|
HC Z SCREW 48 HD
|
Facility
OP
|
$669.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605841
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$221.02 |
| Max. Negotiated Rate |
$622.88 |
| Rate for Payer: Aetna Commercial |
$565.28
|
| Rate for Payer: Aetna Medicare |
$221.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$221.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$384.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$418.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$254.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$243.12
|
| Rate for Payer: Cash Price |
$415.25
|
| Rate for Payer: Cash Price |
$415.25
|
| Rate for Payer: Centivo All Commercial |
$341.58
|
| Rate for Payer: Cigna All Commercial |
$578.00
|
| Rate for Payer: CORVEL All Commercial |
$622.88
|
| Rate for Payer: Coventry All Commercial |
$589.39
|
| Rate for Payer: Encore All Commercial |
$616.51
|
| Rate for Payer: Frontpath All Commercial |
$616.18
|
| Rate for Payer: Humana ChoiceCare |
$578.47
|
| Rate for Payer: Humana Medicare |
$341.58
|
| Rate for Payer: Lucent All Commercial |
$341.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$602.78
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$502.32
|
| Rate for Payer: PHP All Commercial |
$507.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$261.21
|
| Rate for Payer: Sagamore Health Network All Products |
$517.05
|
| Rate for Payer: Signature Care EPO |
$555.90
|
| Rate for Payer: Signature Care PPO |
$589.39
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$569.30
|
| Rate for Payer: United Healthcare Commercial |
$527.77
|
| Rate for Payer: United Healthcare Medicare |
$221.02
|
|
|
HC Z SCREW 48 HD
|
Facility
IP
|
$669.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605841
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$502.32 |
| Max. Negotiated Rate |
$622.88 |
| Rate for Payer: Aetna Commercial |
$578.67
|
| Rate for Payer: Cash Price |
$415.25
|
| Rate for Payer: Cigna All Commercial |
$578.00
|
| Rate for Payer: CORVEL All Commercial |
$622.88
|
| Rate for Payer: Coventry All Commercial |
$589.39
|
| Rate for Payer: Encore All Commercial |
$616.51
|
| Rate for Payer: Frontpath All Commercial |
$616.18
|
| Rate for Payer: Humana ChoiceCare |
$578.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$602.78
|
| Rate for Payer: PHCS All Commercial |
$502.32
|
| Rate for Payer: PHP All Commercial |
$507.95
|
| Rate for Payer: Sagamore Health Network All Products |
$517.05
|
| Rate for Payer: Signature Care EPO |
$555.90
|
| Rate for Payer: Signature Care PPO |
$589.39
|
| Rate for Payer: United Healthcare Commercial |
$527.77
|
|
|
HC Z SCREW 48HDLS
|
Facility
IP
|
$669.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605842
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$502.32 |
| Max. Negotiated Rate |
$622.88 |
| Rate for Payer: Aetna Commercial |
$578.67
|
| Rate for Payer: Cash Price |
$415.25
|
| Rate for Payer: Cigna All Commercial |
$578.00
|
| Rate for Payer: CORVEL All Commercial |
$622.88
|
| Rate for Payer: Coventry All Commercial |
$589.39
|
| Rate for Payer: Encore All Commercial |
$616.51
|
| Rate for Payer: Frontpath All Commercial |
$616.18
|
| Rate for Payer: Humana ChoiceCare |
$578.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$602.78
|
| Rate for Payer: PHCS All Commercial |
$502.32
|
| Rate for Payer: PHP All Commercial |
$507.95
|
| Rate for Payer: Sagamore Health Network All Products |
$517.05
|
| Rate for Payer: Signature Care EPO |
$555.90
|
| Rate for Payer: Signature Care PPO |
$589.39
|
| Rate for Payer: United Healthcare Commercial |
$527.77
|
|
|
HC Z SCREW 48HDLS
|
Facility
OP
|
$669.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605842
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$221.02 |
| Max. Negotiated Rate |
$622.88 |
| Rate for Payer: Aetna Commercial |
$565.28
|
| Rate for Payer: Aetna Medicare |
$221.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$221.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$384.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$418.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$254.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$243.12
|
| Rate for Payer: Cash Price |
$415.25
|
| Rate for Payer: Cash Price |
$415.25
|
| Rate for Payer: Centivo All Commercial |
$341.58
|
| Rate for Payer: Cigna All Commercial |
$578.00
|
| Rate for Payer: CORVEL All Commercial |
$622.88
|
| Rate for Payer: Coventry All Commercial |
$589.39
|
| Rate for Payer: Encore All Commercial |
$616.51
|
| Rate for Payer: Frontpath All Commercial |
$616.18
|
| Rate for Payer: Humana ChoiceCare |
$578.47
|
| Rate for Payer: Humana Medicare |
$341.58
|
| Rate for Payer: Lucent All Commercial |
$341.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$602.78
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$502.32
|
| Rate for Payer: PHP All Commercial |
$507.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$261.21
|
| Rate for Payer: Sagamore Health Network All Products |
$517.05
|
| Rate for Payer: Signature Care EPO |
$555.90
|
| Rate for Payer: Signature Care PPO |
$589.39
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$569.30
|
| Rate for Payer: United Healthcare Commercial |
$527.77
|
| Rate for Payer: United Healthcare Medicare |
$221.02
|
|
|
HC Z SCREW 4.8X30 CANC
|
Facility
OP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606153
|
|
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 4.8X30 CANC
|
Facility
IP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606153
|
|
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 4.8X40 CANC
|
Facility
IP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606152
|
|
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 4.8X40 CANC
|
Facility
OP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606152
|
|
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 4.8X44 CANC
|
Facility
OP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606154
|
|
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 4.8X44 CANC
|
Facility
IP
|
$933.24
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606154
|
|
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 4X20 NCB CORT ST
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606923
|
|
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 4X20 NCB CORT ST
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606923
|
|
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 4X22 NCB CORT ST
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606920
|
|
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 4X22 NCB CORT ST
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606920
|
|
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 4X24 NCB CORT ST
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606921
|
|
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 4X24 NCB CORT ST
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606921
|
|
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 4X26 AFFIX CORT
|
Facility
IP
|
$819.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608272
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$614.51 |
| Max. Negotiated Rate |
$762.00 |
| Rate for Payer: Aetna Commercial |
$707.92
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cigna All Commercial |
$707.10
|
| Rate for Payer: CORVEL All Commercial |
$762.00
|
| Rate for Payer: Coventry All Commercial |
$721.03
|
| Rate for Payer: Encore All Commercial |
$754.21
|
| Rate for Payer: Frontpath All Commercial |
$753.80
|
| Rate for Payer: Humana ChoiceCare |
$707.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$737.42
|
| Rate for Payer: PHCS All Commercial |
$614.51
|
| Rate for Payer: PHP All Commercial |
$621.40
|
| Rate for Payer: Sagamore Health Network All Products |
$632.54
|
| Rate for Payer: Signature Care EPO |
$680.06
|
| Rate for Payer: Signature Care PPO |
$721.03
|
| Rate for Payer: United Healthcare Commercial |
$645.65
|
|
|
HC Z SCREW 4X26 AFFIX CORT
|
Facility
OP
|
$819.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608272
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$270.39 |
| Max. Negotiated Rate |
$762.00 |
| Rate for Payer: Aetna Commercial |
$691.53
|
| Rate for Payer: Aetna Medicare |
$270.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$270.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$470.55
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$512.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$310.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$297.42
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Centivo All Commercial |
$417.87
|
| Rate for Payer: Cigna All Commercial |
$707.10
|
| Rate for Payer: CORVEL All Commercial |
$762.00
|
| Rate for Payer: Coventry All Commercial |
$721.03
|
| Rate for Payer: Encore All Commercial |
$754.21
|
| Rate for Payer: Frontpath All Commercial |
$753.80
|
| Rate for Payer: Humana ChoiceCare |
$707.67
|
| Rate for Payer: Humana Medicare |
$417.87
|
| Rate for Payer: Lucent All Commercial |
$417.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$737.42
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$614.51
|
| Rate for Payer: PHP All Commercial |
$621.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$319.55
|
| Rate for Payer: Sagamore Health Network All Products |
$632.54
|
| Rate for Payer: Signature Care EPO |
$680.06
|
| Rate for Payer: Signature Care PPO |
$721.03
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$696.45
|
| Rate for Payer: United Healthcare Commercial |
$645.65
|
| Rate for Payer: United Healthcare Medicare |
$270.39
|
|
|
HC Z SCREW 4X28 AFFIX CORT
|
Facility
OP
|
$819.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608273
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$270.39 |
| Max. Negotiated Rate |
$762.00 |
| Rate for Payer: Aetna Commercial |
$691.53
|
| Rate for Payer: Aetna Medicare |
$270.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$270.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$470.55
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$512.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$310.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$297.42
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Centivo All Commercial |
$417.87
|
| Rate for Payer: Cigna All Commercial |
$707.10
|
| Rate for Payer: CORVEL All Commercial |
$762.00
|
| Rate for Payer: Coventry All Commercial |
$721.03
|
| Rate for Payer: Encore All Commercial |
$754.21
|
| Rate for Payer: Frontpath All Commercial |
$753.80
|
| Rate for Payer: Humana ChoiceCare |
$707.67
|
| Rate for Payer: Humana Medicare |
$417.87
|
| Rate for Payer: Lucent All Commercial |
$417.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$737.42
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$614.51
|
| Rate for Payer: PHP All Commercial |
$621.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$319.55
|
| Rate for Payer: Sagamore Health Network All Products |
$632.54
|
| Rate for Payer: Signature Care EPO |
$680.06
|
| Rate for Payer: Signature Care PPO |
$721.03
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$696.45
|
| Rate for Payer: United Healthcare Commercial |
$645.65
|
| Rate for Payer: United Healthcare Medicare |
$270.39
|
|
|
HC Z SCREW 4X28 AFFIX CORT
|
Facility
IP
|
$819.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608273
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$614.51 |
| Max. Negotiated Rate |
$762.00 |
| Rate for Payer: Aetna Commercial |
$707.92
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cigna All Commercial |
$707.10
|
| Rate for Payer: CORVEL All Commercial |
$762.00
|
| Rate for Payer: Coventry All Commercial |
$721.03
|
| Rate for Payer: Encore All Commercial |
$754.21
|
| Rate for Payer: Frontpath All Commercial |
$753.80
|
| Rate for Payer: Humana ChoiceCare |
$707.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$737.42
|
| Rate for Payer: PHCS All Commercial |
$614.51
|
| Rate for Payer: PHP All Commercial |
$621.40
|
| Rate for Payer: Sagamore Health Network All Products |
$632.54
|
| Rate for Payer: Signature Care EPO |
$680.06
|
| Rate for Payer: Signature Care PPO |
$721.03
|
| Rate for Payer: United Healthcare Commercial |
$645.65
|
|
|
HC Z SCREW 4X30 CORT
|
Facility
OP
|
$819.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607417
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$270.39 |
| Max. Negotiated Rate |
$762.00 |
| Rate for Payer: Aetna Commercial |
$691.53
|
| Rate for Payer: Aetna Medicare |
$270.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$270.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$470.55
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$512.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$310.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$297.42
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Centivo All Commercial |
$417.87
|
| Rate for Payer: Cigna All Commercial |
$707.10
|
| Rate for Payer: CORVEL All Commercial |
$762.00
|
| Rate for Payer: Coventry All Commercial |
$721.03
|
| Rate for Payer: Encore All Commercial |
$754.21
|
| Rate for Payer: Frontpath All Commercial |
$753.80
|
| Rate for Payer: Humana ChoiceCare |
$707.67
|
| Rate for Payer: Humana Medicare |
$417.87
|
| Rate for Payer: Lucent All Commercial |
$417.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$737.42
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$614.51
|
| Rate for Payer: PHP All Commercial |
$621.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$319.55
|
| Rate for Payer: Sagamore Health Network All Products |
$632.54
|
| Rate for Payer: Signature Care EPO |
$680.06
|
| Rate for Payer: Signature Care PPO |
$721.03
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$696.45
|
| Rate for Payer: United Healthcare Commercial |
$645.65
|
| Rate for Payer: United Healthcare Medicare |
$270.39
|
|
|
HC Z SCREW 4X30 CORT
|
Facility
IP
|
$819.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607417
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$614.51 |
| Max. Negotiated Rate |
$762.00 |
| Rate for Payer: Aetna Commercial |
$707.92
|
| Rate for Payer: Cash Price |
$508.00
|
| Rate for Payer: Cigna All Commercial |
$707.10
|
| Rate for Payer: CORVEL All Commercial |
$762.00
|
| Rate for Payer: Coventry All Commercial |
$721.03
|
| Rate for Payer: Encore All Commercial |
$754.21
|
| Rate for Payer: Frontpath All Commercial |
$753.80
|
| Rate for Payer: Humana ChoiceCare |
$707.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$737.42
|
| Rate for Payer: PHCS All Commercial |
$614.51
|
| Rate for Payer: PHP All Commercial |
$621.40
|
| Rate for Payer: Sagamore Health Network All Products |
$632.54
|
| Rate for Payer: Signature Care EPO |
$680.06
|
| Rate for Payer: Signature Care PPO |
$721.03
|
| Rate for Payer: United Healthcare Commercial |
$645.65
|
|
|
HC Z SCREW 4X36 NCB CORT ST
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607449
|
|
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 4X36 NCB CORT ST
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607449
|
|
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 4X38 AFFIX BT
|
Facility
OP
|
$827.70
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608271
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$273.14 |
| Max. Negotiated Rate |
$769.76 |
| Rate for Payer: Aetna Commercial |
$698.58
|
| Rate for Payer: Aetna Medicare |
$273.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$273.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$475.35
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$517.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$314.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$300.46
|
| Rate for Payer: Cash Price |
$513.17
|
| Rate for Payer: Cash Price |
$513.17
|
| Rate for Payer: Centivo All Commercial |
$422.13
|
| Rate for Payer: Cigna All Commercial |
$714.31
|
| Rate for Payer: CORVEL All Commercial |
$769.76
|
| Rate for Payer: Coventry All Commercial |
$728.38
|
| Rate for Payer: Encore All Commercial |
$761.90
|
| Rate for Payer: Frontpath All Commercial |
$761.48
|
| Rate for Payer: Humana ChoiceCare |
$714.88
|
| Rate for Payer: Humana Medicare |
$422.13
|
| Rate for Payer: Lucent All Commercial |
$422.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$744.93
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$620.78
|
| Rate for Payer: PHP All Commercial |
$627.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$322.80
|
| Rate for Payer: Sagamore Health Network All Products |
$638.98
|
| Rate for Payer: Signature Care EPO |
$686.99
|
| Rate for Payer: Signature Care PPO |
$728.38
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$703.54
|
| Rate for Payer: United Healthcare Commercial |
$652.23
|
| Rate for Payer: United Healthcare Medicare |
$273.14
|
|
