|
HC Z SCREW 4.0X12 CANC LOCK
|
Facility
IP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606882
|
|
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 4.0X12 CANC LOCK
|
Facility
OP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606882
|
|
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 4.0X12 CANN 1/2 THD
|
Facility
IP
|
$904.95
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604449
|
|
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 4.0X12 CANN 1/2 THD
|
Facility
OP
|
$904.95
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604449
|
|
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 4.0X12 CANN 1/3 THD
|
Facility
OP
|
$904.95
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604448
|
|
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 4.0X12 CANN 1/3 THD
|
Facility
IP
|
$904.95
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604448
|
|
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 4.0X12 CANN LAG
|
Facility
IP
|
$858.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606764
|
|
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 CANN LAG
|
Facility
OP
|
$858.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606764
|
|
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 4.0X14 CANC FT
|
Facility
IP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606841
|
|
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 4.0X14 CANC FT
|
Facility
OP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606841
|
|
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 4.0X14 CANC LAG
|
Facility
IP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606864
|
|
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 4.0X14 CANC LAG
|
Facility
OP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606864
|
|
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 4.0X14 CANC LOCK
|
Facility
IP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606883
|
|
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 4.0X14 CANC LOCK
|
Facility
OP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606883
|
|
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 4.0X14 CANN 1/2 THD
|
Facility
OP
|
$904.95
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604453
|
|
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 4.0X14 CANN 1/2 THD
|
Facility
IP
|
$904.95
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604453
|
|
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 4.0X14 CANN 1/3 THD
|
Facility
OP
|
$904.95
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604452
|
|
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 4.0X14 CANN 1/3 THD
|
Facility
IP
|
$904.95
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604452
|
|
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 4.0X14 CANN LAG
|
Facility
OP
|
$858.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606765
|
|
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 4.0X14 CANN LAG
|
Facility
IP
|
$858.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606765
|
|
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 4.0X16 CANC FT
|
Facility
OP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606842
|
|
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 4.0X16 CANC FT
|
Facility
IP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606842
|
|
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 4.0X16 CANC LAG
|
Facility
IP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606865
|
|
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 4.0X16 CANC LAG
|
Facility
OP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606865
|
|
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 4.0X16 CANC LOCK
|
Facility
OP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606884
|
|
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
|
|
