|
HC Z SCREW 4.3X38 HDLS SHRT
|
Facility
IP
|
$1,790.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607012
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,342.50 |
| Max. Negotiated Rate |
$1,664.70 |
| Rate for Payer: Aetna Commercial |
$1,546.56
|
| Rate for Payer: Cash Price |
$1,109.80
|
| Rate for Payer: Cigna All Commercial |
$1,544.77
|
| Rate for Payer: CORVEL All Commercial |
$1,664.70
|
| Rate for Payer: Coventry All Commercial |
$1,575.20
|
| Rate for Payer: Encore All Commercial |
$1,647.70
|
| Rate for Payer: Frontpath All Commercial |
$1,646.80
|
| Rate for Payer: Humana ChoiceCare |
$1,546.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,611.00
|
| Rate for Payer: PHCS All Commercial |
$1,342.50
|
| Rate for Payer: PHP All Commercial |
$1,357.54
|
| Rate for Payer: Sagamore Health Network All Products |
$1,381.88
|
| Rate for Payer: Signature Care EPO |
$1,485.70
|
| Rate for Payer: Signature Care PPO |
$1,575.20
|
| Rate for Payer: United Healthcare Commercial |
$1,410.52
|
|
|
HC Z SCREW 4.5X100 CORT FT
|
Facility
OP
|
$392.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607734
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$129.36 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$330.85
|
| Rate for Payer: Aetna Medicare |
$129.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$129.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$225.13
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$245.04
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$148.76
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$142.30
|
| Rate for Payer: Cash Price |
$243.04
|
| Rate for Payer: Cash Price |
$243.04
|
| Rate for Payer: Centivo All Commercial |
$199.92
|
| Rate for Payer: Cigna All Commercial |
$338.30
|
| Rate for Payer: CORVEL All Commercial |
$364.56
|
| Rate for Payer: Coventry All Commercial |
$344.96
|
| Rate for Payer: Encore All Commercial |
$360.84
|
| Rate for Payer: Frontpath All Commercial |
$360.64
|
| Rate for Payer: Humana ChoiceCare |
$338.57
|
| Rate for Payer: Humana Medicare |
$199.92
|
| Rate for Payer: Lucent All Commercial |
$199.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$352.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$294.00
|
| Rate for Payer: PHP All Commercial |
$297.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$152.88
|
| Rate for Payer: Sagamore Health Network All Products |
$302.62
|
| Rate for Payer: Signature Care EPO |
$325.36
|
| Rate for Payer: Signature Care PPO |
$344.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$333.20
|
| Rate for Payer: United Healthcare Commercial |
$308.90
|
| Rate for Payer: United Healthcare Medicare |
$129.36
|
|
|
HC Z SCREW 4.5X100 CORT FT
|
Facility
IP
|
$392.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607734
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$294.00 |
| Max. Negotiated Rate |
$364.56 |
| Rate for Payer: Aetna Commercial |
$338.69
|
| Rate for Payer: Cash Price |
$243.04
|
| Rate for Payer: Cigna All Commercial |
$338.30
|
| Rate for Payer: CORVEL All Commercial |
$364.56
|
| Rate for Payer: Coventry All Commercial |
$344.96
|
| Rate for Payer: Encore All Commercial |
$360.84
|
| Rate for Payer: Frontpath All Commercial |
$360.64
|
| Rate for Payer: Humana ChoiceCare |
$338.57
|
| Rate for Payer: Lutheran Preferred All Commercial |
$352.80
|
| Rate for Payer: PHCS All Commercial |
$294.00
|
| Rate for Payer: PHP All Commercial |
$297.29
|
| Rate for Payer: Sagamore Health Network All Products |
$302.62
|
| Rate for Payer: Signature Care EPO |
$325.36
|
| Rate for Payer: Signature Care PPO |
$344.96
|
| Rate for Payer: United Healthcare Commercial |
$308.90
|
|
|
HC Z SCREW 4.5X15 S-T
|
Facility
IP
|
$579.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605393
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$434.70 |
| Max. Negotiated Rate |
$539.03 |
| Rate for Payer: Aetna Commercial |
$500.77
|
| Rate for Payer: Cash Price |
$359.35
|
| Rate for Payer: Cigna All Commercial |
$500.19
|
| Rate for Payer: CORVEL All Commercial |
$539.03
|
| Rate for Payer: Coventry All Commercial |
$510.05
|
| Rate for Payer: Encore All Commercial |
$533.52
|
| Rate for Payer: Frontpath All Commercial |
$533.23
|
| Rate for Payer: Humana ChoiceCare |
$500.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.64
|
| Rate for Payer: PHCS All Commercial |
$434.70
|
| Rate for Payer: PHP All Commercial |
$439.57
|
| Rate for Payer: Sagamore Health Network All Products |
$447.45
|
| Rate for Payer: Signature Care EPO |
$481.07
|
| Rate for Payer: Signature Care PPO |
$510.05
|
| Rate for Payer: United Healthcare Commercial |
$456.72
|
|
|
HC Z SCREW 4.5X15 S-T
|
Facility
OP
|
$579.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605393
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$191.27 |
| Max. Negotiated Rate |
$539.03 |
| Rate for Payer: Aetna Commercial |
$489.18
|
| Rate for Payer: Aetna Medicare |
$191.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$191.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$332.86
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$362.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$219.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$210.39
|
| Rate for Payer: Cash Price |
$359.35
|
| Rate for Payer: Cash Price |
$359.35
|
| Rate for Payer: Centivo All Commercial |
$295.60
|
| Rate for Payer: Cigna All Commercial |
$500.19
|
| Rate for Payer: CORVEL All Commercial |
$539.03
|
| Rate for Payer: Coventry All Commercial |
$510.05
|
| Rate for Payer: Encore All Commercial |
$533.52
|
| Rate for Payer: Frontpath All Commercial |
$533.23
|
| Rate for Payer: Humana ChoiceCare |
$500.60
|
| Rate for Payer: Humana Medicare |
$295.60
|
| Rate for Payer: Lucent All Commercial |
$295.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.64
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$434.70
|
| Rate for Payer: PHP All Commercial |
$439.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$226.04
|
| Rate for Payer: Sagamore Health Network All Products |
$447.45
|
| Rate for Payer: Signature Care EPO |
$481.07
|
| Rate for Payer: Signature Care PPO |
$510.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$492.66
|
| Rate for Payer: United Healthcare Commercial |
$456.72
|
| Rate for Payer: United Healthcare Medicare |
$191.27
|
|
|
HC Z SCREW 4.5X20 S-T
|
Facility
OP
|
$579.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605394
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$191.27 |
| Max. Negotiated Rate |
$539.03 |
| Rate for Payer: Aetna Commercial |
$489.18
|
| Rate for Payer: Aetna Medicare |
$191.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$191.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$332.86
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$362.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$219.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$210.39
|
| Rate for Payer: Cash Price |
$359.35
|
| Rate for Payer: Cash Price |
$359.35
|
| Rate for Payer: Centivo All Commercial |
$295.60
|
| Rate for Payer: Cigna All Commercial |
$500.19
|
| Rate for Payer: CORVEL All Commercial |
$539.03
|
| Rate for Payer: Coventry All Commercial |
$510.05
|
| Rate for Payer: Encore All Commercial |
$533.52
|
| Rate for Payer: Frontpath All Commercial |
$533.23
|
| Rate for Payer: Humana ChoiceCare |
$500.60
|
| Rate for Payer: Humana Medicare |
$295.60
|
| Rate for Payer: Lucent All Commercial |
$295.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.64
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$434.70
|
| Rate for Payer: PHP All Commercial |
$439.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$226.04
|
| Rate for Payer: Sagamore Health Network All Products |
$447.45
|
| Rate for Payer: Signature Care EPO |
$481.07
|
| Rate for Payer: Signature Care PPO |
$510.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$492.66
|
| Rate for Payer: United Healthcare Commercial |
$456.72
|
| Rate for Payer: United Healthcare Medicare |
$191.27
|
|
|
HC Z SCREW 4.5X20 S-T
|
Facility
IP
|
$579.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605394
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$434.70 |
| Max. Negotiated Rate |
$539.03 |
| Rate for Payer: Aetna Commercial |
$500.77
|
| Rate for Payer: Cash Price |
$359.35
|
| Rate for Payer: Cigna All Commercial |
$500.19
|
| Rate for Payer: CORVEL All Commercial |
$539.03
|
| Rate for Payer: Coventry All Commercial |
$510.05
|
| Rate for Payer: Encore All Commercial |
$533.52
|
| Rate for Payer: Frontpath All Commercial |
$533.23
|
| Rate for Payer: Humana ChoiceCare |
$500.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.64
|
| Rate for Payer: PHCS All Commercial |
$434.70
|
| Rate for Payer: PHP All Commercial |
$439.57
|
| Rate for Payer: Sagamore Health Network All Products |
$447.45
|
| Rate for Payer: Signature Care EPO |
$481.07
|
| Rate for Payer: Signature Care PPO |
$510.05
|
| Rate for Payer: United Healthcare Commercial |
$456.72
|
|
|
HC Z SCREW 4.5 X 22 CORT FT
|
Facility
OP
|
$346.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608085
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$114.32 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$292.39
|
| Rate for Payer: Aetna Medicare |
$114.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$114.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$198.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$216.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$131.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$125.75
|
| Rate for Payer: Cash Price |
$214.79
|
| Rate for Payer: Cash Price |
$214.79
|
| Rate for Payer: Centivo All Commercial |
$176.68
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Humana Medicare |
$176.68
|
| Rate for Payer: Lucent All Commercial |
$176.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$135.11
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$294.47
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
| Rate for Payer: United Healthcare Medicare |
$114.32
|
|
|
HC Z SCREW 4.5 X 22 CORT FT
|
Facility
IP
|
$346.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608085
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$259.82 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$299.32
|
| Rate for Payer: Cash Price |
$214.79
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
|
|
HC Z SCREW 4.5 X 24 CORT FT
|
Facility
OP
|
$346.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608086
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$114.32 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$292.39
|
| Rate for Payer: Aetna Medicare |
$114.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$114.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$198.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$216.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$131.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$125.75
|
| Rate for Payer: Cash Price |
$214.79
|
| Rate for Payer: Cash Price |
$214.79
|
| Rate for Payer: Centivo All Commercial |
$176.68
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Humana Medicare |
$176.68
|
| Rate for Payer: Lucent All Commercial |
$176.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$135.11
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$294.47
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
| Rate for Payer: United Healthcare Medicare |
$114.32
|
|
|
HC Z SCREW 4.5 X 24 CORT FT
|
Facility
IP
|
$346.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608086
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$259.82 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$299.32
|
| Rate for Payer: Cash Price |
$214.79
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
|
|
HC Z SCREW 4.5 X 24 CORT LOCK
|
Facility
OP
|
$855.47
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608087
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.31 |
| Max. Negotiated Rate |
$795.59 |
| Rate for Payer: Aetna Commercial |
$722.02
|
| Rate for Payer: Aetna Medicare |
$282.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$282.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$491.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$534.75
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$324.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$310.54
|
| Rate for Payer: Cash Price |
$530.39
|
| Rate for Payer: Cash Price |
$530.39
|
| Rate for Payer: Centivo All Commercial |
$436.29
|
| Rate for Payer: Cigna All Commercial |
$738.27
|
| Rate for Payer: CORVEL All Commercial |
$795.59
|
| Rate for Payer: Coventry All Commercial |
$752.81
|
| Rate for Payer: Encore All Commercial |
$787.46
|
| Rate for Payer: Frontpath All Commercial |
$787.03
|
| Rate for Payer: Humana ChoiceCare |
$738.87
|
| Rate for Payer: Humana Medicare |
$436.29
|
| Rate for Payer: Lucent All Commercial |
$436.29
|
| Rate for Payer: Lutheran Preferred All Commercial |
$769.92
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$641.60
|
| Rate for Payer: PHP All Commercial |
$648.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$333.63
|
| Rate for Payer: Sagamore Health Network All Products |
$660.42
|
| Rate for Payer: Signature Care EPO |
$710.04
|
| Rate for Payer: Signature Care PPO |
$752.81
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$727.15
|
| Rate for Payer: United Healthcare Commercial |
$674.11
|
| Rate for Payer: United Healthcare Medicare |
$282.31
|
|
|
HC Z SCREW 4.5 X 24 CORT LOCK
|
Facility
IP
|
$855.47
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608087
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$641.60 |
| Max. Negotiated Rate |
$795.59 |
| Rate for Payer: Aetna Commercial |
$739.13
|
| Rate for Payer: Cash Price |
$530.39
|
| Rate for Payer: Cigna All Commercial |
$738.27
|
| Rate for Payer: CORVEL All Commercial |
$795.59
|
| Rate for Payer: Coventry All Commercial |
$752.81
|
| Rate for Payer: Encore All Commercial |
$787.46
|
| Rate for Payer: Frontpath All Commercial |
$787.03
|
| Rate for Payer: Humana ChoiceCare |
$738.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$769.92
|
| Rate for Payer: PHCS All Commercial |
$641.60
|
| Rate for Payer: PHP All Commercial |
$648.79
|
| Rate for Payer: Sagamore Health Network All Products |
$660.42
|
| Rate for Payer: Signature Care EPO |
$710.04
|
| Rate for Payer: Signature Care PPO |
$752.81
|
| Rate for Payer: United Healthcare Commercial |
$674.11
|
|
|
HC Z SCREW 4.5X25 S-T
|
Facility
IP
|
$579.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605395
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$434.70 |
| Max. Negotiated Rate |
$539.03 |
| Rate for Payer: Aetna Commercial |
$500.77
|
| Rate for Payer: Cash Price |
$359.35
|
| Rate for Payer: Cigna All Commercial |
$500.19
|
| Rate for Payer: CORVEL All Commercial |
$539.03
|
| Rate for Payer: Coventry All Commercial |
$510.05
|
| Rate for Payer: Encore All Commercial |
$533.52
|
| Rate for Payer: Frontpath All Commercial |
$533.23
|
| Rate for Payer: Humana ChoiceCare |
$500.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.64
|
| Rate for Payer: PHCS All Commercial |
$434.70
|
| Rate for Payer: PHP All Commercial |
$439.57
|
| Rate for Payer: Sagamore Health Network All Products |
$447.45
|
| Rate for Payer: Signature Care EPO |
$481.07
|
| Rate for Payer: Signature Care PPO |
$510.05
|
| Rate for Payer: United Healthcare Commercial |
$456.72
|
|
|
HC Z SCREW 4.5X25 S-T
|
Facility
OP
|
$579.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605395
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$191.27 |
| Max. Negotiated Rate |
$539.03 |
| Rate for Payer: Aetna Commercial |
$489.18
|
| Rate for Payer: Aetna Medicare |
$191.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$191.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$332.86
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$362.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$219.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$210.39
|
| Rate for Payer: Cash Price |
$359.35
|
| Rate for Payer: Cash Price |
$359.35
|
| Rate for Payer: Centivo All Commercial |
$295.60
|
| Rate for Payer: Cigna All Commercial |
$500.19
|
| Rate for Payer: CORVEL All Commercial |
$539.03
|
| Rate for Payer: Coventry All Commercial |
$510.05
|
| Rate for Payer: Encore All Commercial |
$533.52
|
| Rate for Payer: Frontpath All Commercial |
$533.23
|
| Rate for Payer: Humana ChoiceCare |
$500.60
|
| Rate for Payer: Humana Medicare |
$295.60
|
| Rate for Payer: Lucent All Commercial |
$295.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.64
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$434.70
|
| Rate for Payer: PHP All Commercial |
$439.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$226.04
|
| Rate for Payer: Sagamore Health Network All Products |
$447.45
|
| Rate for Payer: Signature Care EPO |
$481.07
|
| Rate for Payer: Signature Care PPO |
$510.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$492.66
|
| Rate for Payer: United Healthcare Commercial |
$456.72
|
| Rate for Payer: United Healthcare Medicare |
$191.27
|
|
|
HC Z SCREW 4.5X26 CORT FT
|
Facility
OP
|
$346.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607648
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$114.32 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$292.39
|
| Rate for Payer: Aetna Medicare |
$114.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$114.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$198.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$216.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$131.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$125.75
|
| Rate for Payer: Cash Price |
$214.79
|
| Rate for Payer: Cash Price |
$214.79
|
| Rate for Payer: Centivo All Commercial |
$176.68
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Humana Medicare |
$176.68
|
| Rate for Payer: Lucent All Commercial |
$176.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$135.11
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$294.47
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
| Rate for Payer: United Healthcare Medicare |
$114.32
|
|
|
HC Z SCREW 4.5X26 CORT FT
|
Facility
IP
|
$346.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607648
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$259.82 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$299.32
|
| Rate for Payer: Cash Price |
$214.79
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
|
|
HC Z SCREW 4.5 X 26 CORT LOCK
|
Facility
OP
|
$855.47
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608088
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.31 |
| Max. Negotiated Rate |
$795.59 |
| Rate for Payer: Aetna Commercial |
$722.02
|
| Rate for Payer: Aetna Medicare |
$282.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$282.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$491.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$534.75
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$324.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$310.54
|
| Rate for Payer: Cash Price |
$530.39
|
| Rate for Payer: Cash Price |
$530.39
|
| Rate for Payer: Centivo All Commercial |
$436.29
|
| Rate for Payer: Cigna All Commercial |
$738.27
|
| Rate for Payer: CORVEL All Commercial |
$795.59
|
| Rate for Payer: Coventry All Commercial |
$752.81
|
| Rate for Payer: Encore All Commercial |
$787.46
|
| Rate for Payer: Frontpath All Commercial |
$787.03
|
| Rate for Payer: Humana ChoiceCare |
$738.87
|
| Rate for Payer: Humana Medicare |
$436.29
|
| Rate for Payer: Lucent All Commercial |
$436.29
|
| Rate for Payer: Lutheran Preferred All Commercial |
$769.92
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$641.60
|
| Rate for Payer: PHP All Commercial |
$648.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$333.63
|
| Rate for Payer: Sagamore Health Network All Products |
$660.42
|
| Rate for Payer: Signature Care EPO |
$710.04
|
| Rate for Payer: Signature Care PPO |
$752.81
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$727.15
|
| Rate for Payer: United Healthcare Commercial |
$674.11
|
| Rate for Payer: United Healthcare Medicare |
$282.31
|
|
|
HC Z SCREW 4.5 X 26 CORT LOCK
|
Facility
IP
|
$855.47
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608088
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$641.60 |
| Max. Negotiated Rate |
$795.59 |
| Rate for Payer: Aetna Commercial |
$739.13
|
| Rate for Payer: Cash Price |
$530.39
|
| Rate for Payer: Cigna All Commercial |
$738.27
|
| Rate for Payer: CORVEL All Commercial |
$795.59
|
| Rate for Payer: Coventry All Commercial |
$752.81
|
| Rate for Payer: Encore All Commercial |
$787.46
|
| Rate for Payer: Frontpath All Commercial |
$787.03
|
| Rate for Payer: Humana ChoiceCare |
$738.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$769.92
|
| Rate for Payer: PHCS All Commercial |
$641.60
|
| Rate for Payer: PHP All Commercial |
$648.79
|
| Rate for Payer: Sagamore Health Network All Products |
$660.42
|
| Rate for Payer: Signature Care EPO |
$710.04
|
| Rate for Payer: Signature Care PPO |
$752.81
|
| Rate for Payer: United Healthcare Commercial |
$674.11
|
|
|
HC Z SCREW 4.5X26 LOCK PL
|
Facility
OP
|
$932.12
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606179
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$307.60 |
| Max. Negotiated Rate |
$866.87 |
| Rate for Payer: Aetna Commercial |
$786.71
|
| Rate for Payer: Aetna Medicare |
$307.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$307.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$535.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$582.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$353.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$338.36
|
| Rate for Payer: Cash Price |
$577.91
|
| Rate for Payer: Cash Price |
$577.91
|
| Rate for Payer: Centivo All Commercial |
$475.38
|
| Rate for Payer: Cigna All Commercial |
$804.42
|
| Rate for Payer: CORVEL All Commercial |
$866.87
|
| Rate for Payer: Coventry All Commercial |
$820.27
|
| Rate for Payer: Encore All Commercial |
$858.02
|
| Rate for Payer: Frontpath All Commercial |
$857.55
|
| Rate for Payer: Humana ChoiceCare |
$805.07
|
| Rate for Payer: Humana Medicare |
$475.38
|
| Rate for Payer: Lucent All Commercial |
$475.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$838.91
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$699.09
|
| Rate for Payer: PHP All Commercial |
$706.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$363.53
|
| Rate for Payer: Sagamore Health Network All Products |
$719.60
|
| Rate for Payer: Signature Care EPO |
$773.66
|
| Rate for Payer: Signature Care PPO |
$820.27
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$792.30
|
| Rate for Payer: United Healthcare Commercial |
$734.51
|
| Rate for Payer: United Healthcare Medicare |
$307.60
|
|
|
HC Z SCREW 4.5X26 LOCK PL
|
Facility
IP
|
$932.12
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606179
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$699.09 |
| Max. Negotiated Rate |
$866.87 |
| Rate for Payer: Aetna Commercial |
$805.35
|
| Rate for Payer: Cash Price |
$577.91
|
| Rate for Payer: Cigna All Commercial |
$804.42
|
| Rate for Payer: CORVEL All Commercial |
$866.87
|
| Rate for Payer: Coventry All Commercial |
$820.27
|
| Rate for Payer: Encore All Commercial |
$858.02
|
| Rate for Payer: Frontpath All Commercial |
$857.55
|
| Rate for Payer: Humana ChoiceCare |
$805.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$838.91
|
| Rate for Payer: PHCS All Commercial |
$699.09
|
| Rate for Payer: PHP All Commercial |
$706.92
|
| Rate for Payer: Sagamore Health Network All Products |
$719.60
|
| Rate for Payer: Signature Care EPO |
$773.66
|
| Rate for Payer: Signature Care PPO |
$820.27
|
| Rate for Payer: United Healthcare Commercial |
$734.51
|
|
|
HC Z SCREW 4.5X28 CORT FT
|
Facility
OP
|
$346.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607649
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$114.32 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$292.39
|
| Rate for Payer: Aetna Medicare |
$114.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$114.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$198.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$216.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$131.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$125.75
|
| Rate for Payer: Cash Price |
$214.79
|
| Rate for Payer: Cash Price |
$214.79
|
| Rate for Payer: Centivo All Commercial |
$176.68
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Humana Medicare |
$176.68
|
| Rate for Payer: Lucent All Commercial |
$176.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$135.11
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$294.47
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
| Rate for Payer: United Healthcare Medicare |
$114.32
|
|
|
HC Z SCREW 4.5X28 CORT FT
|
Facility
IP
|
$346.43
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607649
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$259.82 |
| Max. Negotiated Rate |
$322.18 |
| Rate for Payer: Aetna Commercial |
$299.32
|
| Rate for Payer: Cash Price |
$214.79
|
| Rate for Payer: Cigna All Commercial |
$298.97
|
| Rate for Payer: CORVEL All Commercial |
$322.18
|
| Rate for Payer: Coventry All Commercial |
$304.86
|
| Rate for Payer: Encore All Commercial |
$318.89
|
| Rate for Payer: Frontpath All Commercial |
$318.72
|
| Rate for Payer: Humana ChoiceCare |
$299.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.79
|
| Rate for Payer: PHCS All Commercial |
$259.82
|
| Rate for Payer: PHP All Commercial |
$262.73
|
| Rate for Payer: Sagamore Health Network All Products |
$267.44
|
| Rate for Payer: Signature Care EPO |
$287.54
|
| Rate for Payer: Signature Care PPO |
$304.86
|
| Rate for Payer: United Healthcare Commercial |
$272.99
|
|
|
HC Z SCREW 4.5X30 CORT
|
Facility
IP
|
$392.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606602
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$294.00 |
| Max. Negotiated Rate |
$364.56 |
| Rate for Payer: Aetna Commercial |
$338.69
|
| Rate for Payer: Cash Price |
$243.04
|
| Rate for Payer: Cigna All Commercial |
$338.30
|
| Rate for Payer: CORVEL All Commercial |
$364.56
|
| Rate for Payer: Coventry All Commercial |
$344.96
|
| Rate for Payer: Encore All Commercial |
$360.84
|
| Rate for Payer: Frontpath All Commercial |
$360.64
|
| Rate for Payer: Humana ChoiceCare |
$338.57
|
| Rate for Payer: Lutheran Preferred All Commercial |
$352.80
|
| Rate for Payer: PHCS All Commercial |
$294.00
|
| Rate for Payer: PHP All Commercial |
$297.29
|
| Rate for Payer: Sagamore Health Network All Products |
$302.62
|
| Rate for Payer: Signature Care EPO |
$325.36
|
| Rate for Payer: Signature Care PPO |
$344.96
|
| Rate for Payer: United Healthcare Commercial |
$308.90
|
|
|
HC Z SCREW 4.5X30 CORT
|
Facility
OP
|
$392.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606602
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$129.36 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$330.85
|
| Rate for Payer: Aetna Medicare |
$129.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$129.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$225.13
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$245.04
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$148.76
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$142.30
|
| Rate for Payer: Cash Price |
$243.04
|
| Rate for Payer: Cash Price |
$243.04
|
| Rate for Payer: Centivo All Commercial |
$199.92
|
| Rate for Payer: Cigna All Commercial |
$338.30
|
| Rate for Payer: CORVEL All Commercial |
$364.56
|
| Rate for Payer: Coventry All Commercial |
$344.96
|
| Rate for Payer: Encore All Commercial |
$360.84
|
| Rate for Payer: Frontpath All Commercial |
$360.64
|
| Rate for Payer: Humana ChoiceCare |
$338.57
|
| Rate for Payer: Humana Medicare |
$199.92
|
| Rate for Payer: Lucent All Commercial |
$199.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$352.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$294.00
|
| Rate for Payer: PHP All Commercial |
$297.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$152.88
|
| Rate for Payer: Sagamore Health Network All Products |
$302.62
|
| Rate for Payer: Signature Care EPO |
$325.36
|
| Rate for Payer: Signature Care PPO |
$344.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$333.20
|
| Rate for Payer: United Healthcare Commercial |
$308.90
|
| Rate for Payer: United Healthcare Medicare |
$129.36
|
|
