|
HC Z NAIL 11X180 HFN 130 DEG
|
Facility
IP
|
$5,719.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606521
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,289.57 |
| Max. Negotiated Rate |
$5,319.07 |
| Rate for Payer: Aetna Commercial |
$4,941.59
|
| Rate for Payer: Cash Price |
$3,546.05
|
| Rate for Payer: Cigna All Commercial |
$4,935.87
|
| Rate for Payer: CORVEL All Commercial |
$5,319.07
|
| Rate for Payer: Coventry All Commercial |
$5,033.10
|
| Rate for Payer: Encore All Commercial |
$5,264.74
|
| Rate for Payer: Frontpath All Commercial |
$5,261.88
|
| Rate for Payer: Humana ChoiceCare |
$4,939.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,147.49
|
| Rate for Payer: PHCS All Commercial |
$4,289.57
|
| Rate for Payer: PHP All Commercial |
$4,337.62
|
| Rate for Payer: Sagamore Health Network All Products |
$4,415.40
|
| Rate for Payer: Signature Care EPO |
$4,747.13
|
| Rate for Payer: Signature Care PPO |
$5,033.10
|
| Rate for Payer: United Healthcare Commercial |
$4,506.91
|
|
|
HC Z NAIL 11X180 HFN 130 DEG
|
Facility
IP
|
$5,719.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606244
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,289.57 |
| Max. Negotiated Rate |
$5,319.07 |
| Rate for Payer: Aetna Commercial |
$4,941.59
|
| Rate for Payer: Cash Price |
$3,546.05
|
| Rate for Payer: Cigna All Commercial |
$4,935.87
|
| Rate for Payer: CORVEL All Commercial |
$5,319.07
|
| Rate for Payer: Coventry All Commercial |
$5,033.10
|
| Rate for Payer: Encore All Commercial |
$5,264.74
|
| Rate for Payer: Frontpath All Commercial |
$5,261.88
|
| Rate for Payer: Humana ChoiceCare |
$4,939.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,147.49
|
| Rate for Payer: PHCS All Commercial |
$4,289.57
|
| Rate for Payer: PHP All Commercial |
$4,337.62
|
| Rate for Payer: Sagamore Health Network All Products |
$4,415.40
|
| Rate for Payer: Signature Care EPO |
$4,747.13
|
| Rate for Payer: Signature Care PPO |
$5,033.10
|
| Rate for Payer: United Healthcare Commercial |
$4,506.91
|
|
|
HC Z NAIL 11X180 HFN 130 DEG
|
Facility
OP
|
$5,719.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606244
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,319.07 |
| Rate for Payer: Aetna Commercial |
$4,827.20
|
| Rate for Payer: Aetna Medicare |
$1,887.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,887.41
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,284.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,575.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,170.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,076.15
|
| Rate for Payer: Cash Price |
$3,546.05
|
| Rate for Payer: Cash Price |
$3,546.05
|
| Rate for Payer: Centivo All Commercial |
$2,916.91
|
| Rate for Payer: Cigna All Commercial |
$4,935.87
|
| Rate for Payer: CORVEL All Commercial |
$5,319.07
|
| Rate for Payer: Coventry All Commercial |
$5,033.10
|
| Rate for Payer: Encore All Commercial |
$5,264.74
|
| Rate for Payer: Frontpath All Commercial |
$5,261.88
|
| Rate for Payer: Humana ChoiceCare |
$4,939.87
|
| Rate for Payer: Humana Medicare |
$2,916.91
|
| Rate for Payer: Lucent All Commercial |
$2,916.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,147.49
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,289.57
|
| Rate for Payer: PHP All Commercial |
$4,337.62
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,230.58
|
| Rate for Payer: Sagamore Health Network All Products |
$4,415.40
|
| Rate for Payer: Signature Care EPO |
$4,747.13
|
| Rate for Payer: Signature Care PPO |
$5,033.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,861.52
|
| Rate for Payer: United Healthcare Commercial |
$4,506.91
|
| Rate for Payer: United Healthcare Medicare |
$1,887.41
|
|
|
HC Z NAIL 11X320 HFN 130 DEG
|
Facility
IP
|
$8,097.37
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606651
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,073.03 |
| Max. Negotiated Rate |
$7,530.55 |
| Rate for Payer: Aetna Commercial |
$6,996.13
|
| Rate for Payer: Cash Price |
$5,020.37
|
| Rate for Payer: Cigna All Commercial |
$6,988.03
|
| Rate for Payer: CORVEL All Commercial |
$7,530.55
|
| Rate for Payer: Coventry All Commercial |
$7,125.69
|
| Rate for Payer: Encore All Commercial |
$7,453.63
|
| Rate for Payer: Frontpath All Commercial |
$7,449.58
|
| Rate for Payer: Humana ChoiceCare |
$6,993.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,287.63
|
| Rate for Payer: PHCS All Commercial |
$6,073.03
|
| Rate for Payer: PHP All Commercial |
$6,141.05
|
| Rate for Payer: Sagamore Health Network All Products |
$6,251.17
|
| Rate for Payer: Signature Care EPO |
$6,720.82
|
| Rate for Payer: Signature Care PPO |
$7,125.69
|
| Rate for Payer: United Healthcare Commercial |
$6,380.73
|
|
|
HC Z NAIL 11X320 HFN 130 DEG
|
Facility
OP
|
$8,097.37
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606651
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,530.55 |
| Rate for Payer: Aetna Commercial |
$6,834.18
|
| Rate for Payer: Aetna Medicare |
$2,672.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,672.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,650.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,061.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,072.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,939.35
|
| Rate for Payer: Cash Price |
$5,020.37
|
| Rate for Payer: Cash Price |
$5,020.37
|
| Rate for Payer: Centivo All Commercial |
$4,129.66
|
| Rate for Payer: Cigna All Commercial |
$6,988.03
|
| Rate for Payer: CORVEL All Commercial |
$7,530.55
|
| Rate for Payer: Coventry All Commercial |
$7,125.69
|
| Rate for Payer: Encore All Commercial |
$7,453.63
|
| Rate for Payer: Frontpath All Commercial |
$7,449.58
|
| Rate for Payer: Humana ChoiceCare |
$6,993.70
|
| Rate for Payer: Humana Medicare |
$4,129.66
|
| Rate for Payer: Lucent All Commercial |
$4,129.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,287.63
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,073.03
|
| Rate for Payer: PHP All Commercial |
$6,141.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,157.97
|
| Rate for Payer: Sagamore Health Network All Products |
$6,251.17
|
| Rate for Payer: Signature Care EPO |
$6,720.82
|
| Rate for Payer: Signature Care PPO |
$7,125.69
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,882.76
|
| Rate for Payer: United Healthcare Commercial |
$6,380.73
|
| Rate for Payer: United Healthcare Medicare |
$2,672.13
|
|
|
HC Z NAIL 11X340 HFN 130 DEG
|
Facility
OP
|
$8,097.37
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607778
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,530.55 |
| Rate for Payer: Aetna Commercial |
$6,834.18
|
| Rate for Payer: Aetna Medicare |
$2,672.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,672.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,650.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,061.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,072.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,939.35
|
| Rate for Payer: Cash Price |
$5,020.37
|
| Rate for Payer: Cash Price |
$5,020.37
|
| Rate for Payer: Centivo All Commercial |
$4,129.66
|
| Rate for Payer: Cigna All Commercial |
$6,988.03
|
| Rate for Payer: CORVEL All Commercial |
$7,530.55
|
| Rate for Payer: Coventry All Commercial |
$7,125.69
|
| Rate for Payer: Encore All Commercial |
$7,453.63
|
| Rate for Payer: Frontpath All Commercial |
$7,449.58
|
| Rate for Payer: Humana ChoiceCare |
$6,993.70
|
| Rate for Payer: Humana Medicare |
$4,129.66
|
| Rate for Payer: Lucent All Commercial |
$4,129.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,287.63
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,073.03
|
| Rate for Payer: PHP All Commercial |
$6,141.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,157.97
|
| Rate for Payer: Sagamore Health Network All Products |
$6,251.17
|
| Rate for Payer: Signature Care EPO |
$6,720.82
|
| Rate for Payer: Signature Care PPO |
$7,125.69
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,882.76
|
| Rate for Payer: United Healthcare Commercial |
$6,380.73
|
| Rate for Payer: United Healthcare Medicare |
$2,672.13
|
|
|
HC Z NAIL 11X340 HFN 130 DEG
|
Facility
IP
|
$8,097.37
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607778
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,073.03 |
| Max. Negotiated Rate |
$7,530.55 |
| Rate for Payer: Aetna Commercial |
$6,996.13
|
| Rate for Payer: Cash Price |
$5,020.37
|
| Rate for Payer: Cigna All Commercial |
$6,988.03
|
| Rate for Payer: CORVEL All Commercial |
$7,530.55
|
| Rate for Payer: Coventry All Commercial |
$7,125.69
|
| Rate for Payer: Encore All Commercial |
$7,453.63
|
| Rate for Payer: Frontpath All Commercial |
$7,449.58
|
| Rate for Payer: Humana ChoiceCare |
$6,993.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,287.63
|
| Rate for Payer: PHCS All Commercial |
$6,073.03
|
| Rate for Payer: PHP All Commercial |
$6,141.05
|
| Rate for Payer: Sagamore Health Network All Products |
$6,251.17
|
| Rate for Payer: Signature Care EPO |
$6,720.82
|
| Rate for Payer: Signature Care PPO |
$7,125.69
|
| Rate for Payer: United Healthcare Commercial |
$6,380.73
|
|
|
HC Z NAIL 11X360 HFN 130 DEG
|
Facility
IP
|
$8,097.37
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607732
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,073.03 |
| Max. Negotiated Rate |
$7,530.55 |
| Rate for Payer: Aetna Commercial |
$6,996.13
|
| Rate for Payer: Cash Price |
$5,020.37
|
| Rate for Payer: Cigna All Commercial |
$6,988.03
|
| Rate for Payer: CORVEL All Commercial |
$7,530.55
|
| Rate for Payer: Coventry All Commercial |
$7,125.69
|
| Rate for Payer: Encore All Commercial |
$7,453.63
|
| Rate for Payer: Frontpath All Commercial |
$7,449.58
|
| Rate for Payer: Humana ChoiceCare |
$6,993.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,287.63
|
| Rate for Payer: PHCS All Commercial |
$6,073.03
|
| Rate for Payer: PHP All Commercial |
$6,141.05
|
| Rate for Payer: Sagamore Health Network All Products |
$6,251.17
|
| Rate for Payer: Signature Care EPO |
$6,720.82
|
| Rate for Payer: Signature Care PPO |
$7,125.69
|
| Rate for Payer: United Healthcare Commercial |
$6,380.73
|
|
|
HC Z NAIL 11X360 HFN 130 DEG
|
Facility
OP
|
$8,097.37
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607732
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,530.55 |
| Rate for Payer: Aetna Commercial |
$6,834.18
|
| Rate for Payer: Aetna Medicare |
$2,672.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,672.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,650.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,061.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,072.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,939.35
|
| Rate for Payer: Cash Price |
$5,020.37
|
| Rate for Payer: Cash Price |
$5,020.37
|
| Rate for Payer: Centivo All Commercial |
$4,129.66
|
| Rate for Payer: Cigna All Commercial |
$6,988.03
|
| Rate for Payer: CORVEL All Commercial |
$7,530.55
|
| Rate for Payer: Coventry All Commercial |
$7,125.69
|
| Rate for Payer: Encore All Commercial |
$7,453.63
|
| Rate for Payer: Frontpath All Commercial |
$7,449.58
|
| Rate for Payer: Humana ChoiceCare |
$6,993.70
|
| Rate for Payer: Humana Medicare |
$4,129.66
|
| Rate for Payer: Lucent All Commercial |
$4,129.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,287.63
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,073.03
|
| Rate for Payer: PHP All Commercial |
$6,141.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,157.97
|
| Rate for Payer: Sagamore Health Network All Products |
$6,251.17
|
| Rate for Payer: Signature Care EPO |
$6,720.82
|
| Rate for Payer: Signature Care PPO |
$7,125.69
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,882.76
|
| Rate for Payer: United Healthcare Commercial |
$6,380.73
|
| Rate for Payer: United Healthcare Medicare |
$2,672.13
|
|
|
HC Z NAIL 11X360 HFN 130 DEG R
|
Facility
IP
|
$8,097.37
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607766
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,073.03 |
| Max. Negotiated Rate |
$7,530.55 |
| Rate for Payer: Aetna Commercial |
$6,996.13
|
| Rate for Payer: Cash Price |
$5,020.37
|
| Rate for Payer: Cigna All Commercial |
$6,988.03
|
| Rate for Payer: CORVEL All Commercial |
$7,530.55
|
| Rate for Payer: Coventry All Commercial |
$7,125.69
|
| Rate for Payer: Encore All Commercial |
$7,453.63
|
| Rate for Payer: Frontpath All Commercial |
$7,449.58
|
| Rate for Payer: Humana ChoiceCare |
$6,993.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,287.63
|
| Rate for Payer: PHCS All Commercial |
$6,073.03
|
| Rate for Payer: PHP All Commercial |
$6,141.05
|
| Rate for Payer: Sagamore Health Network All Products |
$6,251.17
|
| Rate for Payer: Signature Care EPO |
$6,720.82
|
| Rate for Payer: Signature Care PPO |
$7,125.69
|
| Rate for Payer: United Healthcare Commercial |
$6,380.73
|
|
|
HC Z NAIL 11X360 HFN 130 DEG R
|
Facility
OP
|
$8,097.37
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607766
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,530.55 |
| Rate for Payer: Aetna Commercial |
$6,834.18
|
| Rate for Payer: Aetna Medicare |
$2,672.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,672.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,650.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,061.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,072.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,939.35
|
| Rate for Payer: Cash Price |
$5,020.37
|
| Rate for Payer: Cash Price |
$5,020.37
|
| Rate for Payer: Centivo All Commercial |
$4,129.66
|
| Rate for Payer: Cigna All Commercial |
$6,988.03
|
| Rate for Payer: CORVEL All Commercial |
$7,530.55
|
| Rate for Payer: Coventry All Commercial |
$7,125.69
|
| Rate for Payer: Encore All Commercial |
$7,453.63
|
| Rate for Payer: Frontpath All Commercial |
$7,449.58
|
| Rate for Payer: Humana ChoiceCare |
$6,993.70
|
| Rate for Payer: Humana Medicare |
$4,129.66
|
| Rate for Payer: Lucent All Commercial |
$4,129.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,287.63
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,073.03
|
| Rate for Payer: PHP All Commercial |
$6,141.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,157.97
|
| Rate for Payer: Sagamore Health Network All Products |
$6,251.17
|
| Rate for Payer: Signature Care EPO |
$6,720.82
|
| Rate for Payer: Signature Care PPO |
$7,125.69
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,882.76
|
| Rate for Payer: United Healthcare Commercial |
$6,380.73
|
| Rate for Payer: United Healthcare Medicare |
$2,672.13
|
|
|
HC Z NAIL 11X380 HFN 130 DEG L
|
Facility
OP
|
$8,097.37
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608251
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,530.55 |
| Rate for Payer: Aetna Commercial |
$6,834.18
|
| Rate for Payer: Aetna Medicare |
$2,672.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,672.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,650.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,061.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,072.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,939.35
|
| Rate for Payer: Cash Price |
$5,020.37
|
| Rate for Payer: Cash Price |
$5,020.37
|
| Rate for Payer: Centivo All Commercial |
$4,129.66
|
| Rate for Payer: Cigna All Commercial |
$6,988.03
|
| Rate for Payer: CORVEL All Commercial |
$7,530.55
|
| Rate for Payer: Coventry All Commercial |
$7,125.69
|
| Rate for Payer: Encore All Commercial |
$7,453.63
|
| Rate for Payer: Frontpath All Commercial |
$7,449.58
|
| Rate for Payer: Humana ChoiceCare |
$6,993.70
|
| Rate for Payer: Humana Medicare |
$4,129.66
|
| Rate for Payer: Lucent All Commercial |
$4,129.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,287.63
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,073.03
|
| Rate for Payer: PHP All Commercial |
$6,141.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,157.97
|
| Rate for Payer: Sagamore Health Network All Products |
$6,251.17
|
| Rate for Payer: Signature Care EPO |
$6,720.82
|
| Rate for Payer: Signature Care PPO |
$7,125.69
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,882.76
|
| Rate for Payer: United Healthcare Commercial |
$6,380.73
|
| Rate for Payer: United Healthcare Medicare |
$2,672.13
|
|
|
HC Z NAIL 11X380 HFN 130 DEG L
|
Facility
IP
|
$8,097.37
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41608251
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,073.03 |
| Max. Negotiated Rate |
$7,530.55 |
| Rate for Payer: Aetna Commercial |
$6,996.13
|
| Rate for Payer: Cash Price |
$5,020.37
|
| Rate for Payer: Cigna All Commercial |
$6,988.03
|
| Rate for Payer: CORVEL All Commercial |
$7,530.55
|
| Rate for Payer: Coventry All Commercial |
$7,125.69
|
| Rate for Payer: Encore All Commercial |
$7,453.63
|
| Rate for Payer: Frontpath All Commercial |
$7,449.58
|
| Rate for Payer: Humana ChoiceCare |
$6,993.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,287.63
|
| Rate for Payer: PHCS All Commercial |
$6,073.03
|
| Rate for Payer: PHP All Commercial |
$6,141.05
|
| Rate for Payer: Sagamore Health Network All Products |
$6,251.17
|
| Rate for Payer: Signature Care EPO |
$6,720.82
|
| Rate for Payer: Signature Care PPO |
$7,125.69
|
| Rate for Payer: United Healthcare Commercial |
$6,380.73
|
|
|
HC Z NAIL 11X400 HFN 130 DEG
|
Facility
IP
|
$8,097.37
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606908
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,073.03 |
| Max. Negotiated Rate |
$7,530.55 |
| Rate for Payer: Aetna Commercial |
$6,996.13
|
| Rate for Payer: Cash Price |
$5,020.37
|
| Rate for Payer: Cigna All Commercial |
$6,988.03
|
| Rate for Payer: CORVEL All Commercial |
$7,530.55
|
| Rate for Payer: Coventry All Commercial |
$7,125.69
|
| Rate for Payer: Encore All Commercial |
$7,453.63
|
| Rate for Payer: Frontpath All Commercial |
$7,449.58
|
| Rate for Payer: Humana ChoiceCare |
$6,993.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,287.63
|
| Rate for Payer: PHCS All Commercial |
$6,073.03
|
| Rate for Payer: PHP All Commercial |
$6,141.05
|
| Rate for Payer: Sagamore Health Network All Products |
$6,251.17
|
| Rate for Payer: Signature Care EPO |
$6,720.82
|
| Rate for Payer: Signature Care PPO |
$7,125.69
|
| Rate for Payer: United Healthcare Commercial |
$6,380.73
|
|
|
HC Z NAIL 11X400 HFN 130 DEG
|
Facility
OP
|
$8,097.37
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606908
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,530.55 |
| Rate for Payer: Aetna Commercial |
$6,834.18
|
| Rate for Payer: Aetna Medicare |
$2,672.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,672.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,650.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,061.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,072.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,939.35
|
| Rate for Payer: Cash Price |
$5,020.37
|
| Rate for Payer: Cash Price |
$5,020.37
|
| Rate for Payer: Centivo All Commercial |
$4,129.66
|
| Rate for Payer: Cigna All Commercial |
$6,988.03
|
| Rate for Payer: CORVEL All Commercial |
$7,530.55
|
| Rate for Payer: Coventry All Commercial |
$7,125.69
|
| Rate for Payer: Encore All Commercial |
$7,453.63
|
| Rate for Payer: Frontpath All Commercial |
$7,449.58
|
| Rate for Payer: Humana ChoiceCare |
$6,993.70
|
| Rate for Payer: Humana Medicare |
$4,129.66
|
| Rate for Payer: Lucent All Commercial |
$4,129.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,287.63
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,073.03
|
| Rate for Payer: PHP All Commercial |
$6,141.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,157.97
|
| Rate for Payer: Sagamore Health Network All Products |
$6,251.17
|
| Rate for Payer: Signature Care EPO |
$6,720.82
|
| Rate for Payer: Signature Care PPO |
$7,125.69
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,882.76
|
| Rate for Payer: United Healthcare Commercial |
$6,380.73
|
| Rate for Payer: United Healthcare Medicare |
$2,672.13
|
|
|
HC Z NAIL 4.0X25 CORT SCREW FA
|
Facility
IP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603895
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$699.11 |
| Max. Negotiated Rate |
$866.90 |
| Rate for Payer: Aetna Commercial |
$805.38
|
| Rate for Payer: Cash Price |
$577.93
|
| Rate for Payer: Cigna All Commercial |
$804.45
|
| Rate for Payer: CORVEL All Commercial |
$866.90
|
| Rate for Payer: Coventry All Commercial |
$820.29
|
| Rate for Payer: Encore All Commercial |
$858.04
|
| Rate for Payer: Frontpath All Commercial |
$857.58
|
| Rate for Payer: Humana ChoiceCare |
$805.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$838.94
|
| Rate for Payer: PHCS All Commercial |
$699.11
|
| Rate for Payer: PHP All Commercial |
$706.94
|
| Rate for Payer: Sagamore Health Network All Products |
$719.62
|
| Rate for Payer: Signature Care EPO |
$773.68
|
| Rate for Payer: Signature Care PPO |
$820.29
|
| Rate for Payer: United Healthcare Commercial |
$734.53
|
|
|
HC Z NAIL 4.0X25 CORT SCREW FA
|
Facility
OP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603895
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$307.61 |
| Max. Negotiated Rate |
$866.90 |
| Rate for Payer: Aetna Commercial |
$786.73
|
| Rate for Payer: Aetna Medicare |
$307.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$307.61
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$535.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$582.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$353.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$338.37
|
| Rate for Payer: Cash Price |
$577.93
|
| Rate for Payer: Cash Price |
$577.93
|
| Rate for Payer: Centivo All Commercial |
$475.40
|
| Rate for Payer: Cigna All Commercial |
$804.45
|
| Rate for Payer: CORVEL All Commercial |
$866.90
|
| Rate for Payer: Coventry All Commercial |
$820.29
|
| Rate for Payer: Encore All Commercial |
$858.04
|
| Rate for Payer: Frontpath All Commercial |
$857.58
|
| Rate for Payer: Humana ChoiceCare |
$805.10
|
| Rate for Payer: Humana Medicare |
$475.40
|
| Rate for Payer: Lucent All Commercial |
$475.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$838.94
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$699.11
|
| Rate for Payer: PHP All Commercial |
$706.94
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$363.54
|
| Rate for Payer: Sagamore Health Network All Products |
$719.62
|
| Rate for Payer: Signature Care EPO |
$773.68
|
| Rate for Payer: Signature Care PPO |
$820.29
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$792.33
|
| Rate for Payer: United Healthcare Commercial |
$734.53
|
| Rate for Payer: United Healthcare Medicare |
$307.61
|
|
|
HC Z NAIL 5.0X100 CORT SCREW FA
|
Facility
IP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603041
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$699.11 |
| Max. Negotiated Rate |
$866.90 |
| Rate for Payer: Aetna Commercial |
$805.38
|
| Rate for Payer: Cash Price |
$577.93
|
| Rate for Payer: Cigna All Commercial |
$804.45
|
| Rate for Payer: CORVEL All Commercial |
$866.90
|
| Rate for Payer: Coventry All Commercial |
$820.29
|
| Rate for Payer: Encore All Commercial |
$858.04
|
| Rate for Payer: Frontpath All Commercial |
$857.58
|
| Rate for Payer: Humana ChoiceCare |
$805.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$838.94
|
| Rate for Payer: PHCS All Commercial |
$699.11
|
| Rate for Payer: PHP All Commercial |
$706.94
|
| Rate for Payer: Sagamore Health Network All Products |
$719.62
|
| Rate for Payer: Signature Care EPO |
$773.68
|
| Rate for Payer: Signature Care PPO |
$820.29
|
| Rate for Payer: United Healthcare Commercial |
$734.53
|
|
|
HC Z NAIL 5.0X100 CORT SCREW FA
|
Facility
OP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603041
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$307.61 |
| Max. Negotiated Rate |
$866.90 |
| Rate for Payer: Aetna Commercial |
$786.73
|
| Rate for Payer: Aetna Medicare |
$307.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$307.61
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$535.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$582.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$353.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$338.37
|
| Rate for Payer: Cash Price |
$577.93
|
| Rate for Payer: Cash Price |
$577.93
|
| Rate for Payer: Centivo All Commercial |
$475.40
|
| Rate for Payer: Cigna All Commercial |
$804.45
|
| Rate for Payer: CORVEL All Commercial |
$866.90
|
| Rate for Payer: Coventry All Commercial |
$820.29
|
| Rate for Payer: Encore All Commercial |
$858.04
|
| Rate for Payer: Frontpath All Commercial |
$857.58
|
| Rate for Payer: Humana ChoiceCare |
$805.10
|
| Rate for Payer: Humana Medicare |
$475.40
|
| Rate for Payer: Lucent All Commercial |
$475.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$838.94
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$699.11
|
| Rate for Payer: PHP All Commercial |
$706.94
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$363.54
|
| Rate for Payer: Sagamore Health Network All Products |
$719.62
|
| Rate for Payer: Signature Care EPO |
$773.68
|
| Rate for Payer: Signature Care PPO |
$820.29
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$792.33
|
| Rate for Payer: United Healthcare Commercial |
$734.53
|
| Rate for Payer: United Healthcare Medicare |
$307.61
|
|
|
HC Z NAIL 5.0X20 CORT SCREW FA
|
Facility
IP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$699.11 |
| Max. Negotiated Rate |
$866.90 |
| Rate for Payer: Aetna Commercial |
$805.38
|
| Rate for Payer: Cash Price |
$577.93
|
| Rate for Payer: Cigna All Commercial |
$804.45
|
| Rate for Payer: CORVEL All Commercial |
$866.90
|
| Rate for Payer: Coventry All Commercial |
$820.29
|
| Rate for Payer: Encore All Commercial |
$858.04
|
| Rate for Payer: Frontpath All Commercial |
$857.58
|
| Rate for Payer: Humana ChoiceCare |
$805.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$838.94
|
| Rate for Payer: PHCS All Commercial |
$699.11
|
| Rate for Payer: PHP All Commercial |
$706.94
|
| Rate for Payer: Sagamore Health Network All Products |
$719.62
|
| Rate for Payer: Signature Care EPO |
$773.68
|
| Rate for Payer: Signature Care PPO |
$820.29
|
| Rate for Payer: United Healthcare Commercial |
$734.53
|
|
|
HC Z NAIL 5.0X20 CORT SCREW FA
|
Facility
OP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$307.61 |
| Max. Negotiated Rate |
$866.90 |
| Rate for Payer: Aetna Commercial |
$786.73
|
| Rate for Payer: Aetna Medicare |
$307.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$307.61
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$535.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$582.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$353.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$338.37
|
| Rate for Payer: Cash Price |
$577.93
|
| Rate for Payer: Cash Price |
$577.93
|
| Rate for Payer: Centivo All Commercial |
$475.40
|
| Rate for Payer: Cigna All Commercial |
$804.45
|
| Rate for Payer: CORVEL All Commercial |
$866.90
|
| Rate for Payer: Coventry All Commercial |
$820.29
|
| Rate for Payer: Encore All Commercial |
$858.04
|
| Rate for Payer: Frontpath All Commercial |
$857.58
|
| Rate for Payer: Humana ChoiceCare |
$805.10
|
| Rate for Payer: Humana Medicare |
$475.40
|
| Rate for Payer: Lucent All Commercial |
$475.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$838.94
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$699.11
|
| Rate for Payer: PHP All Commercial |
$706.94
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$363.54
|
| Rate for Payer: Sagamore Health Network All Products |
$719.62
|
| Rate for Payer: Signature Care EPO |
$773.68
|
| Rate for Payer: Signature Care PPO |
$820.29
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$792.33
|
| Rate for Payer: United Healthcare Commercial |
$734.53
|
| Rate for Payer: United Healthcare Medicare |
$307.61
|
|
|
HC Z NAIL 5.0X22.5 CORT SCREW FA
|
Facility
IP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603019
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$699.11 |
| Max. Negotiated Rate |
$866.90 |
| Rate for Payer: Aetna Commercial |
$805.38
|
| Rate for Payer: Cash Price |
$577.93
|
| Rate for Payer: Cigna All Commercial |
$804.45
|
| Rate for Payer: CORVEL All Commercial |
$866.90
|
| Rate for Payer: Coventry All Commercial |
$820.29
|
| Rate for Payer: Encore All Commercial |
$858.04
|
| Rate for Payer: Frontpath All Commercial |
$857.58
|
| Rate for Payer: Humana ChoiceCare |
$805.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$838.94
|
| Rate for Payer: PHCS All Commercial |
$699.11
|
| Rate for Payer: PHP All Commercial |
$706.94
|
| Rate for Payer: Sagamore Health Network All Products |
$719.62
|
| Rate for Payer: Signature Care EPO |
$773.68
|
| Rate for Payer: Signature Care PPO |
$820.29
|
| Rate for Payer: United Healthcare Commercial |
$734.53
|
|
|
HC Z NAIL 5.0X22.5 CORT SCREW FA
|
Facility
OP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603019
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$307.61 |
| Max. Negotiated Rate |
$866.90 |
| Rate for Payer: Aetna Commercial |
$786.73
|
| Rate for Payer: Aetna Medicare |
$307.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$307.61
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$535.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$582.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$353.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$338.37
|
| Rate for Payer: Cash Price |
$577.93
|
| Rate for Payer: Cash Price |
$577.93
|
| Rate for Payer: Centivo All Commercial |
$475.40
|
| Rate for Payer: Cigna All Commercial |
$804.45
|
| Rate for Payer: CORVEL All Commercial |
$866.90
|
| Rate for Payer: Coventry All Commercial |
$820.29
|
| Rate for Payer: Encore All Commercial |
$858.04
|
| Rate for Payer: Frontpath All Commercial |
$857.58
|
| Rate for Payer: Humana ChoiceCare |
$805.10
|
| Rate for Payer: Humana Medicare |
$475.40
|
| Rate for Payer: Lucent All Commercial |
$475.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$838.94
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$699.11
|
| Rate for Payer: PHP All Commercial |
$706.94
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$363.54
|
| Rate for Payer: Sagamore Health Network All Products |
$719.62
|
| Rate for Payer: Signature Care EPO |
$773.68
|
| Rate for Payer: Signature Care PPO |
$820.29
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$792.33
|
| Rate for Payer: United Healthcare Commercial |
$734.53
|
| Rate for Payer: United Healthcare Medicare |
$307.61
|
|
|
HC Z NAIL 5.0X25 CORT SCREW FA
|
Facility
IP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603020
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$699.11 |
| Max. Negotiated Rate |
$866.90 |
| Rate for Payer: Aetna Commercial |
$805.38
|
| Rate for Payer: Cash Price |
$577.93
|
| Rate for Payer: Cigna All Commercial |
$804.45
|
| Rate for Payer: CORVEL All Commercial |
$866.90
|
| Rate for Payer: Coventry All Commercial |
$820.29
|
| Rate for Payer: Encore All Commercial |
$858.04
|
| Rate for Payer: Frontpath All Commercial |
$857.58
|
| Rate for Payer: Humana ChoiceCare |
$805.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$838.94
|
| Rate for Payer: PHCS All Commercial |
$699.11
|
| Rate for Payer: PHP All Commercial |
$706.94
|
| Rate for Payer: Sagamore Health Network All Products |
$719.62
|
| Rate for Payer: Signature Care EPO |
$773.68
|
| Rate for Payer: Signature Care PPO |
$820.29
|
| Rate for Payer: United Healthcare Commercial |
$734.53
|
|
|
HC Z NAIL 5.0X25 CORT SCREW FA
|
Facility
OP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603020
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$307.61 |
| Max. Negotiated Rate |
$866.90 |
| Rate for Payer: Aetna Commercial |
$786.73
|
| Rate for Payer: Aetna Medicare |
$307.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$307.61
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$535.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$582.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$353.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$338.37
|
| Rate for Payer: Cash Price |
$577.93
|
| Rate for Payer: Cash Price |
$577.93
|
| Rate for Payer: Centivo All Commercial |
$475.40
|
| Rate for Payer: Cigna All Commercial |
$804.45
|
| Rate for Payer: CORVEL All Commercial |
$866.90
|
| Rate for Payer: Coventry All Commercial |
$820.29
|
| Rate for Payer: Encore All Commercial |
$858.04
|
| Rate for Payer: Frontpath All Commercial |
$857.58
|
| Rate for Payer: Humana ChoiceCare |
$805.10
|
| Rate for Payer: Humana Medicare |
$475.40
|
| Rate for Payer: Lucent All Commercial |
$475.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$838.94
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$699.11
|
| Rate for Payer: PHP All Commercial |
$706.94
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$363.54
|
| Rate for Payer: Sagamore Health Network All Products |
$719.62
|
| Rate for Payer: Signature Care EPO |
$773.68
|
| Rate for Payer: Signature Care PPO |
$820.29
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$792.33
|
| Rate for Payer: United Healthcare Commercial |
$734.53
|
| Rate for Payer: United Healthcare Medicare |
$307.61
|
|
