|
HC Z PULSAVAC PLUS FAN KIT
|
Facility
IP
|
$2,047.50
|
|
| Hospital Charge Code |
41603949
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,535.62 |
| Max. Negotiated Rate |
$1,904.18 |
| Rate for Payer: Aetna Commercial |
$1,769.04
|
| Rate for Payer: Cash Price |
$1,269.45
|
| Rate for Payer: Cigna All Commercial |
$1,766.99
|
| Rate for Payer: CORVEL All Commercial |
$1,904.18
|
| Rate for Payer: Coventry All Commercial |
$1,801.80
|
| Rate for Payer: Encore All Commercial |
$1,884.72
|
| Rate for Payer: Frontpath All Commercial |
$1,883.70
|
| Rate for Payer: Humana ChoiceCare |
$1,768.43
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,842.75
|
| Rate for Payer: PHCS All Commercial |
$1,535.62
|
| Rate for Payer: PHP All Commercial |
$1,552.82
|
| Rate for Payer: Sagamore Health Network All Products |
$1,580.67
|
| Rate for Payer: Signature Care EPO |
$1,699.42
|
| Rate for Payer: Signature Care PPO |
$1,801.80
|
| Rate for Payer: United Healthcare Commercial |
$1,613.43
|
|
|
HC Z QUICK-VAC MIXING BOWL
|
Facility
OP
|
$658.00
|
|
| Hospital Charge Code |
41602623
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$611.94 |
| Rate for Payer: Aetna Commercial |
$555.35
|
| Rate for Payer: Aetna Medicare |
$217.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$217.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$377.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$411.32
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$249.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$238.85
|
| Rate for Payer: Cash Price |
$407.96
|
| Rate for Payer: Cash Price |
$407.96
|
| Rate for Payer: Centivo All Commercial |
$335.58
|
| Rate for Payer: Cigna All Commercial |
$567.85
|
| Rate for Payer: CORVEL All Commercial |
$611.94
|
| Rate for Payer: Coventry All Commercial |
$579.04
|
| Rate for Payer: Encore All Commercial |
$605.69
|
| Rate for Payer: Frontpath All Commercial |
$605.36
|
| Rate for Payer: Humana ChoiceCare |
$568.31
|
| Rate for Payer: Humana Medicare |
$335.58
|
| Rate for Payer: Lucent All Commercial |
$335.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$592.20
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$493.50
|
| Rate for Payer: PHP All Commercial |
$499.03
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$256.62
|
| Rate for Payer: Sagamore Health Network All Products |
$507.98
|
| Rate for Payer: Signature Care EPO |
$546.14
|
| Rate for Payer: Signature Care PPO |
$579.04
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$559.30
|
| Rate for Payer: United Healthcare Commercial |
$518.50
|
| Rate for Payer: United Healthcare Medicare |
$217.14
|
|
|
HC Z QUICK-VAC MIXING BOWL
|
Facility
IP
|
$658.00
|
|
| Hospital Charge Code |
41602623
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$493.50 |
| Max. Negotiated Rate |
$611.94 |
| Rate for Payer: Aetna Commercial |
$568.51
|
| Rate for Payer: Cash Price |
$407.96
|
| Rate for Payer: Cigna All Commercial |
$567.85
|
| Rate for Payer: CORVEL All Commercial |
$611.94
|
| Rate for Payer: Coventry All Commercial |
$579.04
|
| Rate for Payer: Encore All Commercial |
$605.69
|
| Rate for Payer: Frontpath All Commercial |
$605.36
|
| Rate for Payer: Humana ChoiceCare |
$568.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$592.20
|
| Rate for Payer: PHCS All Commercial |
$493.50
|
| Rate for Payer: PHP All Commercial |
$499.03
|
| Rate for Payer: Sagamore Health Network All Products |
$507.98
|
| Rate for Payer: Signature Care EPO |
$546.14
|
| Rate for Payer: Signature Care PPO |
$579.04
|
| Rate for Payer: United Healthcare Commercial |
$518.50
|
|
|
HC Z REAMER GUID BUSHING
|
Facility
IP
|
$528.08
|
|
| Hospital Charge Code |
41606611
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$396.06 |
| Max. Negotiated Rate |
$491.11 |
| Rate for Payer: Aetna Commercial |
$456.26
|
| Rate for Payer: Cash Price |
$327.41
|
| Rate for Payer: Cigna All Commercial |
$455.73
|
| Rate for Payer: CORVEL All Commercial |
$491.11
|
| Rate for Payer: Coventry All Commercial |
$464.71
|
| Rate for Payer: Encore All Commercial |
$486.10
|
| Rate for Payer: Frontpath All Commercial |
$485.83
|
| Rate for Payer: Humana ChoiceCare |
$456.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$475.27
|
| Rate for Payer: PHCS All Commercial |
$396.06
|
| Rate for Payer: PHP All Commercial |
$400.50
|
| Rate for Payer: Sagamore Health Network All Products |
$407.68
|
| Rate for Payer: Signature Care EPO |
$438.31
|
| Rate for Payer: Signature Care PPO |
$464.71
|
| Rate for Payer: United Healthcare Commercial |
$416.13
|
|
|
HC Z REAMER GUID BUSHING
|
Facility
OP
|
$528.08
|
|
| Hospital Charge Code |
41606611
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$491.11 |
| Rate for Payer: Aetna Commercial |
$445.70
|
| Rate for Payer: Aetna Medicare |
$174.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$174.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$303.28
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$330.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$200.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$191.69
|
| Rate for Payer: Cash Price |
$327.41
|
| Rate for Payer: Cash Price |
$327.41
|
| Rate for Payer: Centivo All Commercial |
$269.32
|
| Rate for Payer: Cigna All Commercial |
$455.73
|
| Rate for Payer: CORVEL All Commercial |
$491.11
|
| Rate for Payer: Coventry All Commercial |
$464.71
|
| Rate for Payer: Encore All Commercial |
$486.10
|
| Rate for Payer: Frontpath All Commercial |
$485.83
|
| Rate for Payer: Humana ChoiceCare |
$456.10
|
| Rate for Payer: Humana Medicare |
$269.32
|
| Rate for Payer: Lucent All Commercial |
$269.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$475.27
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$396.06
|
| Rate for Payer: PHP All Commercial |
$400.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$205.95
|
| Rate for Payer: Sagamore Health Network All Products |
$407.68
|
| Rate for Payer: Signature Care EPO |
$438.31
|
| Rate for Payer: Signature Care PPO |
$464.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$448.87
|
| Rate for Payer: United Healthcare Commercial |
$416.13
|
| Rate for Payer: United Healthcare Medicare |
$174.27
|
|
|
HC Z REAMER GUIDE SCREW
|
Facility
IP
|
$528.08
|
|
| Hospital Charge Code |
41606610
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$396.06 |
| Max. Negotiated Rate |
$491.11 |
| Rate for Payer: Aetna Commercial |
$456.26
|
| Rate for Payer: Cash Price |
$327.41
|
| Rate for Payer: Cigna All Commercial |
$455.73
|
| Rate for Payer: CORVEL All Commercial |
$491.11
|
| Rate for Payer: Coventry All Commercial |
$464.71
|
| Rate for Payer: Encore All Commercial |
$486.10
|
| Rate for Payer: Frontpath All Commercial |
$485.83
|
| Rate for Payer: Humana ChoiceCare |
$456.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$475.27
|
| Rate for Payer: PHCS All Commercial |
$396.06
|
| Rate for Payer: PHP All Commercial |
$400.50
|
| Rate for Payer: Sagamore Health Network All Products |
$407.68
|
| Rate for Payer: Signature Care EPO |
$438.31
|
| Rate for Payer: Signature Care PPO |
$464.71
|
| Rate for Payer: United Healthcare Commercial |
$416.13
|
|
|
HC Z REAMER GUIDE SCREW
|
Facility
OP
|
$528.08
|
|
| Hospital Charge Code |
41606610
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$491.11 |
| Rate for Payer: Aetna Commercial |
$445.70
|
| Rate for Payer: Aetna Medicare |
$174.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$174.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$303.28
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$330.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$200.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$191.69
|
| Rate for Payer: Cash Price |
$327.41
|
| Rate for Payer: Cash Price |
$327.41
|
| Rate for Payer: Centivo All Commercial |
$269.32
|
| Rate for Payer: Cigna All Commercial |
$455.73
|
| Rate for Payer: CORVEL All Commercial |
$491.11
|
| Rate for Payer: Coventry All Commercial |
$464.71
|
| Rate for Payer: Encore All Commercial |
$486.10
|
| Rate for Payer: Frontpath All Commercial |
$485.83
|
| Rate for Payer: Humana ChoiceCare |
$456.10
|
| Rate for Payer: Humana Medicare |
$269.32
|
| Rate for Payer: Lucent All Commercial |
$269.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$475.27
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$396.06
|
| Rate for Payer: PHP All Commercial |
$400.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$205.95
|
| Rate for Payer: Sagamore Health Network All Products |
$407.68
|
| Rate for Payer: Signature Care EPO |
$438.31
|
| Rate for Payer: Signature Care PPO |
$464.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$448.87
|
| Rate for Payer: United Healthcare Commercial |
$416.13
|
| Rate for Payer: United Healthcare Medicare |
$174.27
|
|
|
HC Z REAMER LAG SCREW CM 3.2
|
Facility
IP
|
$2,430.15
|
|
| Hospital Charge Code |
41602572
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,822.61 |
| Max. Negotiated Rate |
$2,260.04 |
| Rate for Payer: Aetna Commercial |
$2,099.65
|
| Rate for Payer: Cash Price |
$1,506.69
|
| Rate for Payer: Cigna All Commercial |
$2,097.22
|
| Rate for Payer: CORVEL All Commercial |
$2,260.04
|
| Rate for Payer: Coventry All Commercial |
$2,138.53
|
| Rate for Payer: Encore All Commercial |
$2,236.95
|
| Rate for Payer: Frontpath All Commercial |
$2,235.74
|
| Rate for Payer: Humana ChoiceCare |
$2,098.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,187.14
|
| Rate for Payer: PHCS All Commercial |
$1,822.61
|
| Rate for Payer: PHP All Commercial |
$1,843.03
|
| Rate for Payer: Sagamore Health Network All Products |
$1,876.08
|
| Rate for Payer: Signature Care EPO |
$2,017.02
|
| Rate for Payer: Signature Care PPO |
$2,138.53
|
| Rate for Payer: United Healthcare Commercial |
$1,914.96
|
|
|
HC Z REAMER LAG SCREW CM 3.2
|
Facility
OP
|
$2,430.15
|
|
| Hospital Charge Code |
41602572
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$2,260.04 |
| Rate for Payer: Aetna Commercial |
$2,051.05
|
| Rate for Payer: Aetna Medicare |
$801.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$801.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,395.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,519.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$922.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$882.14
|
| Rate for Payer: Cash Price |
$1,506.69
|
| Rate for Payer: Cash Price |
$1,506.69
|
| Rate for Payer: Centivo All Commercial |
$1,239.38
|
| Rate for Payer: Cigna All Commercial |
$2,097.22
|
| Rate for Payer: CORVEL All Commercial |
$2,260.04
|
| Rate for Payer: Coventry All Commercial |
$2,138.53
|
| Rate for Payer: Encore All Commercial |
$2,236.95
|
| Rate for Payer: Frontpath All Commercial |
$2,235.74
|
| Rate for Payer: Humana ChoiceCare |
$2,098.92
|
| Rate for Payer: Humana Medicare |
$1,239.38
|
| Rate for Payer: Lucent All Commercial |
$1,239.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,187.14
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,822.61
|
| Rate for Payer: PHP All Commercial |
$1,843.03
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$947.76
|
| Rate for Payer: Sagamore Health Network All Products |
$1,876.08
|
| Rate for Payer: Signature Care EPO |
$2,017.02
|
| Rate for Payer: Signature Care PPO |
$2,138.53
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,065.63
|
| Rate for Payer: United Healthcare Commercial |
$1,914.96
|
| Rate for Payer: United Healthcare Medicare |
$801.95
|
|
|
HC Z REAMER PATELLA BLADE 35MM
|
Facility
OP
|
$920.92
|
|
| Hospital Charge Code |
41607384
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$856.46 |
| Rate for Payer: Aetna Commercial |
$777.26
|
| Rate for Payer: Aetna Medicare |
$303.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$303.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$528.88
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$575.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$349.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$334.29
|
| Rate for Payer: Cash Price |
$570.97
|
| Rate for Payer: Cash Price |
$570.97
|
| Rate for Payer: Centivo All Commercial |
$469.67
|
| Rate for Payer: Cigna All Commercial |
$794.75
|
| Rate for Payer: CORVEL All Commercial |
$856.46
|
| Rate for Payer: Coventry All Commercial |
$810.41
|
| Rate for Payer: Encore All Commercial |
$847.71
|
| Rate for Payer: Frontpath All Commercial |
$847.25
|
| Rate for Payer: Humana ChoiceCare |
$795.40
|
| Rate for Payer: Humana Medicare |
$469.67
|
| Rate for Payer: Lucent All Commercial |
$469.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$828.83
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$690.69
|
| Rate for Payer: PHP All Commercial |
$698.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$359.16
|
| Rate for Payer: Sagamore Health Network All Products |
$710.95
|
| Rate for Payer: Signature Care EPO |
$764.36
|
| Rate for Payer: Signature Care PPO |
$810.41
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$782.78
|
| Rate for Payer: United Healthcare Commercial |
$725.68
|
| Rate for Payer: United Healthcare Medicare |
$303.90
|
|
|
HC Z REAMER PATELLA BLADE 35MM
|
Facility
IP
|
$920.92
|
|
| Hospital Charge Code |
41607384
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$690.69 |
| Max. Negotiated Rate |
$856.46 |
| Rate for Payer: Aetna Commercial |
$795.67
|
| Rate for Payer: Cash Price |
$570.97
|
| Rate for Payer: Cigna All Commercial |
$794.75
|
| Rate for Payer: CORVEL All Commercial |
$856.46
|
| Rate for Payer: Coventry All Commercial |
$810.41
|
| Rate for Payer: Encore All Commercial |
$847.71
|
| Rate for Payer: Frontpath All Commercial |
$847.25
|
| Rate for Payer: Humana ChoiceCare |
$795.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$828.83
|
| Rate for Payer: PHCS All Commercial |
$690.69
|
| Rate for Payer: PHP All Commercial |
$698.43
|
| Rate for Payer: Sagamore Health Network All Products |
$710.95
|
| Rate for Payer: Signature Care EPO |
$764.36
|
| Rate for Payer: Signature Care PPO |
$810.41
|
| Rate for Payer: United Healthcare Commercial |
$725.68
|
|
|
HC Z REAMER PATELLA BLADE 41
|
Facility
OP
|
$920.92
|
|
| Hospital Charge Code |
41607610
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$856.46 |
| Rate for Payer: Aetna Commercial |
$777.26
|
| Rate for Payer: Aetna Medicare |
$303.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$303.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$528.88
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$575.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$349.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$334.29
|
| Rate for Payer: Cash Price |
$570.97
|
| Rate for Payer: Cash Price |
$570.97
|
| Rate for Payer: Centivo All Commercial |
$469.67
|
| Rate for Payer: Cigna All Commercial |
$794.75
|
| Rate for Payer: CORVEL All Commercial |
$856.46
|
| Rate for Payer: Coventry All Commercial |
$810.41
|
| Rate for Payer: Encore All Commercial |
$847.71
|
| Rate for Payer: Frontpath All Commercial |
$847.25
|
| Rate for Payer: Humana ChoiceCare |
$795.40
|
| Rate for Payer: Humana Medicare |
$469.67
|
| Rate for Payer: Lucent All Commercial |
$469.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$828.83
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$690.69
|
| Rate for Payer: PHP All Commercial |
$698.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$359.16
|
| Rate for Payer: Sagamore Health Network All Products |
$710.95
|
| Rate for Payer: Signature Care EPO |
$764.36
|
| Rate for Payer: Signature Care PPO |
$810.41
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$782.78
|
| Rate for Payer: United Healthcare Commercial |
$725.68
|
| Rate for Payer: United Healthcare Medicare |
$303.90
|
|
|
HC Z REAMER PATELLA BLADE 41
|
Facility
IP
|
$920.92
|
|
| Hospital Charge Code |
41607610
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$690.69 |
| Max. Negotiated Rate |
$856.46 |
| Rate for Payer: Aetna Commercial |
$795.67
|
| Rate for Payer: Cash Price |
$570.97
|
| Rate for Payer: Cigna All Commercial |
$794.75
|
| Rate for Payer: CORVEL All Commercial |
$856.46
|
| Rate for Payer: Coventry All Commercial |
$810.41
|
| Rate for Payer: Encore All Commercial |
$847.71
|
| Rate for Payer: Frontpath All Commercial |
$847.25
|
| Rate for Payer: Humana ChoiceCare |
$795.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$828.83
|
| Rate for Payer: PHCS All Commercial |
$690.69
|
| Rate for Payer: PHP All Commercial |
$698.43
|
| Rate for Payer: Sagamore Health Network All Products |
$710.95
|
| Rate for Payer: Signature Care EPO |
$764.36
|
| Rate for Payer: Signature Care PPO |
$810.41
|
| Rate for Payer: United Healthcare Commercial |
$725.68
|
|
|
HC Z REAMER PATELLA BLADE 46MM
|
Facility
IP
|
$920.92
|
|
| Hospital Charge Code |
41606177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$690.69 |
| Max. Negotiated Rate |
$856.46 |
| Rate for Payer: Aetna Commercial |
$795.67
|
| Rate for Payer: Cash Price |
$570.97
|
| Rate for Payer: Cigna All Commercial |
$794.75
|
| Rate for Payer: CORVEL All Commercial |
$856.46
|
| Rate for Payer: Coventry All Commercial |
$810.41
|
| Rate for Payer: Encore All Commercial |
$847.71
|
| Rate for Payer: Frontpath All Commercial |
$847.25
|
| Rate for Payer: Humana ChoiceCare |
$795.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$828.83
|
| Rate for Payer: PHCS All Commercial |
$690.69
|
| Rate for Payer: PHP All Commercial |
$698.43
|
| Rate for Payer: Sagamore Health Network All Products |
$710.95
|
| Rate for Payer: Signature Care EPO |
$764.36
|
| Rate for Payer: Signature Care PPO |
$810.41
|
| Rate for Payer: United Healthcare Commercial |
$725.68
|
|
|
HC Z REAMER PATELLA BLADE 46MM
|
Facility
OP
|
$920.92
|
|
| Hospital Charge Code |
41606177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$856.46 |
| Rate for Payer: Aetna Commercial |
$777.26
|
| Rate for Payer: Aetna Medicare |
$303.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$303.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$528.88
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$575.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$349.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$334.29
|
| Rate for Payer: Cash Price |
$570.97
|
| Rate for Payer: Cash Price |
$570.97
|
| Rate for Payer: Centivo All Commercial |
$469.67
|
| Rate for Payer: Cigna All Commercial |
$794.75
|
| Rate for Payer: CORVEL All Commercial |
$856.46
|
| Rate for Payer: Coventry All Commercial |
$810.41
|
| Rate for Payer: Encore All Commercial |
$847.71
|
| Rate for Payer: Frontpath All Commercial |
$847.25
|
| Rate for Payer: Humana ChoiceCare |
$795.40
|
| Rate for Payer: Humana Medicare |
$469.67
|
| Rate for Payer: Lucent All Commercial |
$469.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$828.83
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$690.69
|
| Rate for Payer: PHP All Commercial |
$698.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$359.16
|
| Rate for Payer: Sagamore Health Network All Products |
$710.95
|
| Rate for Payer: Signature Care EPO |
$764.36
|
| Rate for Payer: Signature Care PPO |
$810.41
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$782.78
|
| Rate for Payer: United Healthcare Commercial |
$725.68
|
| Rate for Payer: United Healthcare Medicare |
$303.90
|
|
|
HC Z REAMER TAPER 13.5
|
Facility
IP
|
$1,869.55
|
|
| Hospital Charge Code |
41606198
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,402.16 |
| Max. Negotiated Rate |
$1,738.68 |
| Rate for Payer: Aetna Commercial |
$1,615.29
|
| Rate for Payer: Cash Price |
$1,159.12
|
| Rate for Payer: Cigna All Commercial |
$1,613.42
|
| Rate for Payer: CORVEL All Commercial |
$1,738.68
|
| Rate for Payer: Coventry All Commercial |
$1,645.20
|
| Rate for Payer: Encore All Commercial |
$1,720.92
|
| Rate for Payer: Frontpath All Commercial |
$1,719.99
|
| Rate for Payer: Humana ChoiceCare |
$1,614.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,682.60
|
| Rate for Payer: PHCS All Commercial |
$1,402.16
|
| Rate for Payer: PHP All Commercial |
$1,417.87
|
| Rate for Payer: Sagamore Health Network All Products |
$1,443.29
|
| Rate for Payer: Signature Care EPO |
$1,551.73
|
| Rate for Payer: Signature Care PPO |
$1,645.20
|
| Rate for Payer: United Healthcare Commercial |
$1,473.21
|
|
|
HC Z REAMER TAPER 13.5
|
Facility
OP
|
$1,869.55
|
|
| Hospital Charge Code |
41606198
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,738.68 |
| Rate for Payer: Aetna Commercial |
$1,577.90
|
| Rate for Payer: Aetna Medicare |
$616.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$616.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,073.68
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,168.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$709.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$678.65
|
| Rate for Payer: Cash Price |
$1,159.12
|
| Rate for Payer: Cash Price |
$1,159.12
|
| Rate for Payer: Centivo All Commercial |
$953.47
|
| Rate for Payer: Cigna All Commercial |
$1,613.42
|
| Rate for Payer: CORVEL All Commercial |
$1,738.68
|
| Rate for Payer: Coventry All Commercial |
$1,645.20
|
| Rate for Payer: Encore All Commercial |
$1,720.92
|
| Rate for Payer: Frontpath All Commercial |
$1,719.99
|
| Rate for Payer: Humana ChoiceCare |
$1,614.73
|
| Rate for Payer: Humana Medicare |
$953.47
|
| Rate for Payer: Lucent All Commercial |
$953.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,682.60
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,402.16
|
| Rate for Payer: PHP All Commercial |
$1,417.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$729.12
|
| Rate for Payer: Sagamore Health Network All Products |
$1,443.29
|
| Rate for Payer: Signature Care EPO |
$1,551.73
|
| Rate for Payer: Signature Care PPO |
$1,645.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,589.12
|
| Rate for Payer: United Healthcare Commercial |
$1,473.21
|
| Rate for Payer: United Healthcare Medicare |
$616.95
|
|
|
HC Z RE+LINE PLATE KIT 15X6
|
Facility
OP
|
$3,337.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603520
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,103.60 |
| Rate for Payer: Aetna Commercial |
$2,816.60
|
| Rate for Payer: Aetna Medicare |
$1,101.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,101.28
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,916.55
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,086.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,266.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,211.40
|
| Rate for Payer: Cash Price |
$2,069.06
|
| Rate for Payer: Cash Price |
$2,069.06
|
| Rate for Payer: Centivo All Commercial |
$1,701.97
|
| Rate for Payer: Cigna All Commercial |
$2,880.00
|
| Rate for Payer: CORVEL All Commercial |
$3,103.60
|
| Rate for Payer: Coventry All Commercial |
$2,936.74
|
| Rate for Payer: Encore All Commercial |
$3,071.89
|
| Rate for Payer: Frontpath All Commercial |
$3,070.22
|
| Rate for Payer: Humana ChoiceCare |
$2,882.34
|
| Rate for Payer: Humana Medicare |
$1,701.97
|
| Rate for Payer: Lucent All Commercial |
$1,701.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,003.48
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,502.90
|
| Rate for Payer: PHP All Commercial |
$2,530.93
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,301.51
|
| Rate for Payer: Sagamore Health Network All Products |
$2,576.32
|
| Rate for Payer: Signature Care EPO |
$2,769.88
|
| Rate for Payer: Signature Care PPO |
$2,936.74
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,836.62
|
| Rate for Payer: United Healthcare Commercial |
$2,629.71
|
| Rate for Payer: United Healthcare Medicare |
$1,101.28
|
|
|
HC Z RE+LINE PLATE KIT 15X6
|
Facility
IP
|
$3,337.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603520
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,502.90 |
| Max. Negotiated Rate |
$3,103.60 |
| Rate for Payer: Aetna Commercial |
$2,883.34
|
| Rate for Payer: Cash Price |
$2,069.06
|
| Rate for Payer: Cigna All Commercial |
$2,880.00
|
| Rate for Payer: CORVEL All Commercial |
$3,103.60
|
| Rate for Payer: Coventry All Commercial |
$2,936.74
|
| Rate for Payer: Encore All Commercial |
$3,071.89
|
| Rate for Payer: Frontpath All Commercial |
$3,070.22
|
| Rate for Payer: Humana ChoiceCare |
$2,882.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,003.48
|
| Rate for Payer: PHCS All Commercial |
$2,502.90
|
| Rate for Payer: PHP All Commercial |
$2,530.93
|
| Rate for Payer: Sagamore Health Network All Products |
$2,576.32
|
| Rate for Payer: Signature Care EPO |
$2,769.88
|
| Rate for Payer: Signature Care PPO |
$2,936.74
|
| Rate for Payer: United Healthcare Commercial |
$2,629.71
|
|
|
HC Z RE+LINE SCREW 2.7X16 COMP
|
Facility
IP
|
$990.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603519
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$742.50 |
| Max. Negotiated Rate |
$920.70 |
| Rate for Payer: Aetna Commercial |
$855.36
|
| Rate for Payer: Cash Price |
$613.80
|
| Rate for Payer: Cigna All Commercial |
$854.37
|
| Rate for Payer: CORVEL All Commercial |
$920.70
|
| Rate for Payer: Coventry All Commercial |
$871.20
|
| Rate for Payer: Encore All Commercial |
$911.30
|
| Rate for Payer: Frontpath All Commercial |
$910.80
|
| Rate for Payer: Humana ChoiceCare |
$855.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$891.00
|
| Rate for Payer: PHCS All Commercial |
$742.50
|
| Rate for Payer: PHP All Commercial |
$750.82
|
| Rate for Payer: Sagamore Health Network All Products |
$764.28
|
| Rate for Payer: Signature Care EPO |
$821.70
|
| Rate for Payer: Signature Care PPO |
$871.20
|
| Rate for Payer: United Healthcare Commercial |
$780.12
|
|
|
HC Z RE+LINE SCREW 2.7X16 COMP
|
Facility
OP
|
$990.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603519
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$326.70 |
| Max. Negotiated Rate |
$920.70 |
| Rate for Payer: Aetna Commercial |
$835.56
|
| Rate for Payer: Aetna Medicare |
$326.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$326.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$568.56
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$618.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$375.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$359.37
|
| Rate for Payer: Cash Price |
$613.80
|
| Rate for Payer: Cash Price |
$613.80
|
| Rate for Payer: Centivo All Commercial |
$504.90
|
| Rate for Payer: Cigna All Commercial |
$854.37
|
| Rate for Payer: CORVEL All Commercial |
$920.70
|
| Rate for Payer: Coventry All Commercial |
$871.20
|
| Rate for Payer: Encore All Commercial |
$911.30
|
| Rate for Payer: Frontpath All Commercial |
$910.80
|
| Rate for Payer: Humana ChoiceCare |
$855.06
|
| Rate for Payer: Humana Medicare |
$504.90
|
| Rate for Payer: Lucent All Commercial |
$504.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$891.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$742.50
|
| Rate for Payer: PHP All Commercial |
$750.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$386.10
|
| Rate for Payer: Sagamore Health Network All Products |
$764.28
|
| Rate for Payer: Signature Care EPO |
$821.70
|
| Rate for Payer: Signature Care PPO |
$871.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$841.50
|
| Rate for Payer: United Healthcare Commercial |
$780.12
|
| Rate for Payer: United Healthcare Medicare |
$326.70
|
|
|
HC Z RE+LINE SCREW 2.7X18 COMP
|
Facility
OP
|
$990.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603722
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$326.70 |
| Max. Negotiated Rate |
$920.70 |
| Rate for Payer: Aetna Commercial |
$835.56
|
| Rate for Payer: Aetna Medicare |
$326.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$326.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$568.56
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$618.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$375.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$359.37
|
| Rate for Payer: Cash Price |
$613.80
|
| Rate for Payer: Cash Price |
$613.80
|
| Rate for Payer: Centivo All Commercial |
$504.90
|
| Rate for Payer: Cigna All Commercial |
$854.37
|
| Rate for Payer: CORVEL All Commercial |
$920.70
|
| Rate for Payer: Coventry All Commercial |
$871.20
|
| Rate for Payer: Encore All Commercial |
$911.30
|
| Rate for Payer: Frontpath All Commercial |
$910.80
|
| Rate for Payer: Humana ChoiceCare |
$855.06
|
| Rate for Payer: Humana Medicare |
$504.90
|
| Rate for Payer: Lucent All Commercial |
$504.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$891.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$742.50
|
| Rate for Payer: PHP All Commercial |
$750.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$386.10
|
| Rate for Payer: Sagamore Health Network All Products |
$764.28
|
| Rate for Payer: Signature Care EPO |
$821.70
|
| Rate for Payer: Signature Care PPO |
$871.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$841.50
|
| Rate for Payer: United Healthcare Commercial |
$780.12
|
| Rate for Payer: United Healthcare Medicare |
$326.70
|
|
|
HC Z RE+LINE SCREW 2.7X18 COMP
|
Facility
IP
|
$990.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603722
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$742.50 |
| Max. Negotiated Rate |
$920.70 |
| Rate for Payer: Aetna Commercial |
$855.36
|
| Rate for Payer: Cash Price |
$613.80
|
| Rate for Payer: Cigna All Commercial |
$854.37
|
| Rate for Payer: CORVEL All Commercial |
$920.70
|
| Rate for Payer: Coventry All Commercial |
$871.20
|
| Rate for Payer: Encore All Commercial |
$911.30
|
| Rate for Payer: Frontpath All Commercial |
$910.80
|
| Rate for Payer: Humana ChoiceCare |
$855.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$891.00
|
| Rate for Payer: PHCS All Commercial |
$742.50
|
| Rate for Payer: PHP All Commercial |
$750.82
|
| Rate for Payer: Sagamore Health Network All Products |
$764.28
|
| Rate for Payer: Signature Care EPO |
$821.70
|
| Rate for Payer: Signature Care PPO |
$871.20
|
| Rate for Payer: United Healthcare Commercial |
$780.12
|
|
|
HC Z REPLACEMENT RING 21
|
Facility
OP
|
$1,046.75
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605581
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$345.43 |
| Max. Negotiated Rate |
$973.48 |
| Rate for Payer: Aetna Commercial |
$883.46
|
| Rate for Payer: Aetna Medicare |
$345.43
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$345.43
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$601.15
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$654.32
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$397.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$379.97
|
| Rate for Payer: Cash Price |
$648.99
|
| Rate for Payer: Cash Price |
$648.99
|
| Rate for Payer: Centivo All Commercial |
$533.84
|
| Rate for Payer: Cigna All Commercial |
$903.35
|
| Rate for Payer: CORVEL All Commercial |
$973.48
|
| Rate for Payer: Coventry All Commercial |
$921.14
|
| Rate for Payer: Encore All Commercial |
$963.53
|
| Rate for Payer: Frontpath All Commercial |
$963.01
|
| Rate for Payer: Humana ChoiceCare |
$904.08
|
| Rate for Payer: Humana Medicare |
$533.84
|
| Rate for Payer: Lucent All Commercial |
$533.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$942.08
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$785.06
|
| Rate for Payer: PHP All Commercial |
$793.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$408.23
|
| Rate for Payer: Sagamore Health Network All Products |
$808.09
|
| Rate for Payer: Signature Care EPO |
$868.80
|
| Rate for Payer: Signature Care PPO |
$921.14
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$889.74
|
| Rate for Payer: United Healthcare Commercial |
$824.84
|
| Rate for Payer: United Healthcare Medicare |
$345.43
|
|
|
HC Z REPLACEMENT RING 21
|
Facility
IP
|
$1,046.75
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41605581
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$785.06 |
| Max. Negotiated Rate |
$973.48 |
| Rate for Payer: Aetna Commercial |
$904.39
|
| Rate for Payer: Cash Price |
$648.99
|
| Rate for Payer: Cigna All Commercial |
$903.35
|
| Rate for Payer: CORVEL All Commercial |
$973.48
|
| Rate for Payer: Coventry All Commercial |
$921.14
|
| Rate for Payer: Encore All Commercial |
$963.53
|
| Rate for Payer: Frontpath All Commercial |
$963.01
|
| Rate for Payer: Humana ChoiceCare |
$904.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$942.08
|
| Rate for Payer: PHCS All Commercial |
$785.06
|
| Rate for Payer: PHP All Commercial |
$793.86
|
| Rate for Payer: Sagamore Health Network All Products |
$808.09
|
| Rate for Payer: Signature Care EPO |
$868.80
|
| Rate for Payer: Signature Care PPO |
$921.14
|
| Rate for Payer: United Healthcare Commercial |
$824.84
|
|
