|
HC Z SCREW 3.5X70 CORT LOCK
|
Facility
OP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603797
|
|
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 3.5X70 CORT LP
|
Facility
OP
|
$466.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606721
|
|
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 3.5X70 CORT LP
|
Facility
IP
|
$466.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606721
|
|
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 3.5X75 CORT LP
|
Facility
OP
|
$466.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606722
|
|
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 3.5X75 CORT LP
|
Facility
IP
|
$466.62
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606722
|
|
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 3.5X80 MD
|
Facility
IP
|
$944.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607754
|
|
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 3.5X80 MD
|
Facility
OP
|
$944.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607754
|
|
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 3.5X85 LOCK CANN
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606628
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.70 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$590.03
|
| Rate for Payer: Aetna Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$401.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$437.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$265.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$253.77
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Centivo All Commercial |
$356.54
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Humana Medicare |
$356.54
|
| Rate for Payer: Lucent All Commercial |
$356.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.65
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$594.23
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
| Rate for Payer: United Healthcare Medicare |
$230.70
|
|
|
HC Z SCREW 3.5X85 LOCK CANN
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606628
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.32 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$604.01
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
|
|
HC Z SCREW 3.5X8 LOCK ST
|
Facility
OP
|
$802.95
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606469
|
|
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 3.5X8 LOCK ST
|
Facility
IP
|
$802.95
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606469
|
|
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 3.5X90 LOCK CANN
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606629
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.32 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$604.01
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
|
|
HC Z SCREW 3.5X90 LOCK CANN
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606629
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.70 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$590.03
|
| Rate for Payer: Aetna Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$401.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$437.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$265.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$253.77
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Centivo All Commercial |
$356.54
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Humana Medicare |
$356.54
|
| Rate for Payer: Lucent All Commercial |
$356.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.65
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$594.23
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
| Rate for Payer: United Healthcare Medicare |
$230.70
|
|
|
HC Z SCREW 4.0X10 CANC FT
|
Facility
IP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606839
|
|
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 4.0X10 CANC FT
|
Facility
OP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606839
|
|
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 4.0X10 CANC LOCK
|
Facility
OP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606881
|
|
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 4.0X10 CANC LOCK
|
Facility
IP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606881
|
|
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 4.0X10 CANN 1/2 THD
|
Facility
IP
|
$904.95
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604445
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$678.71 |
| Max. Negotiated Rate |
$841.60 |
| Rate for Payer: Aetna Commercial |
$781.88
|
| Rate for Payer: Cash Price |
$561.07
|
| Rate for Payer: Cigna All Commercial |
$780.97
|
| Rate for Payer: CORVEL All Commercial |
$841.60
|
| Rate for Payer: Coventry All Commercial |
$796.36
|
| Rate for Payer: Encore All Commercial |
$833.01
|
| Rate for Payer: Frontpath All Commercial |
$832.55
|
| Rate for Payer: Humana ChoiceCare |
$781.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$814.46
|
| Rate for Payer: PHCS All Commercial |
$678.71
|
| Rate for Payer: PHP All Commercial |
$686.31
|
| Rate for Payer: Sagamore Health Network All Products |
$698.62
|
| Rate for Payer: Signature Care EPO |
$751.11
|
| Rate for Payer: Signature Care PPO |
$796.36
|
| Rate for Payer: United Healthcare Commercial |
$713.10
|
|
|
HC Z SCREW 4.0X10 CANN 1/2 THD
|
Facility
OP
|
$904.95
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604445
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$298.63 |
| Max. Negotiated Rate |
$841.60 |
| Rate for Payer: Aetna Commercial |
$763.78
|
| Rate for Payer: Aetna Medicare |
$298.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$298.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$519.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$565.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$343.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$328.50
|
| Rate for Payer: Cash Price |
$561.07
|
| Rate for Payer: Cash Price |
$561.07
|
| Rate for Payer: Centivo All Commercial |
$461.52
|
| Rate for Payer: Cigna All Commercial |
$780.97
|
| Rate for Payer: CORVEL All Commercial |
$841.60
|
| Rate for Payer: Coventry All Commercial |
$796.36
|
| Rate for Payer: Encore All Commercial |
$833.01
|
| Rate for Payer: Frontpath All Commercial |
$832.55
|
| Rate for Payer: Humana ChoiceCare |
$781.61
|
| Rate for Payer: Humana Medicare |
$461.52
|
| Rate for Payer: Lucent All Commercial |
$461.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$814.46
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$678.71
|
| Rate for Payer: PHP All Commercial |
$686.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$352.93
|
| Rate for Payer: Sagamore Health Network All Products |
$698.62
|
| Rate for Payer: Signature Care EPO |
$751.11
|
| Rate for Payer: Signature Care PPO |
$796.36
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$769.21
|
| Rate for Payer: United Healthcare Commercial |
$713.10
|
| Rate for Payer: United Healthcare Medicare |
$298.63
|
|
|
HC Z SCREW 4.0X10 CANN 1/3 THD
|
Facility
IP
|
$904.95
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604444
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$678.71 |
| Max. Negotiated Rate |
$841.60 |
| Rate for Payer: Aetna Commercial |
$781.88
|
| Rate for Payer: Cash Price |
$561.07
|
| Rate for Payer: Cigna All Commercial |
$780.97
|
| Rate for Payer: CORVEL All Commercial |
$841.60
|
| Rate for Payer: Coventry All Commercial |
$796.36
|
| Rate for Payer: Encore All Commercial |
$833.01
|
| Rate for Payer: Frontpath All Commercial |
$832.55
|
| Rate for Payer: Humana ChoiceCare |
$781.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$814.46
|
| Rate for Payer: PHCS All Commercial |
$678.71
|
| Rate for Payer: PHP All Commercial |
$686.31
|
| Rate for Payer: Sagamore Health Network All Products |
$698.62
|
| Rate for Payer: Signature Care EPO |
$751.11
|
| Rate for Payer: Signature Care PPO |
$796.36
|
| Rate for Payer: United Healthcare Commercial |
$713.10
|
|
|
HC Z SCREW 4.0X10 CANN 1/3 THD
|
Facility
OP
|
$904.95
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604444
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$298.63 |
| Max. Negotiated Rate |
$841.60 |
| Rate for Payer: Aetna Commercial |
$763.78
|
| Rate for Payer: Aetna Medicare |
$298.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$298.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$519.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$565.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$343.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$328.50
|
| Rate for Payer: Cash Price |
$561.07
|
| Rate for Payer: Cash Price |
$561.07
|
| Rate for Payer: Centivo All Commercial |
$461.52
|
| Rate for Payer: Cigna All Commercial |
$780.97
|
| Rate for Payer: CORVEL All Commercial |
$841.60
|
| Rate for Payer: Coventry All Commercial |
$796.36
|
| Rate for Payer: Encore All Commercial |
$833.01
|
| Rate for Payer: Frontpath All Commercial |
$832.55
|
| Rate for Payer: Humana ChoiceCare |
$781.61
|
| Rate for Payer: Humana Medicare |
$461.52
|
| Rate for Payer: Lucent All Commercial |
$461.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$814.46
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$678.71
|
| Rate for Payer: PHP All Commercial |
$686.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$352.93
|
| Rate for Payer: Sagamore Health Network All Products |
$698.62
|
| Rate for Payer: Signature Care EPO |
$751.11
|
| Rate for Payer: Signature Care PPO |
$796.36
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$769.21
|
| Rate for Payer: United Healthcare Commercial |
$713.10
|
| Rate for Payer: United Healthcare Medicare |
$298.63
|
|
|
HC Z SCREW 4.0X10 CANN LAG
|
Facility
OP
|
$858.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606763
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$283.30 |
| Max. Negotiated Rate |
$798.40 |
| Rate for Payer: Aetna Commercial |
$724.57
|
| Rate for Payer: Aetna Medicare |
$283.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$283.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$493.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$536.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$325.80
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$311.64
|
| Rate for Payer: Cash Price |
$532.27
|
| Rate for Payer: Cash Price |
$532.27
|
| Rate for Payer: Centivo All Commercial |
$437.84
|
| Rate for Payer: Cigna All Commercial |
$740.89
|
| Rate for Payer: CORVEL All Commercial |
$798.40
|
| Rate for Payer: Coventry All Commercial |
$755.48
|
| Rate for Payer: Encore All Commercial |
$790.25
|
| Rate for Payer: Frontpath All Commercial |
$789.82
|
| Rate for Payer: Humana ChoiceCare |
$741.49
|
| Rate for Payer: Humana Medicare |
$437.84
|
| Rate for Payer: Lucent All Commercial |
$437.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$772.65
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$643.88
|
| Rate for Payer: PHP All Commercial |
$651.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$334.82
|
| Rate for Payer: Sagamore Health Network All Products |
$662.76
|
| Rate for Payer: Signature Care EPO |
$712.56
|
| Rate for Payer: Signature Care PPO |
$755.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$729.72
|
| Rate for Payer: United Healthcare Commercial |
$676.50
|
| Rate for Payer: United Healthcare Medicare |
$283.30
|
|
|
HC Z SCREW 4.0X10 CANN LAG
|
Facility
IP
|
$858.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606763
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$643.88 |
| Max. Negotiated Rate |
$798.40 |
| Rate for Payer: Aetna Commercial |
$741.74
|
| Rate for Payer: Cash Price |
$532.27
|
| Rate for Payer: Cigna All Commercial |
$740.89
|
| Rate for Payer: CORVEL All Commercial |
$798.40
|
| Rate for Payer: Coventry All Commercial |
$755.48
|
| Rate for Payer: Encore All Commercial |
$790.25
|
| Rate for Payer: Frontpath All Commercial |
$789.82
|
| Rate for Payer: Humana ChoiceCare |
$741.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$772.65
|
| Rate for Payer: PHCS All Commercial |
$643.88
|
| Rate for Payer: PHP All Commercial |
$651.09
|
| Rate for Payer: Sagamore Health Network All Products |
$662.76
|
| Rate for Payer: Signature Care EPO |
$712.56
|
| Rate for Payer: Signature Care PPO |
$755.48
|
| Rate for Payer: United Healthcare Commercial |
$676.50
|
|
|
HC Z SCREW 4.0X12 CANC FT
|
Facility
IP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606840
|
|
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 4.0X12 CANC FT
|
Facility
OP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606840
|
|
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
|
|
