|
HC Z NAIL 5.0X27.5 CORT SCREW FA
|
Facility
OP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603021
|
|
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 5.0X27.5 CORT SCREW FA
|
Facility
IP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603021
|
|
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 5.0X30 CORT SCREW FA
|
Facility
IP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603022
|
|
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 5.0X30 CORT SCREW FA
|
Facility
OP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603022
|
|
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 5.0X32.5 CORT SCREW FA
|
Facility
IP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603023
|
|
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 5.0X32.5 CORT SCREW FA
|
Facility
OP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603023
|
|
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 5.0X37.5 CORT SCREW FA
|
Facility
IP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603024
|
|
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 5.0X37.5 CORT SCREW FA
|
Facility
OP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603024
|
|
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 5.0X40 CORT SCREW FA
|
Facility
OP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603025
|
|
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 5.0X40 CORT SCREW FA
|
Facility
IP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603025
|
|
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 5.0X42.5 CORT SCREW FA
|
Facility
OP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603026
|
|
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 5.0X42.5 CORT SCREW FA
|
Facility
IP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603026
|
|
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 5.0X42.5 CORT SCREW PT
|
Facility
IP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603894
|
|
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 5.0X42.5 CORT SCREW PT
|
Facility
OP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603894
|
|
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 5.0X45 CORT SCREW FA
|
Facility
IP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603027
|
|
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 5.0X45 CORT SCREW FA
|
Facility
OP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603027
|
|
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 5.0X47.5 CORT SCREW FA
|
Facility
IP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603028
|
|
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 5.0X47.5 CORT SCREW FA
|
Facility
OP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603028
|
|
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 5.0X50 CORT SCREW FA
|
Facility
OP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603029
|
|
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 5.0X50 CORT SCREW FA
|
Facility
IP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603029
|
|
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 5.0X52.5 CORT SCREW FA
|
Facility
OP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603030
|
|
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 5.0X52.5 CORT SCREW FA
|
Facility
IP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603030
|
|
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 5.0X55 CORT SCREW FA
|
Facility
IP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603031
|
|
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 5.0X55 CORT SCREW FA
|
Facility
OP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603031
|
|
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 5.0X57.5 CORT SCREW FA
|
Facility
IP
|
$932.15
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603032
|
|
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
|
|
