|
HC Z NAIL 6.0X60 CANC SCREW FA
|
Facility
IP
|
$965.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606503
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$724.05 |
| Max. Negotiated Rate |
$897.82 |
| Rate for Payer: Aetna Commercial |
$834.11
|
| Rate for Payer: Cash Price |
$598.55
|
| Rate for Payer: Cigna All Commercial |
$833.14
|
| Rate for Payer: CORVEL All Commercial |
$897.82
|
| Rate for Payer: Coventry All Commercial |
$849.55
|
| Rate for Payer: Encore All Commercial |
$888.65
|
| Rate for Payer: Frontpath All Commercial |
$888.17
|
| Rate for Payer: Humana ChoiceCare |
$833.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$868.86
|
| Rate for Payer: PHCS All Commercial |
$724.05
|
| Rate for Payer: PHP All Commercial |
$732.16
|
| Rate for Payer: Sagamore Health Network All Products |
$745.29
|
| Rate for Payer: Signature Care EPO |
$801.28
|
| Rate for Payer: Signature Care PPO |
$849.55
|
| Rate for Payer: United Healthcare Commercial |
$760.74
|
|
|
HC Z NAIL 6.0X60 CANC SCREW FA
|
Facility
OP
|
$965.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606503
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$318.58 |
| Max. Negotiated Rate |
$897.82 |
| Rate for Payer: Aetna Commercial |
$814.80
|
| Rate for Payer: Aetna Medicare |
$318.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$318.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$554.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$603.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$366.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$350.44
|
| Rate for Payer: Cash Price |
$598.55
|
| Rate for Payer: Cash Price |
$598.55
|
| Rate for Payer: Centivo All Commercial |
$492.35
|
| Rate for Payer: Cigna All Commercial |
$833.14
|
| Rate for Payer: CORVEL All Commercial |
$897.82
|
| Rate for Payer: Coventry All Commercial |
$849.55
|
| Rate for Payer: Encore All Commercial |
$888.65
|
| Rate for Payer: Frontpath All Commercial |
$888.17
|
| Rate for Payer: Humana ChoiceCare |
$833.82
|
| Rate for Payer: Humana Medicare |
$492.35
|
| Rate for Payer: Lucent All Commercial |
$492.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$868.86
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$724.05
|
| Rate for Payer: PHP All Commercial |
$732.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$376.51
|
| Rate for Payer: Sagamore Health Network All Products |
$745.29
|
| Rate for Payer: Signature Care EPO |
$801.28
|
| Rate for Payer: Signature Care PPO |
$849.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$820.59
|
| Rate for Payer: United Healthcare Commercial |
$760.74
|
| Rate for Payer: United Healthcare Medicare |
$318.58
|
|
|
HC Z NAIL 6.0X65 CANC SCREW FA
|
Facility
OP
|
$965.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603460
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$318.58 |
| Max. Negotiated Rate |
$897.82 |
| Rate for Payer: Aetna Commercial |
$814.80
|
| Rate for Payer: Aetna Medicare |
$318.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$318.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$554.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$603.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$366.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$350.44
|
| Rate for Payer: Cash Price |
$598.55
|
| Rate for Payer: Cash Price |
$598.55
|
| Rate for Payer: Centivo All Commercial |
$492.35
|
| Rate for Payer: Cigna All Commercial |
$833.14
|
| Rate for Payer: CORVEL All Commercial |
$897.82
|
| Rate for Payer: Coventry All Commercial |
$849.55
|
| Rate for Payer: Encore All Commercial |
$888.65
|
| Rate for Payer: Frontpath All Commercial |
$888.17
|
| Rate for Payer: Humana ChoiceCare |
$833.82
|
| Rate for Payer: Humana Medicare |
$492.35
|
| Rate for Payer: Lucent All Commercial |
$492.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$868.86
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$724.05
|
| Rate for Payer: PHP All Commercial |
$732.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$376.51
|
| Rate for Payer: Sagamore Health Network All Products |
$745.29
|
| Rate for Payer: Signature Care EPO |
$801.28
|
| Rate for Payer: Signature Care PPO |
$849.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$820.59
|
| Rate for Payer: United Healthcare Commercial |
$760.74
|
| Rate for Payer: United Healthcare Medicare |
$318.58
|
|
|
HC Z NAIL 6.0X65 CANC SCREW FA
|
Facility
IP
|
$965.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603460
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$724.05 |
| Max. Negotiated Rate |
$897.82 |
| Rate for Payer: Aetna Commercial |
$834.11
|
| Rate for Payer: Cash Price |
$598.55
|
| Rate for Payer: Cigna All Commercial |
$833.14
|
| Rate for Payer: CORVEL All Commercial |
$897.82
|
| Rate for Payer: Coventry All Commercial |
$849.55
|
| Rate for Payer: Encore All Commercial |
$888.65
|
| Rate for Payer: Frontpath All Commercial |
$888.17
|
| Rate for Payer: Humana ChoiceCare |
$833.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$868.86
|
| Rate for Payer: PHCS All Commercial |
$724.05
|
| Rate for Payer: PHP All Commercial |
$732.16
|
| Rate for Payer: Sagamore Health Network All Products |
$745.29
|
| Rate for Payer: Signature Care EPO |
$801.28
|
| Rate for Payer: Signature Care PPO |
$849.55
|
| Rate for Payer: United Healthcare Commercial |
$760.74
|
|
|
HC Z NAIL 60X70 CANC SCREW FA
|
Facility
IP
|
$965.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606196
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$724.05 |
| Max. Negotiated Rate |
$897.82 |
| Rate for Payer: Aetna Commercial |
$834.11
|
| Rate for Payer: Cash Price |
$598.55
|
| Rate for Payer: Cigna All Commercial |
$833.14
|
| Rate for Payer: CORVEL All Commercial |
$897.82
|
| Rate for Payer: Coventry All Commercial |
$849.55
|
| Rate for Payer: Encore All Commercial |
$888.65
|
| Rate for Payer: Frontpath All Commercial |
$888.17
|
| Rate for Payer: Humana ChoiceCare |
$833.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$868.86
|
| Rate for Payer: PHCS All Commercial |
$724.05
|
| Rate for Payer: PHP All Commercial |
$732.16
|
| Rate for Payer: Sagamore Health Network All Products |
$745.29
|
| Rate for Payer: Signature Care EPO |
$801.28
|
| Rate for Payer: Signature Care PPO |
$849.55
|
| Rate for Payer: United Healthcare Commercial |
$760.74
|
|
|
HC Z NAIL 60X70 CANC SCREW FA
|
Facility
OP
|
$965.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606196
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$318.58 |
| Max. Negotiated Rate |
$897.82 |
| Rate for Payer: Aetna Commercial |
$814.80
|
| Rate for Payer: Aetna Medicare |
$318.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$318.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$554.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$603.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$366.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$350.44
|
| Rate for Payer: Cash Price |
$598.55
|
| Rate for Payer: Cash Price |
$598.55
|
| Rate for Payer: Centivo All Commercial |
$492.35
|
| Rate for Payer: Cigna All Commercial |
$833.14
|
| Rate for Payer: CORVEL All Commercial |
$897.82
|
| Rate for Payer: Coventry All Commercial |
$849.55
|
| Rate for Payer: Encore All Commercial |
$888.65
|
| Rate for Payer: Frontpath All Commercial |
$888.17
|
| Rate for Payer: Humana ChoiceCare |
$833.82
|
| Rate for Payer: Humana Medicare |
$492.35
|
| Rate for Payer: Lucent All Commercial |
$492.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$868.86
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$724.05
|
| Rate for Payer: PHP All Commercial |
$732.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$376.51
|
| Rate for Payer: Sagamore Health Network All Products |
$745.29
|
| Rate for Payer: Signature Care EPO |
$801.28
|
| Rate for Payer: Signature Care PPO |
$849.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$820.59
|
| Rate for Payer: United Healthcare Commercial |
$760.74
|
| Rate for Payer: United Healthcare Medicare |
$318.58
|
|
|
HC Z NAIL 6.0X75 CANC SCREW FA
|
Facility
IP
|
$965.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603459
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$724.05 |
| Max. Negotiated Rate |
$897.82 |
| Rate for Payer: Aetna Commercial |
$834.11
|
| Rate for Payer: Cash Price |
$598.55
|
| Rate for Payer: Cigna All Commercial |
$833.14
|
| Rate for Payer: CORVEL All Commercial |
$897.82
|
| Rate for Payer: Coventry All Commercial |
$849.55
|
| Rate for Payer: Encore All Commercial |
$888.65
|
| Rate for Payer: Frontpath All Commercial |
$888.17
|
| Rate for Payer: Humana ChoiceCare |
$833.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$868.86
|
| Rate for Payer: PHCS All Commercial |
$724.05
|
| Rate for Payer: PHP All Commercial |
$732.16
|
| Rate for Payer: Sagamore Health Network All Products |
$745.29
|
| Rate for Payer: Signature Care EPO |
$801.28
|
| Rate for Payer: Signature Care PPO |
$849.55
|
| Rate for Payer: United Healthcare Commercial |
$760.74
|
|
|
HC Z NAIL 6.0X75 CANC SCREW FA
|
Facility
OP
|
$965.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603459
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$318.58 |
| Max. Negotiated Rate |
$897.82 |
| Rate for Payer: Aetna Commercial |
$814.80
|
| Rate for Payer: Aetna Medicare |
$318.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$318.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$554.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$603.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$366.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$350.44
|
| Rate for Payer: Cash Price |
$598.55
|
| Rate for Payer: Cash Price |
$598.55
|
| Rate for Payer: Centivo All Commercial |
$492.35
|
| Rate for Payer: Cigna All Commercial |
$833.14
|
| Rate for Payer: CORVEL All Commercial |
$897.82
|
| Rate for Payer: Coventry All Commercial |
$849.55
|
| Rate for Payer: Encore All Commercial |
$888.65
|
| Rate for Payer: Frontpath All Commercial |
$888.17
|
| Rate for Payer: Humana ChoiceCare |
$833.82
|
| Rate for Payer: Humana Medicare |
$492.35
|
| Rate for Payer: Lucent All Commercial |
$492.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$868.86
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$724.05
|
| Rate for Payer: PHP All Commercial |
$732.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$376.51
|
| Rate for Payer: Sagamore Health Network All Products |
$745.29
|
| Rate for Payer: Signature Care EPO |
$801.28
|
| Rate for Payer: Signature Care PPO |
$849.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$820.59
|
| Rate for Payer: United Healthcare Commercial |
$760.74
|
| Rate for Payer: United Healthcare Medicare |
$318.58
|
|
|
HC Z NAIL 6.0X80 CANC SCREW FA
|
Facility
OP
|
$965.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606993
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$318.58 |
| Max. Negotiated Rate |
$897.82 |
| Rate for Payer: Aetna Commercial |
$814.80
|
| Rate for Payer: Aetna Medicare |
$318.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$318.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$554.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$603.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$366.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$350.44
|
| Rate for Payer: Cash Price |
$598.55
|
| Rate for Payer: Cash Price |
$598.55
|
| Rate for Payer: Centivo All Commercial |
$492.35
|
| Rate for Payer: Cigna All Commercial |
$833.14
|
| Rate for Payer: CORVEL All Commercial |
$897.82
|
| Rate for Payer: Coventry All Commercial |
$849.55
|
| Rate for Payer: Encore All Commercial |
$888.65
|
| Rate for Payer: Frontpath All Commercial |
$888.17
|
| Rate for Payer: Humana ChoiceCare |
$833.82
|
| Rate for Payer: Humana Medicare |
$492.35
|
| Rate for Payer: Lucent All Commercial |
$492.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$868.86
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$724.05
|
| Rate for Payer: PHP All Commercial |
$732.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$376.51
|
| Rate for Payer: Sagamore Health Network All Products |
$745.29
|
| Rate for Payer: Signature Care EPO |
$801.28
|
| Rate for Payer: Signature Care PPO |
$849.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$820.59
|
| Rate for Payer: United Healthcare Commercial |
$760.74
|
| Rate for Payer: United Healthcare Medicare |
$318.58
|
|
|
HC Z NAIL 6.0X80 CANC SCREW FA
|
Facility
IP
|
$965.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606993
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$724.05 |
| Max. Negotiated Rate |
$897.82 |
| Rate for Payer: Aetna Commercial |
$834.11
|
| Rate for Payer: Cash Price |
$598.55
|
| Rate for Payer: Cigna All Commercial |
$833.14
|
| Rate for Payer: CORVEL All Commercial |
$897.82
|
| Rate for Payer: Coventry All Commercial |
$849.55
|
| Rate for Payer: Encore All Commercial |
$888.65
|
| Rate for Payer: Frontpath All Commercial |
$888.17
|
| Rate for Payer: Humana ChoiceCare |
$833.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$868.86
|
| Rate for Payer: PHCS All Commercial |
$724.05
|
| Rate for Payer: PHP All Commercial |
$732.16
|
| Rate for Payer: Sagamore Health Network All Products |
$745.29
|
| Rate for Payer: Signature Care EPO |
$801.28
|
| Rate for Payer: Signature Care PPO |
$849.55
|
| Rate for Payer: United Healthcare Commercial |
$760.74
|
|
|
HC Z NAIL 6.0X85 CANC SCREW FA
|
Facility
IP
|
$965.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606994
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$724.05 |
| Max. Negotiated Rate |
$897.82 |
| Rate for Payer: Aetna Commercial |
$834.11
|
| Rate for Payer: Cash Price |
$598.55
|
| Rate for Payer: Cigna All Commercial |
$833.14
|
| Rate for Payer: CORVEL All Commercial |
$897.82
|
| Rate for Payer: Coventry All Commercial |
$849.55
|
| Rate for Payer: Encore All Commercial |
$888.65
|
| Rate for Payer: Frontpath All Commercial |
$888.17
|
| Rate for Payer: Humana ChoiceCare |
$833.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$868.86
|
| Rate for Payer: PHCS All Commercial |
$724.05
|
| Rate for Payer: PHP All Commercial |
$732.16
|
| Rate for Payer: Sagamore Health Network All Products |
$745.29
|
| Rate for Payer: Signature Care EPO |
$801.28
|
| Rate for Payer: Signature Care PPO |
$849.55
|
| Rate for Payer: United Healthcare Commercial |
$760.74
|
|
|
HC Z NAIL 6.0X85 CANC SCREW FA
|
Facility
OP
|
$965.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606994
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$318.58 |
| Max. Negotiated Rate |
$897.82 |
| Rate for Payer: Aetna Commercial |
$814.80
|
| Rate for Payer: Aetna Medicare |
$318.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$318.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$554.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$603.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$366.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$350.44
|
| Rate for Payer: Cash Price |
$598.55
|
| Rate for Payer: Cash Price |
$598.55
|
| Rate for Payer: Centivo All Commercial |
$492.35
|
| Rate for Payer: Cigna All Commercial |
$833.14
|
| Rate for Payer: CORVEL All Commercial |
$897.82
|
| Rate for Payer: Coventry All Commercial |
$849.55
|
| Rate for Payer: Encore All Commercial |
$888.65
|
| Rate for Payer: Frontpath All Commercial |
$888.17
|
| Rate for Payer: Humana ChoiceCare |
$833.82
|
| Rate for Payer: Humana Medicare |
$492.35
|
| Rate for Payer: Lucent All Commercial |
$492.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$868.86
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$724.05
|
| Rate for Payer: PHP All Commercial |
$732.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$376.51
|
| Rate for Payer: Sagamore Health Network All Products |
$745.29
|
| Rate for Payer: Signature Care EPO |
$801.28
|
| Rate for Payer: Signature Care PPO |
$849.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$820.59
|
| Rate for Payer: United Healthcare Commercial |
$760.74
|
| Rate for Payer: United Healthcare Medicare |
$318.58
|
|
|
HC Z NAIL 6.0X95 CANC SCREW FA
|
Facility
IP
|
$965.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606504
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$724.05 |
| Max. Negotiated Rate |
$897.82 |
| Rate for Payer: Aetna Commercial |
$834.11
|
| Rate for Payer: Cash Price |
$598.55
|
| Rate for Payer: Cigna All Commercial |
$833.14
|
| Rate for Payer: CORVEL All Commercial |
$897.82
|
| Rate for Payer: Coventry All Commercial |
$849.55
|
| Rate for Payer: Encore All Commercial |
$888.65
|
| Rate for Payer: Frontpath All Commercial |
$888.17
|
| Rate for Payer: Humana ChoiceCare |
$833.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$868.86
|
| Rate for Payer: PHCS All Commercial |
$724.05
|
| Rate for Payer: PHP All Commercial |
$732.16
|
| Rate for Payer: Sagamore Health Network All Products |
$745.29
|
| Rate for Payer: Signature Care EPO |
$801.28
|
| Rate for Payer: Signature Care PPO |
$849.55
|
| Rate for Payer: United Healthcare Commercial |
$760.74
|
|
|
HC Z NAIL 6.0X95 CANC SCREW FA
|
Facility
OP
|
$965.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606504
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$318.58 |
| Max. Negotiated Rate |
$897.82 |
| Rate for Payer: Aetna Commercial |
$814.80
|
| Rate for Payer: Aetna Medicare |
$318.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$318.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$554.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$603.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$366.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$350.44
|
| Rate for Payer: Cash Price |
$598.55
|
| Rate for Payer: Cash Price |
$598.55
|
| Rate for Payer: Centivo All Commercial |
$492.35
|
| Rate for Payer: Cigna All Commercial |
$833.14
|
| Rate for Payer: CORVEL All Commercial |
$897.82
|
| Rate for Payer: Coventry All Commercial |
$849.55
|
| Rate for Payer: Encore All Commercial |
$888.65
|
| Rate for Payer: Frontpath All Commercial |
$888.17
|
| Rate for Payer: Humana ChoiceCare |
$833.82
|
| Rate for Payer: Humana Medicare |
$492.35
|
| Rate for Payer: Lucent All Commercial |
$492.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$868.86
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$724.05
|
| Rate for Payer: PHP All Commercial |
$732.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$376.51
|
| Rate for Payer: Sagamore Health Network All Products |
$745.29
|
| Rate for Payer: Signature Care EPO |
$801.28
|
| Rate for Payer: Signature Care PPO |
$849.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$820.59
|
| Rate for Payer: United Healthcare Commercial |
$760.74
|
| Rate for Payer: United Healthcare Medicare |
$318.58
|
|
|
HC Z NAIL 7X220 AFFIX PROX HUM L
|
Facility
IP
|
$5,925.42
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608274
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,444.06 |
| Max. Negotiated Rate |
$5,510.64 |
| Rate for Payer: Aetna Commercial |
$5,119.56
|
| Rate for Payer: Cash Price |
$3,673.76
|
| Rate for Payer: Cigna All Commercial |
$5,113.64
|
| Rate for Payer: CORVEL All Commercial |
$5,510.64
|
| Rate for Payer: Coventry All Commercial |
$5,214.37
|
| Rate for Payer: Encore All Commercial |
$5,454.35
|
| Rate for Payer: Frontpath All Commercial |
$5,451.39
|
| Rate for Payer: Humana ChoiceCare |
$5,117.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,332.88
|
| Rate for Payer: PHCS All Commercial |
$4,444.06
|
| Rate for Payer: PHP All Commercial |
$4,493.84
|
| Rate for Payer: Sagamore Health Network All Products |
$4,574.42
|
| Rate for Payer: Signature Care EPO |
$4,918.10
|
| Rate for Payer: Signature Care PPO |
$5,214.37
|
| Rate for Payer: United Healthcare Commercial |
$4,669.23
|
|
|
HC Z NAIL 7X220 AFFIX PROX HUM L
|
Facility
OP
|
$5,925.42
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608274
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,510.64 |
| Rate for Payer: Aetna Commercial |
$5,001.05
|
| Rate for Payer: Aetna Medicare |
$1,955.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,955.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,402.97
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,703.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,248.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,150.93
|
| Rate for Payer: Cash Price |
$3,673.76
|
| Rate for Payer: Cash Price |
$3,673.76
|
| Rate for Payer: Centivo All Commercial |
$3,021.96
|
| Rate for Payer: Cigna All Commercial |
$5,113.64
|
| Rate for Payer: CORVEL All Commercial |
$5,510.64
|
| Rate for Payer: Coventry All Commercial |
$5,214.37
|
| Rate for Payer: Encore All Commercial |
$5,454.35
|
| Rate for Payer: Frontpath All Commercial |
$5,451.39
|
| Rate for Payer: Humana ChoiceCare |
$5,117.79
|
| Rate for Payer: Humana Medicare |
$3,021.96
|
| Rate for Payer: Lucent All Commercial |
$3,021.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,332.88
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,444.06
|
| Rate for Payer: PHP All Commercial |
$4,493.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,310.91
|
| Rate for Payer: Sagamore Health Network All Products |
$4,574.42
|
| Rate for Payer: Signature Care EPO |
$4,918.10
|
| Rate for Payer: Signature Care PPO |
$5,214.37
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,036.61
|
| Rate for Payer: United Healthcare Commercial |
$4,669.23
|
| Rate for Payer: United Healthcare Medicare |
$1,955.39
|
|
|
HC Z NAIL 9X160 AFFIX PROX HUM R
|
Facility
IP
|
$5,851.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607418
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,388.55 |
| Max. Negotiated Rate |
$5,441.80 |
| Rate for Payer: Aetna Commercial |
$5,055.61
|
| Rate for Payer: Cash Price |
$3,627.87
|
| Rate for Payer: Cigna All Commercial |
$5,049.76
|
| Rate for Payer: CORVEL All Commercial |
$5,441.80
|
| Rate for Payer: Coventry All Commercial |
$5,149.23
|
| Rate for Payer: Encore All Commercial |
$5,386.21
|
| Rate for Payer: Frontpath All Commercial |
$5,383.29
|
| Rate for Payer: Humana ChoiceCare |
$5,053.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,266.26
|
| Rate for Payer: PHCS All Commercial |
$4,388.55
|
| Rate for Payer: PHP All Commercial |
$4,437.70
|
| Rate for Payer: Sagamore Health Network All Products |
$4,517.28
|
| Rate for Payer: Signature Care EPO |
$4,856.66
|
| Rate for Payer: Signature Care PPO |
$5,149.23
|
| Rate for Payer: United Healthcare Commercial |
$4,610.90
|
|
|
HC Z NAIL 9X160 AFFIX PROX HUM R
|
Facility
OP
|
$5,851.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607418
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,441.80 |
| Rate for Payer: Aetna Commercial |
$4,938.58
|
| Rate for Payer: Aetna Medicare |
$1,930.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,930.96
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,360.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,657.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,220.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,124.06
|
| Rate for Payer: Cash Price |
$3,627.87
|
| Rate for Payer: Cash Price |
$3,627.87
|
| Rate for Payer: Centivo All Commercial |
$2,984.21
|
| Rate for Payer: Cigna All Commercial |
$5,049.76
|
| Rate for Payer: CORVEL All Commercial |
$5,441.80
|
| Rate for Payer: Coventry All Commercial |
$5,149.23
|
| Rate for Payer: Encore All Commercial |
$5,386.21
|
| Rate for Payer: Frontpath All Commercial |
$5,383.29
|
| Rate for Payer: Humana ChoiceCare |
$5,053.85
|
| Rate for Payer: Humana Medicare |
$2,984.21
|
| Rate for Payer: Lucent All Commercial |
$2,984.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,266.26
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,388.55
|
| Rate for Payer: PHP All Commercial |
$4,437.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,282.05
|
| Rate for Payer: Sagamore Health Network All Products |
$4,517.28
|
| Rate for Payer: Signature Care EPO |
$4,856.66
|
| Rate for Payer: Signature Care PPO |
$5,149.23
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,973.69
|
| Rate for Payer: United Healthcare Commercial |
$4,610.90
|
| Rate for Payer: United Healthcare Medicare |
$1,930.96
|
|
|
HC Z NAIL 9X180 HFN 130 DEG
|
Facility
IP
|
$5,719.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608033
|
|
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 9X180 HFN 130 DEG
|
Facility
OP
|
$5,719.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608033
|
|
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 CAP 0MM
|
Facility
OP
|
$998.70
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607477
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$329.57 |
| Max. Negotiated Rate |
$928.79 |
| Rate for Payer: Aetna Commercial |
$842.90
|
| Rate for Payer: Aetna Medicare |
$329.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$329.57
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$573.55
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$624.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$379.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$362.53
|
| Rate for Payer: Cash Price |
$619.19
|
| Rate for Payer: Cash Price |
$619.19
|
| Rate for Payer: Centivo All Commercial |
$509.34
|
| Rate for Payer: Cigna All Commercial |
$861.88
|
| Rate for Payer: CORVEL All Commercial |
$928.79
|
| Rate for Payer: Coventry All Commercial |
$878.86
|
| Rate for Payer: Encore All Commercial |
$919.30
|
| Rate for Payer: Frontpath All Commercial |
$918.80
|
| Rate for Payer: Humana ChoiceCare |
$862.58
|
| Rate for Payer: Humana Medicare |
$509.34
|
| Rate for Payer: Lucent All Commercial |
$509.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$898.83
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$749.02
|
| Rate for Payer: PHP All Commercial |
$757.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$389.49
|
| Rate for Payer: Sagamore Health Network All Products |
$771.00
|
| Rate for Payer: Signature Care EPO |
$828.92
|
| Rate for Payer: Signature Care PPO |
$878.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$848.90
|
| Rate for Payer: United Healthcare Commercial |
$786.98
|
| Rate for Payer: United Healthcare Medicare |
$329.57
|
|
|
HC Z NAIL CAP 0MM
|
Facility
IP
|
$998.70
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607477
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$749.02 |
| Max. Negotiated Rate |
$928.79 |
| Rate for Payer: Aetna Commercial |
$862.88
|
| Rate for Payer: Cash Price |
$619.19
|
| Rate for Payer: Cigna All Commercial |
$861.88
|
| Rate for Payer: CORVEL All Commercial |
$928.79
|
| Rate for Payer: Coventry All Commercial |
$878.86
|
| Rate for Payer: Encore All Commercial |
$919.30
|
| Rate for Payer: Frontpath All Commercial |
$918.80
|
| Rate for Payer: Humana ChoiceCare |
$862.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$898.83
|
| Rate for Payer: PHCS All Commercial |
$749.02
|
| Rate for Payer: PHP All Commercial |
$757.41
|
| Rate for Payer: Sagamore Health Network All Products |
$771.00
|
| Rate for Payer: Signature Care EPO |
$828.92
|
| Rate for Payer: Signature Care PPO |
$878.86
|
| Rate for Payer: United Healthcare Commercial |
$786.98
|
|
|
HC Z NAIL CAP 10.5X7.5 AFFIX
|
Facility
OP
|
$524.93
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607419
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$173.23 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$443.04
|
| Rate for Payer: Aetna Medicare |
$173.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$173.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$301.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$328.13
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$199.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$190.55
|
| Rate for Payer: Cash Price |
$325.46
|
| Rate for Payer: Cash Price |
$325.46
|
| Rate for Payer: Centivo All Commercial |
$267.71
|
| Rate for Payer: Cigna All Commercial |
$453.01
|
| Rate for Payer: CORVEL All Commercial |
$488.18
|
| Rate for Payer: Coventry All Commercial |
$461.94
|
| Rate for Payer: Encore All Commercial |
$483.20
|
| Rate for Payer: Frontpath All Commercial |
$482.94
|
| Rate for Payer: Humana ChoiceCare |
$453.38
|
| Rate for Payer: Humana Medicare |
$267.71
|
| Rate for Payer: Lucent All Commercial |
$267.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$472.44
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$393.70
|
| Rate for Payer: PHP All Commercial |
$398.11
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$204.72
|
| Rate for Payer: Sagamore Health Network All Products |
$405.25
|
| Rate for Payer: Signature Care EPO |
$435.69
|
| Rate for Payer: Signature Care PPO |
$461.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$446.19
|
| Rate for Payer: United Healthcare Commercial |
$413.64
|
| Rate for Payer: United Healthcare Medicare |
$173.23
|
|
|
HC Z NAIL CAP 10.5X7.5 AFFIX
|
Facility
IP
|
$524.93
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607419
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$393.70 |
| Max. Negotiated Rate |
$488.18 |
| Rate for Payer: Aetna Commercial |
$453.54
|
| Rate for Payer: Cash Price |
$325.46
|
| Rate for Payer: Cigna All Commercial |
$453.01
|
| Rate for Payer: CORVEL All Commercial |
$488.18
|
| Rate for Payer: Coventry All Commercial |
$461.94
|
| Rate for Payer: Encore All Commercial |
$483.20
|
| Rate for Payer: Frontpath All Commercial |
$482.94
|
| Rate for Payer: Humana ChoiceCare |
$453.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$472.44
|
| Rate for Payer: PHCS All Commercial |
$393.70
|
| Rate for Payer: PHP All Commercial |
$398.11
|
| Rate for Payer: Sagamore Health Network All Products |
$405.25
|
| Rate for Payer: Signature Care EPO |
$435.69
|
| Rate for Payer: Signature Care PPO |
$461.94
|
| Rate for Payer: United Healthcare Commercial |
$413.64
|
|
|
HC Z NAIL CPM 10MMX21.5CM 125 L
|
Facility
IP
|
$5,153.22
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602977
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,864.92 |
| Max. Negotiated Rate |
$4,792.49 |
| Rate for Payer: Aetna Commercial |
$4,452.38
|
| Rate for Payer: Cash Price |
$3,195.00
|
| Rate for Payer: Cigna All Commercial |
$4,447.23
|
| Rate for Payer: CORVEL All Commercial |
$4,792.49
|
| Rate for Payer: Coventry All Commercial |
$4,534.83
|
| Rate for Payer: Encore All Commercial |
$4,743.54
|
| Rate for Payer: Frontpath All Commercial |
$4,740.96
|
| Rate for Payer: Humana ChoiceCare |
$4,450.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,637.90
|
| Rate for Payer: PHCS All Commercial |
$3,864.92
|
| Rate for Payer: PHP All Commercial |
$3,908.20
|
| Rate for Payer: Sagamore Health Network All Products |
$3,978.29
|
| Rate for Payer: Signature Care EPO |
$4,277.17
|
| Rate for Payer: Signature Care PPO |
$4,534.83
|
| Rate for Payer: United Healthcare Commercial |
$4,060.74
|
|
