|
HC Z SCREW 3.5X30 LOCK ST
|
Facility
IP
|
$802.95
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606480
|
|
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 3.5X30 LOCK ST
|
Facility
OP
|
$802.95
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606480
|
|
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 3.5X 30 MD
|
Facility
OP
|
$944.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606663
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$311.64 |
| Max. Negotiated Rate |
$878.25 |
| Rate for Payer: Aetna Commercial |
$797.03
|
| Rate for Payer: Aetna Medicare |
$311.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$311.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$542.34
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$590.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$358.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$342.80
|
| Rate for Payer: Cash Price |
$585.50
|
| Rate for Payer: Cash Price |
$585.50
|
| Rate for Payer: Centivo All Commercial |
$481.62
|
| Rate for Payer: Cigna All Commercial |
$814.97
|
| Rate for Payer: CORVEL All Commercial |
$878.25
|
| Rate for Payer: Coventry All Commercial |
$831.03
|
| Rate for Payer: Encore All Commercial |
$869.27
|
| Rate for Payer: Frontpath All Commercial |
$868.80
|
| Rate for Payer: Humana ChoiceCare |
$815.64
|
| Rate for Payer: Humana Medicare |
$481.62
|
| Rate for Payer: Lucent All Commercial |
$481.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$849.92
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$708.26
|
| Rate for Payer: PHP All Commercial |
$716.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$368.30
|
| Rate for Payer: Sagamore Health Network All Products |
$729.04
|
| Rate for Payer: Signature Care EPO |
$783.81
|
| Rate for Payer: Signature Care PPO |
$831.03
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$802.70
|
| Rate for Payer: United Healthcare Commercial |
$744.15
|
| Rate for Payer: United Healthcare Medicare |
$311.64
|
|
|
HC Z SCREW 3.5X 30 MD
|
Facility
IP
|
$944.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606663
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$708.26 |
| Max. Negotiated Rate |
$878.25 |
| Rate for Payer: Aetna Commercial |
$815.92
|
| Rate for Payer: Cash Price |
$585.50
|
| Rate for Payer: Cigna All Commercial |
$814.97
|
| Rate for Payer: CORVEL All Commercial |
$878.25
|
| Rate for Payer: Coventry All Commercial |
$831.03
|
| Rate for Payer: Encore All Commercial |
$869.27
|
| Rate for Payer: Frontpath All Commercial |
$868.80
|
| Rate for Payer: Humana ChoiceCare |
$815.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$849.92
|
| Rate for Payer: PHCS All Commercial |
$708.26
|
| Rate for Payer: PHP All Commercial |
$716.20
|
| Rate for Payer: Sagamore Health Network All Products |
$729.04
|
| Rate for Payer: Signature Care EPO |
$783.81
|
| Rate for Payer: Signature Care PPO |
$831.03
|
| Rate for Payer: United Healthcare Commercial |
$744.15
|
|
|
HC Z SCREW 3.5X32 CANN FT
|
Facility
IP
|
$872.65
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604487
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$654.49 |
| Max. Negotiated Rate |
$811.56 |
| Rate for Payer: Aetna Commercial |
$753.97
|
| Rate for Payer: Cash Price |
$541.04
|
| Rate for Payer: Cigna All Commercial |
$753.10
|
| Rate for Payer: CORVEL All Commercial |
$811.56
|
| Rate for Payer: Coventry All Commercial |
$767.93
|
| Rate for Payer: Encore All Commercial |
$803.27
|
| Rate for Payer: Frontpath All Commercial |
$802.84
|
| Rate for Payer: Humana ChoiceCare |
$753.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$785.38
|
| Rate for Payer: PHCS All Commercial |
$654.49
|
| Rate for Payer: PHP All Commercial |
$661.82
|
| Rate for Payer: Sagamore Health Network All Products |
$673.69
|
| Rate for Payer: Signature Care EPO |
$724.30
|
| Rate for Payer: Signature Care PPO |
$767.93
|
| Rate for Payer: United Healthcare Commercial |
$687.65
|
|
|
HC Z SCREW 3.5X32 CANN FT
|
Facility
OP
|
$872.65
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604487
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$287.97 |
| Max. Negotiated Rate |
$811.56 |
| Rate for Payer: Aetna Commercial |
$736.52
|
| Rate for Payer: Aetna Medicare |
$287.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$287.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$501.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$545.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$331.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$316.77
|
| Rate for Payer: Cash Price |
$541.04
|
| Rate for Payer: Cash Price |
$541.04
|
| Rate for Payer: Centivo All Commercial |
$445.05
|
| Rate for Payer: Cigna All Commercial |
$753.10
|
| Rate for Payer: CORVEL All Commercial |
$811.56
|
| Rate for Payer: Coventry All Commercial |
$767.93
|
| Rate for Payer: Encore All Commercial |
$803.27
|
| Rate for Payer: Frontpath All Commercial |
$802.84
|
| Rate for Payer: Humana ChoiceCare |
$753.71
|
| Rate for Payer: Humana Medicare |
$445.05
|
| Rate for Payer: Lucent All Commercial |
$445.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$785.38
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$654.49
|
| Rate for Payer: PHP All Commercial |
$661.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$340.33
|
| Rate for Payer: Sagamore Health Network All Products |
$673.69
|
| Rate for Payer: Signature Care EPO |
$724.30
|
| Rate for Payer: Signature Care PPO |
$767.93
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$741.75
|
| Rate for Payer: United Healthcare Commercial |
$687.65
|
| Rate for Payer: United Healthcare Medicare |
$287.97
|
|
|
HC Z SCREW 3.5X32 CANN PT
|
Facility
OP
|
$872.65
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604486
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$287.97 |
| Max. Negotiated Rate |
$811.56 |
| Rate for Payer: Aetna Commercial |
$736.52
|
| Rate for Payer: Aetna Medicare |
$287.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$287.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$501.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$545.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$331.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$316.77
|
| Rate for Payer: Cash Price |
$541.04
|
| Rate for Payer: Cash Price |
$541.04
|
| Rate for Payer: Centivo All Commercial |
$445.05
|
| Rate for Payer: Cigna All Commercial |
$753.10
|
| Rate for Payer: CORVEL All Commercial |
$811.56
|
| Rate for Payer: Coventry All Commercial |
$767.93
|
| Rate for Payer: Encore All Commercial |
$803.27
|
| Rate for Payer: Frontpath All Commercial |
$802.84
|
| Rate for Payer: Humana ChoiceCare |
$753.71
|
| Rate for Payer: Humana Medicare |
$445.05
|
| Rate for Payer: Lucent All Commercial |
$445.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$785.38
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$654.49
|
| Rate for Payer: PHP All Commercial |
$661.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$340.33
|
| Rate for Payer: Sagamore Health Network All Products |
$673.69
|
| Rate for Payer: Signature Care EPO |
$724.30
|
| Rate for Payer: Signature Care PPO |
$767.93
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$741.75
|
| Rate for Payer: United Healthcare Commercial |
$687.65
|
| Rate for Payer: United Healthcare Medicare |
$287.97
|
|
|
HC Z SCREW 3.5X32 CANN PT
|
Facility
IP
|
$872.65
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604486
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$654.49 |
| Max. Negotiated Rate |
$811.56 |
| Rate for Payer: Aetna Commercial |
$753.97
|
| Rate for Payer: Cash Price |
$541.04
|
| Rate for Payer: Cigna All Commercial |
$753.10
|
| Rate for Payer: CORVEL All Commercial |
$811.56
|
| Rate for Payer: Coventry All Commercial |
$767.93
|
| Rate for Payer: Encore All Commercial |
$803.27
|
| Rate for Payer: Frontpath All Commercial |
$802.84
|
| Rate for Payer: Humana ChoiceCare |
$753.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$785.38
|
| Rate for Payer: PHCS All Commercial |
$654.49
|
| Rate for Payer: PHP All Commercial |
$661.82
|
| Rate for Payer: Sagamore Health Network All Products |
$673.69
|
| Rate for Payer: Signature Care EPO |
$724.30
|
| Rate for Payer: Signature Care PPO |
$767.93
|
| Rate for Payer: United Healthcare Commercial |
$687.65
|
|
|
HC Z SCREW 3.5X32 CORT
|
Facility
OP
|
$424.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606825
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$139.99 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$358.02
|
| Rate for Payer: Aetna Medicare |
$139.99
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$139.99
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$243.62
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$265.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$160.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$153.98
|
| Rate for Payer: Cash Price |
$263.00
|
| Rate for Payer: Cash Price |
$263.00
|
| Rate for Payer: Centivo All Commercial |
$216.34
|
| Rate for Payer: Cigna All Commercial |
$366.08
|
| Rate for Payer: CORVEL All Commercial |
$394.51
|
| Rate for Payer: Coventry All Commercial |
$373.30
|
| Rate for Payer: Encore All Commercial |
$390.48
|
| Rate for Payer: Frontpath All Commercial |
$390.26
|
| Rate for Payer: Humana ChoiceCare |
$366.38
|
| Rate for Payer: Humana Medicare |
$216.34
|
| Rate for Payer: Lucent All Commercial |
$216.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$381.78
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$318.15
|
| Rate for Payer: PHP All Commercial |
$321.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$165.44
|
| Rate for Payer: Sagamore Health Network All Products |
$327.48
|
| Rate for Payer: Signature Care EPO |
$352.09
|
| Rate for Payer: Signature Care PPO |
$373.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$360.57
|
| Rate for Payer: United Healthcare Commercial |
$334.27
|
| Rate for Payer: United Healthcare Medicare |
$139.99
|
|
|
HC Z SCREW 3.5X32 CORT
|
Facility
IP
|
$424.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606825
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$318.15 |
| Max. Negotiated Rate |
$394.51 |
| Rate for Payer: Aetna Commercial |
$366.51
|
| Rate for Payer: Cash Price |
$263.00
|
| Rate for Payer: Cigna All Commercial |
$366.08
|
| Rate for Payer: CORVEL All Commercial |
$394.51
|
| Rate for Payer: Coventry All Commercial |
$373.30
|
| Rate for Payer: Encore All Commercial |
$390.48
|
| Rate for Payer: Frontpath All Commercial |
$390.26
|
| Rate for Payer: Humana ChoiceCare |
$366.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$381.78
|
| Rate for Payer: PHCS All Commercial |
$318.15
|
| Rate for Payer: PHP All Commercial |
$321.71
|
| Rate for Payer: Sagamore Health Network All Products |
$327.48
|
| Rate for Payer: Signature Care EPO |
$352.09
|
| Rate for Payer: Signature Care PPO |
$373.30
|
| Rate for Payer: United Healthcare Commercial |
$334.27
|
|
|
HC Z SCREW 3.5X32 CORT LOCK
|
Facility
IP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603813
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$699.93 |
| Max. Negotiated Rate |
$867.91 |
| Rate for Payer: Aetna Commercial |
$806.32
|
| Rate for Payer: Cash Price |
$578.61
|
| Rate for Payer: Cigna All Commercial |
$805.39
|
| Rate for Payer: CORVEL All Commercial |
$867.91
|
| Rate for Payer: Coventry All Commercial |
$821.25
|
| Rate for Payer: Encore All Commercial |
$859.05
|
| Rate for Payer: Frontpath All Commercial |
$858.58
|
| Rate for Payer: Humana ChoiceCare |
$806.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$839.92
|
| Rate for Payer: PHCS All Commercial |
$699.93
|
| Rate for Payer: PHP All Commercial |
$707.77
|
| Rate for Payer: Sagamore Health Network All Products |
$720.46
|
| Rate for Payer: Signature Care EPO |
$774.59
|
| Rate for Payer: Signature Care PPO |
$821.25
|
| Rate for Payer: United Healthcare Commercial |
$735.39
|
|
|
HC Z SCREW 3.5X32 CORT LOCK
|
Facility
OP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603813
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$307.97 |
| Max. Negotiated Rate |
$867.91 |
| Rate for Payer: Aetna Commercial |
$787.65
|
| Rate for Payer: Aetna Medicare |
$307.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$307.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$535.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$583.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$354.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$338.77
|
| Rate for Payer: Cash Price |
$578.61
|
| Rate for Payer: Cash Price |
$578.61
|
| Rate for Payer: Centivo All Commercial |
$475.95
|
| Rate for Payer: Cigna All Commercial |
$805.39
|
| Rate for Payer: CORVEL All Commercial |
$867.91
|
| Rate for Payer: Coventry All Commercial |
$821.25
|
| Rate for Payer: Encore All Commercial |
$859.05
|
| Rate for Payer: Frontpath All Commercial |
$858.58
|
| Rate for Payer: Humana ChoiceCare |
$806.04
|
| Rate for Payer: Humana Medicare |
$475.95
|
| Rate for Payer: Lucent All Commercial |
$475.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$839.92
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$699.93
|
| Rate for Payer: PHP All Commercial |
$707.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$363.96
|
| Rate for Payer: Sagamore Health Network All Products |
$720.46
|
| Rate for Payer: Signature Care EPO |
$774.59
|
| Rate for Payer: Signature Care PPO |
$821.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$793.25
|
| Rate for Payer: United Healthcare Commercial |
$735.39
|
| Rate for Payer: United Healthcare Medicare |
$307.97
|
|
|
HC Z SCREW 3.5X32 CORT LP
|
Facility
IP
|
$466.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606709
|
|
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 3.5X32 CORT LP
|
Facility
OP
|
$466.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606709
|
|
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 3.5X 32 MD
|
Facility
OP
|
$944.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606664
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$311.64 |
| Max. Negotiated Rate |
$878.25 |
| Rate for Payer: Aetna Commercial |
$797.03
|
| Rate for Payer: Aetna Medicare |
$311.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$311.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$542.34
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$590.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$358.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$342.80
|
| Rate for Payer: Cash Price |
$585.50
|
| Rate for Payer: Cash Price |
$585.50
|
| Rate for Payer: Centivo All Commercial |
$481.62
|
| Rate for Payer: Cigna All Commercial |
$814.97
|
| Rate for Payer: CORVEL All Commercial |
$878.25
|
| Rate for Payer: Coventry All Commercial |
$831.03
|
| Rate for Payer: Encore All Commercial |
$869.27
|
| Rate for Payer: Frontpath All Commercial |
$868.80
|
| Rate for Payer: Humana ChoiceCare |
$815.64
|
| Rate for Payer: Humana Medicare |
$481.62
|
| Rate for Payer: Lucent All Commercial |
$481.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$849.92
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$708.26
|
| Rate for Payer: PHP All Commercial |
$716.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$368.30
|
| Rate for Payer: Sagamore Health Network All Products |
$729.04
|
| Rate for Payer: Signature Care EPO |
$783.81
|
| Rate for Payer: Signature Care PPO |
$831.03
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$802.70
|
| Rate for Payer: United Healthcare Commercial |
$744.15
|
| Rate for Payer: United Healthcare Medicare |
$311.64
|
|
|
HC Z SCREW 3.5X 32 MD
|
Facility
IP
|
$944.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606664
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$708.26 |
| Max. Negotiated Rate |
$878.25 |
| Rate for Payer: Aetna Commercial |
$815.92
|
| Rate for Payer: Cash Price |
$585.50
|
| Rate for Payer: Cigna All Commercial |
$814.97
|
| Rate for Payer: CORVEL All Commercial |
$878.25
|
| Rate for Payer: Coventry All Commercial |
$831.03
|
| Rate for Payer: Encore All Commercial |
$869.27
|
| Rate for Payer: Frontpath All Commercial |
$868.80
|
| Rate for Payer: Humana ChoiceCare |
$815.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$849.92
|
| Rate for Payer: PHCS All Commercial |
$708.26
|
| Rate for Payer: PHP All Commercial |
$716.20
|
| Rate for Payer: Sagamore Health Network All Products |
$729.04
|
| Rate for Payer: Signature Care EPO |
$783.81
|
| Rate for Payer: Signature Care PPO |
$831.03
|
| Rate for Payer: United Healthcare Commercial |
$744.15
|
|
|
HC Z SCREW 3.5X33 HEX
|
Facility
IP
|
$826.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607769
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$619.88 |
| Max. Negotiated Rate |
$768.64 |
| Rate for Payer: Aetna Commercial |
$714.10
|
| Rate for Payer: Cash Price |
$512.43
|
| Rate for Payer: Cigna All Commercial |
$713.27
|
| Rate for Payer: CORVEL All Commercial |
$768.64
|
| Rate for Payer: Coventry All Commercial |
$727.32
|
| Rate for Payer: Encore All Commercial |
$760.79
|
| Rate for Payer: Frontpath All Commercial |
$760.38
|
| Rate for Payer: Humana ChoiceCare |
$713.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$743.85
|
| Rate for Payer: PHCS All Commercial |
$619.88
|
| Rate for Payer: PHP All Commercial |
$626.82
|
| Rate for Payer: Sagamore Health Network All Products |
$638.06
|
| Rate for Payer: Signature Care EPO |
$686.00
|
| Rate for Payer: Signature Care PPO |
$727.32
|
| Rate for Payer: United Healthcare Commercial |
$651.28
|
|
|
HC Z SCREW 3.5X33 HEX
|
Facility
OP
|
$826.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607769
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$272.74 |
| Max. Negotiated Rate |
$768.64 |
| Rate for Payer: Aetna Commercial |
$697.57
|
| Rate for Payer: Aetna Medicare |
$272.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$272.74
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$474.66
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$516.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$313.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$300.02
|
| Rate for Payer: Cash Price |
$512.43
|
| Rate for Payer: Cash Price |
$512.43
|
| Rate for Payer: Centivo All Commercial |
$421.52
|
| Rate for Payer: Cigna All Commercial |
$713.27
|
| Rate for Payer: CORVEL All Commercial |
$768.64
|
| Rate for Payer: Coventry All Commercial |
$727.32
|
| Rate for Payer: Encore All Commercial |
$760.79
|
| Rate for Payer: Frontpath All Commercial |
$760.38
|
| Rate for Payer: Humana ChoiceCare |
$713.85
|
| Rate for Payer: Humana Medicare |
$421.52
|
| Rate for Payer: Lucent All Commercial |
$421.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$743.85
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$619.88
|
| Rate for Payer: PHP All Commercial |
$626.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$322.34
|
| Rate for Payer: Sagamore Health Network All Products |
$638.06
|
| Rate for Payer: Signature Care EPO |
$686.00
|
| Rate for Payer: Signature Care PPO |
$727.32
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$702.52
|
| Rate for Payer: United Healthcare Commercial |
$651.28
|
| Rate for Payer: United Healthcare Medicare |
$272.74
|
|
|
HC Z SCREW 3.5X34 CANN FT
|
Facility
IP
|
$872.65
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604491
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$654.49 |
| Max. Negotiated Rate |
$811.56 |
| Rate for Payer: Aetna Commercial |
$753.97
|
| Rate for Payer: Cash Price |
$541.04
|
| Rate for Payer: Cigna All Commercial |
$753.10
|
| Rate for Payer: CORVEL All Commercial |
$811.56
|
| Rate for Payer: Coventry All Commercial |
$767.93
|
| Rate for Payer: Encore All Commercial |
$803.27
|
| Rate for Payer: Frontpath All Commercial |
$802.84
|
| Rate for Payer: Humana ChoiceCare |
$753.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$785.38
|
| Rate for Payer: PHCS All Commercial |
$654.49
|
| Rate for Payer: PHP All Commercial |
$661.82
|
| Rate for Payer: Sagamore Health Network All Products |
$673.69
|
| Rate for Payer: Signature Care EPO |
$724.30
|
| Rate for Payer: Signature Care PPO |
$767.93
|
| Rate for Payer: United Healthcare Commercial |
$687.65
|
|
|
HC Z SCREW 3.5X34 CANN FT
|
Facility
OP
|
$872.65
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604491
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$287.97 |
| Max. Negotiated Rate |
$811.56 |
| Rate for Payer: Aetna Commercial |
$736.52
|
| Rate for Payer: Aetna Medicare |
$287.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$287.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$501.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$545.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$331.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$316.77
|
| Rate for Payer: Cash Price |
$541.04
|
| Rate for Payer: Cash Price |
$541.04
|
| Rate for Payer: Centivo All Commercial |
$445.05
|
| Rate for Payer: Cigna All Commercial |
$753.10
|
| Rate for Payer: CORVEL All Commercial |
$811.56
|
| Rate for Payer: Coventry All Commercial |
$767.93
|
| Rate for Payer: Encore All Commercial |
$803.27
|
| Rate for Payer: Frontpath All Commercial |
$802.84
|
| Rate for Payer: Humana ChoiceCare |
$753.71
|
| Rate for Payer: Humana Medicare |
$445.05
|
| Rate for Payer: Lucent All Commercial |
$445.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$785.38
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$654.49
|
| Rate for Payer: PHP All Commercial |
$661.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$340.33
|
| Rate for Payer: Sagamore Health Network All Products |
$673.69
|
| Rate for Payer: Signature Care EPO |
$724.30
|
| Rate for Payer: Signature Care PPO |
$767.93
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$741.75
|
| Rate for Payer: United Healthcare Commercial |
$687.65
|
| Rate for Payer: United Healthcare Medicare |
$287.97
|
|
|
HC Z SCREW 3.5X34 CANN PT
|
Facility
OP
|
$872.65
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604490
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$287.97 |
| Max. Negotiated Rate |
$811.56 |
| Rate for Payer: Aetna Commercial |
$736.52
|
| Rate for Payer: Aetna Medicare |
$287.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$287.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$501.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$545.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$331.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$316.77
|
| Rate for Payer: Cash Price |
$541.04
|
| Rate for Payer: Cash Price |
$541.04
|
| Rate for Payer: Centivo All Commercial |
$445.05
|
| Rate for Payer: Cigna All Commercial |
$753.10
|
| Rate for Payer: CORVEL All Commercial |
$811.56
|
| Rate for Payer: Coventry All Commercial |
$767.93
|
| Rate for Payer: Encore All Commercial |
$803.27
|
| Rate for Payer: Frontpath All Commercial |
$802.84
|
| Rate for Payer: Humana ChoiceCare |
$753.71
|
| Rate for Payer: Humana Medicare |
$445.05
|
| Rate for Payer: Lucent All Commercial |
$445.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$785.38
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$654.49
|
| Rate for Payer: PHP All Commercial |
$661.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$340.33
|
| Rate for Payer: Sagamore Health Network All Products |
$673.69
|
| Rate for Payer: Signature Care EPO |
$724.30
|
| Rate for Payer: Signature Care PPO |
$767.93
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$741.75
|
| Rate for Payer: United Healthcare Commercial |
$687.65
|
| Rate for Payer: United Healthcare Medicare |
$287.97
|
|
|
HC Z SCREW 3.5X34 CANN PT
|
Facility
IP
|
$872.65
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604490
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$654.49 |
| Max. Negotiated Rate |
$811.56 |
| Rate for Payer: Aetna Commercial |
$753.97
|
| Rate for Payer: Cash Price |
$541.04
|
| Rate for Payer: Cigna All Commercial |
$753.10
|
| Rate for Payer: CORVEL All Commercial |
$811.56
|
| Rate for Payer: Coventry All Commercial |
$767.93
|
| Rate for Payer: Encore All Commercial |
$803.27
|
| Rate for Payer: Frontpath All Commercial |
$802.84
|
| Rate for Payer: Humana ChoiceCare |
$753.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$785.38
|
| Rate for Payer: PHCS All Commercial |
$654.49
|
| Rate for Payer: PHP All Commercial |
$661.82
|
| Rate for Payer: Sagamore Health Network All Products |
$673.69
|
| Rate for Payer: Signature Care EPO |
$724.30
|
| Rate for Payer: Signature Care PPO |
$767.93
|
| Rate for Payer: United Healthcare Commercial |
$687.65
|
|
|
HC Z SCREW 3.5X34 CORT
|
Facility
IP
|
$424.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606826
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$318.15 |
| Max. Negotiated Rate |
$394.51 |
| Rate for Payer: Aetna Commercial |
$366.51
|
| Rate for Payer: Cash Price |
$263.00
|
| Rate for Payer: Cigna All Commercial |
$366.08
|
| Rate for Payer: CORVEL All Commercial |
$394.51
|
| Rate for Payer: Coventry All Commercial |
$373.30
|
| Rate for Payer: Encore All Commercial |
$390.48
|
| Rate for Payer: Frontpath All Commercial |
$390.26
|
| Rate for Payer: Humana ChoiceCare |
$366.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$381.78
|
| Rate for Payer: PHCS All Commercial |
$318.15
|
| Rate for Payer: PHP All Commercial |
$321.71
|
| Rate for Payer: Sagamore Health Network All Products |
$327.48
|
| Rate for Payer: Signature Care EPO |
$352.09
|
| Rate for Payer: Signature Care PPO |
$373.30
|
| Rate for Payer: United Healthcare Commercial |
$334.27
|
|
|
HC Z SCREW 3.5X34 CORT
|
Facility
OP
|
$424.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606826
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$139.99 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$358.02
|
| Rate for Payer: Aetna Medicare |
$139.99
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$139.99
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$243.62
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$265.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$160.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$153.98
|
| Rate for Payer: Cash Price |
$263.00
|
| Rate for Payer: Cash Price |
$263.00
|
| Rate for Payer: Centivo All Commercial |
$216.34
|
| Rate for Payer: Cigna All Commercial |
$366.08
|
| Rate for Payer: CORVEL All Commercial |
$394.51
|
| Rate for Payer: Coventry All Commercial |
$373.30
|
| Rate for Payer: Encore All Commercial |
$390.48
|
| Rate for Payer: Frontpath All Commercial |
$390.26
|
| Rate for Payer: Humana ChoiceCare |
$366.38
|
| Rate for Payer: Humana Medicare |
$216.34
|
| Rate for Payer: Lucent All Commercial |
$216.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$381.78
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$318.15
|
| Rate for Payer: PHP All Commercial |
$321.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$165.44
|
| Rate for Payer: Sagamore Health Network All Products |
$327.48
|
| Rate for Payer: Signature Care EPO |
$352.09
|
| Rate for Payer: Signature Care PPO |
$373.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$360.57
|
| Rate for Payer: United Healthcare Commercial |
$334.27
|
| Rate for Payer: United Healthcare Medicare |
$139.99
|
|
|
HC Z SCREW 3.5X34 CORT LOCK
|
Facility
IP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603812
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$699.93 |
| Max. Negotiated Rate |
$867.91 |
| Rate for Payer: Aetna Commercial |
$806.32
|
| Rate for Payer: Cash Price |
$578.61
|
| Rate for Payer: Cigna All Commercial |
$805.39
|
| Rate for Payer: CORVEL All Commercial |
$867.91
|
| Rate for Payer: Coventry All Commercial |
$821.25
|
| Rate for Payer: Encore All Commercial |
$859.05
|
| Rate for Payer: Frontpath All Commercial |
$858.58
|
| Rate for Payer: Humana ChoiceCare |
$806.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$839.92
|
| Rate for Payer: PHCS All Commercial |
$699.93
|
| Rate for Payer: PHP All Commercial |
$707.77
|
| Rate for Payer: Sagamore Health Network All Products |
$720.46
|
| Rate for Payer: Signature Care EPO |
$774.59
|
| Rate for Payer: Signature Care PPO |
$821.25
|
| Rate for Payer: United Healthcare Commercial |
$735.39
|
|
