|
HC Z SCREW 2.7X26 NON LOCK SQ
|
Facility
IP
|
$466.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606289
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$349.96 |
| Max. Negotiated Rate |
$433.96 |
| Rate for Payer: Aetna Commercial |
$403.16
|
| Rate for Payer: Cash Price |
$289.30
|
| Rate for Payer: Cigna All Commercial |
$402.69
|
| Rate for Payer: CORVEL All Commercial |
$433.96
|
| Rate for Payer: Coventry All Commercial |
$410.63
|
| Rate for Payer: Encore All Commercial |
$429.52
|
| Rate for Payer: Frontpath All Commercial |
$429.29
|
| Rate for Payer: Humana ChoiceCare |
$403.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$419.96
|
| Rate for Payer: PHCS All Commercial |
$349.96
|
| Rate for Payer: PHP All Commercial |
$353.88
|
| Rate for Payer: Sagamore Health Network All Products |
$360.23
|
| Rate for Payer: Signature Care EPO |
$387.29
|
| Rate for Payer: Signature Care PPO |
$410.63
|
| Rate for Payer: United Healthcare Commercial |
$367.70
|
|
|
HC Z SCREW 2.7X26 NON LOCK SQ STE
|
Facility
OP
|
$855.47
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606455
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.31 |
| Max. Negotiated Rate |
$795.59 |
| Rate for Payer: Aetna Commercial |
$722.02
|
| Rate for Payer: Aetna Medicare |
$282.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$282.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$491.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$534.75
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$324.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$310.54
|
| Rate for Payer: Cash Price |
$530.39
|
| Rate for Payer: Cash Price |
$530.39
|
| Rate for Payer: Centivo All Commercial |
$436.29
|
| Rate for Payer: Cigna All Commercial |
$738.27
|
| Rate for Payer: CORVEL All Commercial |
$795.59
|
| Rate for Payer: Coventry All Commercial |
$752.81
|
| Rate for Payer: Encore All Commercial |
$787.46
|
| Rate for Payer: Frontpath All Commercial |
$787.03
|
| Rate for Payer: Humana ChoiceCare |
$738.87
|
| Rate for Payer: Humana Medicare |
$436.29
|
| Rate for Payer: Lucent All Commercial |
$436.29
|
| Rate for Payer: Lutheran Preferred All Commercial |
$769.92
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$641.60
|
| Rate for Payer: PHP All Commercial |
$648.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$333.63
|
| Rate for Payer: Sagamore Health Network All Products |
$660.42
|
| Rate for Payer: Signature Care EPO |
$710.04
|
| Rate for Payer: Signature Care PPO |
$752.81
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$727.15
|
| Rate for Payer: United Healthcare Commercial |
$674.11
|
| Rate for Payer: United Healthcare Medicare |
$282.31
|
|
|
HC Z SCREW 2.7X26 NON LOCK SQ STE
|
Facility
IP
|
$855.47
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606455
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$641.60 |
| Max. Negotiated Rate |
$795.59 |
| Rate for Payer: Aetna Commercial |
$739.13
|
| Rate for Payer: Cash Price |
$530.39
|
| Rate for Payer: Cigna All Commercial |
$738.27
|
| Rate for Payer: CORVEL All Commercial |
$795.59
|
| Rate for Payer: Coventry All Commercial |
$752.81
|
| Rate for Payer: Encore All Commercial |
$787.46
|
| Rate for Payer: Frontpath All Commercial |
$787.03
|
| Rate for Payer: Humana ChoiceCare |
$738.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$769.92
|
| Rate for Payer: PHCS All Commercial |
$641.60
|
| Rate for Payer: PHP All Commercial |
$648.79
|
| Rate for Payer: Sagamore Health Network All Products |
$660.42
|
| Rate for Payer: Signature Care EPO |
$710.04
|
| Rate for Payer: Signature Care PPO |
$752.81
|
| Rate for Payer: United Healthcare Commercial |
$674.11
|
|
|
HC Z SCREW 2.7X28 CORT FT
|
Facility
IP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606795
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$291.64 |
| Max. Negotiated Rate |
$361.63 |
| Rate for Payer: Aetna Commercial |
$335.97
|
| Rate for Payer: Cash Price |
$241.09
|
| Rate for Payer: Cigna All Commercial |
$335.58
|
| Rate for Payer: CORVEL All Commercial |
$361.63
|
| Rate for Payer: Coventry All Commercial |
$342.19
|
| Rate for Payer: Encore All Commercial |
$357.94
|
| Rate for Payer: Frontpath All Commercial |
$357.74
|
| Rate for Payer: Humana ChoiceCare |
$335.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$349.96
|
| Rate for Payer: PHCS All Commercial |
$291.64
|
| Rate for Payer: PHP All Commercial |
$294.90
|
| Rate for Payer: Sagamore Health Network All Products |
$300.19
|
| Rate for Payer: Signature Care EPO |
$322.75
|
| Rate for Payer: Signature Care PPO |
$342.19
|
| Rate for Payer: United Healthcare Commercial |
$306.41
|
|
|
HC Z SCREW 2.7X28 CORT FT
|
Facility
OP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606795
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$128.32 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$328.19
|
| Rate for Payer: Aetna Medicare |
$128.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$128.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$223.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$243.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$147.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$141.15
|
| Rate for Payer: Cash Price |
$241.09
|
| Rate for Payer: Cash Price |
$241.09
|
| Rate for Payer: Centivo All Commercial |
$198.31
|
| Rate for Payer: Cigna All Commercial |
$335.58
|
| Rate for Payer: CORVEL All Commercial |
$361.63
|
| Rate for Payer: Coventry All Commercial |
$342.19
|
| Rate for Payer: Encore All Commercial |
$357.94
|
| Rate for Payer: Frontpath All Commercial |
$357.74
|
| Rate for Payer: Humana ChoiceCare |
$335.85
|
| Rate for Payer: Humana Medicare |
$198.31
|
| Rate for Payer: Lucent All Commercial |
$198.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$349.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$291.64
|
| Rate for Payer: PHP All Commercial |
$294.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$151.65
|
| Rate for Payer: Sagamore Health Network All Products |
$300.19
|
| Rate for Payer: Signature Care EPO |
$322.75
|
| Rate for Payer: Signature Care PPO |
$342.19
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$330.52
|
| Rate for Payer: United Healthcare Commercial |
$306.41
|
| Rate for Payer: United Healthcare Medicare |
$128.32
|
|
|
HC Z SCREW 2.7X28 LOCK
|
Facility
IP
|
$722.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$541.80 |
| Max. Negotiated Rate |
$671.83 |
| Rate for Payer: Aetna Commercial |
$624.15
|
| Rate for Payer: Cash Price |
$447.89
|
| Rate for Payer: Cigna All Commercial |
$623.43
|
| Rate for Payer: CORVEL All Commercial |
$671.83
|
| Rate for Payer: Coventry All Commercial |
$635.71
|
| Rate for Payer: Encore All Commercial |
$664.97
|
| Rate for Payer: Frontpath All Commercial |
$664.61
|
| Rate for Payer: Humana ChoiceCare |
$623.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$650.16
|
| Rate for Payer: PHCS All Commercial |
$541.80
|
| Rate for Payer: PHP All Commercial |
$547.87
|
| Rate for Payer: Sagamore Health Network All Products |
$557.69
|
| Rate for Payer: Signature Care EPO |
$599.59
|
| Rate for Payer: Signature Care PPO |
$635.71
|
| Rate for Payer: United Healthcare Commercial |
$569.25
|
|
|
HC Z SCREW 2.7X28 LOCK
|
Facility
OP
|
$722.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$238.39 |
| Max. Negotiated Rate |
$671.83 |
| Rate for Payer: Aetna Commercial |
$609.71
|
| Rate for Payer: Aetna Medicare |
$238.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$238.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$414.87
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$451.57
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$274.15
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$262.23
|
| Rate for Payer: Cash Price |
$447.89
|
| Rate for Payer: Cash Price |
$447.89
|
| Rate for Payer: Centivo All Commercial |
$368.42
|
| Rate for Payer: Cigna All Commercial |
$623.43
|
| Rate for Payer: CORVEL All Commercial |
$671.83
|
| Rate for Payer: Coventry All Commercial |
$635.71
|
| Rate for Payer: Encore All Commercial |
$664.97
|
| Rate for Payer: Frontpath All Commercial |
$664.61
|
| Rate for Payer: Humana ChoiceCare |
$623.94
|
| Rate for Payer: Humana Medicare |
$368.42
|
| Rate for Payer: Lucent All Commercial |
$368.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$650.16
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$541.80
|
| Rate for Payer: PHP All Commercial |
$547.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$281.74
|
| Rate for Payer: Sagamore Health Network All Products |
$557.69
|
| Rate for Payer: Signature Care EPO |
$599.59
|
| Rate for Payer: Signature Care PPO |
$635.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$614.04
|
| Rate for Payer: United Healthcare Commercial |
$569.25
|
| Rate for Payer: United Healthcare Medicare |
$238.39
|
|
|
HC Z SCREW 2.7X28 LOCK SQ
|
Facility
IP
|
$777.70
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606276
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$583.28 |
| Max. Negotiated Rate |
$723.26 |
| Rate for Payer: Aetna Commercial |
$671.93
|
| Rate for Payer: Cash Price |
$482.17
|
| Rate for Payer: Cigna All Commercial |
$671.16
|
| Rate for Payer: CORVEL All Commercial |
$723.26
|
| Rate for Payer: Coventry All Commercial |
$684.38
|
| Rate for Payer: Encore All Commercial |
$715.87
|
| Rate for Payer: Frontpath All Commercial |
$715.48
|
| Rate for Payer: Humana ChoiceCare |
$671.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$699.93
|
| Rate for Payer: PHCS All Commercial |
$583.28
|
| Rate for Payer: PHP All Commercial |
$589.81
|
| Rate for Payer: Sagamore Health Network All Products |
$600.38
|
| Rate for Payer: Signature Care EPO |
$645.49
|
| Rate for Payer: Signature Care PPO |
$684.38
|
| Rate for Payer: United Healthcare Commercial |
$612.83
|
|
|
HC Z SCREW 2.7X28 LOCK SQ
|
Facility
OP
|
$777.70
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606276
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$256.64 |
| Max. Negotiated Rate |
$723.26 |
| Rate for Payer: Aetna Commercial |
$656.38
|
| Rate for Payer: Aetna Medicare |
$256.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$256.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$446.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$486.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$295.14
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$282.31
|
| Rate for Payer: Cash Price |
$482.17
|
| Rate for Payer: Cash Price |
$482.17
|
| Rate for Payer: Centivo All Commercial |
$396.63
|
| Rate for Payer: Cigna All Commercial |
$671.16
|
| Rate for Payer: CORVEL All Commercial |
$723.26
|
| Rate for Payer: Coventry All Commercial |
$684.38
|
| Rate for Payer: Encore All Commercial |
$715.87
|
| Rate for Payer: Frontpath All Commercial |
$715.48
|
| Rate for Payer: Humana ChoiceCare |
$671.70
|
| Rate for Payer: Humana Medicare |
$396.63
|
| Rate for Payer: Lucent All Commercial |
$396.63
|
| Rate for Payer: Lutheran Preferred All Commercial |
$699.93
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$583.28
|
| Rate for Payer: PHP All Commercial |
$589.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$303.30
|
| Rate for Payer: Sagamore Health Network All Products |
$600.38
|
| Rate for Payer: Signature Care EPO |
$645.49
|
| Rate for Payer: Signature Care PPO |
$684.38
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$661.04
|
| Rate for Payer: United Healthcare Commercial |
$612.83
|
| Rate for Payer: United Healthcare Medicare |
$256.64
|
|
|
HC Z SCREW 2.7X28 LOCK SQ STE
|
Facility
OP
|
$855.47
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606445
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.31 |
| Max. Negotiated Rate |
$795.59 |
| Rate for Payer: Aetna Commercial |
$722.02
|
| Rate for Payer: Aetna Medicare |
$282.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$282.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$491.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$534.75
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$324.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$310.54
|
| Rate for Payer: Cash Price |
$530.39
|
| Rate for Payer: Cash Price |
$530.39
|
| Rate for Payer: Centivo All Commercial |
$436.29
|
| Rate for Payer: Cigna All Commercial |
$738.27
|
| Rate for Payer: CORVEL All Commercial |
$795.59
|
| Rate for Payer: Coventry All Commercial |
$752.81
|
| Rate for Payer: Encore All Commercial |
$787.46
|
| Rate for Payer: Frontpath All Commercial |
$787.03
|
| Rate for Payer: Humana ChoiceCare |
$738.87
|
| Rate for Payer: Humana Medicare |
$436.29
|
| Rate for Payer: Lucent All Commercial |
$436.29
|
| Rate for Payer: Lutheran Preferred All Commercial |
$769.92
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$641.60
|
| Rate for Payer: PHP All Commercial |
$648.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$333.63
|
| Rate for Payer: Sagamore Health Network All Products |
$660.42
|
| Rate for Payer: Signature Care EPO |
$710.04
|
| Rate for Payer: Signature Care PPO |
$752.81
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$727.15
|
| Rate for Payer: United Healthcare Commercial |
$674.11
|
| Rate for Payer: United Healthcare Medicare |
$282.31
|
|
|
HC Z SCREW 2.7X28 LOCK SQ STE
|
Facility
IP
|
$855.47
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606445
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$641.60 |
| Max. Negotiated Rate |
$795.59 |
| Rate for Payer: Aetna Commercial |
$739.13
|
| Rate for Payer: Cash Price |
$530.39
|
| Rate for Payer: Cigna All Commercial |
$738.27
|
| Rate for Payer: CORVEL All Commercial |
$795.59
|
| Rate for Payer: Coventry All Commercial |
$752.81
|
| Rate for Payer: Encore All Commercial |
$787.46
|
| Rate for Payer: Frontpath All Commercial |
$787.03
|
| Rate for Payer: Humana ChoiceCare |
$738.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$769.92
|
| Rate for Payer: PHCS All Commercial |
$641.60
|
| Rate for Payer: PHP All Commercial |
$648.79
|
| Rate for Payer: Sagamore Health Network All Products |
$660.42
|
| Rate for Payer: Signature Care EPO |
$710.04
|
| Rate for Payer: Signature Care PPO |
$752.81
|
| Rate for Payer: United Healthcare Commercial |
$674.11
|
|
|
HC Z SCREW 2.7X28 MD
|
Facility
OP
|
$802.95
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606306
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$264.97 |
| Max. Negotiated Rate |
$746.74 |
| Rate for Payer: Aetna Commercial |
$677.69
|
| Rate for Payer: Aetna Medicare |
$264.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$264.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$461.13
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$501.92
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$304.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$291.47
|
| Rate for Payer: Cash Price |
$497.83
|
| Rate for Payer: Cash Price |
$497.83
|
| Rate for Payer: Centivo All Commercial |
$409.50
|
| Rate for Payer: Cigna All Commercial |
$692.95
|
| Rate for Payer: CORVEL All Commercial |
$746.74
|
| Rate for Payer: Coventry All Commercial |
$706.60
|
| Rate for Payer: Encore All Commercial |
$739.12
|
| Rate for Payer: Frontpath All Commercial |
$738.71
|
| Rate for Payer: Humana ChoiceCare |
$693.51
|
| Rate for Payer: Humana Medicare |
$409.50
|
| Rate for Payer: Lucent All Commercial |
$409.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$722.66
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$602.21
|
| Rate for Payer: PHP All Commercial |
$608.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$313.15
|
| Rate for Payer: Sagamore Health Network All Products |
$619.88
|
| Rate for Payer: Signature Care EPO |
$666.45
|
| Rate for Payer: Signature Care PPO |
$706.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$682.51
|
| Rate for Payer: United Healthcare Commercial |
$632.72
|
| Rate for Payer: United Healthcare Medicare |
$264.97
|
|
|
HC Z SCREW 2.7X28 MD
|
Facility
IP
|
$802.95
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606306
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$602.21 |
| Max. Negotiated Rate |
$746.74 |
| Rate for Payer: Aetna Commercial |
$693.75
|
| Rate for Payer: Cash Price |
$497.83
|
| Rate for Payer: Cigna All Commercial |
$692.95
|
| Rate for Payer: CORVEL All Commercial |
$746.74
|
| Rate for Payer: Coventry All Commercial |
$706.60
|
| Rate for Payer: Encore All Commercial |
$739.12
|
| Rate for Payer: Frontpath All Commercial |
$738.71
|
| Rate for Payer: Humana ChoiceCare |
$693.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$722.66
|
| Rate for Payer: PHCS All Commercial |
$602.21
|
| Rate for Payer: PHP All Commercial |
$608.96
|
| Rate for Payer: Sagamore Health Network All Products |
$619.88
|
| Rate for Payer: Signature Care EPO |
$666.45
|
| Rate for Payer: Signature Care PPO |
$706.60
|
| Rate for Payer: United Healthcare Commercial |
$632.72
|
|
|
HC Z SCREW 2.7X28 MD STE
|
Facility
IP
|
$1,615.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606467
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,211.25 |
| Max. Negotiated Rate |
$1,501.95 |
| Rate for Payer: Aetna Commercial |
$1,395.36
|
| Rate for Payer: Cash Price |
$1,001.30
|
| Rate for Payer: Cigna All Commercial |
$1,393.74
|
| Rate for Payer: CORVEL All Commercial |
$1,501.95
|
| Rate for Payer: Coventry All Commercial |
$1,421.20
|
| Rate for Payer: Encore All Commercial |
$1,486.61
|
| Rate for Payer: Frontpath All Commercial |
$1,485.80
|
| Rate for Payer: Humana ChoiceCare |
$1,394.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,453.50
|
| Rate for Payer: PHCS All Commercial |
$1,211.25
|
| Rate for Payer: PHP All Commercial |
$1,224.82
|
| Rate for Payer: Sagamore Health Network All Products |
$1,246.78
|
| Rate for Payer: Signature Care EPO |
$1,340.45
|
| Rate for Payer: Signature Care PPO |
$1,421.20
|
| Rate for Payer: United Healthcare Commercial |
$1,272.62
|
|
|
HC Z SCREW 2.7X28 MD STE
|
Facility
OP
|
$1,615.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606467
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,501.95 |
| Rate for Payer: Aetna Commercial |
$1,363.06
|
| Rate for Payer: Aetna Medicare |
$532.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$532.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$927.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,009.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$612.89
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$586.24
|
| Rate for Payer: Cash Price |
$1,001.30
|
| Rate for Payer: Cash Price |
$1,001.30
|
| Rate for Payer: Centivo All Commercial |
$823.65
|
| Rate for Payer: Cigna All Commercial |
$1,393.74
|
| Rate for Payer: CORVEL All Commercial |
$1,501.95
|
| Rate for Payer: Coventry All Commercial |
$1,421.20
|
| Rate for Payer: Encore All Commercial |
$1,486.61
|
| Rate for Payer: Frontpath All Commercial |
$1,485.80
|
| Rate for Payer: Humana ChoiceCare |
$1,394.88
|
| Rate for Payer: Humana Medicare |
$823.65
|
| Rate for Payer: Lucent All Commercial |
$823.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,453.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,211.25
|
| Rate for Payer: PHP All Commercial |
$1,224.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$629.85
|
| Rate for Payer: Sagamore Health Network All Products |
$1,246.78
|
| Rate for Payer: Signature Care EPO |
$1,340.45
|
| Rate for Payer: Signature Care PPO |
$1,421.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,372.75
|
| Rate for Payer: United Healthcare Commercial |
$1,272.62
|
| Rate for Payer: United Healthcare Medicare |
$532.95
|
|
|
HC Z SCREW 2.7X28 NON LOCK SQ
|
Facility
OP
|
$466.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606290
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.98 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$393.83
|
| Rate for Payer: Aetna Medicare |
$153.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$153.98
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$267.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$291.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$177.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$169.38
|
| Rate for Payer: Cash Price |
$289.30
|
| Rate for Payer: Cash Price |
$289.30
|
| Rate for Payer: Centivo All Commercial |
$237.98
|
| Rate for Payer: Cigna All Commercial |
$402.69
|
| Rate for Payer: CORVEL All Commercial |
$433.96
|
| Rate for Payer: Coventry All Commercial |
$410.63
|
| Rate for Payer: Encore All Commercial |
$429.52
|
| Rate for Payer: Frontpath All Commercial |
$429.29
|
| Rate for Payer: Humana ChoiceCare |
$403.02
|
| Rate for Payer: Humana Medicare |
$237.98
|
| Rate for Payer: Lucent All Commercial |
$237.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$419.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$349.96
|
| Rate for Payer: PHP All Commercial |
$353.88
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$181.98
|
| Rate for Payer: Sagamore Health Network All Products |
$360.23
|
| Rate for Payer: Signature Care EPO |
$387.29
|
| Rate for Payer: Signature Care PPO |
$410.63
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$396.63
|
| Rate for Payer: United Healthcare Commercial |
$367.70
|
| Rate for Payer: United Healthcare Medicare |
$153.98
|
|
|
HC Z SCREW 2.7X28 NON LOCK SQ
|
Facility
IP
|
$466.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606290
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$349.96 |
| Max. Negotiated Rate |
$433.96 |
| Rate for Payer: Aetna Commercial |
$403.16
|
| Rate for Payer: Cash Price |
$289.30
|
| Rate for Payer: Cigna All Commercial |
$402.69
|
| Rate for Payer: CORVEL All Commercial |
$433.96
|
| Rate for Payer: Coventry All Commercial |
$410.63
|
| Rate for Payer: Encore All Commercial |
$429.52
|
| Rate for Payer: Frontpath All Commercial |
$429.29
|
| Rate for Payer: Humana ChoiceCare |
$403.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$419.96
|
| Rate for Payer: PHCS All Commercial |
$349.96
|
| Rate for Payer: PHP All Commercial |
$353.88
|
| Rate for Payer: Sagamore Health Network All Products |
$360.23
|
| Rate for Payer: Signature Care EPO |
$387.29
|
| Rate for Payer: Signature Care PPO |
$410.63
|
| Rate for Payer: United Healthcare Commercial |
$367.70
|
|
|
HC Z SCREW 2.7X28 NON LOCK SQ STE
|
Facility
IP
|
$855.47
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606456
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$641.60 |
| Max. Negotiated Rate |
$795.59 |
| Rate for Payer: Aetna Commercial |
$739.13
|
| Rate for Payer: Cash Price |
$530.39
|
| Rate for Payer: Cigna All Commercial |
$738.27
|
| Rate for Payer: CORVEL All Commercial |
$795.59
|
| Rate for Payer: Coventry All Commercial |
$752.81
|
| Rate for Payer: Encore All Commercial |
$787.46
|
| Rate for Payer: Frontpath All Commercial |
$787.03
|
| Rate for Payer: Humana ChoiceCare |
$738.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$769.92
|
| Rate for Payer: PHCS All Commercial |
$641.60
|
| Rate for Payer: PHP All Commercial |
$648.79
|
| Rate for Payer: Sagamore Health Network All Products |
$660.42
|
| Rate for Payer: Signature Care EPO |
$710.04
|
| Rate for Payer: Signature Care PPO |
$752.81
|
| Rate for Payer: United Healthcare Commercial |
$674.11
|
|
|
HC Z SCREW 2.7X28 NON LOCK SQ STE
|
Facility
OP
|
$855.47
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606456
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.31 |
| Max. Negotiated Rate |
$795.59 |
| Rate for Payer: Aetna Commercial |
$722.02
|
| Rate for Payer: Aetna Medicare |
$282.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$282.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$491.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$534.75
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$324.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$310.54
|
| Rate for Payer: Cash Price |
$530.39
|
| Rate for Payer: Cash Price |
$530.39
|
| Rate for Payer: Centivo All Commercial |
$436.29
|
| Rate for Payer: Cigna All Commercial |
$738.27
|
| Rate for Payer: CORVEL All Commercial |
$795.59
|
| Rate for Payer: Coventry All Commercial |
$752.81
|
| Rate for Payer: Encore All Commercial |
$787.46
|
| Rate for Payer: Frontpath All Commercial |
$787.03
|
| Rate for Payer: Humana ChoiceCare |
$738.87
|
| Rate for Payer: Humana Medicare |
$436.29
|
| Rate for Payer: Lucent All Commercial |
$436.29
|
| Rate for Payer: Lutheran Preferred All Commercial |
$769.92
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$641.60
|
| Rate for Payer: PHP All Commercial |
$648.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$333.63
|
| Rate for Payer: Sagamore Health Network All Products |
$660.42
|
| Rate for Payer: Signature Care EPO |
$710.04
|
| Rate for Payer: Signature Care PPO |
$752.81
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$727.15
|
| Rate for Payer: United Healthcare Commercial |
$674.11
|
| Rate for Payer: United Healthcare Medicare |
$282.31
|
|
|
HC Z SCREW 2.7X30 CORT FT
|
Facility
IP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606796
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$291.64 |
| Max. Negotiated Rate |
$361.63 |
| Rate for Payer: Aetna Commercial |
$335.97
|
| Rate for Payer: Cash Price |
$241.09
|
| Rate for Payer: Cigna All Commercial |
$335.58
|
| Rate for Payer: CORVEL All Commercial |
$361.63
|
| Rate for Payer: Coventry All Commercial |
$342.19
|
| Rate for Payer: Encore All Commercial |
$357.94
|
| Rate for Payer: Frontpath All Commercial |
$357.74
|
| Rate for Payer: Humana ChoiceCare |
$335.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$349.96
|
| Rate for Payer: PHCS All Commercial |
$291.64
|
| Rate for Payer: PHP All Commercial |
$294.90
|
| Rate for Payer: Sagamore Health Network All Products |
$300.19
|
| Rate for Payer: Signature Care EPO |
$322.75
|
| Rate for Payer: Signature Care PPO |
$342.19
|
| Rate for Payer: United Healthcare Commercial |
$306.41
|
|
|
HC Z SCREW 2.7X30 CORT FT
|
Facility
OP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606796
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$128.32 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$328.19
|
| Rate for Payer: Aetna Medicare |
$128.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$128.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$223.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$243.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$147.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$141.15
|
| Rate for Payer: Cash Price |
$241.09
|
| Rate for Payer: Cash Price |
$241.09
|
| Rate for Payer: Centivo All Commercial |
$198.31
|
| Rate for Payer: Cigna All Commercial |
$335.58
|
| Rate for Payer: CORVEL All Commercial |
$361.63
|
| Rate for Payer: Coventry All Commercial |
$342.19
|
| Rate for Payer: Encore All Commercial |
$357.94
|
| Rate for Payer: Frontpath All Commercial |
$357.74
|
| Rate for Payer: Humana ChoiceCare |
$335.85
|
| Rate for Payer: Humana Medicare |
$198.31
|
| Rate for Payer: Lucent All Commercial |
$198.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$349.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$291.64
|
| Rate for Payer: PHP All Commercial |
$294.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$151.65
|
| Rate for Payer: Sagamore Health Network All Products |
$300.19
|
| Rate for Payer: Signature Care EPO |
$322.75
|
| Rate for Payer: Signature Care PPO |
$342.19
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$330.52
|
| Rate for Payer: United Healthcare Commercial |
$306.41
|
| Rate for Payer: United Healthcare Medicare |
$128.32
|
|
|
HC Z SCREW 2.7X30 CORT S-T HEX SM
|
Facility
IP
|
$149.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604624
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$111.88 |
| Max. Negotiated Rate |
$138.73 |
| Rate for Payer: Aetna Commercial |
$128.88
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Cigna All Commercial |
$128.73
|
| Rate for Payer: CORVEL All Commercial |
$138.73
|
| Rate for Payer: Coventry All Commercial |
$131.27
|
| Rate for Payer: Encore All Commercial |
$137.31
|
| Rate for Payer: Frontpath All Commercial |
$137.24
|
| Rate for Payer: Humana ChoiceCare |
$128.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$134.25
|
| Rate for Payer: PHCS All Commercial |
$111.88
|
| Rate for Payer: PHP All Commercial |
$113.13
|
| Rate for Payer: Sagamore Health Network All Products |
$115.16
|
| Rate for Payer: Signature Care EPO |
$123.81
|
| Rate for Payer: Signature Care PPO |
$131.27
|
| Rate for Payer: United Healthcare Commercial |
$117.55
|
|
|
HC Z SCREW 2.7X30 CORT S-T HEX SM
|
Facility
OP
|
$149.17
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604624
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$49.23 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$125.90
|
| Rate for Payer: Aetna Medicare |
$49.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$49.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$85.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$93.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$56.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$54.15
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Cash Price |
$92.49
|
| Rate for Payer: Centivo All Commercial |
$76.08
|
| Rate for Payer: Cigna All Commercial |
$128.73
|
| Rate for Payer: CORVEL All Commercial |
$138.73
|
| Rate for Payer: Coventry All Commercial |
$131.27
|
| Rate for Payer: Encore All Commercial |
$137.31
|
| Rate for Payer: Frontpath All Commercial |
$137.24
|
| Rate for Payer: Humana ChoiceCare |
$128.84
|
| Rate for Payer: Humana Medicare |
$76.08
|
| Rate for Payer: Lucent All Commercial |
$76.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$134.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$111.88
|
| Rate for Payer: PHP All Commercial |
$113.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$58.18
|
| Rate for Payer: Sagamore Health Network All Products |
$115.16
|
| Rate for Payer: Signature Care EPO |
$123.81
|
| Rate for Payer: Signature Care PPO |
$131.27
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$126.79
|
| Rate for Payer: United Healthcare Commercial |
$117.55
|
| Rate for Payer: United Healthcare Medicare |
$49.23
|
|
|
HC Z SCREW 2.7X30 LOCK
|
Facility
IP
|
$722.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604128
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$541.80 |
| Max. Negotiated Rate |
$671.83 |
| Rate for Payer: Aetna Commercial |
$624.15
|
| Rate for Payer: Cash Price |
$447.89
|
| Rate for Payer: Cigna All Commercial |
$623.43
|
| Rate for Payer: CORVEL All Commercial |
$671.83
|
| Rate for Payer: Coventry All Commercial |
$635.71
|
| Rate for Payer: Encore All Commercial |
$664.97
|
| Rate for Payer: Frontpath All Commercial |
$664.61
|
| Rate for Payer: Humana ChoiceCare |
$623.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$650.16
|
| Rate for Payer: PHCS All Commercial |
$541.80
|
| Rate for Payer: PHP All Commercial |
$547.87
|
| Rate for Payer: Sagamore Health Network All Products |
$557.69
|
| Rate for Payer: Signature Care EPO |
$599.59
|
| Rate for Payer: Signature Care PPO |
$635.71
|
| Rate for Payer: United Healthcare Commercial |
$569.25
|
|
|
HC Z SCREW 2.7X30 LOCK
|
Facility
OP
|
$722.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604128
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$238.39 |
| Max. Negotiated Rate |
$671.83 |
| Rate for Payer: Aetna Commercial |
$609.71
|
| Rate for Payer: Aetna Medicare |
$238.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$238.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$414.87
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$451.57
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$274.15
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$262.23
|
| Rate for Payer: Cash Price |
$447.89
|
| Rate for Payer: Cash Price |
$447.89
|
| Rate for Payer: Centivo All Commercial |
$368.42
|
| Rate for Payer: Cigna All Commercial |
$623.43
|
| Rate for Payer: CORVEL All Commercial |
$671.83
|
| Rate for Payer: Coventry All Commercial |
$635.71
|
| Rate for Payer: Encore All Commercial |
$664.97
|
| Rate for Payer: Frontpath All Commercial |
$664.61
|
| Rate for Payer: Humana ChoiceCare |
$623.94
|
| Rate for Payer: Humana Medicare |
$368.42
|
| Rate for Payer: Lucent All Commercial |
$368.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$650.16
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$541.80
|
| Rate for Payer: PHP All Commercial |
$547.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$281.74
|
| Rate for Payer: Sagamore Health Network All Products |
$557.69
|
| Rate for Payer: Signature Care EPO |
$599.59
|
| Rate for Payer: Signature Care PPO |
$635.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$614.04
|
| Rate for Payer: United Healthcare Commercial |
$569.25
|
| Rate for Payer: United Healthcare Medicare |
$238.39
|
|
