|
HC ACU 3.5X30 LOCK HEX SCREW
|
Facility
OP
|
$1,140.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602644
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$376.20 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Aetna Commercial |
$962.16
|
| Rate for Payer: Aetna Medicare |
$376.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$376.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$654.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$712.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$432.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$413.82
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Centivo All Commercial |
$581.40
|
| Rate for Payer: Cigna All Commercial |
$983.82
|
| Rate for Payer: CORVEL All Commercial |
$1,060.20
|
| Rate for Payer: Coventry All Commercial |
$1,003.20
|
| Rate for Payer: Encore All Commercial |
$1,049.37
|
| Rate for Payer: Frontpath All Commercial |
$1,048.80
|
| Rate for Payer: Humana ChoiceCare |
$984.62
|
| Rate for Payer: Humana Medicare |
$581.40
|
| Rate for Payer: Lucent All Commercial |
$581.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,026.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$855.00
|
| Rate for Payer: PHP All Commercial |
$864.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$444.60
|
| Rate for Payer: Sagamore Health Network All Products |
$880.08
|
| Rate for Payer: Signature Care EPO |
$946.20
|
| Rate for Payer: Signature Care PPO |
$1,003.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$969.00
|
| Rate for Payer: United Healthcare Commercial |
$898.32
|
| Rate for Payer: United Healthcare Medicare |
$376.20
|
|
|
HC ACU 3.5X30 NON-LOCK HEX SCREW
|
Facility
IP
|
$952.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602659
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$714.00 |
| Max. Negotiated Rate |
$885.36 |
| Rate for Payer: Aetna Commercial |
$822.53
|
| Rate for Payer: Cash Price |
$590.24
|
| Rate for Payer: Cigna All Commercial |
$821.58
|
| Rate for Payer: CORVEL All Commercial |
$885.36
|
| Rate for Payer: Coventry All Commercial |
$837.76
|
| Rate for Payer: Encore All Commercial |
$876.32
|
| Rate for Payer: Frontpath All Commercial |
$875.84
|
| Rate for Payer: Humana ChoiceCare |
$822.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$856.80
|
| Rate for Payer: PHCS All Commercial |
$714.00
|
| Rate for Payer: PHP All Commercial |
$722.00
|
| Rate for Payer: Sagamore Health Network All Products |
$734.94
|
| Rate for Payer: Signature Care EPO |
$790.16
|
| Rate for Payer: Signature Care PPO |
$837.76
|
| Rate for Payer: United Healthcare Commercial |
$750.18
|
|
|
HC ACU 3.5X30 NON-LOCK HEX SCREW
|
Facility
OP
|
$952.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602659
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$314.16 |
| Max. Negotiated Rate |
$885.36 |
| Rate for Payer: Aetna Commercial |
$803.49
|
| Rate for Payer: Aetna Medicare |
$314.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$314.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$546.73
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$595.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$361.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$345.58
|
| Rate for Payer: Cash Price |
$590.24
|
| Rate for Payer: Cash Price |
$590.24
|
| Rate for Payer: Centivo All Commercial |
$485.52
|
| Rate for Payer: Cigna All Commercial |
$821.58
|
| Rate for Payer: CORVEL All Commercial |
$885.36
|
| Rate for Payer: Coventry All Commercial |
$837.76
|
| Rate for Payer: Encore All Commercial |
$876.32
|
| Rate for Payer: Frontpath All Commercial |
$875.84
|
| Rate for Payer: Humana ChoiceCare |
$822.24
|
| Rate for Payer: Humana Medicare |
$485.52
|
| Rate for Payer: Lucent All Commercial |
$485.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$856.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$714.00
|
| Rate for Payer: PHP All Commercial |
$722.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$371.28
|
| Rate for Payer: Sagamore Health Network All Products |
$734.94
|
| Rate for Payer: Signature Care EPO |
$790.16
|
| Rate for Payer: Signature Care PPO |
$837.76
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$809.20
|
| Rate for Payer: United Healthcare Commercial |
$750.18
|
| Rate for Payer: United Healthcare Medicare |
$314.16
|
|
|
HC ACU 3.5X32 LOCK HEX SCREW
|
Facility
IP
|
$1,140.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602645
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$855.00 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Aetna Commercial |
$984.96
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Cigna All Commercial |
$983.82
|
| Rate for Payer: CORVEL All Commercial |
$1,060.20
|
| Rate for Payer: Coventry All Commercial |
$1,003.20
|
| Rate for Payer: Encore All Commercial |
$1,049.37
|
| Rate for Payer: Frontpath All Commercial |
$1,048.80
|
| Rate for Payer: Humana ChoiceCare |
$984.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,026.00
|
| Rate for Payer: PHCS All Commercial |
$855.00
|
| Rate for Payer: PHP All Commercial |
$864.58
|
| Rate for Payer: Sagamore Health Network All Products |
$880.08
|
| Rate for Payer: Signature Care EPO |
$946.20
|
| Rate for Payer: Signature Care PPO |
$1,003.20
|
| Rate for Payer: United Healthcare Commercial |
$898.32
|
|
|
HC ACU 3.5X32 LOCK HEX SCREW
|
Facility
OP
|
$1,140.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602645
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$376.20 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Aetna Commercial |
$962.16
|
| Rate for Payer: Aetna Medicare |
$376.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$376.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$654.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$712.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$432.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$413.82
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Centivo All Commercial |
$581.40
|
| Rate for Payer: Cigna All Commercial |
$983.82
|
| Rate for Payer: CORVEL All Commercial |
$1,060.20
|
| Rate for Payer: Coventry All Commercial |
$1,003.20
|
| Rate for Payer: Encore All Commercial |
$1,049.37
|
| Rate for Payer: Frontpath All Commercial |
$1,048.80
|
| Rate for Payer: Humana ChoiceCare |
$984.62
|
| Rate for Payer: Humana Medicare |
$581.40
|
| Rate for Payer: Lucent All Commercial |
$581.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,026.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$855.00
|
| Rate for Payer: PHP All Commercial |
$864.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$444.60
|
| Rate for Payer: Sagamore Health Network All Products |
$880.08
|
| Rate for Payer: Signature Care EPO |
$946.20
|
| Rate for Payer: Signature Care PPO |
$1,003.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$969.00
|
| Rate for Payer: United Healthcare Commercial |
$898.32
|
| Rate for Payer: United Healthcare Medicare |
$376.20
|
|
|
HC ACU 3.5X32 NON-LOCK HEX SCREW
|
Facility
OP
|
$952.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602660
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$314.16 |
| Max. Negotiated Rate |
$885.36 |
| Rate for Payer: Aetna Commercial |
$803.49
|
| Rate for Payer: Aetna Medicare |
$314.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$314.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$546.73
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$595.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$361.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$345.58
|
| Rate for Payer: Cash Price |
$590.24
|
| Rate for Payer: Cash Price |
$590.24
|
| Rate for Payer: Centivo All Commercial |
$485.52
|
| Rate for Payer: Cigna All Commercial |
$821.58
|
| Rate for Payer: CORVEL All Commercial |
$885.36
|
| Rate for Payer: Coventry All Commercial |
$837.76
|
| Rate for Payer: Encore All Commercial |
$876.32
|
| Rate for Payer: Frontpath All Commercial |
$875.84
|
| Rate for Payer: Humana ChoiceCare |
$822.24
|
| Rate for Payer: Humana Medicare |
$485.52
|
| Rate for Payer: Lucent All Commercial |
$485.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$856.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$714.00
|
| Rate for Payer: PHP All Commercial |
$722.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$371.28
|
| Rate for Payer: Sagamore Health Network All Products |
$734.94
|
| Rate for Payer: Signature Care EPO |
$790.16
|
| Rate for Payer: Signature Care PPO |
$837.76
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$809.20
|
| Rate for Payer: United Healthcare Commercial |
$750.18
|
| Rate for Payer: United Healthcare Medicare |
$314.16
|
|
|
HC ACU 3.5X32 NON-LOCK HEX SCREW
|
Facility
IP
|
$952.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602660
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$714.00 |
| Max. Negotiated Rate |
$885.36 |
| Rate for Payer: Aetna Commercial |
$822.53
|
| Rate for Payer: Cash Price |
$590.24
|
| Rate for Payer: Cigna All Commercial |
$821.58
|
| Rate for Payer: CORVEL All Commercial |
$885.36
|
| Rate for Payer: Coventry All Commercial |
$837.76
|
| Rate for Payer: Encore All Commercial |
$876.32
|
| Rate for Payer: Frontpath All Commercial |
$875.84
|
| Rate for Payer: Humana ChoiceCare |
$822.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$856.80
|
| Rate for Payer: PHCS All Commercial |
$714.00
|
| Rate for Payer: PHP All Commercial |
$722.00
|
| Rate for Payer: Sagamore Health Network All Products |
$734.94
|
| Rate for Payer: Signature Care EPO |
$790.16
|
| Rate for Payer: Signature Care PPO |
$837.76
|
| Rate for Payer: United Healthcare Commercial |
$750.18
|
|
|
HC ACU 3.5X34 LOCK HEX SCREW
|
Facility
OP
|
$1,140.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602646
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$376.20 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Aetna Commercial |
$962.16
|
| Rate for Payer: Aetna Medicare |
$376.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$376.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$654.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$712.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$432.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$413.82
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Centivo All Commercial |
$581.40
|
| Rate for Payer: Cigna All Commercial |
$983.82
|
| Rate for Payer: CORVEL All Commercial |
$1,060.20
|
| Rate for Payer: Coventry All Commercial |
$1,003.20
|
| Rate for Payer: Encore All Commercial |
$1,049.37
|
| Rate for Payer: Frontpath All Commercial |
$1,048.80
|
| Rate for Payer: Humana ChoiceCare |
$984.62
|
| Rate for Payer: Humana Medicare |
$581.40
|
| Rate for Payer: Lucent All Commercial |
$581.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,026.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$855.00
|
| Rate for Payer: PHP All Commercial |
$864.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$444.60
|
| Rate for Payer: Sagamore Health Network All Products |
$880.08
|
| Rate for Payer: Signature Care EPO |
$946.20
|
| Rate for Payer: Signature Care PPO |
$1,003.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$969.00
|
| Rate for Payer: United Healthcare Commercial |
$898.32
|
| Rate for Payer: United Healthcare Medicare |
$376.20
|
|
|
HC ACU 3.5X34 LOCK HEX SCREW
|
Facility
IP
|
$1,140.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602646
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$855.00 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Aetna Commercial |
$984.96
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Cigna All Commercial |
$983.82
|
| Rate for Payer: CORVEL All Commercial |
$1,060.20
|
| Rate for Payer: Coventry All Commercial |
$1,003.20
|
| Rate for Payer: Encore All Commercial |
$1,049.37
|
| Rate for Payer: Frontpath All Commercial |
$1,048.80
|
| Rate for Payer: Humana ChoiceCare |
$984.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,026.00
|
| Rate for Payer: PHCS All Commercial |
$855.00
|
| Rate for Payer: PHP All Commercial |
$864.58
|
| Rate for Payer: Sagamore Health Network All Products |
$880.08
|
| Rate for Payer: Signature Care EPO |
$946.20
|
| Rate for Payer: Signature Care PPO |
$1,003.20
|
| Rate for Payer: United Healthcare Commercial |
$898.32
|
|
|
HC ACU 3.5X34 NON-LOCK HEX SCREW
|
Facility
IP
|
$952.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602661
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$714.00 |
| Max. Negotiated Rate |
$885.36 |
| Rate for Payer: Aetna Commercial |
$822.53
|
| Rate for Payer: Cash Price |
$590.24
|
| Rate for Payer: Cigna All Commercial |
$821.58
|
| Rate for Payer: CORVEL All Commercial |
$885.36
|
| Rate for Payer: Coventry All Commercial |
$837.76
|
| Rate for Payer: Encore All Commercial |
$876.32
|
| Rate for Payer: Frontpath All Commercial |
$875.84
|
| Rate for Payer: Humana ChoiceCare |
$822.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$856.80
|
| Rate for Payer: PHCS All Commercial |
$714.00
|
| Rate for Payer: PHP All Commercial |
$722.00
|
| Rate for Payer: Sagamore Health Network All Products |
$734.94
|
| Rate for Payer: Signature Care EPO |
$790.16
|
| Rate for Payer: Signature Care PPO |
$837.76
|
| Rate for Payer: United Healthcare Commercial |
$750.18
|
|
|
HC ACU 3.5X34 NON-LOCK HEX SCREW
|
Facility
OP
|
$952.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602661
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$314.16 |
| Max. Negotiated Rate |
$885.36 |
| Rate for Payer: Aetna Commercial |
$803.49
|
| Rate for Payer: Aetna Medicare |
$314.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$314.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$546.73
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$595.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$361.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$345.58
|
| Rate for Payer: Cash Price |
$590.24
|
| Rate for Payer: Cash Price |
$590.24
|
| Rate for Payer: Centivo All Commercial |
$485.52
|
| Rate for Payer: Cigna All Commercial |
$821.58
|
| Rate for Payer: CORVEL All Commercial |
$885.36
|
| Rate for Payer: Coventry All Commercial |
$837.76
|
| Rate for Payer: Encore All Commercial |
$876.32
|
| Rate for Payer: Frontpath All Commercial |
$875.84
|
| Rate for Payer: Humana ChoiceCare |
$822.24
|
| Rate for Payer: Humana Medicare |
$485.52
|
| Rate for Payer: Lucent All Commercial |
$485.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$856.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$714.00
|
| Rate for Payer: PHP All Commercial |
$722.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$371.28
|
| Rate for Payer: Sagamore Health Network All Products |
$734.94
|
| Rate for Payer: Signature Care EPO |
$790.16
|
| Rate for Payer: Signature Care PPO |
$837.76
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$809.20
|
| Rate for Payer: United Healthcare Commercial |
$750.18
|
| Rate for Payer: United Healthcare Medicare |
$314.16
|
|
|
HC ACU 3.5X36 LOCK HEX SCREW
|
Facility
IP
|
$1,140.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602647
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$855.00 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Aetna Commercial |
$984.96
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Cigna All Commercial |
$983.82
|
| Rate for Payer: CORVEL All Commercial |
$1,060.20
|
| Rate for Payer: Coventry All Commercial |
$1,003.20
|
| Rate for Payer: Encore All Commercial |
$1,049.37
|
| Rate for Payer: Frontpath All Commercial |
$1,048.80
|
| Rate for Payer: Humana ChoiceCare |
$984.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,026.00
|
| Rate for Payer: PHCS All Commercial |
$855.00
|
| Rate for Payer: PHP All Commercial |
$864.58
|
| Rate for Payer: Sagamore Health Network All Products |
$880.08
|
| Rate for Payer: Signature Care EPO |
$946.20
|
| Rate for Payer: Signature Care PPO |
$1,003.20
|
| Rate for Payer: United Healthcare Commercial |
$898.32
|
|
|
HC ACU 3.5X36 LOCK HEX SCREW
|
Facility
OP
|
$1,140.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602647
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$376.20 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Aetna Commercial |
$962.16
|
| Rate for Payer: Aetna Medicare |
$376.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$376.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$654.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$712.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$432.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$413.82
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Centivo All Commercial |
$581.40
|
| Rate for Payer: Cigna All Commercial |
$983.82
|
| Rate for Payer: CORVEL All Commercial |
$1,060.20
|
| Rate for Payer: Coventry All Commercial |
$1,003.20
|
| Rate for Payer: Encore All Commercial |
$1,049.37
|
| Rate for Payer: Frontpath All Commercial |
$1,048.80
|
| Rate for Payer: Humana ChoiceCare |
$984.62
|
| Rate for Payer: Humana Medicare |
$581.40
|
| Rate for Payer: Lucent All Commercial |
$581.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,026.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$855.00
|
| Rate for Payer: PHP All Commercial |
$864.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$444.60
|
| Rate for Payer: Sagamore Health Network All Products |
$880.08
|
| Rate for Payer: Signature Care EPO |
$946.20
|
| Rate for Payer: Signature Care PPO |
$1,003.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$969.00
|
| Rate for Payer: United Healthcare Commercial |
$898.32
|
| Rate for Payer: United Healthcare Medicare |
$376.20
|
|
|
HC ACU 3.5X36 NON-LOCK HEX SCREW
|
Facility
OP
|
$952.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602662
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$314.16 |
| Max. Negotiated Rate |
$885.36 |
| Rate for Payer: Aetna Commercial |
$803.49
|
| Rate for Payer: Aetna Medicare |
$314.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$314.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$546.73
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$595.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$361.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$345.58
|
| Rate for Payer: Cash Price |
$590.24
|
| Rate for Payer: Cash Price |
$590.24
|
| Rate for Payer: Centivo All Commercial |
$485.52
|
| Rate for Payer: Cigna All Commercial |
$821.58
|
| Rate for Payer: CORVEL All Commercial |
$885.36
|
| Rate for Payer: Coventry All Commercial |
$837.76
|
| Rate for Payer: Encore All Commercial |
$876.32
|
| Rate for Payer: Frontpath All Commercial |
$875.84
|
| Rate for Payer: Humana ChoiceCare |
$822.24
|
| Rate for Payer: Humana Medicare |
$485.52
|
| Rate for Payer: Lucent All Commercial |
$485.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$856.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$714.00
|
| Rate for Payer: PHP All Commercial |
$722.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$371.28
|
| Rate for Payer: Sagamore Health Network All Products |
$734.94
|
| Rate for Payer: Signature Care EPO |
$790.16
|
| Rate for Payer: Signature Care PPO |
$837.76
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$809.20
|
| Rate for Payer: United Healthcare Commercial |
$750.18
|
| Rate for Payer: United Healthcare Medicare |
$314.16
|
|
|
HC ACU 3.5X36 NON-LOCK HEX SCREW
|
Facility
IP
|
$952.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602662
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$714.00 |
| Max. Negotiated Rate |
$885.36 |
| Rate for Payer: Aetna Commercial |
$822.53
|
| Rate for Payer: Cash Price |
$590.24
|
| Rate for Payer: Cigna All Commercial |
$821.58
|
| Rate for Payer: CORVEL All Commercial |
$885.36
|
| Rate for Payer: Coventry All Commercial |
$837.76
|
| Rate for Payer: Encore All Commercial |
$876.32
|
| Rate for Payer: Frontpath All Commercial |
$875.84
|
| Rate for Payer: Humana ChoiceCare |
$822.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$856.80
|
| Rate for Payer: PHCS All Commercial |
$714.00
|
| Rate for Payer: PHP All Commercial |
$722.00
|
| Rate for Payer: Sagamore Health Network All Products |
$734.94
|
| Rate for Payer: Signature Care EPO |
$790.16
|
| Rate for Payer: Signature Care PPO |
$837.76
|
| Rate for Payer: United Healthcare Commercial |
$750.18
|
|
|
HC ACU 3.5X38 LOCK HEX SCREW
|
Facility
OP
|
$1,140.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602648
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$376.20 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Aetna Commercial |
$962.16
|
| Rate for Payer: Aetna Medicare |
$376.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$376.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$654.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$712.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$432.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$413.82
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Centivo All Commercial |
$581.40
|
| Rate for Payer: Cigna All Commercial |
$983.82
|
| Rate for Payer: CORVEL All Commercial |
$1,060.20
|
| Rate for Payer: Coventry All Commercial |
$1,003.20
|
| Rate for Payer: Encore All Commercial |
$1,049.37
|
| Rate for Payer: Frontpath All Commercial |
$1,048.80
|
| Rate for Payer: Humana ChoiceCare |
$984.62
|
| Rate for Payer: Humana Medicare |
$581.40
|
| Rate for Payer: Lucent All Commercial |
$581.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,026.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$855.00
|
| Rate for Payer: PHP All Commercial |
$864.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$444.60
|
| Rate for Payer: Sagamore Health Network All Products |
$880.08
|
| Rate for Payer: Signature Care EPO |
$946.20
|
| Rate for Payer: Signature Care PPO |
$1,003.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$969.00
|
| Rate for Payer: United Healthcare Commercial |
$898.32
|
| Rate for Payer: United Healthcare Medicare |
$376.20
|
|
|
HC ACU 3.5X38 LOCK HEX SCREW
|
Facility
IP
|
$1,140.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602648
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$855.00 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Aetna Commercial |
$984.96
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Cigna All Commercial |
$983.82
|
| Rate for Payer: CORVEL All Commercial |
$1,060.20
|
| Rate for Payer: Coventry All Commercial |
$1,003.20
|
| Rate for Payer: Encore All Commercial |
$1,049.37
|
| Rate for Payer: Frontpath All Commercial |
$1,048.80
|
| Rate for Payer: Humana ChoiceCare |
$984.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,026.00
|
| Rate for Payer: PHCS All Commercial |
$855.00
|
| Rate for Payer: PHP All Commercial |
$864.58
|
| Rate for Payer: Sagamore Health Network All Products |
$880.08
|
| Rate for Payer: Signature Care EPO |
$946.20
|
| Rate for Payer: Signature Care PPO |
$1,003.20
|
| Rate for Payer: United Healthcare Commercial |
$898.32
|
|
|
HC ACU 3.5X38 NON-LOCK HEX SCREW
|
Facility
IP
|
$952.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602663
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$714.00 |
| Max. Negotiated Rate |
$885.36 |
| Rate for Payer: Aetna Commercial |
$822.53
|
| Rate for Payer: Cash Price |
$590.24
|
| Rate for Payer: Cigna All Commercial |
$821.58
|
| Rate for Payer: CORVEL All Commercial |
$885.36
|
| Rate for Payer: Coventry All Commercial |
$837.76
|
| Rate for Payer: Encore All Commercial |
$876.32
|
| Rate for Payer: Frontpath All Commercial |
$875.84
|
| Rate for Payer: Humana ChoiceCare |
$822.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$856.80
|
| Rate for Payer: PHCS All Commercial |
$714.00
|
| Rate for Payer: PHP All Commercial |
$722.00
|
| Rate for Payer: Sagamore Health Network All Products |
$734.94
|
| Rate for Payer: Signature Care EPO |
$790.16
|
| Rate for Payer: Signature Care PPO |
$837.76
|
| Rate for Payer: United Healthcare Commercial |
$750.18
|
|
|
HC ACU 3.5X38 NON-LOCK HEX SCREW
|
Facility
OP
|
$952.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602663
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$314.16 |
| Max. Negotiated Rate |
$885.36 |
| Rate for Payer: Aetna Commercial |
$803.49
|
| Rate for Payer: Aetna Medicare |
$314.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$314.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$546.73
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$595.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$361.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$345.58
|
| Rate for Payer: Cash Price |
$590.24
|
| Rate for Payer: Cash Price |
$590.24
|
| Rate for Payer: Centivo All Commercial |
$485.52
|
| Rate for Payer: Cigna All Commercial |
$821.58
|
| Rate for Payer: CORVEL All Commercial |
$885.36
|
| Rate for Payer: Coventry All Commercial |
$837.76
|
| Rate for Payer: Encore All Commercial |
$876.32
|
| Rate for Payer: Frontpath All Commercial |
$875.84
|
| Rate for Payer: Humana ChoiceCare |
$822.24
|
| Rate for Payer: Humana Medicare |
$485.52
|
| Rate for Payer: Lucent All Commercial |
$485.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$856.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$714.00
|
| Rate for Payer: PHP All Commercial |
$722.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$371.28
|
| Rate for Payer: Sagamore Health Network All Products |
$734.94
|
| Rate for Payer: Signature Care EPO |
$790.16
|
| Rate for Payer: Signature Care PPO |
$837.76
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$809.20
|
| Rate for Payer: United Healthcare Commercial |
$750.18
|
| Rate for Payer: United Healthcare Medicare |
$314.16
|
|
|
HC ACU 3.5X40 LOCK HEX SCREW
|
Facility
IP
|
$1,140.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602649
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$855.00 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Aetna Commercial |
$984.96
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Cigna All Commercial |
$983.82
|
| Rate for Payer: CORVEL All Commercial |
$1,060.20
|
| Rate for Payer: Coventry All Commercial |
$1,003.20
|
| Rate for Payer: Encore All Commercial |
$1,049.37
|
| Rate for Payer: Frontpath All Commercial |
$1,048.80
|
| Rate for Payer: Humana ChoiceCare |
$984.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,026.00
|
| Rate for Payer: PHCS All Commercial |
$855.00
|
| Rate for Payer: PHP All Commercial |
$864.58
|
| Rate for Payer: Sagamore Health Network All Products |
$880.08
|
| Rate for Payer: Signature Care EPO |
$946.20
|
| Rate for Payer: Signature Care PPO |
$1,003.20
|
| Rate for Payer: United Healthcare Commercial |
$898.32
|
|
|
HC ACU 3.5X40 LOCK HEX SCREW
|
Facility
OP
|
$1,140.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602649
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$376.20 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Aetna Commercial |
$962.16
|
| Rate for Payer: Aetna Medicare |
$376.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$376.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$654.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$712.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$432.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$413.82
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Centivo All Commercial |
$581.40
|
| Rate for Payer: Cigna All Commercial |
$983.82
|
| Rate for Payer: CORVEL All Commercial |
$1,060.20
|
| Rate for Payer: Coventry All Commercial |
$1,003.20
|
| Rate for Payer: Encore All Commercial |
$1,049.37
|
| Rate for Payer: Frontpath All Commercial |
$1,048.80
|
| Rate for Payer: Humana ChoiceCare |
$984.62
|
| Rate for Payer: Humana Medicare |
$581.40
|
| Rate for Payer: Lucent All Commercial |
$581.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,026.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$855.00
|
| Rate for Payer: PHP All Commercial |
$864.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$444.60
|
| Rate for Payer: Sagamore Health Network All Products |
$880.08
|
| Rate for Payer: Signature Care EPO |
$946.20
|
| Rate for Payer: Signature Care PPO |
$1,003.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$969.00
|
| Rate for Payer: United Healthcare Commercial |
$898.32
|
| Rate for Payer: United Healthcare Medicare |
$376.20
|
|
|
HC ACU 3.5X40 NON-LOCK HEX SCREW
|
Facility
IP
|
$952.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602664
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$714.00 |
| Max. Negotiated Rate |
$885.36 |
| Rate for Payer: Aetna Commercial |
$822.53
|
| Rate for Payer: Cash Price |
$590.24
|
| Rate for Payer: Cigna All Commercial |
$821.58
|
| Rate for Payer: CORVEL All Commercial |
$885.36
|
| Rate for Payer: Coventry All Commercial |
$837.76
|
| Rate for Payer: Encore All Commercial |
$876.32
|
| Rate for Payer: Frontpath All Commercial |
$875.84
|
| Rate for Payer: Humana ChoiceCare |
$822.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$856.80
|
| Rate for Payer: PHCS All Commercial |
$714.00
|
| Rate for Payer: PHP All Commercial |
$722.00
|
| Rate for Payer: Sagamore Health Network All Products |
$734.94
|
| Rate for Payer: Signature Care EPO |
$790.16
|
| Rate for Payer: Signature Care PPO |
$837.76
|
| Rate for Payer: United Healthcare Commercial |
$750.18
|
|
|
HC ACU 3.5X40 NON-LOCK HEX SCREW
|
Facility
OP
|
$952.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602664
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$314.16 |
| Max. Negotiated Rate |
$885.36 |
| Rate for Payer: Aetna Commercial |
$803.49
|
| Rate for Payer: Aetna Medicare |
$314.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$314.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$546.73
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$595.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$361.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$345.58
|
| Rate for Payer: Cash Price |
$590.24
|
| Rate for Payer: Cash Price |
$590.24
|
| Rate for Payer: Centivo All Commercial |
$485.52
|
| Rate for Payer: Cigna All Commercial |
$821.58
|
| Rate for Payer: CORVEL All Commercial |
$885.36
|
| Rate for Payer: Coventry All Commercial |
$837.76
|
| Rate for Payer: Encore All Commercial |
$876.32
|
| Rate for Payer: Frontpath All Commercial |
$875.84
|
| Rate for Payer: Humana ChoiceCare |
$822.24
|
| Rate for Payer: Humana Medicare |
$485.52
|
| Rate for Payer: Lucent All Commercial |
$485.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$856.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$714.00
|
| Rate for Payer: PHP All Commercial |
$722.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$371.28
|
| Rate for Payer: Sagamore Health Network All Products |
$734.94
|
| Rate for Payer: Signature Care EPO |
$790.16
|
| Rate for Payer: Signature Care PPO |
$837.76
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$809.20
|
| Rate for Payer: United Healthcare Commercial |
$750.18
|
| Rate for Payer: United Healthcare Medicare |
$314.16
|
|
|
HC ACU 3.5X42 LOCK HEX SCREW
|
Facility
IP
|
$1,140.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602722
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$855.00 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Aetna Commercial |
$984.96
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Cigna All Commercial |
$983.82
|
| Rate for Payer: CORVEL All Commercial |
$1,060.20
|
| Rate for Payer: Coventry All Commercial |
$1,003.20
|
| Rate for Payer: Encore All Commercial |
$1,049.37
|
| Rate for Payer: Frontpath All Commercial |
$1,048.80
|
| Rate for Payer: Humana ChoiceCare |
$984.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,026.00
|
| Rate for Payer: PHCS All Commercial |
$855.00
|
| Rate for Payer: PHP All Commercial |
$864.58
|
| Rate for Payer: Sagamore Health Network All Products |
$880.08
|
| Rate for Payer: Signature Care EPO |
$946.20
|
| Rate for Payer: Signature Care PPO |
$1,003.20
|
| Rate for Payer: United Healthcare Commercial |
$898.32
|
|
|
HC ACU 3.5X42 LOCK HEX SCREW
|
Facility
OP
|
$1,140.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602722
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$376.20 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Aetna Commercial |
$962.16
|
| Rate for Payer: Aetna Medicare |
$376.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$376.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$654.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$712.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$432.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$413.82
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Cash Price |
$706.80
|
| Rate for Payer: Centivo All Commercial |
$581.40
|
| Rate for Payer: Cigna All Commercial |
$983.82
|
| Rate for Payer: CORVEL All Commercial |
$1,060.20
|
| Rate for Payer: Coventry All Commercial |
$1,003.20
|
| Rate for Payer: Encore All Commercial |
$1,049.37
|
| Rate for Payer: Frontpath All Commercial |
$1,048.80
|
| Rate for Payer: Humana ChoiceCare |
$984.62
|
| Rate for Payer: Humana Medicare |
$581.40
|
| Rate for Payer: Lucent All Commercial |
$581.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,026.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$855.00
|
| Rate for Payer: PHP All Commercial |
$864.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$444.60
|
| Rate for Payer: Sagamore Health Network All Products |
$880.08
|
| Rate for Payer: Signature Care EPO |
$946.20
|
| Rate for Payer: Signature Care PPO |
$1,003.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$969.00
|
| Rate for Payer: United Healthcare Commercial |
$898.32
|
| Rate for Payer: United Healthcare Medicare |
$376.20
|
|
