|
HC Z SCREW 5X30 NCB CORT ST
|
Facility
OP
|
$782.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606618
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.18 |
| Max. Negotiated Rate |
$727.59 |
| Rate for Payer: Aetna Commercial |
$660.30
|
| Rate for Payer: Aetna Medicare |
$258.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$258.18
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$449.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$489.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$296.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$283.99
|
| Rate for Payer: Cash Price |
$485.06
|
| Rate for Payer: Cash Price |
$485.06
|
| Rate for Payer: Centivo All Commercial |
$399.00
|
| Rate for Payer: Cigna All Commercial |
$675.17
|
| Rate for Payer: CORVEL All Commercial |
$727.59
|
| Rate for Payer: Coventry All Commercial |
$688.47
|
| Rate for Payer: Encore All Commercial |
$720.15
|
| Rate for Payer: Frontpath All Commercial |
$719.76
|
| Rate for Payer: Humana ChoiceCare |
$675.72
|
| Rate for Payer: Humana Medicare |
$399.00
|
| Rate for Payer: Lucent All Commercial |
$399.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$704.12
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$586.76
|
| Rate for Payer: PHP All Commercial |
$593.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$305.12
|
| Rate for Payer: Sagamore Health Network All Products |
$603.97
|
| Rate for Payer: Signature Care EPO |
$649.35
|
| Rate for Payer: Signature Care PPO |
$688.47
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$665.00
|
| Rate for Payer: United Healthcare Commercial |
$616.49
|
| Rate for Payer: United Healthcare Medicare |
$258.18
|
|
|
HC Z SCREW 5X32
|
Facility
IP
|
$914.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607010
|
|
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 5X32
|
Facility
OP
|
$914.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607010
|
|
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 5X32 NCB CORT ST
|
Facility
IP
|
$782.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606556
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$586.76 |
| Max. Negotiated Rate |
$727.59 |
| Rate for Payer: Aetna Commercial |
$675.95
|
| Rate for Payer: Cash Price |
$485.06
|
| Rate for Payer: Cigna All Commercial |
$675.17
|
| Rate for Payer: CORVEL All Commercial |
$727.59
|
| Rate for Payer: Coventry All Commercial |
$688.47
|
| Rate for Payer: Encore All Commercial |
$720.15
|
| Rate for Payer: Frontpath All Commercial |
$719.76
|
| Rate for Payer: Humana ChoiceCare |
$675.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$704.12
|
| Rate for Payer: PHCS All Commercial |
$586.76
|
| Rate for Payer: PHP All Commercial |
$593.33
|
| Rate for Payer: Sagamore Health Network All Products |
$603.97
|
| Rate for Payer: Signature Care EPO |
$649.35
|
| Rate for Payer: Signature Care PPO |
$688.47
|
| Rate for Payer: United Healthcare Commercial |
$616.49
|
|
|
HC Z SCREW 5X32 NCB CORT ST
|
Facility
OP
|
$782.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606556
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.18 |
| Max. Negotiated Rate |
$727.59 |
| Rate for Payer: Aetna Commercial |
$660.30
|
| Rate for Payer: Aetna Medicare |
$258.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$258.18
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$449.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$489.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$296.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$283.99
|
| Rate for Payer: Cash Price |
$485.06
|
| Rate for Payer: Cash Price |
$485.06
|
| Rate for Payer: Centivo All Commercial |
$399.00
|
| Rate for Payer: Cigna All Commercial |
$675.17
|
| Rate for Payer: CORVEL All Commercial |
$727.59
|
| Rate for Payer: Coventry All Commercial |
$688.47
|
| Rate for Payer: Encore All Commercial |
$720.15
|
| Rate for Payer: Frontpath All Commercial |
$719.76
|
| Rate for Payer: Humana ChoiceCare |
$675.72
|
| Rate for Payer: Humana Medicare |
$399.00
|
| Rate for Payer: Lucent All Commercial |
$399.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$704.12
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$586.76
|
| Rate for Payer: PHP All Commercial |
$593.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$305.12
|
| Rate for Payer: Sagamore Health Network All Products |
$603.97
|
| Rate for Payer: Signature Care EPO |
$649.35
|
| Rate for Payer: Signature Care PPO |
$688.47
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$665.00
|
| Rate for Payer: United Healthcare Commercial |
$616.49
|
| Rate for Payer: United Healthcare Medicare |
$258.18
|
|
|
HC Z SCREW 5X34 CORT
|
Facility
OP
|
$914.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607409
|
|
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 5X34 CORT
|
Facility
IP
|
$914.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607409
|
|
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 5X36 CORT
|
Facility
OP
|
$914.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606245
|
|
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 5X36 CORT
|
Facility
IP
|
$914.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606245
|
|
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 5X36 NCB CORT ST
|
Facility
IP
|
$782.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606619
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$586.76 |
| Max. Negotiated Rate |
$727.59 |
| Rate for Payer: Aetna Commercial |
$675.95
|
| Rate for Payer: Cash Price |
$485.06
|
| Rate for Payer: Cigna All Commercial |
$675.17
|
| Rate for Payer: CORVEL All Commercial |
$727.59
|
| Rate for Payer: Coventry All Commercial |
$688.47
|
| Rate for Payer: Encore All Commercial |
$720.15
|
| Rate for Payer: Frontpath All Commercial |
$719.76
|
| Rate for Payer: Humana ChoiceCare |
$675.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$704.12
|
| Rate for Payer: PHCS All Commercial |
$586.76
|
| Rate for Payer: PHP All Commercial |
$593.33
|
| Rate for Payer: Sagamore Health Network All Products |
$603.97
|
| Rate for Payer: Signature Care EPO |
$649.35
|
| Rate for Payer: Signature Care PPO |
$688.47
|
| Rate for Payer: United Healthcare Commercial |
$616.49
|
|
|
HC Z SCREW 5X36 NCB CORT ST
|
Facility
OP
|
$782.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606619
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.18 |
| Max. Negotiated Rate |
$727.59 |
| Rate for Payer: Aetna Commercial |
$660.30
|
| Rate for Payer: Aetna Medicare |
$258.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$258.18
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$449.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$489.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$296.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$283.99
|
| Rate for Payer: Cash Price |
$485.06
|
| Rate for Payer: Cash Price |
$485.06
|
| Rate for Payer: Centivo All Commercial |
$399.00
|
| Rate for Payer: Cigna All Commercial |
$675.17
|
| Rate for Payer: CORVEL All Commercial |
$727.59
|
| Rate for Payer: Coventry All Commercial |
$688.47
|
| Rate for Payer: Encore All Commercial |
$720.15
|
| Rate for Payer: Frontpath All Commercial |
$719.76
|
| Rate for Payer: Humana ChoiceCare |
$675.72
|
| Rate for Payer: Humana Medicare |
$399.00
|
| Rate for Payer: Lucent All Commercial |
$399.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$704.12
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$586.76
|
| Rate for Payer: PHP All Commercial |
$593.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$305.12
|
| Rate for Payer: Sagamore Health Network All Products |
$603.97
|
| Rate for Payer: Signature Care EPO |
$649.35
|
| Rate for Payer: Signature Care PPO |
$688.47
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$665.00
|
| Rate for Payer: United Healthcare Commercial |
$616.49
|
| Rate for Payer: United Healthcare Medicare |
$258.18
|
|
|
HC Z SCREW 5X38 CORT
|
Facility
OP
|
$914.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606627
|
|
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 5X38 CORT
|
Facility
IP
|
$914.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606614
|
|
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 5X38 CORT
|
Facility
IP
|
$914.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606627
|
|
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 5X38 CORT
|
Facility
OP
|
$914.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606614
|
|
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 5X38 NCB CORT ST
|
Facility
IP
|
$782.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606620
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$586.76 |
| Max. Negotiated Rate |
$727.59 |
| Rate for Payer: Aetna Commercial |
$675.95
|
| Rate for Payer: Cash Price |
$485.06
|
| Rate for Payer: Cigna All Commercial |
$675.17
|
| Rate for Payer: CORVEL All Commercial |
$727.59
|
| Rate for Payer: Coventry All Commercial |
$688.47
|
| Rate for Payer: Encore All Commercial |
$720.15
|
| Rate for Payer: Frontpath All Commercial |
$719.76
|
| Rate for Payer: Humana ChoiceCare |
$675.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$704.12
|
| Rate for Payer: PHCS All Commercial |
$586.76
|
| Rate for Payer: PHP All Commercial |
$593.33
|
| Rate for Payer: Sagamore Health Network All Products |
$603.97
|
| Rate for Payer: Signature Care EPO |
$649.35
|
| Rate for Payer: Signature Care PPO |
$688.47
|
| Rate for Payer: United Healthcare Commercial |
$616.49
|
|
|
HC Z SCREW 5X38 NCB CORT ST
|
Facility
OP
|
$782.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606620
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.18 |
| Max. Negotiated Rate |
$727.59 |
| Rate for Payer: Aetna Commercial |
$660.30
|
| Rate for Payer: Aetna Medicare |
$258.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$258.18
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$449.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$489.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$296.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$283.99
|
| Rate for Payer: Cash Price |
$485.06
|
| Rate for Payer: Cash Price |
$485.06
|
| Rate for Payer: Centivo All Commercial |
$399.00
|
| Rate for Payer: Cigna All Commercial |
$675.17
|
| Rate for Payer: CORVEL All Commercial |
$727.59
|
| Rate for Payer: Coventry All Commercial |
$688.47
|
| Rate for Payer: Encore All Commercial |
$720.15
|
| Rate for Payer: Frontpath All Commercial |
$719.76
|
| Rate for Payer: Humana ChoiceCare |
$675.72
|
| Rate for Payer: Humana Medicare |
$399.00
|
| Rate for Payer: Lucent All Commercial |
$399.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$704.12
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$586.76
|
| Rate for Payer: PHP All Commercial |
$593.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$305.12
|
| Rate for Payer: Sagamore Health Network All Products |
$603.97
|
| Rate for Payer: Signature Care EPO |
$649.35
|
| Rate for Payer: Signature Care PPO |
$688.47
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$665.00
|
| Rate for Payer: United Healthcare Commercial |
$616.49
|
| Rate for Payer: United Healthcare Medicare |
$258.18
|
|
|
HC Z SCREW 5X40 LOCK
|
Facility
IP
|
$1,736.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607920
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,302.00 |
| Max. Negotiated Rate |
$1,614.48 |
| Rate for Payer: Aetna Commercial |
$1,499.90
|
| Rate for Payer: Cash Price |
$1,076.32
|
| Rate for Payer: Cigna All Commercial |
$1,498.17
|
| Rate for Payer: CORVEL All Commercial |
$1,614.48
|
| Rate for Payer: Coventry All Commercial |
$1,527.68
|
| Rate for Payer: Encore All Commercial |
$1,597.99
|
| Rate for Payer: Frontpath All Commercial |
$1,597.12
|
| Rate for Payer: Humana ChoiceCare |
$1,499.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,562.40
|
| Rate for Payer: PHCS All Commercial |
$1,302.00
|
| Rate for Payer: PHP All Commercial |
$1,316.58
|
| Rate for Payer: Sagamore Health Network All Products |
$1,340.19
|
| Rate for Payer: Signature Care EPO |
$1,440.88
|
| Rate for Payer: Signature Care PPO |
$1,527.68
|
| Rate for Payer: United Healthcare Commercial |
$1,367.97
|
|
|
HC Z SCREW 5X40 LOCK
|
Facility
OP
|
$1,736.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607920
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,614.48 |
| Rate for Payer: Aetna Commercial |
$1,465.18
|
| Rate for Payer: Aetna Medicare |
$572.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$572.88
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$996.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,085.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$658.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$630.17
|
| Rate for Payer: Cash Price |
$1,076.32
|
| Rate for Payer: Cash Price |
$1,076.32
|
| Rate for Payer: Centivo All Commercial |
$885.36
|
| Rate for Payer: Cigna All Commercial |
$1,498.17
|
| Rate for Payer: CORVEL All Commercial |
$1,614.48
|
| Rate for Payer: Coventry All Commercial |
$1,527.68
|
| Rate for Payer: Encore All Commercial |
$1,597.99
|
| Rate for Payer: Frontpath All Commercial |
$1,597.12
|
| Rate for Payer: Humana ChoiceCare |
$1,499.38
|
| Rate for Payer: Humana Medicare |
$885.36
|
| Rate for Payer: Lucent All Commercial |
$885.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,562.40
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,302.00
|
| Rate for Payer: PHP All Commercial |
$1,316.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$677.04
|
| Rate for Payer: Sagamore Health Network All Products |
$1,340.19
|
| Rate for Payer: Signature Care EPO |
$1,440.88
|
| Rate for Payer: Signature Care PPO |
$1,527.68
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,475.60
|
| Rate for Payer: United Healthcare Commercial |
$1,367.97
|
| Rate for Payer: United Healthcare Medicare |
$572.88
|
|
|
HC Z SCREW 5X40 NCB CORT ST
|
Facility
IP
|
$782.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606557
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$586.76 |
| Max. Negotiated Rate |
$727.59 |
| Rate for Payer: Aetna Commercial |
$675.95
|
| Rate for Payer: Cash Price |
$485.06
|
| Rate for Payer: Cigna All Commercial |
$675.17
|
| Rate for Payer: CORVEL All Commercial |
$727.59
|
| Rate for Payer: Coventry All Commercial |
$688.47
|
| Rate for Payer: Encore All Commercial |
$720.15
|
| Rate for Payer: Frontpath All Commercial |
$719.76
|
| Rate for Payer: Humana ChoiceCare |
$675.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$704.12
|
| Rate for Payer: PHCS All Commercial |
$586.76
|
| Rate for Payer: PHP All Commercial |
$593.33
|
| Rate for Payer: Sagamore Health Network All Products |
$603.97
|
| Rate for Payer: Signature Care EPO |
$649.35
|
| Rate for Payer: Signature Care PPO |
$688.47
|
| Rate for Payer: United Healthcare Commercial |
$616.49
|
|
|
HC Z SCREW 5X40 NCB CORT ST
|
Facility
OP
|
$782.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606557
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.18 |
| Max. Negotiated Rate |
$727.59 |
| Rate for Payer: Aetna Commercial |
$660.30
|
| Rate for Payer: Aetna Medicare |
$258.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$258.18
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$449.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$489.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$296.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$283.99
|
| Rate for Payer: Cash Price |
$485.06
|
| Rate for Payer: Cash Price |
$485.06
|
| Rate for Payer: Centivo All Commercial |
$399.00
|
| Rate for Payer: Cigna All Commercial |
$675.17
|
| Rate for Payer: CORVEL All Commercial |
$727.59
|
| Rate for Payer: Coventry All Commercial |
$688.47
|
| Rate for Payer: Encore All Commercial |
$720.15
|
| Rate for Payer: Frontpath All Commercial |
$719.76
|
| Rate for Payer: Humana ChoiceCare |
$675.72
|
| Rate for Payer: Humana Medicare |
$399.00
|
| Rate for Payer: Lucent All Commercial |
$399.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$704.12
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$586.76
|
| Rate for Payer: PHP All Commercial |
$593.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$305.12
|
| Rate for Payer: Sagamore Health Network All Products |
$603.97
|
| Rate for Payer: Signature Care EPO |
$649.35
|
| Rate for Payer: Signature Care PPO |
$688.47
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$665.00
|
| Rate for Payer: United Healthcare Commercial |
$616.49
|
| Rate for Payer: United Healthcare Medicare |
$258.18
|
|
|
HC Z SCREW 5X42 CORT
|
Facility
IP
|
$914.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606650
|
|
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 5X42 CORT
|
Facility
OP
|
$914.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606650
|
|
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 5X42 NCB CORT ST
|
Facility
IP
|
$782.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607447
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$586.76 |
| Max. Negotiated Rate |
$727.59 |
| Rate for Payer: Aetna Commercial |
$675.95
|
| Rate for Payer: Cash Price |
$485.06
|
| Rate for Payer: Cigna All Commercial |
$675.17
|
| Rate for Payer: CORVEL All Commercial |
$727.59
|
| Rate for Payer: Coventry All Commercial |
$688.47
|
| Rate for Payer: Encore All Commercial |
$720.15
|
| Rate for Payer: Frontpath All Commercial |
$719.76
|
| Rate for Payer: Humana ChoiceCare |
$675.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$704.12
|
| Rate for Payer: PHCS All Commercial |
$586.76
|
| Rate for Payer: PHP All Commercial |
$593.33
|
| Rate for Payer: Sagamore Health Network All Products |
$603.97
|
| Rate for Payer: Signature Care EPO |
$649.35
|
| Rate for Payer: Signature Care PPO |
$688.47
|
| Rate for Payer: United Healthcare Commercial |
$616.49
|
|
|
HC Z SCREW 5X42 NCB CORT ST
|
Facility
OP
|
$782.35
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607447
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$258.18 |
| Max. Negotiated Rate |
$727.59 |
| Rate for Payer: Aetna Commercial |
$660.30
|
| Rate for Payer: Aetna Medicare |
$258.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$258.18
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$449.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$489.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$296.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$283.99
|
| Rate for Payer: Cash Price |
$485.06
|
| Rate for Payer: Cash Price |
$485.06
|
| Rate for Payer: Centivo All Commercial |
$399.00
|
| Rate for Payer: Cigna All Commercial |
$675.17
|
| Rate for Payer: CORVEL All Commercial |
$727.59
|
| Rate for Payer: Coventry All Commercial |
$688.47
|
| Rate for Payer: Encore All Commercial |
$720.15
|
| Rate for Payer: Frontpath All Commercial |
$719.76
|
| Rate for Payer: Humana ChoiceCare |
$675.72
|
| Rate for Payer: Humana Medicare |
$399.00
|
| Rate for Payer: Lucent All Commercial |
$399.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$704.12
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$586.76
|
| Rate for Payer: PHP All Commercial |
$593.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$305.12
|
| Rate for Payer: Sagamore Health Network All Products |
$603.97
|
| Rate for Payer: Signature Care EPO |
$649.35
|
| Rate for Payer: Signature Care PPO |
$688.47
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$665.00
|
| Rate for Payer: United Healthcare Commercial |
$616.49
|
| Rate for Payer: United Healthcare Medicare |
$258.18
|
|
