|
HC Z K-WIRE .062 6IN
|
Facility
OP
|
$298.27
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603536
|
|
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 .062 6IN
|
Facility
IP
|
$298.27
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603536
|
|
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 .062 6IN TROC TIP
|
Facility
IP
|
$486.92
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603586
|
|
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 .062 6IN TROC TIP
|
Facility
OP
|
$486.92
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603586
|
|
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 .062 9IN
|
Facility
IP
|
$74.67
|
|
| Hospital Charge Code |
41602111
|
|
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 K WIRE .062 9IN
|
Facility
OP
|
$74.67
|
|
| Hospital Charge Code |
41602111
|
|
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 0.6 70 TROC T
|
Facility
IP
|
$559.30
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604274
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$419.48 |
| Max. Negotiated Rate |
$520.15 |
| Rate for Payer: Aetna Commercial |
$483.24
|
| Rate for Payer: Cash Price |
$346.77
|
| Rate for Payer: Cigna All Commercial |
$482.68
|
| Rate for Payer: CORVEL All Commercial |
$520.15
|
| Rate for Payer: Coventry All Commercial |
$492.18
|
| Rate for Payer: Encore All Commercial |
$514.84
|
| Rate for Payer: Frontpath All Commercial |
$514.56
|
| Rate for Payer: Humana ChoiceCare |
$483.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$503.37
|
| Rate for Payer: PHCS All Commercial |
$419.48
|
| Rate for Payer: PHP All Commercial |
$424.17
|
| Rate for Payer: Sagamore Health Network All Products |
$431.78
|
| Rate for Payer: Signature Care EPO |
$464.22
|
| Rate for Payer: Signature Care PPO |
$492.18
|
| Rate for Payer: United Healthcare Commercial |
$440.73
|
|
|
HC Z K-WIRE 0.6 70 TROC T
|
Facility
OP
|
$559.30
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604274
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$184.57 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$472.05
|
| Rate for Payer: Aetna Medicare |
$184.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$184.57
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$321.21
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$349.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$212.25
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$203.03
|
| Rate for Payer: Cash Price |
$346.77
|
| Rate for Payer: Cash Price |
$346.77
|
| Rate for Payer: Centivo All Commercial |
$285.24
|
| Rate for Payer: Cigna All Commercial |
$482.68
|
| Rate for Payer: CORVEL All Commercial |
$520.15
|
| Rate for Payer: Coventry All Commercial |
$492.18
|
| Rate for Payer: Encore All Commercial |
$514.84
|
| Rate for Payer: Frontpath All Commercial |
$514.56
|
| Rate for Payer: Humana ChoiceCare |
$483.07
|
| Rate for Payer: Humana Medicare |
$285.24
|
| Rate for Payer: Lucent All Commercial |
$285.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$503.37
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$419.48
|
| Rate for Payer: PHP All Commercial |
$424.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$218.13
|
| Rate for Payer: Sagamore Health Network All Products |
$431.78
|
| Rate for Payer: Signature Care EPO |
$464.22
|
| Rate for Payer: Signature Care PPO |
$492.18
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$475.40
|
| Rate for Payer: United Healthcare Commercial |
$440.73
|
| Rate for Payer: United Healthcare Medicare |
$184.57
|
|
|
HC Z K-WIRE 0.8 70 TROC T
|
Facility
OP
|
$559.30
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604275
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$184.57 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$472.05
|
| Rate for Payer: Aetna Medicare |
$184.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$184.57
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$321.21
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$349.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$212.25
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$203.03
|
| Rate for Payer: Cash Price |
$346.77
|
| Rate for Payer: Cash Price |
$346.77
|
| Rate for Payer: Centivo All Commercial |
$285.24
|
| Rate for Payer: Cigna All Commercial |
$482.68
|
| Rate for Payer: CORVEL All Commercial |
$520.15
|
| Rate for Payer: Coventry All Commercial |
$492.18
|
| Rate for Payer: Encore All Commercial |
$514.84
|
| Rate for Payer: Frontpath All Commercial |
$514.56
|
| Rate for Payer: Humana ChoiceCare |
$483.07
|
| Rate for Payer: Humana Medicare |
$285.24
|
| Rate for Payer: Lucent All Commercial |
$285.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$503.37
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$419.48
|
| Rate for Payer: PHP All Commercial |
$424.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$218.13
|
| Rate for Payer: Sagamore Health Network All Products |
$431.78
|
| Rate for Payer: Signature Care EPO |
$464.22
|
| Rate for Payer: Signature Care PPO |
$492.18
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$475.40
|
| Rate for Payer: United Healthcare Commercial |
$440.73
|
| Rate for Payer: United Healthcare Medicare |
$184.57
|
|
|
HC Z K-WIRE 0.8 70 TROC T
|
Facility
IP
|
$559.30
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604275
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$419.48 |
| Max. Negotiated Rate |
$520.15 |
| Rate for Payer: Aetna Commercial |
$483.24
|
| Rate for Payer: Cash Price |
$346.77
|
| Rate for Payer: Cigna All Commercial |
$482.68
|
| Rate for Payer: CORVEL All Commercial |
$520.15
|
| Rate for Payer: Coventry All Commercial |
$492.18
|
| Rate for Payer: Encore All Commercial |
$514.84
|
| Rate for Payer: Frontpath All Commercial |
$514.56
|
| Rate for Payer: Humana ChoiceCare |
$483.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$503.37
|
| Rate for Payer: PHCS All Commercial |
$419.48
|
| Rate for Payer: PHP All Commercial |
$424.17
|
| Rate for Payer: Sagamore Health Network All Products |
$431.78
|
| Rate for Payer: Signature Care EPO |
$464.22
|
| Rate for Payer: Signature Care PPO |
$492.18
|
| Rate for Payer: United Healthcare Commercial |
$440.73
|
|
|
HC Z K-WIRE 1.0 150 TROC
|
Facility
OP
|
$559.30
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604276
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$184.57 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$472.05
|
| Rate for Payer: Aetna Medicare |
$184.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$184.57
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$321.21
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$349.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$212.25
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$203.03
|
| Rate for Payer: Cash Price |
$346.77
|
| Rate for Payer: Cash Price |
$346.77
|
| Rate for Payer: Centivo All Commercial |
$285.24
|
| Rate for Payer: Cigna All Commercial |
$482.68
|
| Rate for Payer: CORVEL All Commercial |
$520.15
|
| Rate for Payer: Coventry All Commercial |
$492.18
|
| Rate for Payer: Encore All Commercial |
$514.84
|
| Rate for Payer: Frontpath All Commercial |
$514.56
|
| Rate for Payer: Humana ChoiceCare |
$483.07
|
| Rate for Payer: Humana Medicare |
$285.24
|
| Rate for Payer: Lucent All Commercial |
$285.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$503.37
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$419.48
|
| Rate for Payer: PHP All Commercial |
$424.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$218.13
|
| Rate for Payer: Sagamore Health Network All Products |
$431.78
|
| Rate for Payer: Signature Care EPO |
$464.22
|
| Rate for Payer: Signature Care PPO |
$492.18
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$475.40
|
| Rate for Payer: United Healthcare Commercial |
$440.73
|
| Rate for Payer: United Healthcare Medicare |
$184.57
|
|
|
HC Z K-WIRE 1.0 150 TROC
|
Facility
IP
|
$559.30
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604276
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$419.48 |
| Max. Negotiated Rate |
$520.15 |
| Rate for Payer: Aetna Commercial |
$483.24
|
| Rate for Payer: Cash Price |
$346.77
|
| Rate for Payer: Cigna All Commercial |
$482.68
|
| Rate for Payer: CORVEL All Commercial |
$520.15
|
| Rate for Payer: Coventry All Commercial |
$492.18
|
| Rate for Payer: Encore All Commercial |
$514.84
|
| Rate for Payer: Frontpath All Commercial |
$514.56
|
| Rate for Payer: Humana ChoiceCare |
$483.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$503.37
|
| Rate for Payer: PHCS All Commercial |
$419.48
|
| Rate for Payer: PHP All Commercial |
$424.17
|
| Rate for Payer: Sagamore Health Network All Products |
$431.78
|
| Rate for Payer: Signature Care EPO |
$464.22
|
| Rate for Payer: Signature Care PPO |
$492.18
|
| Rate for Payer: United Healthcare Commercial |
$440.73
|
|
|
HC Z K-WIRE 1.25
|
Facility
IP
|
$247.03
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603607
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$185.27 |
| Max. Negotiated Rate |
$229.74 |
| Rate for Payer: Aetna Commercial |
$213.43
|
| Rate for Payer: Cash Price |
$153.16
|
| Rate for Payer: Cigna All Commercial |
$213.19
|
| Rate for Payer: CORVEL All Commercial |
$229.74
|
| Rate for Payer: Coventry All Commercial |
$217.39
|
| Rate for Payer: Encore All Commercial |
$227.39
|
| Rate for Payer: Frontpath All Commercial |
$227.27
|
| Rate for Payer: Humana ChoiceCare |
$213.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$222.33
|
| Rate for Payer: PHCS All Commercial |
$185.27
|
| Rate for Payer: PHP All Commercial |
$187.35
|
| Rate for Payer: Sagamore Health Network All Products |
$190.71
|
| Rate for Payer: Signature Care EPO |
$205.03
|
| Rate for Payer: Signature Care PPO |
$217.39
|
| Rate for Payer: United Healthcare Commercial |
$194.66
|
|
|
HC Z K-WIRE 1.25
|
Facility
OP
|
$247.03
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603607
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$81.52 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$208.49
|
| Rate for Payer: Aetna Medicare |
$81.52
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$81.52
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$141.87
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$154.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$93.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$89.67
|
| Rate for Payer: Cash Price |
$153.16
|
| Rate for Payer: Cash Price |
$153.16
|
| Rate for Payer: Centivo All Commercial |
$125.99
|
| Rate for Payer: Cigna All Commercial |
$213.19
|
| Rate for Payer: CORVEL All Commercial |
$229.74
|
| Rate for Payer: Coventry All Commercial |
$217.39
|
| Rate for Payer: Encore All Commercial |
$227.39
|
| Rate for Payer: Frontpath All Commercial |
$227.27
|
| Rate for Payer: Humana ChoiceCare |
$213.36
|
| Rate for Payer: Humana Medicare |
$125.99
|
| Rate for Payer: Lucent All Commercial |
$125.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$222.33
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$185.27
|
| Rate for Payer: PHP All Commercial |
$187.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$96.34
|
| Rate for Payer: Sagamore Health Network All Products |
$190.71
|
| Rate for Payer: Signature Care EPO |
$205.03
|
| Rate for Payer: Signature Care PPO |
$217.39
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$209.98
|
| Rate for Payer: United Healthcare Commercial |
$194.66
|
| Rate for Payer: United Healthcare Medicare |
$81.52
|
|
|
HC Z K-WIRE 1.25 150 TROC
|
Facility
IP
|
$559.30
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604226
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$419.48 |
| Max. Negotiated Rate |
$520.15 |
| Rate for Payer: Aetna Commercial |
$483.24
|
| Rate for Payer: Cash Price |
$346.77
|
| Rate for Payer: Cigna All Commercial |
$482.68
|
| Rate for Payer: CORVEL All Commercial |
$520.15
|
| Rate for Payer: Coventry All Commercial |
$492.18
|
| Rate for Payer: Encore All Commercial |
$514.84
|
| Rate for Payer: Frontpath All Commercial |
$514.56
|
| Rate for Payer: Humana ChoiceCare |
$483.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$503.37
|
| Rate for Payer: PHCS All Commercial |
$419.48
|
| Rate for Payer: PHP All Commercial |
$424.17
|
| Rate for Payer: Sagamore Health Network All Products |
$431.78
|
| Rate for Payer: Signature Care EPO |
$464.22
|
| Rate for Payer: Signature Care PPO |
$492.18
|
| Rate for Payer: United Healthcare Commercial |
$440.73
|
|
|
HC Z K-WIRE 1.25 150 TROC
|
Facility
OP
|
$559.30
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604226
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$184.57 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$472.05
|
| Rate for Payer: Aetna Medicare |
$184.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$184.57
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$321.21
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$349.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$212.25
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$203.03
|
| Rate for Payer: Cash Price |
$346.77
|
| Rate for Payer: Cash Price |
$346.77
|
| Rate for Payer: Centivo All Commercial |
$285.24
|
| Rate for Payer: Cigna All Commercial |
$482.68
|
| Rate for Payer: CORVEL All Commercial |
$520.15
|
| Rate for Payer: Coventry All Commercial |
$492.18
|
| Rate for Payer: Encore All Commercial |
$514.84
|
| Rate for Payer: Frontpath All Commercial |
$514.56
|
| Rate for Payer: Humana ChoiceCare |
$483.07
|
| Rate for Payer: Humana Medicare |
$285.24
|
| Rate for Payer: Lucent All Commercial |
$285.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$503.37
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$419.48
|
| Rate for Payer: PHP All Commercial |
$424.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$218.13
|
| Rate for Payer: Sagamore Health Network All Products |
$431.78
|
| Rate for Payer: Signature Care EPO |
$464.22
|
| Rate for Payer: Signature Care PPO |
$492.18
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$475.40
|
| Rate for Payer: United Healthcare Commercial |
$440.73
|
| Rate for Payer: United Healthcare Medicare |
$184.57
|
|
|
HC Z K-WIRE 1.6 150 TROC TIP
|
Facility
OP
|
$559.30
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603909
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$184.57 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$472.05
|
| Rate for Payer: Aetna Medicare |
$184.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$184.57
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$321.21
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$349.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$212.25
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$203.03
|
| Rate for Payer: Cash Price |
$346.77
|
| Rate for Payer: Cash Price |
$346.77
|
| Rate for Payer: Centivo All Commercial |
$285.24
|
| Rate for Payer: Cigna All Commercial |
$482.68
|
| Rate for Payer: CORVEL All Commercial |
$520.15
|
| Rate for Payer: Coventry All Commercial |
$492.18
|
| Rate for Payer: Encore All Commercial |
$514.84
|
| Rate for Payer: Frontpath All Commercial |
$514.56
|
| Rate for Payer: Humana ChoiceCare |
$483.07
|
| Rate for Payer: Humana Medicare |
$285.24
|
| Rate for Payer: Lucent All Commercial |
$285.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$503.37
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$419.48
|
| Rate for Payer: PHP All Commercial |
$424.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$218.13
|
| Rate for Payer: Sagamore Health Network All Products |
$431.78
|
| Rate for Payer: Signature Care EPO |
$464.22
|
| Rate for Payer: Signature Care PPO |
$492.18
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$475.40
|
| Rate for Payer: United Healthcare Commercial |
$440.73
|
| Rate for Payer: United Healthcare Medicare |
$184.57
|
|
|
HC Z K-WIRE 1.6 150 TROC TIP
|
Facility
IP
|
$559.30
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603909
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$419.48 |
| Max. Negotiated Rate |
$520.15 |
| Rate for Payer: Aetna Commercial |
$483.24
|
| Rate for Payer: Cash Price |
$346.77
|
| Rate for Payer: Cigna All Commercial |
$482.68
|
| Rate for Payer: CORVEL All Commercial |
$520.15
|
| Rate for Payer: Coventry All Commercial |
$492.18
|
| Rate for Payer: Encore All Commercial |
$514.84
|
| Rate for Payer: Frontpath All Commercial |
$514.56
|
| Rate for Payer: Humana ChoiceCare |
$483.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$503.37
|
| Rate for Payer: PHCS All Commercial |
$419.48
|
| Rate for Payer: PHP All Commercial |
$424.17
|
| Rate for Payer: Sagamore Health Network All Products |
$431.78
|
| Rate for Payer: Signature Care EPO |
$464.22
|
| Rate for Payer: Signature Care PPO |
$492.18
|
| Rate for Payer: United Healthcare Commercial |
$440.73
|
|
|
HC Z KWIRE 1.6 NS
|
Facility
OP
|
$155.54
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607465
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$51.33 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$131.28
|
| Rate for Payer: Aetna Medicare |
$51.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$51.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$89.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$97.23
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$59.03
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$56.46
|
| Rate for Payer: Cash Price |
$96.44
|
| Rate for Payer: Cash Price |
$96.44
|
| Rate for Payer: Centivo All Commercial |
$79.33
|
| Rate for Payer: Cigna All Commercial |
$134.23
|
| Rate for Payer: CORVEL All Commercial |
$144.65
|
| Rate for Payer: Coventry All Commercial |
$136.88
|
| Rate for Payer: Encore All Commercial |
$143.17
|
| Rate for Payer: Frontpath All Commercial |
$143.10
|
| Rate for Payer: Humana ChoiceCare |
$134.34
|
| Rate for Payer: Humana Medicare |
$79.33
|
| Rate for Payer: Lucent All Commercial |
$79.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$139.99
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$116.66
|
| Rate for Payer: PHP All Commercial |
$117.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$60.66
|
| Rate for Payer: Sagamore Health Network All Products |
$120.08
|
| Rate for Payer: Signature Care EPO |
$129.10
|
| Rate for Payer: Signature Care PPO |
$136.88
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$132.21
|
| Rate for Payer: United Healthcare Commercial |
$122.57
|
| Rate for Payer: United Healthcare Medicare |
$51.33
|
|
|
HC Z KWIRE 1.6 NS
|
Facility
IP
|
$155.54
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607465
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.66 |
| Max. Negotiated Rate |
$144.65 |
| Rate for Payer: Aetna Commercial |
$134.39
|
| Rate for Payer: Cash Price |
$96.44
|
| Rate for Payer: Cigna All Commercial |
$134.23
|
| Rate for Payer: CORVEL All Commercial |
$144.65
|
| Rate for Payer: Coventry All Commercial |
$136.88
|
| Rate for Payer: Encore All Commercial |
$143.17
|
| Rate for Payer: Frontpath All Commercial |
$143.10
|
| Rate for Payer: Humana ChoiceCare |
$134.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$139.99
|
| Rate for Payer: PHCS All Commercial |
$116.66
|
| Rate for Payer: PHP All Commercial |
$117.96
|
| Rate for Payer: Sagamore Health Network All Products |
$120.08
|
| Rate for Payer: Signature Care EPO |
$129.10
|
| Rate for Payer: Signature Care PPO |
$136.88
|
| Rate for Payer: United Healthcare Commercial |
$122.57
|
|
|
HC Z KWIRE 1.6 SS
|
Facility
IP
|
$233.31
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606547
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$174.98 |
| Max. Negotiated Rate |
$216.98 |
| Rate for Payer: Aetna Commercial |
$201.58
|
| Rate for Payer: Cash Price |
$144.65
|
| Rate for Payer: Cigna All Commercial |
$201.35
|
| Rate for Payer: CORVEL All Commercial |
$216.98
|
| Rate for Payer: Coventry All Commercial |
$205.31
|
| Rate for Payer: Encore All Commercial |
$214.76
|
| Rate for Payer: Frontpath All Commercial |
$214.65
|
| Rate for Payer: Humana ChoiceCare |
$201.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$209.98
|
| Rate for Payer: PHCS All Commercial |
$174.98
|
| Rate for Payer: PHP All Commercial |
$176.94
|
| Rate for Payer: Sagamore Health Network All Products |
$180.12
|
| Rate for Payer: Signature Care EPO |
$193.65
|
| Rate for Payer: Signature Care PPO |
$205.31
|
| Rate for Payer: United Healthcare Commercial |
$183.85
|
|
|
HC Z KWIRE 1.6 SS
|
Facility
OP
|
$233.31
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606547
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$76.99 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$196.91
|
| Rate for Payer: Aetna Medicare |
$76.99
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$76.99
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$133.99
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$145.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$88.54
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$84.69
|
| Rate for Payer: Cash Price |
$144.65
|
| Rate for Payer: Cash Price |
$144.65
|
| Rate for Payer: Centivo All Commercial |
$118.99
|
| Rate for Payer: Cigna All Commercial |
$201.35
|
| Rate for Payer: CORVEL All Commercial |
$216.98
|
| Rate for Payer: Coventry All Commercial |
$205.31
|
| Rate for Payer: Encore All Commercial |
$214.76
|
| Rate for Payer: Frontpath All Commercial |
$214.65
|
| Rate for Payer: Humana ChoiceCare |
$201.51
|
| Rate for Payer: Humana Medicare |
$118.99
|
| Rate for Payer: Lucent All Commercial |
$118.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$209.98
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$174.98
|
| Rate for Payer: PHP All Commercial |
$176.94
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$90.99
|
| Rate for Payer: Sagamore Health Network All Products |
$180.12
|
| Rate for Payer: Signature Care EPO |
$193.65
|
| Rate for Payer: Signature Care PPO |
$205.31
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$198.31
|
| Rate for Payer: United Healthcare Commercial |
$183.85
|
| Rate for Payer: United Healthcare Medicare |
$76.99
|
|
|
HC Z KWIRE 1.6 THD
|
Facility
OP
|
$268.66
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606358
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.66 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$226.75
|
| Rate for Payer: Aetna Medicare |
$88.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$88.66
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$154.29
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$167.94
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$101.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$97.52
|
| Rate for Payer: Cash Price |
$166.57
|
| Rate for Payer: Cash Price |
$166.57
|
| Rate for Payer: Centivo All Commercial |
$137.02
|
| Rate for Payer: Cigna All Commercial |
$231.85
|
| Rate for Payer: CORVEL All Commercial |
$249.85
|
| Rate for Payer: Coventry All Commercial |
$236.42
|
| Rate for Payer: Encore All Commercial |
$247.30
|
| Rate for Payer: Frontpath All Commercial |
$247.17
|
| Rate for Payer: Humana ChoiceCare |
$232.04
|
| Rate for Payer: Humana Medicare |
$137.02
|
| Rate for Payer: Lucent All Commercial |
$137.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$241.79
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$201.50
|
| Rate for Payer: PHP All Commercial |
$203.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$104.78
|
| Rate for Payer: Sagamore Health Network All Products |
$207.41
|
| Rate for Payer: Signature Care EPO |
$222.99
|
| Rate for Payer: Signature Care PPO |
$236.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$228.36
|
| Rate for Payer: United Healthcare Commercial |
$211.70
|
| Rate for Payer: United Healthcare Medicare |
$88.66
|
|
|
HC Z KWIRE 1.6 THD
|
Facility
IP
|
$268.66
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606358
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$201.50 |
| Max. Negotiated Rate |
$249.85 |
| Rate for Payer: Aetna Commercial |
$232.12
|
| Rate for Payer: Cash Price |
$166.57
|
| Rate for Payer: Cigna All Commercial |
$231.85
|
| Rate for Payer: CORVEL All Commercial |
$249.85
|
| Rate for Payer: Coventry All Commercial |
$236.42
|
| Rate for Payer: Encore All Commercial |
$247.30
|
| Rate for Payer: Frontpath All Commercial |
$247.17
|
| Rate for Payer: Humana ChoiceCare |
$232.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$241.79
|
| Rate for Payer: PHCS All Commercial |
$201.50
|
| Rate for Payer: PHP All Commercial |
$203.75
|
| Rate for Payer: Sagamore Health Network All Products |
$207.41
|
| Rate for Payer: Signature Care EPO |
$222.99
|
| Rate for Payer: Signature Care PPO |
$236.42
|
| Rate for Payer: United Healthcare Commercial |
$211.70
|
|
|
HC Z KWIRE 1.6 TROCH STE
|
Facility
IP
|
$864.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606481
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$648.38 |
| Max. Negotiated Rate |
$803.98 |
| Rate for Payer: Aetna Commercial |
$746.93
|
| Rate for Payer: Cash Price |
$535.99
|
| Rate for Payer: Cigna All Commercial |
$746.06
|
| Rate for Payer: CORVEL All Commercial |
$803.98
|
| Rate for Payer: Coventry All Commercial |
$760.76
|
| Rate for Payer: Encore All Commercial |
$795.77
|
| Rate for Payer: Frontpath All Commercial |
$795.34
|
| Rate for Payer: Humana ChoiceCare |
$746.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$778.05
|
| Rate for Payer: PHCS All Commercial |
$648.38
|
| Rate for Payer: PHP All Commercial |
$655.64
|
| Rate for Payer: Sagamore Health Network All Products |
$667.39
|
| Rate for Payer: Signature Care EPO |
$717.54
|
| Rate for Payer: Signature Care PPO |
$760.76
|
| Rate for Payer: United Healthcare Commercial |
$681.23
|
|
