|
HC Z SCREW 2.4X24
|
Facility
IP
|
$428.82
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604318
|
|
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 2.4X24
|
Facility
OP
|
$428.82
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604318
|
|
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 2.4X24 LOCK
|
Facility
IP
|
$629.23
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604317
|
|
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 2.4X24 LOCK
|
Facility
OP
|
$629.23
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604317
|
|
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 2.4X26
|
Facility
IP
|
$428.82
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604321
|
|
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 2.4X26
|
Facility
OP
|
$428.82
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604321
|
|
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 2.4X26 LOCK
|
Facility
OP
|
$629.23
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604320
|
|
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 2.4X26 LOCK
|
Facility
IP
|
$629.23
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604320
|
|
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 2.4X28
|
Facility
OP
|
$428.82
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604324
|
|
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 2.4X28
|
Facility
IP
|
$428.82
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604324
|
|
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 2.4X28 LOCK
|
Facility
OP
|
$629.23
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604323
|
|
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 2.4X28 LOCK
|
Facility
IP
|
$629.23
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604323
|
|
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 2.4X30
|
Facility
OP
|
$428.82
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604327
|
|
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 2.4X30
|
Facility
IP
|
$428.82
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604327
|
|
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 2.4X30 LOCK
|
Facility
OP
|
$629.23
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604326
|
|
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 2.4X30 LOCK
|
Facility
IP
|
$629.23
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604326
|
|
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 2.5X10 FT PEG
|
Facility
IP
|
$622.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606500
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$466.62 |
| Max. Negotiated Rate |
$578.61 |
| Rate for Payer: Aetna Commercial |
$537.55
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Cigna All Commercial |
$536.92
|
| Rate for Payer: CORVEL All Commercial |
$578.61
|
| Rate for Payer: Coventry All Commercial |
$547.50
|
| Rate for Payer: Encore All Commercial |
$572.70
|
| Rate for Payer: Frontpath All Commercial |
$572.39
|
| Rate for Payer: Humana ChoiceCare |
$537.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$559.94
|
| Rate for Payer: PHCS All Commercial |
$466.62
|
| Rate for Payer: PHP All Commercial |
$471.85
|
| Rate for Payer: Sagamore Health Network All Products |
$480.31
|
| Rate for Payer: Signature Care EPO |
$516.39
|
| Rate for Payer: Signature Care PPO |
$547.50
|
| Rate for Payer: United Healthcare Commercial |
$490.26
|
|
|
HC Z SCREW 2.5X10 FT PEG
|
Facility
OP
|
$622.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606500
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$205.31 |
| Max. Negotiated Rate |
$578.61 |
| Rate for Payer: Aetna Commercial |
$525.10
|
| Rate for Payer: Aetna Medicare |
$205.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$205.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$357.31
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$388.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$236.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$225.84
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Centivo All Commercial |
$317.30
|
| Rate for Payer: Cigna All Commercial |
$536.92
|
| Rate for Payer: CORVEL All Commercial |
$578.61
|
| Rate for Payer: Coventry All Commercial |
$547.50
|
| Rate for Payer: Encore All Commercial |
$572.70
|
| Rate for Payer: Frontpath All Commercial |
$572.39
|
| Rate for Payer: Humana ChoiceCare |
$537.36
|
| Rate for Payer: Humana Medicare |
$317.30
|
| Rate for Payer: Lucent All Commercial |
$317.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$559.94
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$466.62
|
| Rate for Payer: PHP All Commercial |
$471.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$242.64
|
| Rate for Payer: Sagamore Health Network All Products |
$480.31
|
| Rate for Payer: Signature Care EPO |
$516.39
|
| Rate for Payer: Signature Care PPO |
$547.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$528.84
|
| Rate for Payer: United Healthcare Commercial |
$490.26
|
| Rate for Payer: United Healthcare Medicare |
$205.31
|
|
|
HC Z SCREW 2.5X12 FT PEG
|
Facility
OP
|
$622.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605898
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$205.31 |
| Max. Negotiated Rate |
$578.61 |
| Rate for Payer: Aetna Commercial |
$525.10
|
| Rate for Payer: Aetna Medicare |
$205.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$205.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$357.31
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$388.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$236.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$225.84
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Centivo All Commercial |
$317.30
|
| Rate for Payer: Cigna All Commercial |
$536.92
|
| Rate for Payer: CORVEL All Commercial |
$578.61
|
| Rate for Payer: Coventry All Commercial |
$547.50
|
| Rate for Payer: Encore All Commercial |
$572.70
|
| Rate for Payer: Frontpath All Commercial |
$572.39
|
| Rate for Payer: Humana ChoiceCare |
$537.36
|
| Rate for Payer: Humana Medicare |
$317.30
|
| Rate for Payer: Lucent All Commercial |
$317.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$559.94
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$466.62
|
| Rate for Payer: PHP All Commercial |
$471.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$242.64
|
| Rate for Payer: Sagamore Health Network All Products |
$480.31
|
| Rate for Payer: Signature Care EPO |
$516.39
|
| Rate for Payer: Signature Care PPO |
$547.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$528.84
|
| Rate for Payer: United Healthcare Commercial |
$490.26
|
| Rate for Payer: United Healthcare Medicare |
$205.31
|
|
|
HC Z SCREW 2.5X12 FT PEG
|
Facility
IP
|
$622.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605898
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$466.62 |
| Max. Negotiated Rate |
$578.61 |
| Rate for Payer: Aetna Commercial |
$537.55
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Cigna All Commercial |
$536.92
|
| Rate for Payer: CORVEL All Commercial |
$578.61
|
| Rate for Payer: Coventry All Commercial |
$547.50
|
| Rate for Payer: Encore All Commercial |
$572.70
|
| Rate for Payer: Frontpath All Commercial |
$572.39
|
| Rate for Payer: Humana ChoiceCare |
$537.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$559.94
|
| Rate for Payer: PHCS All Commercial |
$466.62
|
| Rate for Payer: PHP All Commercial |
$471.85
|
| Rate for Payer: Sagamore Health Network All Products |
$480.31
|
| Rate for Payer: Signature Care EPO |
$516.39
|
| Rate for Payer: Signature Care PPO |
$547.50
|
| Rate for Payer: United Healthcare Commercial |
$490.26
|
|
|
HC Z SCREW 2.5X13 FT PEG
|
Facility
OP
|
$622.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606501
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$205.31 |
| Max. Negotiated Rate |
$578.61 |
| Rate for Payer: Aetna Commercial |
$525.10
|
| Rate for Payer: Aetna Medicare |
$205.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$205.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$357.31
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$388.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$236.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$225.84
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Centivo All Commercial |
$317.30
|
| Rate for Payer: Cigna All Commercial |
$536.92
|
| Rate for Payer: CORVEL All Commercial |
$578.61
|
| Rate for Payer: Coventry All Commercial |
$547.50
|
| Rate for Payer: Encore All Commercial |
$572.70
|
| Rate for Payer: Frontpath All Commercial |
$572.39
|
| Rate for Payer: Humana ChoiceCare |
$537.36
|
| Rate for Payer: Humana Medicare |
$317.30
|
| Rate for Payer: Lucent All Commercial |
$317.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$559.94
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$466.62
|
| Rate for Payer: PHP All Commercial |
$471.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$242.64
|
| Rate for Payer: Sagamore Health Network All Products |
$480.31
|
| Rate for Payer: Signature Care EPO |
$516.39
|
| Rate for Payer: Signature Care PPO |
$547.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$528.84
|
| Rate for Payer: United Healthcare Commercial |
$490.26
|
| Rate for Payer: United Healthcare Medicare |
$205.31
|
|
|
HC Z SCREW 2.5X13 FT PEG
|
Facility
IP
|
$622.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606501
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$466.62 |
| Max. Negotiated Rate |
$578.61 |
| Rate for Payer: Aetna Commercial |
$537.55
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Cigna All Commercial |
$536.92
|
| Rate for Payer: CORVEL All Commercial |
$578.61
|
| Rate for Payer: Coventry All Commercial |
$547.50
|
| Rate for Payer: Encore All Commercial |
$572.70
|
| Rate for Payer: Frontpath All Commercial |
$572.39
|
| Rate for Payer: Humana ChoiceCare |
$537.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$559.94
|
| Rate for Payer: PHCS All Commercial |
$466.62
|
| Rate for Payer: PHP All Commercial |
$471.85
|
| Rate for Payer: Sagamore Health Network All Products |
$480.31
|
| Rate for Payer: Signature Care EPO |
$516.39
|
| Rate for Payer: Signature Care PPO |
$547.50
|
| Rate for Payer: United Healthcare Commercial |
$490.26
|
|
|
HC Z SCREW 2.5X14 FT PEG
|
Facility
IP
|
$622.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606688
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$466.62 |
| Max. Negotiated Rate |
$578.61 |
| Rate for Payer: Aetna Commercial |
$537.55
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Cigna All Commercial |
$536.92
|
| Rate for Payer: CORVEL All Commercial |
$578.61
|
| Rate for Payer: Coventry All Commercial |
$547.50
|
| Rate for Payer: Encore All Commercial |
$572.70
|
| Rate for Payer: Frontpath All Commercial |
$572.39
|
| Rate for Payer: Humana ChoiceCare |
$537.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$559.94
|
| Rate for Payer: PHCS All Commercial |
$466.62
|
| Rate for Payer: PHP All Commercial |
$471.85
|
| Rate for Payer: Sagamore Health Network All Products |
$480.31
|
| Rate for Payer: Signature Care EPO |
$516.39
|
| Rate for Payer: Signature Care PPO |
$547.50
|
| Rate for Payer: United Healthcare Commercial |
$490.26
|
|
|
HC Z SCREW 2.5X14 FT PEG
|
Facility
OP
|
$622.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606688
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$205.31 |
| Max. Negotiated Rate |
$578.61 |
| Rate for Payer: Aetna Commercial |
$525.10
|
| Rate for Payer: Aetna Medicare |
$205.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$205.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$357.31
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$388.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$236.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$225.84
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Centivo All Commercial |
$317.30
|
| Rate for Payer: Cigna All Commercial |
$536.92
|
| Rate for Payer: CORVEL All Commercial |
$578.61
|
| Rate for Payer: Coventry All Commercial |
$547.50
|
| Rate for Payer: Encore All Commercial |
$572.70
|
| Rate for Payer: Frontpath All Commercial |
$572.39
|
| Rate for Payer: Humana ChoiceCare |
$537.36
|
| Rate for Payer: Humana Medicare |
$317.30
|
| Rate for Payer: Lucent All Commercial |
$317.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$559.94
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$466.62
|
| Rate for Payer: PHP All Commercial |
$471.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$242.64
|
| Rate for Payer: Sagamore Health Network All Products |
$480.31
|
| Rate for Payer: Signature Care EPO |
$516.39
|
| Rate for Payer: Signature Care PPO |
$547.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$528.84
|
| Rate for Payer: United Healthcare Commercial |
$490.26
|
| Rate for Payer: United Healthcare Medicare |
$205.31
|
|
|
HC Z SCREW 2.5X16 FT PEG
|
Facility
OP
|
$622.16
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605885
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$205.31 |
| Max. Negotiated Rate |
$578.61 |
| Rate for Payer: Aetna Commercial |
$525.10
|
| Rate for Payer: Aetna Medicare |
$205.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$205.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$357.31
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$388.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$236.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$225.84
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Cash Price |
$385.74
|
| Rate for Payer: Centivo All Commercial |
$317.30
|
| Rate for Payer: Cigna All Commercial |
$536.92
|
| Rate for Payer: CORVEL All Commercial |
$578.61
|
| Rate for Payer: Coventry All Commercial |
$547.50
|
| Rate for Payer: Encore All Commercial |
$572.70
|
| Rate for Payer: Frontpath All Commercial |
$572.39
|
| Rate for Payer: Humana ChoiceCare |
$537.36
|
| Rate for Payer: Humana Medicare |
$317.30
|
| Rate for Payer: Lucent All Commercial |
$317.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$559.94
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$466.62
|
| Rate for Payer: PHP All Commercial |
$471.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$242.64
|
| Rate for Payer: Sagamore Health Network All Products |
$480.31
|
| Rate for Payer: Signature Care EPO |
$516.39
|
| Rate for Payer: Signature Care PPO |
$547.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$528.84
|
| Rate for Payer: United Healthcare Commercial |
$490.26
|
| Rate for Payer: United Healthcare Medicare |
$205.31
|
|
