate for Payer: PHCS All Commercial |
$226.33
|
| Rate for Payer: PHP All Commercial |
$228.86
|
| Rate for Payer: Sagamore Health Network All Products |
$232.97
|
| Rate for Payer: Signature Care EPO |
$250.47
|
| Rate for Payer: Signature Care PPO |
$265.56
|
| Rate for Payer: United Healthcare Commercial |
$237.79
|
|
|
HC Z K-WIRE .054 6IN TROC TIP
|
Facility
IP
|
$102.67
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603585
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$77.00 |
| Max. Negotiated Rate |
$95.48 |
| Rate for Payer: Aetna Commercial |
$88.71
|
| Rate for Payer: Cash Price |
$63.66
|
| Rate for Payer: Cigna All Commercial |
$88.60
|
| Rate for Payer: CORVEL All Commercial |
$95.48
|
| Rate for Payer: Coventry All Commercial |
$90.35
|
| Rate for Payer: Encore All Commercial |
$94.51
|
| Rate for Payer: Frontpath All Commercial |
$94.46
|
| Rate for Payer: Humana ChoiceCare |
$88.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$92.40
|
| Rate for Payer: PHCS All Commercial |
$77.00
|
| Rate for Payer: PHP All Commercial |
$77.86
|
| Rate for Payer: Sagamore Health Network All Products |
$79.26
|
| Rate for Payer: Signature Care EPO |
$85.22
|
| Rate for Payer: Signature Care PPO |
$90.35
|
| Rate for Payer: United Healthcare Commercial |
$80.90
|
|
|
HC Z K-WIRE .054 6IN TROC TIP
|
Facility
OP
|
$102.67
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603585
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.88 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$86.65
|
| Rate for Payer: Aetna Medicare |
$33.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$33.88
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$58.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$64.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$38.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$37.27
|
| Rate for Payer: Cash Price |
$63.66
|
| Rate for Payer: Cash Price |
$63.66
|
| Rate for Payer: Centivo All Commercial |
$52.36
|
| Rate for Payer: Cigna All Commercial |
$88.60
|
| Rate for Payer: CORVEL All Commercial |
$95.48
|
| Rate for Payer: Coventry All Commercial |
$90.35
|
| Rate for Payer: Encore All Commercial |
$94.51
|
| Rate for Payer: Frontpath All Commercial |
$94.46
|
| Rate for Payer: Humana ChoiceCare |
$88.68
|
| Rate for Payer: Humana Medicare |
$52.36
|
| Rate for Payer: Lucent All Commercial |
$52.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$92.40
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$77.00
|
| Rate for Payer: PHP All Commercial |
$77.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$40.04
|
| Rate for Payer: Sagamore Health Network All Products |
$79.26
|
| Rate for Payer: Signature Care EPO |
$85.22
|
| Rate for Payer: Signature Care PPO |
$90.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$87.27
|
| Rate for Payer: United Healthcare Commercial |
$80.90
|
| Rate for Payer: United Healthcare Medicare |
$33.88
|
|
|
HC Z K-WIRE .062 4IN TROC TIP
|
Facility
IP
|
$280.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603534
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$210.00 |
| Max. Negotiated Rate |
$260.40 |
| Rate for Payer: Aetna Commercial |
$241.92
|
| Rate for Payer: Cash Price |
$173.60
|
| Rate for Payer: Cigna All Commercial |
$241.64
|
| Rate for Payer: CORVEL All Commercial |
$260.40
|
| Rate for Payer: Coventry All Commercial |
$246.40
|
| Rate for Payer: Encore All Commercial |
$257.74
|
| Rate for Payer: Frontpath All Commercial |
$257.60
|
| Rate for Payer: Humana ChoiceCare |
$241.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$252.00
|
| Rate for Payer: PHCS All Commercial |
$210.00
|
| Rate for Payer: PHP All Commercial |
$212.35
|
| Rate for Payer: Sagamore Health Network All Products |
$216.16
|
| Rate for Payer: Signature Care EPO |
$232.40
|
| Rate for Payer: Signature Care PPO |
$246.40
|
| Rate for Payer: United Healthcare Commercial |
$220.64
|
|
|
HC Z K-WIRE .062 4IN TROC TIP
|
Facility
OP
|
$280.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603534
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$92.40 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$236.32
|
| Rate for Payer: Aetna Medicare |
$92.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$92.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$160.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$175.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$106.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$101.64
|
| Rate for Payer: Cash Price |
$173.60
|
| Rate for Payer: Cash Price |
$173.60
|
| Rate for Payer: Centivo All Commercial |
$142.80
|
| Rate for Payer: Cigna All Commercial |
$241.64
|
| Rate for Payer: CORVEL All Commercial |
$260.40
|
| Rate for Payer: Coventry All Commercial |
$246.40
|
| Rate for Payer: Encore All Commercial |
$257.74
|
| Rate for Payer: Frontpath All Commercial |
$257.60
|
| Rate for Payer: Humana ChoiceCare |
$241.84
|
| Rate for Payer: Humana Medicare |
$142.80
|
| Rate for Payer: Lucent All Commercial |
$142.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$252.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$210.00
|
| Rate for Payer: PHP All Commercial |
$212.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$109.20
|
| Rate for Payer: Sagamore Health Network All Products |
$216.16
|
| Rate for Payer: Signature Care EPO |
$232.40
|
| Rate for Payer: Signature Care PPO |
$246.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$238.00
|
| Rate for Payer: United Healthcare Commercial |
$220.64
|
| Rate for Payer: United Healthcare Medicare |
$92.40
|
|
