|
HC Z SCREW 4X38 AFFIX BT
|
Facility
IP
|
$827.70
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608271
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$620.78 |
| Max. Negotiated Rate |
$769.76 |
| Rate for Payer: Aetna Commercial |
$715.13
|
| Rate for Payer: Cash Price |
$513.17
|
| 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: Lutheran Preferred All Commercial |
$744.93
|
| Rate for Payer: PHCS All Commercial |
$620.78
|
| Rate for Payer: PHP All Commercial |
$627.73
|
| 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: United Healthcare Commercial |
$652.23
|
|
|
HC Z SCREW 4X38 NCB CORT ST
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607625
|
|
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 4X38 NCB CORT ST
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607625
|
|
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 4X40 NCB CORT ST
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607450
|
|
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 4X40 NCB CORT ST
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607450
|
|
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 4X42 AFFIX BT
|
Facility
OP
|
$827.70
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607412
|
|
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
|
|
|
HC Z SCREW 4X42 AFFIX BT
|
Facility
IP
|
$827.70
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607412
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$620.78 |
| Max. Negotiated Rate |
$769.76 |
| Rate for Payer: Aetna Commercial |
$715.13
|
| Rate for Payer: Cash Price |
$513.17
|
| 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: Lutheran Preferred All Commercial |
$744.93
|
| Rate for Payer: PHCS All Commercial |
$620.78
|
| Rate for Payer: PHP All Commercial |
$627.73
|
| 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: United Healthcare Commercial |
$652.23
|
|
|
HC Z SCREW 4X46 AFFIX BT
|
Facility
OP
|
$827.70
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607413
|
|
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
|
|
|
HC Z SCREW 4X46 AFFIX BT
|
Facility
IP
|
$827.70
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607413
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$620.78 |
| Max. Negotiated Rate |
$769.76 |
| Rate for Payer: Aetna Commercial |
$715.13
|
| Rate for Payer: Cash Price |
$513.17
|
| 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: Lutheran Preferred All Commercial |
$744.93
|
| Rate for Payer: PHCS All Commercial |
$620.78
|
| Rate for Payer: PHP All Commercial |
$627.73
|
| 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: United Healthcare Commercial |
$652.23
|
|
|
HC Z SCREW 4X48 AFFIX BT
|
Facility
IP
|
$827.70
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607414
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$620.78 |
| Max. Negotiated Rate |
$769.76 |
| Rate for Payer: Aetna Commercial |
$715.13
|
| Rate for Payer: Cash Price |
$513.17
|
| 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: Lutheran Preferred All Commercial |
$744.93
|
| Rate for Payer: PHCS All Commercial |
$620.78
|
| Rate for Payer: PHP All Commercial |
$627.73
|
| 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: United Healthcare Commercial |
$652.23
|
|
|
HC Z SCREW 4X48 AFFIX BT
|
Facility
OP
|
$827.70
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607414
|
|
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
|
|
|
HC Z SCREW 4X50 AFFIX BT
|
Facility
OP
|
$827.70
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607415
|
|
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
|
|
|
HC Z SCREW 4X50 AFFIX BT
|
Facility
IP
|
$827.70
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607415
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$620.78 |
| Max. Negotiated Rate |
$769.76 |
| Rate for Payer: Aetna Commercial |
$715.13
|
| Rate for Payer: Cash Price |
$513.17
|
| 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: Lutheran Preferred All Commercial |
$744.93
|
| Rate for Payer: PHCS All Commercial |
$620.78
|
| Rate for Payer: PHP All Commercial |
$627.73
|
| 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: United Healthcare Commercial |
$652.23
|
|
|
HC Z SCREW 4X58 AFFIX BT
|
Facility
OP
|
$827.70
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607416
|
|
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
|
|
|
HC Z SCREW 4X58 AFFIX BT
|
Facility
IP
|
$827.70
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607416
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$620.78 |
| Max. Negotiated Rate |
$769.76 |
| Rate for Payer: Aetna Commercial |
$715.13
|
| Rate for Payer: Cash Price |
$513.17
|
| 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: Lutheran Preferred All Commercial |
$744.93
|
| Rate for Payer: PHCS All Commercial |
$620.78
|
| Rate for Payer: PHP All Commercial |
$627.73
|
| 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: United Healthcare Commercial |
$652.23
|
|
|
HC Z SCREW 5.0X40 CORT
|
Facility
IP
|
$914.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606514
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$685.54 |
| Max. Negotiated Rate |
$850.07 |
| Rate for Payer: Aetna Commercial |
$789.74
|
| Rate for Payer: Cash Price |
$566.71
|
| Rate for Payer: Cigna All Commercial |
$788.83
|
| Rate for Payer: CORVEL All Commercial |
$850.07
|
| Rate for Payer: Coventry All Commercial |
$804.36
|
| Rate for Payer: Encore All Commercial |
$841.38
|
| Rate for Payer: Frontpath All Commercial |
$840.93
|
| Rate for Payer: Humana ChoiceCare |
$789.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$822.64
|
| Rate for Payer: PHCS All Commercial |
$685.54
|
| Rate for Payer: PHP All Commercial |
$693.22
|
| Rate for Payer: Sagamore Health Network All Products |
$705.65
|
| Rate for Payer: Signature Care EPO |
$758.66
|
| Rate for Payer: Signature Care PPO |
$804.36
|
| Rate for Payer: United Healthcare Commercial |
$720.27
|
|
|
HC Z SCREW 5.0X40 CORT
|
Facility
OP
|
$914.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606514
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$301.64 |
| Max. Negotiated Rate |
$850.07 |
| Rate for Payer: Aetna Commercial |
$771.46
|
| Rate for Payer: Aetna Medicare |
$301.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$301.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$524.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$571.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$346.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$331.80
|
| Rate for Payer: Cash Price |
$566.71
|
| Rate for Payer: Cash Price |
$566.71
|
| Rate for Payer: Centivo All Commercial |
$466.17
|
| Rate for Payer: Cigna All Commercial |
$788.83
|
| Rate for Payer: CORVEL All Commercial |
$850.07
|
| Rate for Payer: Coventry All Commercial |
$804.36
|
| Rate for Payer: Encore All Commercial |
$841.38
|
| Rate for Payer: Frontpath All Commercial |
$840.93
|
| Rate for Payer: Humana ChoiceCare |
$789.46
|
| Rate for Payer: Humana Medicare |
$466.17
|
| Rate for Payer: Lucent All Commercial |
$466.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$822.64
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$685.54
|
| Rate for Payer: PHP All Commercial |
$693.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$356.48
|
| Rate for Payer: Sagamore Health Network All Products |
$705.65
|
| Rate for Payer: Signature Care EPO |
$758.66
|
| Rate for Payer: Signature Care PPO |
$804.36
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$776.94
|
| Rate for Payer: United Healthcare Commercial |
$720.27
|
| Rate for Payer: United Healthcare Medicare |
$301.64
|
|
|
HC Z SCREW 5.5X65 CANN LOCK
|
Facility
OP
|
$865.55
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606181
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$285.63 |
| Max. Negotiated Rate |
$804.96 |
| Rate for Payer: Aetna Commercial |
$730.52
|
| Rate for Payer: Aetna Medicare |
$285.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$285.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$497.09
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$541.06
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$328.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$314.19
|
| Rate for Payer: Cash Price |
$536.64
|
| Rate for Payer: Cash Price |
$536.64
|
| Rate for Payer: Centivo All Commercial |
$441.43
|
| Rate for Payer: Cigna All Commercial |
$746.97
|
| Rate for Payer: CORVEL All Commercial |
$804.96
|
| Rate for Payer: Coventry All Commercial |
$761.68
|
| Rate for Payer: Encore All Commercial |
$796.74
|
| Rate for Payer: Frontpath All Commercial |
$796.31
|
| Rate for Payer: Humana ChoiceCare |
$747.58
|
| Rate for Payer: Humana Medicare |
$441.43
|
| Rate for Payer: Lucent All Commercial |
$441.43
|
| Rate for Payer: Lutheran Preferred All Commercial |
$779.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$649.16
|
| Rate for Payer: PHP All Commercial |
$656.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$337.56
|
| Rate for Payer: Sagamore Health Network All Products |
$668.20
|
| Rate for Payer: Signature Care EPO |
$718.41
|
| Rate for Payer: Signature Care PPO |
$761.68
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$735.72
|
| Rate for Payer: United Healthcare Commercial |
$682.05
|
| Rate for Payer: United Healthcare Medicare |
$285.63
|
|
|
HC Z SCREW 5.5X65 CANN LOCK
|
Facility
IP
|
$865.55
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606181
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$649.16 |
| Max. Negotiated Rate |
$804.96 |
| Rate for Payer: Aetna Commercial |
$747.84
|
| Rate for Payer: Cash Price |
$536.64
|
| Rate for Payer: Cigna All Commercial |
$746.97
|
| Rate for Payer: CORVEL All Commercial |
$804.96
|
| Rate for Payer: Coventry All Commercial |
$761.68
|
| Rate for Payer: Encore All Commercial |
$796.74
|
| Rate for Payer: Frontpath All Commercial |
$796.31
|
| Rate for Payer: Humana ChoiceCare |
$747.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$779.00
|
| Rate for Payer: PHCS All Commercial |
$649.16
|
| Rate for Payer: PHP All Commercial |
$656.43
|
| Rate for Payer: Sagamore Health Network All Products |
$668.20
|
| Rate for Payer: Signature Care EPO |
$718.41
|
| Rate for Payer: Signature Care PPO |
$761.68
|
| Rate for Payer: United Healthcare Commercial |
$682.05
|
|
|
HC Z SCREW 5.5 X 70 CANN LOCK
|
Facility
IP
|
$865.55
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606940
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$649.16 |
| Max. Negotiated Rate |
$804.96 |
| Rate for Payer: Aetna Commercial |
$747.84
|
| Rate for Payer: Cash Price |
$536.64
|
| Rate for Payer: Cigna All Commercial |
$746.97
|
| Rate for Payer: CORVEL All Commercial |
$804.96
|
| Rate for Payer: Coventry All Commercial |
$761.68
|
| Rate for Payer: Encore All Commercial |
$796.74
|
| Rate for Payer: Frontpath All Commercial |
$796.31
|
| Rate for Payer: Humana ChoiceCare |
$747.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$779.00
|
| Rate for Payer: PHCS All Commercial |
$649.16
|
| Rate for Payer: PHP All Commercial |
$656.43
|
| Rate for Payer: Sagamore Health Network All Products |
$668.20
|
| Rate for Payer: Signature Care EPO |
$718.41
|
| Rate for Payer: Signature Care PPO |
$761.68
|
| Rate for Payer: United Healthcare Commercial |
$682.05
|
|
|
HC Z SCREW 5.5 X 70 CANN LOCK
|
Facility
OP
|
$865.55
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606940
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$285.63 |
| Max. Negotiated Rate |
$804.96 |
| Rate for Payer: Aetna Commercial |
$730.52
|
| Rate for Payer: Aetna Medicare |
$285.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$285.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$497.09
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$541.06
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$328.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$314.19
|
| Rate for Payer: Cash Price |
$536.64
|
| Rate for Payer: Cash Price |
$536.64
|
| Rate for Payer: Centivo All Commercial |
$441.43
|
| Rate for Payer: Cigna All Commercial |
$746.97
|
| Rate for Payer: CORVEL All Commercial |
$804.96
|
| Rate for Payer: Coventry All Commercial |
$761.68
|
| Rate for Payer: Encore All Commercial |
$796.74
|
| Rate for Payer: Frontpath All Commercial |
$796.31
|
| Rate for Payer: Humana ChoiceCare |
$747.58
|
| Rate for Payer: Humana Medicare |
$441.43
|
| Rate for Payer: Lucent All Commercial |
$441.43
|
| Rate for Payer: Lutheran Preferred All Commercial |
$779.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$649.16
|
| Rate for Payer: PHP All Commercial |
$656.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$337.56
|
| Rate for Payer: Sagamore Health Network All Products |
$668.20
|
| Rate for Payer: Signature Care EPO |
$718.41
|
| Rate for Payer: Signature Care PPO |
$761.68
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$735.72
|
| Rate for Payer: United Healthcare Commercial |
$682.05
|
| Rate for Payer: United Healthcare Medicare |
$285.63
|
|
|
HC Z SCREW 5.5X70 CANN LOCK
|
Facility
OP
|
$848.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606182
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$280.14 |
| Max. Negotiated Rate |
$789.48 |
| Rate for Payer: Aetna Commercial |
$716.47
|
| Rate for Payer: Aetna Medicare |
$280.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$280.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$487.52
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$530.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$322.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$308.15
|
| Rate for Payer: Cash Price |
$526.32
|
| Rate for Payer: Cash Price |
$526.32
|
| Rate for Payer: Centivo All Commercial |
$432.94
|
| Rate for Payer: Cigna All Commercial |
$732.60
|
| Rate for Payer: CORVEL All Commercial |
$789.48
|
| Rate for Payer: Coventry All Commercial |
$747.03
|
| Rate for Payer: Encore All Commercial |
$781.41
|
| Rate for Payer: Frontpath All Commercial |
$780.99
|
| Rate for Payer: Humana ChoiceCare |
$733.19
|
| Rate for Payer: Humana Medicare |
$432.94
|
| Rate for Payer: Lucent All Commercial |
$432.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$764.01
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$636.68
|
| Rate for Payer: PHP All Commercial |
$643.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$331.07
|
| Rate for Payer: Sagamore Health Network All Products |
$655.35
|
| Rate for Payer: Signature Care EPO |
$704.59
|
| Rate for Payer: Signature Care PPO |
$747.03
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$721.56
|
| Rate for Payer: United Healthcare Commercial |
$668.93
|
| Rate for Payer: United Healthcare Medicare |
$280.14
|
|
|
HC Z SCREW 5.5X70 CANN LOCK
|
Facility
IP
|
$848.90
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606182
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$636.68 |
| Max. Negotiated Rate |
$789.48 |
| Rate for Payer: Aetna Commercial |
$733.45
|
| Rate for Payer: Cash Price |
$526.32
|
| Rate for Payer: Cigna All Commercial |
$732.60
|
| Rate for Payer: CORVEL All Commercial |
$789.48
|
| Rate for Payer: Coventry All Commercial |
$747.03
|
| Rate for Payer: Encore All Commercial |
$781.41
|
| Rate for Payer: Frontpath All Commercial |
$780.99
|
| Rate for Payer: Humana ChoiceCare |
$733.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$764.01
|
| Rate for Payer: PHCS All Commercial |
$636.68
|
| Rate for Payer: PHP All Commercial |
$643.81
|
| Rate for Payer: Sagamore Health Network All Products |
$655.35
|
| Rate for Payer: Signature Care EPO |
$704.59
|
| Rate for Payer: Signature Care PPO |
$747.03
|
| Rate for Payer: United Healthcare Commercial |
$668.93
|
|
|
HC Z SCREW 5.5X75 CANN LOCK
|
Facility
OP
|
$865.55
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606183
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$285.63 |
| Max. Negotiated Rate |
$804.96 |
| Rate for Payer: Aetna Commercial |
$730.52
|
| Rate for Payer: Aetna Medicare |
$285.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$285.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$497.09
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$541.06
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$328.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$314.19
|
| Rate for Payer: Cash Price |
$536.64
|
| Rate for Payer: Cash Price |
$536.64
|
| Rate for Payer: Centivo All Commercial |
$441.43
|
| Rate for Payer: Cigna All Commercial |
$746.97
|
| Rate for Payer: CORVEL All Commercial |
$804.96
|
| Rate for Payer: Coventry All Commercial |
$761.68
|
| Rate for Payer: Encore All Commercial |
$796.74
|
| Rate for Payer: Frontpath All Commercial |
$796.31
|
| Rate for Payer: Humana ChoiceCare |
$747.58
|
| Rate for Payer: Humana Medicare |
$441.43
|
| Rate for Payer: Lucent All Commercial |
$441.43
|
| Rate for Payer: Lutheran Preferred All Commercial |
$779.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$649.16
|
| Rate for Payer: PHP All Commercial |
$656.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$337.56
|
| Rate for Payer: Sagamore Health Network All Products |
$668.20
|
| Rate for Payer: Signature Care EPO |
$718.41
|
| Rate for Payer: Signature Care PPO |
$761.68
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$735.72
|
| Rate for Payer: United Healthcare Commercial |
$682.05
|
| Rate for Payer: United Healthcare Medicare |
$285.63
|
|
|
HC Z SCREW 5.5X75 CANN LOCK
|
Facility
IP
|
$865.55
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606183
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$649.16 |
| Max. Negotiated Rate |
$804.96 |
| Rate for Payer: Aetna Commercial |
$747.84
|
| Rate for Payer: Cash Price |
$536.64
|
| Rate for Payer: Cigna All Commercial |
$746.97
|
| Rate for Payer: CORVEL All Commercial |
$804.96
|
| Rate for Payer: Coventry All Commercial |
$761.68
|
| Rate for Payer: Encore All Commercial |
$796.74
|
| Rate for Payer: Frontpath All Commercial |
$796.31
|
| Rate for Payer: Humana ChoiceCare |
$747.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$779.00
|
| Rate for Payer: PHCS All Commercial |
$649.16
|
| Rate for Payer: PHP All Commercial |
$656.43
|
| Rate for Payer: Sagamore Health Network All Products |
$668.20
|
| Rate for Payer: Signature Care EPO |
$718.41
|
| Rate for Payer: Signature Care PPO |
$761.68
|
| Rate for Payer: United Healthcare Commercial |
$682.05
|
|
