|
HC Z SCREW 1.5X20 NON LOCK
|
Facility
OP
|
$579.74
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607701
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$191.31 |
| Max. Negotiated Rate |
$539.16 |
| Rate for Payer: Aetna Commercial |
$489.30
|
| Rate for Payer: Aetna Medicare |
$191.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$191.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$332.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$362.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$220.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$210.45
|
| Rate for Payer: Cash Price |
$359.44
|
| Rate for Payer: Cash Price |
$359.44
|
| Rate for Payer: Centivo All Commercial |
$295.67
|
| Rate for Payer: Cigna All Commercial |
$500.32
|
| Rate for Payer: CORVEL All Commercial |
$539.16
|
| Rate for Payer: Coventry All Commercial |
$510.17
|
| Rate for Payer: Encore All Commercial |
$533.65
|
| Rate for Payer: Frontpath All Commercial |
$533.36
|
| Rate for Payer: Humana ChoiceCare |
$500.72
|
| Rate for Payer: Humana Medicare |
$295.67
|
| Rate for Payer: Lucent All Commercial |
$295.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.77
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$434.80
|
| Rate for Payer: PHP All Commercial |
$439.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$226.10
|
| Rate for Payer: Sagamore Health Network All Products |
$447.56
|
| Rate for Payer: Signature Care EPO |
$481.18
|
| Rate for Payer: Signature Care PPO |
$510.17
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$492.78
|
| Rate for Payer: United Healthcare Commercial |
$456.84
|
| Rate for Payer: United Healthcare Medicare |
$191.31
|
|
|
HC Z SCREW 1.5X20 NON LOCK
|
Facility
IP
|
$579.74
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607701
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$434.80 |
| Max. Negotiated Rate |
$539.16 |
| Rate for Payer: Aetna Commercial |
$500.90
|
| Rate for Payer: Cash Price |
$359.44
|
| Rate for Payer: Cigna All Commercial |
$500.32
|
| Rate for Payer: CORVEL All Commercial |
$539.16
|
| Rate for Payer: Coventry All Commercial |
$510.17
|
| Rate for Payer: Encore All Commercial |
$533.65
|
| Rate for Payer: Frontpath All Commercial |
$533.36
|
| Rate for Payer: Humana ChoiceCare |
$500.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.77
|
| Rate for Payer: PHCS All Commercial |
$434.80
|
| Rate for Payer: PHP All Commercial |
$439.67
|
| Rate for Payer: Sagamore Health Network All Products |
$447.56
|
| Rate for Payer: Signature Care EPO |
$481.18
|
| Rate for Payer: Signature Care PPO |
$510.17
|
| Rate for Payer: United Healthcare Commercial |
$456.84
|
|
|
HC Z SCREW 1.5X22 LOCK
|
Facility
IP
|
$579.74
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605897
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$434.80 |
| Max. Negotiated Rate |
$539.16 |
| Rate for Payer: Aetna Commercial |
$500.90
|
| Rate for Payer: Cash Price |
$359.44
|
| Rate for Payer: Cigna All Commercial |
$500.32
|
| Rate for Payer: CORVEL All Commercial |
$539.16
|
| Rate for Payer: Coventry All Commercial |
$510.17
|
| Rate for Payer: Encore All Commercial |
$533.65
|
| Rate for Payer: Frontpath All Commercial |
$533.36
|
| Rate for Payer: Humana ChoiceCare |
$500.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.77
|
| Rate for Payer: PHCS All Commercial |
$434.80
|
| Rate for Payer: PHP All Commercial |
$439.67
|
| Rate for Payer: Sagamore Health Network All Products |
$447.56
|
| Rate for Payer: Signature Care EPO |
$481.18
|
| Rate for Payer: Signature Care PPO |
$510.17
|
| Rate for Payer: United Healthcare Commercial |
$456.84
|
|
|
HC Z SCREW 1.5X22 LOCK
|
Facility
OP
|
$579.74
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605897
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$191.31 |
| Max. Negotiated Rate |
$539.16 |
| Rate for Payer: Aetna Commercial |
$489.30
|
| Rate for Payer: Aetna Medicare |
$191.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$191.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$332.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$362.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$220.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$210.45
|
| Rate for Payer: Cash Price |
$359.44
|
| Rate for Payer: Cash Price |
$359.44
|
| Rate for Payer: Centivo All Commercial |
$295.67
|
| Rate for Payer: Cigna All Commercial |
$500.32
|
| Rate for Payer: CORVEL All Commercial |
$539.16
|
| Rate for Payer: Coventry All Commercial |
$510.17
|
| Rate for Payer: Encore All Commercial |
$533.65
|
| Rate for Payer: Frontpath All Commercial |
$533.36
|
| Rate for Payer: Humana ChoiceCare |
$500.72
|
| Rate for Payer: Humana Medicare |
$295.67
|
| Rate for Payer: Lucent All Commercial |
$295.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.77
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$434.80
|
| Rate for Payer: PHP All Commercial |
$439.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$226.10
|
| Rate for Payer: Sagamore Health Network All Products |
$447.56
|
| Rate for Payer: Signature Care EPO |
$481.18
|
| Rate for Payer: Signature Care PPO |
$510.17
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$492.78
|
| Rate for Payer: United Healthcare Commercial |
$456.84
|
| Rate for Payer: United Healthcare Medicare |
$191.31
|
|
|
HC Z SCREW 1.5X8 LOCK
|
Facility
IP
|
$579.74
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606582
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$434.80 |
| Max. Negotiated Rate |
$539.16 |
| Rate for Payer: Aetna Commercial |
$500.90
|
| Rate for Payer: Cash Price |
$359.44
|
| Rate for Payer: Cigna All Commercial |
$500.32
|
| Rate for Payer: CORVEL All Commercial |
$539.16
|
| Rate for Payer: Coventry All Commercial |
$510.17
|
| Rate for Payer: Encore All Commercial |
$533.65
|
| Rate for Payer: Frontpath All Commercial |
$533.36
|
| Rate for Payer: Humana ChoiceCare |
$500.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.77
|
| Rate for Payer: PHCS All Commercial |
$434.80
|
| Rate for Payer: PHP All Commercial |
$439.67
|
| Rate for Payer: Sagamore Health Network All Products |
$447.56
|
| Rate for Payer: Signature Care EPO |
$481.18
|
| Rate for Payer: Signature Care PPO |
$510.17
|
| Rate for Payer: United Healthcare Commercial |
$456.84
|
|
|
HC Z SCREW 1.5X8 LOCK
|
Facility
OP
|
$579.74
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606582
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$191.31 |
| Max. Negotiated Rate |
$539.16 |
| Rate for Payer: Aetna Commercial |
$489.30
|
| Rate for Payer: Aetna Medicare |
$191.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$191.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$332.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$362.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$220.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$210.45
|
| Rate for Payer: Cash Price |
$359.44
|
| Rate for Payer: Cash Price |
$359.44
|
| Rate for Payer: Centivo All Commercial |
$295.67
|
| Rate for Payer: Cigna All Commercial |
$500.32
|
| Rate for Payer: CORVEL All Commercial |
$539.16
|
| Rate for Payer: Coventry All Commercial |
$510.17
|
| Rate for Payer: Encore All Commercial |
$533.65
|
| Rate for Payer: Frontpath All Commercial |
$533.36
|
| Rate for Payer: Humana ChoiceCare |
$500.72
|
| Rate for Payer: Humana Medicare |
$295.67
|
| Rate for Payer: Lucent All Commercial |
$295.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.77
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$434.80
|
| Rate for Payer: PHP All Commercial |
$439.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$226.10
|
| Rate for Payer: Sagamore Health Network All Products |
$447.56
|
| Rate for Payer: Signature Care EPO |
$481.18
|
| Rate for Payer: Signature Care PPO |
$510.17
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$492.78
|
| Rate for Payer: United Healthcare Commercial |
$456.84
|
| Rate for Payer: United Healthcare Medicare |
$191.31
|
|
|
HC Z SCREW 1.5X9 LOCK
|
Facility
OP
|
$579.74
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606324
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$191.31 |
| Max. Negotiated Rate |
$539.16 |
| Rate for Payer: Aetna Commercial |
$489.30
|
| Rate for Payer: Aetna Medicare |
$191.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$191.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$332.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$362.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$220.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$210.45
|
| Rate for Payer: Cash Price |
$359.44
|
| Rate for Payer: Cash Price |
$359.44
|
| Rate for Payer: Centivo All Commercial |
$295.67
|
| Rate for Payer: Cigna All Commercial |
$500.32
|
| Rate for Payer: CORVEL All Commercial |
$539.16
|
| Rate for Payer: Coventry All Commercial |
$510.17
|
| Rate for Payer: Encore All Commercial |
$533.65
|
| Rate for Payer: Frontpath All Commercial |
$533.36
|
| Rate for Payer: Humana ChoiceCare |
$500.72
|
| Rate for Payer: Humana Medicare |
$295.67
|
| Rate for Payer: Lucent All Commercial |
$295.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.77
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$434.80
|
| Rate for Payer: PHP All Commercial |
$439.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$226.10
|
| Rate for Payer: Sagamore Health Network All Products |
$447.56
|
| Rate for Payer: Signature Care EPO |
$481.18
|
| Rate for Payer: Signature Care PPO |
$510.17
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$492.78
|
| Rate for Payer: United Healthcare Commercial |
$456.84
|
| Rate for Payer: United Healthcare Medicare |
$191.31
|
|
|
HC Z SCREW 1.5X9 LOCK
|
Facility
IP
|
$579.74
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606324
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$434.80 |
| Max. Negotiated Rate |
$539.16 |
| Rate for Payer: Aetna Commercial |
$500.90
|
| Rate for Payer: Cash Price |
$359.44
|
| Rate for Payer: Cigna All Commercial |
$500.32
|
| Rate for Payer: CORVEL All Commercial |
$539.16
|
| Rate for Payer: Coventry All Commercial |
$510.17
|
| Rate for Payer: Encore All Commercial |
$533.65
|
| Rate for Payer: Frontpath All Commercial |
$533.36
|
| Rate for Payer: Humana ChoiceCare |
$500.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.77
|
| Rate for Payer: PHCS All Commercial |
$434.80
|
| Rate for Payer: PHP All Commercial |
$439.67
|
| Rate for Payer: Sagamore Health Network All Products |
$447.56
|
| Rate for Payer: Signature Care EPO |
$481.18
|
| Rate for Payer: Signature Care PPO |
$510.17
|
| Rate for Payer: United Healthcare Commercial |
$456.84
|
|
|
HC Z SCREW 1.5X9 NON LOCK
|
Facility
IP
|
$579.74
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608222
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$434.80 |
| Max. Negotiated Rate |
$539.16 |
| Rate for Payer: Aetna Commercial |
$500.90
|
| Rate for Payer: Cash Price |
$359.44
|
| Rate for Payer: Cigna All Commercial |
$500.32
|
| Rate for Payer: CORVEL All Commercial |
$539.16
|
| Rate for Payer: Coventry All Commercial |
$510.17
|
| Rate for Payer: Encore All Commercial |
$533.65
|
| Rate for Payer: Frontpath All Commercial |
$533.36
|
| Rate for Payer: Humana ChoiceCare |
$500.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.77
|
| Rate for Payer: PHCS All Commercial |
$434.80
|
| Rate for Payer: PHP All Commercial |
$439.67
|
| Rate for Payer: Sagamore Health Network All Products |
$447.56
|
| Rate for Payer: Signature Care EPO |
$481.18
|
| Rate for Payer: Signature Care PPO |
$510.17
|
| Rate for Payer: United Healthcare Commercial |
$456.84
|
|
|
HC Z SCREW 1.5X9 NON LOCK
|
Facility
OP
|
$579.74
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608222
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$191.31 |
| Max. Negotiated Rate |
$539.16 |
| Rate for Payer: Aetna Commercial |
$489.30
|
| Rate for Payer: Aetna Medicare |
$191.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$191.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$332.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$362.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$220.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$210.45
|
| Rate for Payer: Cash Price |
$359.44
|
| Rate for Payer: Cash Price |
$359.44
|
| Rate for Payer: Centivo All Commercial |
$295.67
|
| Rate for Payer: Cigna All Commercial |
$500.32
|
| Rate for Payer: CORVEL All Commercial |
$539.16
|
| Rate for Payer: Coventry All Commercial |
$510.17
|
| Rate for Payer: Encore All Commercial |
$533.65
|
| Rate for Payer: Frontpath All Commercial |
$533.36
|
| Rate for Payer: Humana ChoiceCare |
$500.72
|
| Rate for Payer: Humana Medicare |
$295.67
|
| Rate for Payer: Lucent All Commercial |
$295.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.77
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$434.80
|
| Rate for Payer: PHP All Commercial |
$439.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$226.10
|
| Rate for Payer: Sagamore Health Network All Products |
$447.56
|
| Rate for Payer: Signature Care EPO |
$481.18
|
| Rate for Payer: Signature Care PPO |
$510.17
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$492.78
|
| Rate for Payer: United Healthcare Commercial |
$456.84
|
| Rate for Payer: United Healthcare Medicare |
$191.31
|
|
|
HC Z SCREW 2.4X10 CORT
|
Facility
OP
|
$428.82
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603876
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$141.51 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$361.92
|
| Rate for Payer: Aetna Medicare |
$141.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$141.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$246.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$268.06
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$162.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$155.66
|
| Rate for Payer: Cash Price |
$265.87
|
| Rate for Payer: Cash Price |
$265.87
|
| Rate for Payer: Centivo All Commercial |
$218.70
|
| Rate for Payer: Cigna All Commercial |
$370.07
|
| Rate for Payer: CORVEL All Commercial |
$398.80
|
| Rate for Payer: Coventry All Commercial |
$377.36
|
| Rate for Payer: Encore All Commercial |
$394.73
|
| Rate for Payer: Frontpath All Commercial |
$394.51
|
| Rate for Payer: Humana ChoiceCare |
$370.37
|
| Rate for Payer: Humana Medicare |
$218.70
|
| Rate for Payer: Lucent All Commercial |
$218.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$385.94
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$321.62
|
| Rate for Payer: PHP All Commercial |
$325.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$167.24
|
| Rate for Payer: Sagamore Health Network All Products |
$331.05
|
| Rate for Payer: Signature Care EPO |
$355.92
|
| Rate for Payer: Signature Care PPO |
$377.36
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$364.50
|
| Rate for Payer: United Healthcare Commercial |
$337.91
|
| Rate for Payer: United Healthcare Medicare |
$141.51
|
|
|
HC Z SCREW 2.4X10 CORT
|
Facility
IP
|
$428.82
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603876
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$321.62 |
| Max. Negotiated Rate |
$398.80 |
| Rate for Payer: Aetna Commercial |
$370.50
|
| Rate for Payer: Cash Price |
$265.87
|
| Rate for Payer: Cigna All Commercial |
$370.07
|
| Rate for Payer: CORVEL All Commercial |
$398.80
|
| Rate for Payer: Coventry All Commercial |
$377.36
|
| Rate for Payer: Encore All Commercial |
$394.73
|
| Rate for Payer: Frontpath All Commercial |
$394.51
|
| Rate for Payer: Humana ChoiceCare |
$370.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$385.94
|
| Rate for Payer: PHCS All Commercial |
$321.62
|
| Rate for Payer: PHP All Commercial |
$325.22
|
| Rate for Payer: Sagamore Health Network All Products |
$331.05
|
| Rate for Payer: Signature Care EPO |
$355.92
|
| Rate for Payer: Signature Care PPO |
$377.36
|
| Rate for Payer: United Healthcare Commercial |
$337.91
|
|
|
HC Z SCREW 2.4X10 LOCK
|
Facility
IP
|
$629.23
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603604
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$471.92 |
| Max. Negotiated Rate |
$585.18 |
| Rate for Payer: Aetna Commercial |
$543.65
|
| Rate for Payer: Cash Price |
$390.12
|
| Rate for Payer: Cigna All Commercial |
$543.03
|
| Rate for Payer: CORVEL All Commercial |
$585.18
|
| Rate for Payer: Coventry All Commercial |
$553.72
|
| Rate for Payer: Encore All Commercial |
$579.21
|
| Rate for Payer: Frontpath All Commercial |
$578.89
|
| Rate for Payer: Humana ChoiceCare |
$543.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$566.31
|
| Rate for Payer: PHCS All Commercial |
$471.92
|
| Rate for Payer: PHP All Commercial |
$477.21
|
| Rate for Payer: Sagamore Health Network All Products |
$485.77
|
| Rate for Payer: Signature Care EPO |
$522.26
|
| Rate for Payer: Signature Care PPO |
$553.72
|
| Rate for Payer: United Healthcare Commercial |
$495.83
|
|
|
HC Z SCREW 2.4X10 LOCK
|
Facility
OP
|
$629.23
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603604
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$207.65 |
| Max. Negotiated Rate |
$585.18 |
| Rate for Payer: Aetna Commercial |
$531.07
|
| Rate for Payer: Aetna Medicare |
$207.65
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$207.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$361.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$393.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$238.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$228.41
|
| Rate for Payer: Cash Price |
$390.12
|
| Rate for Payer: Cash Price |
$390.12
|
| Rate for Payer: Centivo All Commercial |
$320.91
|
| Rate for Payer: Cigna All Commercial |
$543.03
|
| Rate for Payer: CORVEL All Commercial |
$585.18
|
| Rate for Payer: Coventry All Commercial |
$553.72
|
| Rate for Payer: Encore All Commercial |
$579.21
|
| Rate for Payer: Frontpath All Commercial |
$578.89
|
| Rate for Payer: Humana ChoiceCare |
$543.47
|
| Rate for Payer: Humana Medicare |
$320.91
|
| Rate for Payer: Lucent All Commercial |
$320.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$566.31
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$471.92
|
| Rate for Payer: PHP All Commercial |
$477.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$245.40
|
| Rate for Payer: Sagamore Health Network All Products |
$485.77
|
| Rate for Payer: Signature Care EPO |
$522.26
|
| Rate for Payer: Signature Care PPO |
$553.72
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$534.85
|
| Rate for Payer: United Healthcare Commercial |
$495.83
|
| Rate for Payer: United Healthcare Medicare |
$207.65
|
|
|
HC Z SCREW 2.4X11 CORT
|
Facility
IP
|
$428.82
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604304
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$321.62 |
| Max. Negotiated Rate |
$398.80 |
| Rate for Payer: Aetna Commercial |
$370.50
|
| Rate for Payer: Cash Price |
$265.87
|
| Rate for Payer: Cigna All Commercial |
$370.07
|
| Rate for Payer: CORVEL All Commercial |
$398.80
|
| Rate for Payer: Coventry All Commercial |
$377.36
|
| Rate for Payer: Encore All Commercial |
$394.73
|
| Rate for Payer: Frontpath All Commercial |
$394.51
|
| Rate for Payer: Humana ChoiceCare |
$370.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$385.94
|
| Rate for Payer: PHCS All Commercial |
$321.62
|
| Rate for Payer: PHP All Commercial |
$325.22
|
| Rate for Payer: Sagamore Health Network All Products |
$331.05
|
| Rate for Payer: Signature Care EPO |
$355.92
|
| Rate for Payer: Signature Care PPO |
$377.36
|
| Rate for Payer: United Healthcare Commercial |
$337.91
|
|
|
HC Z SCREW 2.4X11 CORT
|
Facility
OP
|
$428.82
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604304
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$141.51 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$361.92
|
| Rate for Payer: Aetna Medicare |
$141.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$141.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$246.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$268.06
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$162.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$155.66
|
| Rate for Payer: Cash Price |
$265.87
|
| Rate for Payer: Cash Price |
$265.87
|
| Rate for Payer: Centivo All Commercial |
$218.70
|
| Rate for Payer: Cigna All Commercial |
$370.07
|
| Rate for Payer: CORVEL All Commercial |
$398.80
|
| Rate for Payer: Coventry All Commercial |
$377.36
|
| Rate for Payer: Encore All Commercial |
$394.73
|
| Rate for Payer: Frontpath All Commercial |
$394.51
|
| Rate for Payer: Humana ChoiceCare |
$370.37
|
| Rate for Payer: Humana Medicare |
$218.70
|
| Rate for Payer: Lucent All Commercial |
$218.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$385.94
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$321.62
|
| Rate for Payer: PHP All Commercial |
$325.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$167.24
|
| Rate for Payer: Sagamore Health Network All Products |
$331.05
|
| Rate for Payer: Signature Care EPO |
$355.92
|
| Rate for Payer: Signature Care PPO |
$377.36
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$364.50
|
| Rate for Payer: United Healthcare Commercial |
$337.91
|
| Rate for Payer: United Healthcare Medicare |
$141.51
|
|
|
HC Z SCREW 2.4X11 LOCK
|
Facility
IP
|
$629.23
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603978
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$471.92 |
| Max. Negotiated Rate |
$585.18 |
| Rate for Payer: Aetna Commercial |
$543.65
|
| Rate for Payer: Cash Price |
$390.12
|
| Rate for Payer: Cigna All Commercial |
$543.03
|
| Rate for Payer: CORVEL All Commercial |
$585.18
|
| Rate for Payer: Coventry All Commercial |
$553.72
|
| Rate for Payer: Encore All Commercial |
$579.21
|
| Rate for Payer: Frontpath All Commercial |
$578.89
|
| Rate for Payer: Humana ChoiceCare |
$543.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$566.31
|
| Rate for Payer: PHCS All Commercial |
$471.92
|
| Rate for Payer: PHP All Commercial |
$477.21
|
| Rate for Payer: Sagamore Health Network All Products |
$485.77
|
| Rate for Payer: Signature Care EPO |
$522.26
|
| Rate for Payer: Signature Care PPO |
$553.72
|
| Rate for Payer: United Healthcare Commercial |
$495.83
|
|
|
HC Z SCREW 2.4X11 LOCK
|
Facility
OP
|
$629.23
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603978
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$207.65 |
| Max. Negotiated Rate |
$585.18 |
| Rate for Payer: Aetna Commercial |
$531.07
|
| Rate for Payer: Aetna Medicare |
$207.65
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$207.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$361.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$393.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$238.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$228.41
|
| Rate for Payer: Cash Price |
$390.12
|
| Rate for Payer: Cash Price |
$390.12
|
| Rate for Payer: Centivo All Commercial |
$320.91
|
| Rate for Payer: Cigna All Commercial |
$543.03
|
| Rate for Payer: CORVEL All Commercial |
$585.18
|
| Rate for Payer: Coventry All Commercial |
$553.72
|
| Rate for Payer: Encore All Commercial |
$579.21
|
| Rate for Payer: Frontpath All Commercial |
$578.89
|
| Rate for Payer: Humana ChoiceCare |
$543.47
|
| Rate for Payer: Humana Medicare |
$320.91
|
| Rate for Payer: Lucent All Commercial |
$320.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$566.31
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$471.92
|
| Rate for Payer: PHP All Commercial |
$477.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$245.40
|
| Rate for Payer: Sagamore Health Network All Products |
$485.77
|
| Rate for Payer: Signature Care EPO |
$522.26
|
| Rate for Payer: Signature Care PPO |
$553.72
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$534.85
|
| Rate for Payer: United Healthcare Commercial |
$495.83
|
| Rate for Payer: United Healthcare Medicare |
$207.65
|
|
|
HC Z SCREW 2.4X12
|
Facility
IP
|
$428.82
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603603
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$321.62 |
| Max. Negotiated Rate |
$398.80 |
| Rate for Payer: Aetna Commercial |
$370.50
|
| Rate for Payer: Cash Price |
$265.87
|
| Rate for Payer: Cigna All Commercial |
$370.07
|
| Rate for Payer: CORVEL All Commercial |
$398.80
|
| Rate for Payer: Coventry All Commercial |
$377.36
|
| Rate for Payer: Encore All Commercial |
$394.73
|
| Rate for Payer: Frontpath All Commercial |
$394.51
|
| Rate for Payer: Humana ChoiceCare |
$370.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$385.94
|
| Rate for Payer: PHCS All Commercial |
$321.62
|
| Rate for Payer: PHP All Commercial |
$325.22
|
| Rate for Payer: Sagamore Health Network All Products |
$331.05
|
| Rate for Payer: Signature Care EPO |
$355.92
|
| Rate for Payer: Signature Care PPO |
$377.36
|
| Rate for Payer: United Healthcare Commercial |
$337.91
|
|
|
HC Z SCREW 2.4X12
|
Facility
OP
|
$428.82
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603603
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$141.51 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$361.92
|
| Rate for Payer: Aetna Medicare |
$141.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$141.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$246.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$268.06
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$162.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$155.66
|
| Rate for Payer: Cash Price |
$265.87
|
| Rate for Payer: Cash Price |
$265.87
|
| Rate for Payer: Centivo All Commercial |
$218.70
|
| Rate for Payer: Cigna All Commercial |
$370.07
|
| Rate for Payer: CORVEL All Commercial |
$398.80
|
| Rate for Payer: Coventry All Commercial |
$377.36
|
| Rate for Payer: Encore All Commercial |
$394.73
|
| Rate for Payer: Frontpath All Commercial |
$394.51
|
| Rate for Payer: Humana ChoiceCare |
$370.37
|
| Rate for Payer: Humana Medicare |
$218.70
|
| Rate for Payer: Lucent All Commercial |
$218.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$385.94
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$321.62
|
| Rate for Payer: PHP All Commercial |
$325.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$167.24
|
| Rate for Payer: Sagamore Health Network All Products |
$331.05
|
| Rate for Payer: Signature Care EPO |
$355.92
|
| Rate for Payer: Signature Care PPO |
$377.36
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$364.50
|
| Rate for Payer: United Healthcare Commercial |
$337.91
|
| Rate for Payer: United Healthcare Medicare |
$141.51
|
|
|
HC Z SCREW 2.4X12 LOCK
|
Facility
IP
|
$629.23
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603605
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$471.92 |
| Max. Negotiated Rate |
$585.18 |
| Rate for Payer: Aetna Commercial |
$543.65
|
| Rate for Payer: Cash Price |
$390.12
|
| Rate for Payer: Cigna All Commercial |
$543.03
|
| Rate for Payer: CORVEL All Commercial |
$585.18
|
| Rate for Payer: Coventry All Commercial |
$553.72
|
| Rate for Payer: Encore All Commercial |
$579.21
|
| Rate for Payer: Frontpath All Commercial |
$578.89
|
| Rate for Payer: Humana ChoiceCare |
$543.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$566.31
|
| Rate for Payer: PHCS All Commercial |
$471.92
|
| Rate for Payer: PHP All Commercial |
$477.21
|
| Rate for Payer: Sagamore Health Network All Products |
$485.77
|
| Rate for Payer: Signature Care EPO |
$522.26
|
| Rate for Payer: Signature Care PPO |
$553.72
|
| Rate for Payer: United Healthcare Commercial |
$495.83
|
|
|
HC Z SCREW 2.4X12 LOCK
|
Facility
OP
|
$629.23
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603605
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$207.65 |
| Max. Negotiated Rate |
$585.18 |
| Rate for Payer: Aetna Commercial |
$531.07
|
| Rate for Payer: Aetna Medicare |
$207.65
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$207.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$361.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$393.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$238.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$228.41
|
| Rate for Payer: Cash Price |
$390.12
|
| Rate for Payer: Cash Price |
$390.12
|
| Rate for Payer: Centivo All Commercial |
$320.91
|
| Rate for Payer: Cigna All Commercial |
$543.03
|
| Rate for Payer: CORVEL All Commercial |
$585.18
|
| Rate for Payer: Coventry All Commercial |
$553.72
|
| Rate for Payer: Encore All Commercial |
$579.21
|
| Rate for Payer: Frontpath All Commercial |
$578.89
|
| Rate for Payer: Humana ChoiceCare |
$543.47
|
| Rate for Payer: Humana Medicare |
$320.91
|
| Rate for Payer: Lucent All Commercial |
$320.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$566.31
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$471.92
|
| Rate for Payer: PHP All Commercial |
$477.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$245.40
|
| Rate for Payer: Sagamore Health Network All Products |
$485.77
|
| Rate for Payer: Signature Care EPO |
$522.26
|
| Rate for Payer: Signature Care PPO |
$553.72
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$534.85
|
| Rate for Payer: United Healthcare Commercial |
$495.83
|
| Rate for Payer: United Healthcare Medicare |
$207.65
|
|
|
HC Z SCREW 2.4X13 CORT
|
Facility
OP
|
$428.82
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604306
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$141.51 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$361.92
|
| Rate for Payer: Aetna Medicare |
$141.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$141.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$246.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$268.06
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$162.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$155.66
|
| Rate for Payer: Cash Price |
$265.87
|
| Rate for Payer: Cash Price |
$265.87
|
| Rate for Payer: Centivo All Commercial |
$218.70
|
| Rate for Payer: Cigna All Commercial |
$370.07
|
| Rate for Payer: CORVEL All Commercial |
$398.80
|
| Rate for Payer: Coventry All Commercial |
$377.36
|
| Rate for Payer: Encore All Commercial |
$394.73
|
| Rate for Payer: Frontpath All Commercial |
$394.51
|
| Rate for Payer: Humana ChoiceCare |
$370.37
|
| Rate for Payer: Humana Medicare |
$218.70
|
| Rate for Payer: Lucent All Commercial |
$218.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$385.94
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$321.62
|
| Rate for Payer: PHP All Commercial |
$325.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$167.24
|
| Rate for Payer: Sagamore Health Network All Products |
$331.05
|
| Rate for Payer: Signature Care EPO |
$355.92
|
| Rate for Payer: Signature Care PPO |
$377.36
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$364.50
|
| Rate for Payer: United Healthcare Commercial |
$337.91
|
| Rate for Payer: United Healthcare Medicare |
$141.51
|
|
|
HC Z SCREW 2.4X13 CORT
|
Facility
IP
|
$428.82
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604306
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$321.62 |
| Max. Negotiated Rate |
$398.80 |
| Rate for Payer: Aetna Commercial |
$370.50
|
| Rate for Payer: Cash Price |
$265.87
|
| Rate for Payer: Cigna All Commercial |
$370.07
|
| Rate for Payer: CORVEL All Commercial |
$398.80
|
| Rate for Payer: Coventry All Commercial |
$377.36
|
| Rate for Payer: Encore All Commercial |
$394.73
|
| Rate for Payer: Frontpath All Commercial |
$394.51
|
| Rate for Payer: Humana ChoiceCare |
$370.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$385.94
|
| Rate for Payer: PHCS All Commercial |
$321.62
|
| Rate for Payer: PHP All Commercial |
$325.22
|
| Rate for Payer: Sagamore Health Network All Products |
$331.05
|
| Rate for Payer: Signature Care EPO |
$355.92
|
| Rate for Payer: Signature Care PPO |
$377.36
|
| Rate for Payer: United Healthcare Commercial |
$337.91
|
|
|
HC Z SCREW 2.4X13 LOCK
|
Facility
IP
|
$629.23
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604328
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$471.92 |
| Max. Negotiated Rate |
$585.18 |
| Rate for Payer: Aetna Commercial |
$543.65
|
| Rate for Payer: Cash Price |
$390.12
|
| Rate for Payer: Cigna All Commercial |
$543.03
|
| Rate for Payer: CORVEL All Commercial |
$585.18
|
| Rate for Payer: Coventry All Commercial |
$553.72
|
| Rate for Payer: Encore All Commercial |
$579.21
|
| Rate for Payer: Frontpath All Commercial |
$578.89
|
| Rate for Payer: Humana ChoiceCare |
$543.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$566.31
|
| Rate for Payer: PHCS All Commercial |
$471.92
|
| Rate for Payer: PHP All Commercial |
$477.21
|
| Rate for Payer: Sagamore Health Network All Products |
$485.77
|
| Rate for Payer: Signature Care EPO |
$522.26
|
| Rate for Payer: Signature Care PPO |
$553.72
|
| Rate for Payer: United Healthcare Commercial |
$495.83
|
|
