|
HC Z KWIRE 1.6 TROCH STE
|
Facility
OP
|
$864.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606481
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$285.28 |
| Max. Negotiated Rate |
$803.98 |
| Rate for Payer: Aetna Commercial |
$729.64
|
| Rate for Payer: Aetna Medicare |
$285.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$285.28
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$496.48
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$540.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$328.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$313.81
|
| Rate for Payer: Cash Price |
$535.99
|
| Rate for Payer: Cash Price |
$535.99
|
| Rate for Payer: Centivo All Commercial |
$440.90
|
| 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: Humana Medicare |
$440.90
|
| Rate for Payer: Lucent All Commercial |
$440.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$778.05
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$648.38
|
| Rate for Payer: PHP All Commercial |
$655.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$337.16
|
| 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: Three Rivers Preferred All Commercial |
$734.82
|
| Rate for Payer: United Healthcare Commercial |
$681.23
|
| Rate for Payer: United Healthcare Medicare |
$285.28
|
|
|
HC Z KWIRE 1.8X200
|
Facility
IP
|
$1,023.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607475
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$767.85 |
| Max. Negotiated Rate |
$952.13 |
| Rate for Payer: Aetna Commercial |
$884.56
|
| Rate for Payer: Cash Price |
$634.76
|
| Rate for Payer: Cigna All Commercial |
$883.54
|
| Rate for Payer: CORVEL All Commercial |
$952.13
|
| Rate for Payer: Coventry All Commercial |
$900.94
|
| Rate for Payer: Encore All Commercial |
$942.41
|
| Rate for Payer: Frontpath All Commercial |
$941.90
|
| Rate for Payer: Humana ChoiceCare |
$884.26
|
| Rate for Payer: Lutheran Preferred All Commercial |
$921.42
|
| Rate for Payer: PHCS All Commercial |
$767.85
|
| Rate for Payer: PHP All Commercial |
$776.45
|
| Rate for Payer: Sagamore Health Network All Products |
$790.37
|
| Rate for Payer: Signature Care EPO |
$849.75
|
| Rate for Payer: Signature Care PPO |
$900.94
|
| Rate for Payer: United Healthcare Commercial |
$806.75
|
|
|
HC Z KWIRE 1.8X200
|
Facility
OP
|
$1,023.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607475
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$337.85 |
| Max. Negotiated Rate |
$952.13 |
| Rate for Payer: Aetna Commercial |
$864.09
|
| Rate for Payer: Aetna Medicare |
$337.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$337.85
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$587.97
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$639.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$388.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$371.64
|
| Rate for Payer: Cash Price |
$634.76
|
| Rate for Payer: Cash Price |
$634.76
|
| Rate for Payer: Centivo All Commercial |
$522.14
|
| Rate for Payer: Cigna All Commercial |
$883.54
|
| Rate for Payer: CORVEL All Commercial |
$952.13
|
| Rate for Payer: Coventry All Commercial |
$900.94
|
| Rate for Payer: Encore All Commercial |
$942.41
|
| Rate for Payer: Frontpath All Commercial |
$941.90
|
| Rate for Payer: Humana ChoiceCare |
$884.26
|
| Rate for Payer: Humana Medicare |
$522.14
|
| Rate for Payer: Lucent All Commercial |
$522.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$921.42
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$767.85
|
| Rate for Payer: PHP All Commercial |
$776.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$399.28
|
| Rate for Payer: Sagamore Health Network All Products |
$790.37
|
| Rate for Payer: Signature Care EPO |
$849.75
|
| Rate for Payer: Signature Care PPO |
$900.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$870.23
|
| Rate for Payer: United Healthcare Commercial |
$806.75
|
| Rate for Payer: United Healthcare Medicare |
$337.85
|
|
|
HC Z K-WIRE 2.0 150 TROC
|
Facility
OP
|
$559.30
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604227
|
|
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 2.0 150 TROC
|
Facility
IP
|
$559.30
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604227
|
|
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 2.0, 152 S3
|
Facility
OP
|
$268.66
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603753
|
|
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 K-WIRE 2.0, 152 S3
|
Facility
IP
|
$268.66
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603753
|
|
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 2.0 KIRSCH
|
Facility
OP
|
$149.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606568
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$49.23 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$125.90
|
| Rate for Payer: Aetna Medicare |
$49.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$49.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$85.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$93.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$56.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$54.15
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Centivo All Commercial |
$76.08
|
| Rate for Payer: Cigna All Commercial |
$128.73
|
| Rate for Payer: CORVEL All Commercial |
$138.73
|
| Rate for Payer: Coventry All Commercial |
$131.27
|
| Rate for Payer: Encore All Commercial |
$137.31
|
| Rate for Payer: Frontpath All Commercial |
$137.24
|
| Rate for Payer: Humana ChoiceCare |
$128.84
|
| Rate for Payer: Humana Medicare |
$76.08
|
| Rate for Payer: Lucent All Commercial |
$76.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$134.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$111.88
|
| Rate for Payer: PHP All Commercial |
$113.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$58.18
|
| Rate for Payer: Sagamore Health Network All Products |
$115.16
|
| Rate for Payer: Signature Care EPO |
$123.81
|
| Rate for Payer: Signature Care PPO |
$131.27
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$126.79
|
| Rate for Payer: United Healthcare Commercial |
$117.55
|
| Rate for Payer: United Healthcare Medicare |
$49.23
|
|
|
HC Z KWIRE 2.0 KIRSCH
|
Facility
IP
|
$149.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606568
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$111.88 |
| Max. Negotiated Rate |
$138.73 |
| Rate for Payer: Aetna Commercial |
$128.88
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Cigna All Commercial |
$128.73
|
| Rate for Payer: CORVEL All Commercial |
$138.73
|
| Rate for Payer: Coventry All Commercial |
$131.27
|
| Rate for Payer: Encore All Commercial |
$137.31
|
| Rate for Payer: Frontpath All Commercial |
$137.24
|
| Rate for Payer: Humana ChoiceCare |
$128.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$134.25
|
| Rate for Payer: PHCS All Commercial |
$111.88
|
| Rate for Payer: PHP All Commercial |
$113.13
|
| Rate for Payer: Sagamore Health Network All Products |
$115.16
|
| Rate for Payer: Signature Care EPO |
$123.81
|
| Rate for Payer: Signature Care PPO |
$131.27
|
| Rate for Payer: United Healthcare Commercial |
$117.55
|
|
|
HC Z KWIRE .28X6
|
Facility
IP
|
$486.92
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606329
|
|
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 KWIRE .28X6
|
Facility
OP
|
$486.92
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606329
|
|
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 KWIRE .35X6
|
Facility
IP
|
$486.92
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605888
|
|
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 KWIRE .35X6
|
Facility
OP
|
$486.92
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605888
|
|
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 3X285
|
Facility
IP
|
$1,060.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607919
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$795.38 |
| Max. Negotiated Rate |
$986.26 |
| Rate for Payer: Aetna Commercial |
$916.27
|
| Rate for Payer: Cash Price |
$657.51
|
| Rate for Payer: Cigna All Commercial |
$915.21
|
| Rate for Payer: CORVEL All Commercial |
$986.26
|
| Rate for Payer: Coventry All Commercial |
$933.24
|
| Rate for Payer: Encore All Commercial |
$976.19
|
| Rate for Payer: Frontpath All Commercial |
$975.66
|
| Rate for Payer: Humana ChoiceCare |
$915.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$954.45
|
| Rate for Payer: PHCS All Commercial |
$795.38
|
| Rate for Payer: PHP All Commercial |
$804.28
|
| Rate for Payer: Sagamore Health Network All Products |
$818.71
|
| Rate for Payer: Signature Care EPO |
$880.22
|
| Rate for Payer: Signature Care PPO |
$933.24
|
| Rate for Payer: United Healthcare Commercial |
$835.67
|
|
|
HC Z K-WIRE 3X285
|
Facility
OP
|
$1,060.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607919
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$349.96 |
| Max. Negotiated Rate |
$986.26 |
| Rate for Payer: Aetna Commercial |
$895.06
|
| Rate for Payer: Aetna Medicare |
$349.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$349.96
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$609.05
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$662.92
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$402.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$384.96
|
| Rate for Payer: Cash Price |
$657.51
|
| Rate for Payer: Cash Price |
$657.51
|
| Rate for Payer: Centivo All Commercial |
$540.86
|
| Rate for Payer: Cigna All Commercial |
$915.21
|
| Rate for Payer: CORVEL All Commercial |
$986.26
|
| Rate for Payer: Coventry All Commercial |
$933.24
|
| Rate for Payer: Encore All Commercial |
$976.19
|
| Rate for Payer: Frontpath All Commercial |
$975.66
|
| Rate for Payer: Humana ChoiceCare |
$915.95
|
| Rate for Payer: Humana Medicare |
$540.86
|
| Rate for Payer: Lucent All Commercial |
$540.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$954.45
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$795.38
|
| Rate for Payer: PHP All Commercial |
$804.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$413.60
|
| Rate for Payer: Sagamore Health Network All Products |
$818.71
|
| Rate for Payer: Signature Care EPO |
$880.22
|
| Rate for Payer: Signature Care PPO |
$933.24
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$901.42
|
| Rate for Payer: United Healthcare Commercial |
$835.67
|
| Rate for Payer: United Healthcare Medicare |
$349.96
|
|
|
HC Z KWIRE .9X70
|
Facility
OP
|
$226.31
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606955
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$74.68 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$191.01
|
| Rate for Payer: Aetna Medicare |
$74.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$74.68
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$129.97
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$141.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$85.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$82.15
|
| Rate for Payer: Cash Price |
$140.31
|
| Rate for Payer: Cash Price |
$140.31
|
| Rate for Payer: Centivo All Commercial |
$115.42
|
| Rate for Payer: Cigna All Commercial |
$195.31
|
| Rate for Payer: CORVEL All Commercial |
$210.47
|
| Rate for Payer: Coventry All Commercial |
$199.15
|
| Rate for Payer: Encore All Commercial |
$208.32
|
| Rate for Payer: Frontpath All Commercial |
$208.21
|
| Rate for Payer: Humana ChoiceCare |
$195.46
|
| Rate for Payer: Humana Medicare |
$115.42
|
| Rate for Payer: Lucent All Commercial |
$115.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$203.68
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$169.73
|
| Rate for Payer: PHP All Commercial |
$171.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$88.26
|
| Rate for Payer: Sagamore Health Network All Products |
$174.71
|
| Rate for Payer: Signature Care EPO |
$187.84
|
| Rate for Payer: Signature Care PPO |
$199.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$192.36
|
| Rate for Payer: United Healthcare Commercial |
$178.33
|
| Rate for Payer: United Healthcare Medicare |
$74.68
|
|
|
HC Z KWIRE .9X70
|
Facility
IP
|
$226.31
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606955
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$169.73 |
| Max. Negotiated Rate |
$210.47 |
| Rate for Payer: Aetna Commercial |
$195.53
|
| Rate for Payer: Cash Price |
$140.31
|
| Rate for Payer: Cigna All Commercial |
$195.31
|
| Rate for Payer: CORVEL All Commercial |
$210.47
|
| Rate for Payer: Coventry All Commercial |
$199.15
|
| Rate for Payer: Encore All Commercial |
$208.32
|
| Rate for Payer: Frontpath All Commercial |
$208.21
|
| Rate for Payer: Humana ChoiceCare |
$195.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$203.68
|
| Rate for Payer: PHCS All Commercial |
$169.73
|
| Rate for Payer: PHP All Commercial |
$171.63
|
| Rate for Payer: Sagamore Health Network All Products |
$174.71
|
| Rate for Payer: Signature Care EPO |
$187.84
|
| Rate for Payer: Signature Care PPO |
$199.15
|
| Rate for Payer: United Healthcare Commercial |
$178.33
|
|
|
HC Z KWIRE ADAPTER ST
|
Facility
IP
|
$657.51
|
|
| Hospital Charge Code |
41606488
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$493.13 |
| Max. Negotiated Rate |
$611.48 |
| Rate for Payer: Aetna Commercial |
$568.09
|
| Rate for Payer: Cash Price |
$407.66
|
| Rate for Payer: Cigna All Commercial |
$567.43
|
| Rate for Payer: CORVEL All Commercial |
$611.48
|
| Rate for Payer: Coventry All Commercial |
$578.61
|
| Rate for Payer: Encore All Commercial |
$605.24
|
| Rate for Payer: Frontpath All Commercial |
$604.91
|
| Rate for Payer: Humana ChoiceCare |
$567.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$591.76
|
| Rate for Payer: PHCS All Commercial |
$493.13
|
| Rate for Payer: PHP All Commercial |
$498.66
|
| Rate for Payer: Sagamore Health Network All Products |
$507.60
|
| Rate for Payer: Signature Care EPO |
$545.73
|
| Rate for Payer: Signature Care PPO |
$578.61
|
| Rate for Payer: United Healthcare Commercial |
$518.12
|
|
|
HC Z KWIRE ADAPTER ST
|
Facility
OP
|
$657.51
|
|
| Hospital Charge Code |
41606488
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$611.48 |
| Rate for Payer: Aetna Commercial |
$554.94
|
| Rate for Payer: Aetna Medicare |
$216.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$216.98
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$377.61
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$411.01
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$249.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$238.68
|
| Rate for Payer: Cash Price |
$407.66
|
| Rate for Payer: Cash Price |
$407.66
|
| Rate for Payer: Centivo All Commercial |
$335.33
|
| Rate for Payer: Cigna All Commercial |
$567.43
|
| Rate for Payer: CORVEL All Commercial |
$611.48
|
| Rate for Payer: Coventry All Commercial |
$578.61
|
| Rate for Payer: Encore All Commercial |
$605.24
|
| Rate for Payer: Frontpath All Commercial |
$604.91
|
| Rate for Payer: Humana ChoiceCare |
$567.89
|
| Rate for Payer: Humana Medicare |
$335.33
|
| Rate for Payer: Lucent All Commercial |
$335.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$591.76
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$493.13
|
| Rate for Payer: PHP All Commercial |
$498.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$256.43
|
| Rate for Payer: Sagamore Health Network All Products |
$507.60
|
| Rate for Payer: Signature Care EPO |
$545.73
|
| Rate for Payer: Signature Care PPO |
$578.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$558.88
|
| Rate for Payer: United Healthcare Commercial |
$518.12
|
| Rate for Payer: United Healthcare Medicare |
$216.98
|
|
|
HC Z LAG SCREW 10.5X110
|
Facility
OP
|
$2,279.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606930
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,120.19 |
| Rate for Payer: Aetna Commercial |
$1,924.13
|
| Rate for Payer: Aetna Medicare |
$752.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$752.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,309.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,425.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$865.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$827.56
|
| Rate for Payer: Cash Price |
$1,413.46
|
| Rate for Payer: Cash Price |
$1,413.46
|
| Rate for Payer: Centivo All Commercial |
$1,162.68
|
| Rate for Payer: Cigna All Commercial |
$1,967.44
|
| Rate for Payer: CORVEL All Commercial |
$2,120.19
|
| Rate for Payer: Coventry All Commercial |
$2,006.20
|
| Rate for Payer: Encore All Commercial |
$2,098.53
|
| Rate for Payer: Frontpath All Commercial |
$2,097.39
|
| Rate for Payer: Humana ChoiceCare |
$1,969.04
|
| Rate for Payer: Humana Medicare |
$1,162.68
|
| Rate for Payer: Lucent All Commercial |
$1,162.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,051.79
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,709.83
|
| Rate for Payer: PHP All Commercial |
$1,728.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$889.11
|
| Rate for Payer: Sagamore Health Network All Products |
$1,759.98
|
| Rate for Payer: Signature Care EPO |
$1,892.21
|
| Rate for Payer: Signature Care PPO |
$2,006.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,937.80
|
| Rate for Payer: United Healthcare Commercial |
$1,796.46
|
| Rate for Payer: United Healthcare Medicare |
$752.32
|
|
|
HC Z LAG SCREW 10.5X110
|
Facility
IP
|
$2,279.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606930
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,709.83 |
| Max. Negotiated Rate |
$2,120.19 |
| Rate for Payer: Aetna Commercial |
$1,969.72
|
| Rate for Payer: Cash Price |
$1,413.46
|
| Rate for Payer: Cigna All Commercial |
$1,967.44
|
| Rate for Payer: CORVEL All Commercial |
$2,120.19
|
| Rate for Payer: Coventry All Commercial |
$2,006.20
|
| Rate for Payer: Encore All Commercial |
$2,098.53
|
| Rate for Payer: Frontpath All Commercial |
$2,097.39
|
| Rate for Payer: Humana ChoiceCare |
$1,969.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,051.79
|
| Rate for Payer: PHCS All Commercial |
$1,709.83
|
| Rate for Payer: PHP All Commercial |
$1,728.98
|
| Rate for Payer: Sagamore Health Network All Products |
$1,759.98
|
| Rate for Payer: Signature Care EPO |
$1,892.21
|
| Rate for Payer: Signature Care PPO |
$2,006.20
|
| Rate for Payer: United Healthcare Commercial |
$1,796.46
|
|
|
HC Z LAG SCREW 10.5X115
|
Facility
OP
|
$2,279.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606513
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,120.19 |
| Rate for Payer: Aetna Commercial |
$1,924.13
|
| Rate for Payer: Aetna Medicare |
$752.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$752.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,309.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,425.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$865.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$827.56
|
| Rate for Payer: Cash Price |
$1,413.46
|
| Rate for Payer: Cash Price |
$1,413.46
|
| Rate for Payer: Centivo All Commercial |
$1,162.68
|
| Rate for Payer: Cigna All Commercial |
$1,967.44
|
| Rate for Payer: CORVEL All Commercial |
$2,120.19
|
| Rate for Payer: Coventry All Commercial |
$2,006.20
|
| Rate for Payer: Encore All Commercial |
$2,098.53
|
| Rate for Payer: Frontpath All Commercial |
$2,097.39
|
| Rate for Payer: Humana ChoiceCare |
$1,969.04
|
| Rate for Payer: Humana Medicare |
$1,162.68
|
| Rate for Payer: Lucent All Commercial |
$1,162.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,051.79
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,709.83
|
| Rate for Payer: PHP All Commercial |
$1,728.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$889.11
|
| Rate for Payer: Sagamore Health Network All Products |
$1,759.98
|
| Rate for Payer: Signature Care EPO |
$1,892.21
|
| Rate for Payer: Signature Care PPO |
$2,006.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,937.80
|
| Rate for Payer: United Healthcare Commercial |
$1,796.46
|
| Rate for Payer: United Healthcare Medicare |
$752.32
|
|
|
HC Z LAG SCREW 10.5X115
|
Facility
IP
|
$2,279.77
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606513
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,709.83 |
| Max. Negotiated Rate |
$2,120.19 |
| Rate for Payer: Aetna Commercial |
$1,969.72
|
| Rate for Payer: Cash Price |
$1,413.46
|
| Rate for Payer: Cigna All Commercial |
$1,967.44
|
| Rate for Payer: CORVEL All Commercial |
$2,120.19
|
| Rate for Payer: Coventry All Commercial |
$2,006.20
|
| Rate for Payer: Encore All Commercial |
$2,098.53
|
| Rate for Payer: Frontpath All Commercial |
$2,097.39
|
| Rate for Payer: Humana ChoiceCare |
$1,969.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,051.79
|
| Rate for Payer: PHCS All Commercial |
$1,709.83
|
| Rate for Payer: PHP All Commercial |
$1,728.98
|
| Rate for Payer: Sagamore Health Network All Products |
$1,759.98
|
| Rate for Payer: Signature Care EPO |
$1,892.21
|
| Rate for Payer: Signature Care PPO |
$2,006.20
|
| Rate for Payer: United Healthcare Commercial |
$1,796.46
|
|
|
HC Z LAG SCREW 4.0X36 CANN
|
Facility
OP
|
$1,000.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606356
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$330.00 |
| Max. Negotiated Rate |
$930.00 |
| Rate for Payer: Aetna Commercial |
$844.00
|
| Rate for Payer: Aetna Medicare |
$330.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$330.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$574.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$625.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$379.50
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$363.00
|
| Rate for Payer: Cash Price |
$620.00
|
| Rate for Payer: Cash Price |
$620.00
|
| Rate for Payer: Centivo All Commercial |
$510.00
|
| Rate for Payer: Cigna All Commercial |
$863.00
|
| Rate for Payer: CORVEL All Commercial |
$930.00
|
| Rate for Payer: Coventry All Commercial |
$880.00
|
| Rate for Payer: Encore All Commercial |
$920.50
|
| Rate for Payer: Frontpath All Commercial |
$920.00
|
| Rate for Payer: Humana ChoiceCare |
$863.70
|
| Rate for Payer: Humana Medicare |
$510.00
|
| Rate for Payer: Lucent All Commercial |
$510.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$900.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$750.00
|
| Rate for Payer: PHP All Commercial |
$758.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$390.00
|
| Rate for Payer: Sagamore Health Network All Products |
$772.00
|
| Rate for Payer: Signature Care EPO |
$830.00
|
| Rate for Payer: Signature Care PPO |
$880.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$850.00
|
| Rate for Payer: United Healthcare Commercial |
$788.00
|
| Rate for Payer: United Healthcare Medicare |
$330.00
|
|
|
HC Z LAG SCREW 4.0X36 CANN
|
Facility
IP
|
$1,000.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606356
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$750.00 |
| Max. Negotiated Rate |
$930.00 |
| Rate for Payer: Aetna Commercial |
$864.00
|
| Rate for Payer: Cash Price |
$620.00
|
| Rate for Payer: Cigna All Commercial |
$863.00
|
| Rate for Payer: CORVEL All Commercial |
$930.00
|
| Rate for Payer: Coventry All Commercial |
$880.00
|
| Rate for Payer: Encore All Commercial |
$920.50
|
| Rate for Payer: Frontpath All Commercial |
$920.00
|
| Rate for Payer: Humana ChoiceCare |
$863.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$900.00
|
| Rate for Payer: PHCS All Commercial |
$750.00
|
| Rate for Payer: PHP All Commercial |
$758.40
|
| Rate for Payer: Sagamore Health Network All Products |
$772.00
|
| Rate for Payer: Signature Care EPO |
$830.00
|
| Rate for Payer: Signature Care PPO |
$880.00
|
| Rate for Payer: United Healthcare Commercial |
$788.00
|
|
