|
HC Z SCREW BONE 6.5X20
|
Facility
IP
|
$579.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604660
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$434.70 |
| Max. Negotiated Rate |
$539.03 |
| Rate for Payer: Aetna Commercial |
$500.77
|
| Rate for Payer: Cash Price |
$359.35
|
| Rate for Payer: Cigna All Commercial |
$500.19
|
| Rate for Payer: CORVEL All Commercial |
$539.03
|
| Rate for Payer: Coventry All Commercial |
$510.05
|
| Rate for Payer: Encore All Commercial |
$533.52
|
| Rate for Payer: Frontpath All Commercial |
$533.23
|
| Rate for Payer: Humana ChoiceCare |
$500.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.64
|
| Rate for Payer: PHCS All Commercial |
$434.70
|
| Rate for Payer: PHP All Commercial |
$439.57
|
| Rate for Payer: Sagamore Health Network All Products |
$447.45
|
| Rate for Payer: Signature Care EPO |
$481.07
|
| Rate for Payer: Signature Care PPO |
$510.05
|
| Rate for Payer: United Healthcare Commercial |
$456.72
|
|
|
HC Z SCREW BONE 6.5X25
|
Facility
OP
|
$579.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604672
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$191.27 |
| Max. Negotiated Rate |
$539.03 |
| Rate for Payer: Aetna Commercial |
$489.18
|
| Rate for Payer: Aetna Medicare |
$191.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$191.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$332.86
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$362.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$219.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$210.39
|
| Rate for Payer: Cash Price |
$359.35
|
| Rate for Payer: Cash Price |
$359.35
|
| Rate for Payer: Centivo All Commercial |
$295.60
|
| Rate for Payer: Cigna All Commercial |
$500.19
|
| Rate for Payer: CORVEL All Commercial |
$539.03
|
| Rate for Payer: Coventry All Commercial |
$510.05
|
| Rate for Payer: Encore All Commercial |
$533.52
|
| Rate for Payer: Frontpath All Commercial |
$533.23
|
| Rate for Payer: Humana ChoiceCare |
$500.60
|
| Rate for Payer: Humana Medicare |
$295.60
|
| Rate for Payer: Lucent All Commercial |
$295.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.64
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$434.70
|
| Rate for Payer: PHP All Commercial |
$439.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$226.04
|
| Rate for Payer: Sagamore Health Network All Products |
$447.45
|
| Rate for Payer: Signature Care EPO |
$481.07
|
| Rate for Payer: Signature Care PPO |
$510.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$492.66
|
| Rate for Payer: United Healthcare Commercial |
$456.72
|
| Rate for Payer: United Healthcare Medicare |
$191.27
|
|
|
HC Z SCREW BONE 6.5X25
|
Facility
IP
|
$579.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604672
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$434.70 |
| Max. Negotiated Rate |
$539.03 |
| Rate for Payer: Aetna Commercial |
$500.77
|
| Rate for Payer: Cash Price |
$359.35
|
| Rate for Payer: Cigna All Commercial |
$500.19
|
| Rate for Payer: CORVEL All Commercial |
$539.03
|
| Rate for Payer: Coventry All Commercial |
$510.05
|
| Rate for Payer: Encore All Commercial |
$533.52
|
| Rate for Payer: Frontpath All Commercial |
$533.23
|
| Rate for Payer: Humana ChoiceCare |
$500.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.64
|
| Rate for Payer: PHCS All Commercial |
$434.70
|
| Rate for Payer: PHP All Commercial |
$439.57
|
| Rate for Payer: Sagamore Health Network All Products |
$447.45
|
| Rate for Payer: Signature Care EPO |
$481.07
|
| Rate for Payer: Signature Care PPO |
$510.05
|
| Rate for Payer: United Healthcare Commercial |
$456.72
|
|
|
HC Z SCREW BONE 6.5X30
|
Facility
IP
|
$579.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604349
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$434.70 |
| Max. Negotiated Rate |
$539.03 |
| Rate for Payer: Aetna Commercial |
$500.77
|
| Rate for Payer: Cash Price |
$359.35
|
| Rate for Payer: Cigna All Commercial |
$500.19
|
| Rate for Payer: CORVEL All Commercial |
$539.03
|
| Rate for Payer: Coventry All Commercial |
$510.05
|
| Rate for Payer: Encore All Commercial |
$533.52
|
| Rate for Payer: Frontpath All Commercial |
$533.23
|
| Rate for Payer: Humana ChoiceCare |
$500.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.64
|
| Rate for Payer: PHCS All Commercial |
$434.70
|
| Rate for Payer: PHP All Commercial |
$439.57
|
| Rate for Payer: Sagamore Health Network All Products |
$447.45
|
| Rate for Payer: Signature Care EPO |
$481.07
|
| Rate for Payer: Signature Care PPO |
$510.05
|
| Rate for Payer: United Healthcare Commercial |
$456.72
|
|
|
HC Z SCREW BONE 6.5X30
|
Facility
OP
|
$579.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604349
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$191.27 |
| Max. Negotiated Rate |
$539.03 |
| Rate for Payer: Aetna Commercial |
$489.18
|
| Rate for Payer: Aetna Medicare |
$191.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$191.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$332.86
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$362.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$219.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$210.39
|
| Rate for Payer: Cash Price |
$359.35
|
| Rate for Payer: Cash Price |
$359.35
|
| Rate for Payer: Centivo All Commercial |
$295.60
|
| Rate for Payer: Cigna All Commercial |
$500.19
|
| Rate for Payer: CORVEL All Commercial |
$539.03
|
| Rate for Payer: Coventry All Commercial |
$510.05
|
| Rate for Payer: Encore All Commercial |
$533.52
|
| Rate for Payer: Frontpath All Commercial |
$533.23
|
| Rate for Payer: Humana ChoiceCare |
$500.60
|
| Rate for Payer: Humana Medicare |
$295.60
|
| Rate for Payer: Lucent All Commercial |
$295.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$521.64
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$434.70
|
| Rate for Payer: PHP All Commercial |
$439.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$226.04
|
| Rate for Payer: Sagamore Health Network All Products |
$447.45
|
| Rate for Payer: Signature Care EPO |
$481.07
|
| Rate for Payer: Signature Care PPO |
$510.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$492.66
|
| Rate for Payer: United Healthcare Commercial |
$456.72
|
| Rate for Payer: United Healthcare Medicare |
$191.27
|
|
|
HC Z SCREW CAP NCB LOCKING
|
Facility
OP
|
$1,002.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606563
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$330.68 |
| Max. Negotiated Rate |
$931.91 |
| Rate for Payer: Aetna Commercial |
$845.73
|
| Rate for Payer: Aetna Medicare |
$330.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$330.68
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$575.48
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$626.38
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$380.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$363.74
|
| Rate for Payer: Cash Price |
$621.27
|
| Rate for Payer: Cash Price |
$621.27
|
| Rate for Payer: Centivo All Commercial |
$511.05
|
| Rate for Payer: Cigna All Commercial |
$864.77
|
| Rate for Payer: CORVEL All Commercial |
$931.91
|
| Rate for Payer: Coventry All Commercial |
$881.80
|
| Rate for Payer: Encore All Commercial |
$922.39
|
| Rate for Payer: Frontpath All Commercial |
$921.89
|
| Rate for Payer: Humana ChoiceCare |
$865.47
|
| Rate for Payer: Humana Medicare |
$511.05
|
| Rate for Payer: Lucent All Commercial |
$511.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$901.84
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$751.54
|
| Rate for Payer: PHP All Commercial |
$759.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$390.80
|
| Rate for Payer: Sagamore Health Network All Products |
$773.58
|
| Rate for Payer: Signature Care EPO |
$831.70
|
| Rate for Payer: Signature Care PPO |
$881.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$851.74
|
| Rate for Payer: United Healthcare Commercial |
$789.62
|
| Rate for Payer: United Healthcare Medicare |
$330.68
|
|
|
HC Z SCREW CAP NCB LOCKING
|
Facility
IP
|
$1,002.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606563
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$751.54 |
| Max. Negotiated Rate |
$931.91 |
| Rate for Payer: Aetna Commercial |
$865.77
|
| Rate for Payer: Cash Price |
$621.27
|
| Rate for Payer: Cigna All Commercial |
$864.77
|
| Rate for Payer: CORVEL All Commercial |
$931.91
|
| Rate for Payer: Coventry All Commercial |
$881.80
|
| Rate for Payer: Encore All Commercial |
$922.39
|
| Rate for Payer: Frontpath All Commercial |
$921.89
|
| Rate for Payer: Humana ChoiceCare |
$865.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$901.84
|
| Rate for Payer: PHCS All Commercial |
$751.54
|
| Rate for Payer: PHP All Commercial |
$759.95
|
| Rate for Payer: Sagamore Health Network All Products |
$773.58
|
| Rate for Payer: Signature Care EPO |
$831.70
|
| Rate for Payer: Signature Care PPO |
$881.80
|
| Rate for Payer: United Healthcare Commercial |
$789.62
|
|
|
HC Z SCREW CENTRAL 6.5X20
|
Facility
IP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605671
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$381.57 |
| Max. Negotiated Rate |
$473.15 |
| Rate for Payer: Aetna Commercial |
$439.57
|
| Rate for Payer: Cash Price |
$315.43
|
| Rate for Payer: Cigna All Commercial |
$439.06
|
| Rate for Payer: CORVEL All Commercial |
$473.15
|
| Rate for Payer: Coventry All Commercial |
$447.71
|
| Rate for Payer: Encore All Commercial |
$468.31
|
| Rate for Payer: Frontpath All Commercial |
$468.06
|
| Rate for Payer: Humana ChoiceCare |
$439.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.88
|
| Rate for Payer: PHCS All Commercial |
$381.57
|
| Rate for Payer: PHP All Commercial |
$385.84
|
| Rate for Payer: Sagamore Health Network All Products |
$392.76
|
| Rate for Payer: Signature Care EPO |
$422.27
|
| Rate for Payer: Signature Care PPO |
$447.71
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
|
|
HC Z SCREW CENTRAL 6.5X20
|
Facility
OP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605671
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$167.89 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$429.39
|
| Rate for Payer: Aetna Medicare |
$167.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$167.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$292.18
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$318.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$193.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$184.68
|
| Rate for Payer: Cash Price |
$315.43
|
| Rate for Payer: Cash Price |
$315.43
|
| Rate for Payer: Centivo All Commercial |
$259.47
|
| Rate for Payer: Cigna All Commercial |
$439.06
|
| Rate for Payer: CORVEL All Commercial |
$473.15
|
| Rate for Payer: Coventry All Commercial |
$447.71
|
| Rate for Payer: Encore All Commercial |
$468.31
|
| Rate for Payer: Frontpath All Commercial |
$468.06
|
| Rate for Payer: Humana ChoiceCare |
$439.42
|
| Rate for Payer: Humana Medicare |
$259.47
|
| Rate for Payer: Lucent All Commercial |
$259.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.88
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$381.57
|
| Rate for Payer: PHP All Commercial |
$385.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$198.42
|
| Rate for Payer: Sagamore Health Network All Products |
$392.76
|
| Rate for Payer: Signature Care EPO |
$422.27
|
| Rate for Payer: Signature Care PPO |
$447.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$432.45
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
| Rate for Payer: United Healthcare Medicare |
$167.89
|
|
|
HC Z SCREW CENTRAL 6.5X25
|
Facility
IP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605672
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$381.57 |
| Max. Negotiated Rate |
$473.15 |
| Rate for Payer: Aetna Commercial |
$439.57
|
| Rate for Payer: Cash Price |
$315.43
|
| Rate for Payer: Cigna All Commercial |
$439.06
|
| Rate for Payer: CORVEL All Commercial |
$473.15
|
| Rate for Payer: Coventry All Commercial |
$447.71
|
| Rate for Payer: Encore All Commercial |
$468.31
|
| Rate for Payer: Frontpath All Commercial |
$468.06
|
| Rate for Payer: Humana ChoiceCare |
$439.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.88
|
| Rate for Payer: PHCS All Commercial |
$381.57
|
| Rate for Payer: PHP All Commercial |
$385.84
|
| Rate for Payer: Sagamore Health Network All Products |
$392.76
|
| Rate for Payer: Signature Care EPO |
$422.27
|
| Rate for Payer: Signature Care PPO |
$447.71
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
|
|
HC Z SCREW CENTRAL 6.5X25
|
Facility
OP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605672
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$167.89 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$429.39
|
| Rate for Payer: Aetna Medicare |
$167.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$167.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$292.18
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$318.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$193.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$184.68
|
| Rate for Payer: Cash Price |
$315.43
|
| Rate for Payer: Cash Price |
$315.43
|
| Rate for Payer: Centivo All Commercial |
$259.47
|
| Rate for Payer: Cigna All Commercial |
$439.06
|
| Rate for Payer: CORVEL All Commercial |
$473.15
|
| Rate for Payer: Coventry All Commercial |
$447.71
|
| Rate for Payer: Encore All Commercial |
$468.31
|
| Rate for Payer: Frontpath All Commercial |
$468.06
|
| Rate for Payer: Humana ChoiceCare |
$439.42
|
| Rate for Payer: Humana Medicare |
$259.47
|
| Rate for Payer: Lucent All Commercial |
$259.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.88
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$381.57
|
| Rate for Payer: PHP All Commercial |
$385.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$198.42
|
| Rate for Payer: Sagamore Health Network All Products |
$392.76
|
| Rate for Payer: Signature Care EPO |
$422.27
|
| Rate for Payer: Signature Care PPO |
$447.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$432.45
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
| Rate for Payer: United Healthcare Medicare |
$167.89
|
|
|
HC Z SCREW CENTRAL 6.5X30
|
Facility
OP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605673
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$167.89 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$429.39
|
| Rate for Payer: Aetna Medicare |
$167.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$167.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$292.18
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$318.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$193.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$184.68
|
| Rate for Payer: Cash Price |
$315.43
|
| Rate for Payer: Cash Price |
$315.43
|
| Rate for Payer: Centivo All Commercial |
$259.47
|
| Rate for Payer: Cigna All Commercial |
$439.06
|
| Rate for Payer: CORVEL All Commercial |
$473.15
|
| Rate for Payer: Coventry All Commercial |
$447.71
|
| Rate for Payer: Encore All Commercial |
$468.31
|
| Rate for Payer: Frontpath All Commercial |
$468.06
|
| Rate for Payer: Humana ChoiceCare |
$439.42
|
| Rate for Payer: Humana Medicare |
$259.47
|
| Rate for Payer: Lucent All Commercial |
$259.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.88
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$381.57
|
| Rate for Payer: PHP All Commercial |
$385.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$198.42
|
| Rate for Payer: Sagamore Health Network All Products |
$392.76
|
| Rate for Payer: Signature Care EPO |
$422.27
|
| Rate for Payer: Signature Care PPO |
$447.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$432.45
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
| Rate for Payer: United Healthcare Medicare |
$167.89
|
|
|
HC Z SCREW CENTRAL 6.5X30
|
Facility
IP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605673
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$381.57 |
| Max. Negotiated Rate |
$473.15 |
| Rate for Payer: Aetna Commercial |
$439.57
|
| Rate for Payer: Cash Price |
$315.43
|
| Rate for Payer: Cigna All Commercial |
$439.06
|
| Rate for Payer: CORVEL All Commercial |
$473.15
|
| Rate for Payer: Coventry All Commercial |
$447.71
|
| Rate for Payer: Encore All Commercial |
$468.31
|
| Rate for Payer: Frontpath All Commercial |
$468.06
|
| Rate for Payer: Humana ChoiceCare |
$439.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.88
|
| Rate for Payer: PHCS All Commercial |
$381.57
|
| Rate for Payer: PHP All Commercial |
$385.84
|
| Rate for Payer: Sagamore Health Network All Products |
$392.76
|
| Rate for Payer: Signature Care EPO |
$422.27
|
| Rate for Payer: Signature Care PPO |
$447.71
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
|
|
HC Z SCREW CENTRAL 6.5X35
|
Facility
IP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605674
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$381.57 |
| Max. Negotiated Rate |
$473.15 |
| Rate for Payer: Aetna Commercial |
$439.57
|
| Rate for Payer: Cash Price |
$315.43
|
| Rate for Payer: Cigna All Commercial |
$439.06
|
| Rate for Payer: CORVEL All Commercial |
$473.15
|
| Rate for Payer: Coventry All Commercial |
$447.71
|
| Rate for Payer: Encore All Commercial |
$468.31
|
| Rate for Payer: Frontpath All Commercial |
$468.06
|
| Rate for Payer: Humana ChoiceCare |
$439.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.88
|
| Rate for Payer: PHCS All Commercial |
$381.57
|
| Rate for Payer: PHP All Commercial |
$385.84
|
| Rate for Payer: Sagamore Health Network All Products |
$392.76
|
| Rate for Payer: Signature Care EPO |
$422.27
|
| Rate for Payer: Signature Care PPO |
$447.71
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
|
|
HC Z SCREW CENTRAL 6.5X35
|
Facility
OP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605674
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$167.89 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$429.39
|
| Rate for Payer: Aetna Medicare |
$167.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$167.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$292.18
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$318.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$193.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$184.68
|
| Rate for Payer: Cash Price |
$315.43
|
| Rate for Payer: Cash Price |
$315.43
|
| Rate for Payer: Centivo All Commercial |
$259.47
|
| Rate for Payer: Cigna All Commercial |
$439.06
|
| Rate for Payer: CORVEL All Commercial |
$473.15
|
| Rate for Payer: Coventry All Commercial |
$447.71
|
| Rate for Payer: Encore All Commercial |
$468.31
|
| Rate for Payer: Frontpath All Commercial |
$468.06
|
| Rate for Payer: Humana ChoiceCare |
$439.42
|
| Rate for Payer: Humana Medicare |
$259.47
|
| Rate for Payer: Lucent All Commercial |
$259.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.88
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$381.57
|
| Rate for Payer: PHP All Commercial |
$385.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$198.42
|
| Rate for Payer: Sagamore Health Network All Products |
$392.76
|
| Rate for Payer: Signature Care EPO |
$422.27
|
| Rate for Payer: Signature Care PPO |
$447.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$432.45
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
| Rate for Payer: United Healthcare Medicare |
$167.89
|
|
|
HC Z SCREW CENTRAL 6.5X40
|
Facility
OP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605675
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$167.89 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$429.39
|
| Rate for Payer: Aetna Medicare |
$167.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$167.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$292.18
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$318.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$193.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$184.68
|
| Rate for Payer: Cash Price |
$315.43
|
| Rate for Payer: Cash Price |
$315.43
|
| Rate for Payer: Centivo All Commercial |
$259.47
|
| Rate for Payer: Cigna All Commercial |
$439.06
|
| Rate for Payer: CORVEL All Commercial |
$473.15
|
| Rate for Payer: Coventry All Commercial |
$447.71
|
| Rate for Payer: Encore All Commercial |
$468.31
|
| Rate for Payer: Frontpath All Commercial |
$468.06
|
| Rate for Payer: Humana ChoiceCare |
$439.42
|
| Rate for Payer: Humana Medicare |
$259.47
|
| Rate for Payer: Lucent All Commercial |
$259.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.88
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$381.57
|
| Rate for Payer: PHP All Commercial |
$385.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$198.42
|
| Rate for Payer: Sagamore Health Network All Products |
$392.76
|
| Rate for Payer: Signature Care EPO |
$422.27
|
| Rate for Payer: Signature Care PPO |
$447.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$432.45
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
| Rate for Payer: United Healthcare Medicare |
$167.89
|
|
|
HC Z SCREW CENTRAL 6.5X40
|
Facility
IP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605675
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$381.57 |
| Max. Negotiated Rate |
$473.15 |
| Rate for Payer: Aetna Commercial |
$439.57
|
| Rate for Payer: Cash Price |
$315.43
|
| Rate for Payer: Cigna All Commercial |
$439.06
|
| Rate for Payer: CORVEL All Commercial |
$473.15
|
| Rate for Payer: Coventry All Commercial |
$447.71
|
| Rate for Payer: Encore All Commercial |
$468.31
|
| Rate for Payer: Frontpath All Commercial |
$468.06
|
| Rate for Payer: Humana ChoiceCare |
$439.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.88
|
| Rate for Payer: PHCS All Commercial |
$381.57
|
| Rate for Payer: PHP All Commercial |
$385.84
|
| Rate for Payer: Sagamore Health Network All Products |
$392.76
|
| Rate for Payer: Signature Care EPO |
$422.27
|
| Rate for Payer: Signature Care PPO |
$447.71
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
|
|
HC Z SCREW CENTRAL 6.5X45
|
Facility
IP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605676
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$381.57 |
| Max. Negotiated Rate |
$473.15 |
| Rate for Payer: Aetna Commercial |
$439.57
|
| Rate for Payer: Cash Price |
$315.43
|
| Rate for Payer: Cigna All Commercial |
$439.06
|
| Rate for Payer: CORVEL All Commercial |
$473.15
|
| Rate for Payer: Coventry All Commercial |
$447.71
|
| Rate for Payer: Encore All Commercial |
$468.31
|
| Rate for Payer: Frontpath All Commercial |
$468.06
|
| Rate for Payer: Humana ChoiceCare |
$439.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.88
|
| Rate for Payer: PHCS All Commercial |
$381.57
|
| Rate for Payer: PHP All Commercial |
$385.84
|
| Rate for Payer: Sagamore Health Network All Products |
$392.76
|
| Rate for Payer: Signature Care EPO |
$422.27
|
| Rate for Payer: Signature Care PPO |
$447.71
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
|
|
HC Z SCREW CENTRAL 6.5X45
|
Facility
OP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605676
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$167.89 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$429.39
|
| Rate for Payer: Aetna Medicare |
$167.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$167.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$292.18
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$318.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$193.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$184.68
|
| Rate for Payer: Cash Price |
$315.43
|
| Rate for Payer: Cash Price |
$315.43
|
| Rate for Payer: Centivo All Commercial |
$259.47
|
| Rate for Payer: Cigna All Commercial |
$439.06
|
| Rate for Payer: CORVEL All Commercial |
$473.15
|
| Rate for Payer: Coventry All Commercial |
$447.71
|
| Rate for Payer: Encore All Commercial |
$468.31
|
| Rate for Payer: Frontpath All Commercial |
$468.06
|
| Rate for Payer: Humana ChoiceCare |
$439.42
|
| Rate for Payer: Humana Medicare |
$259.47
|
| Rate for Payer: Lucent All Commercial |
$259.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.88
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$381.57
|
| Rate for Payer: PHP All Commercial |
$385.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$198.42
|
| Rate for Payer: Sagamore Health Network All Products |
$392.76
|
| Rate for Payer: Signature Care EPO |
$422.27
|
| Rate for Payer: Signature Care PPO |
$447.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$432.45
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
| Rate for Payer: United Healthcare Medicare |
$167.89
|
|
|
HC Z SCREW CENTRAL 6.5X50
|
Facility
OP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605677
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$167.89 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$429.39
|
| Rate for Payer: Aetna Medicare |
$167.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$167.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$292.18
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$318.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$193.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$184.68
|
| Rate for Payer: Cash Price |
$315.43
|
| Rate for Payer: Cash Price |
$315.43
|
| Rate for Payer: Centivo All Commercial |
$259.47
|
| Rate for Payer: Cigna All Commercial |
$439.06
|
| Rate for Payer: CORVEL All Commercial |
$473.15
|
| Rate for Payer: Coventry All Commercial |
$447.71
|
| Rate for Payer: Encore All Commercial |
$468.31
|
| Rate for Payer: Frontpath All Commercial |
$468.06
|
| Rate for Payer: Humana ChoiceCare |
$439.42
|
| Rate for Payer: Humana Medicare |
$259.47
|
| Rate for Payer: Lucent All Commercial |
$259.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.88
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$381.57
|
| Rate for Payer: PHP All Commercial |
$385.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$198.42
|
| Rate for Payer: Sagamore Health Network All Products |
$392.76
|
| Rate for Payer: Signature Care EPO |
$422.27
|
| Rate for Payer: Signature Care PPO |
$447.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$432.45
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
| Rate for Payer: United Healthcare Medicare |
$167.89
|
|
|
HC Z SCREW CENTRAL 6.5X50
|
Facility
IP
|
$508.76
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605677
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$381.57 |
| Max. Negotiated Rate |
$473.15 |
| Rate for Payer: Aetna Commercial |
$439.57
|
| Rate for Payer: Cash Price |
$315.43
|
| Rate for Payer: Cigna All Commercial |
$439.06
|
| Rate for Payer: CORVEL All Commercial |
$473.15
|
| Rate for Payer: Coventry All Commercial |
$447.71
|
| Rate for Payer: Encore All Commercial |
$468.31
|
| Rate for Payer: Frontpath All Commercial |
$468.06
|
| Rate for Payer: Humana ChoiceCare |
$439.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.88
|
| Rate for Payer: PHCS All Commercial |
$381.57
|
| Rate for Payer: PHP All Commercial |
$385.84
|
| Rate for Payer: Sagamore Health Network All Products |
$392.76
|
| Rate for Payer: Signature Care EPO |
$422.27
|
| Rate for Payer: Signature Care PPO |
$447.71
|
| Rate for Payer: United Healthcare Commercial |
$400.90
|
|
|
HC Z SCREW DRIVER DVR
|
Facility
IP
|
$1,140.00
|
|
| Hospital Charge Code |
41606483
|
|
Hospital Revenue Code
|
272
|
| 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 Z SCREW DRIVER DVR
|
Facility
OP
|
$1,140.00
|
|
| Hospital Charge Code |
41606483
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| 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 |
$121.68
|
| 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 |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| 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 Z SCREW HEX 2.7X24 COR
|
Facility
IP
|
$130.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604272
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$97.86 |
| Max. Negotiated Rate |
$121.35 |
| Rate for Payer: Aetna Commercial |
$112.73
|
| Rate for Payer: Cash Price |
$80.90
|
| Rate for Payer: Cigna All Commercial |
$112.60
|
| Rate for Payer: CORVEL All Commercial |
$121.35
|
| Rate for Payer: Coventry All Commercial |
$114.82
|
| Rate for Payer: Encore All Commercial |
$120.11
|
| Rate for Payer: Frontpath All Commercial |
$120.04
|
| Rate for Payer: Humana ChoiceCare |
$112.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$117.43
|
| Rate for Payer: PHCS All Commercial |
$97.86
|
| Rate for Payer: PHP All Commercial |
$98.96
|
| Rate for Payer: Sagamore Health Network All Products |
$100.73
|
| Rate for Payer: Signature Care EPO |
$108.30
|
| Rate for Payer: Signature Care PPO |
$114.82
|
| Rate for Payer: United Healthcare Commercial |
$102.82
|
|
|
HC Z SCREW HEX 2.7X24 COR
|
Facility
OP
|
$130.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604272
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$43.06 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$110.13
|
| Rate for Payer: Aetna Medicare |
$43.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$43.06
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$74.93
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$81.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$49.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$47.36
|
| Rate for Payer: Cash Price |
$80.90
|
| Rate for Payer: Cash Price |
$80.90
|
| Rate for Payer: Centivo All Commercial |
$66.54
|
| Rate for Payer: Cigna All Commercial |
$112.60
|
| Rate for Payer: CORVEL All Commercial |
$121.35
|
| Rate for Payer: Coventry All Commercial |
$114.82
|
| Rate for Payer: Encore All Commercial |
$120.11
|
| Rate for Payer: Frontpath All Commercial |
$120.04
|
| Rate for Payer: Humana ChoiceCare |
$112.70
|
| Rate for Payer: Humana Medicare |
$66.54
|
| Rate for Payer: Lucent All Commercial |
$66.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$117.43
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$97.86
|
| Rate for Payer: PHP All Commercial |
$98.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$50.89
|
| Rate for Payer: Sagamore Health Network All Products |
$100.73
|
| Rate for Payer: Signature Care EPO |
$108.30
|
| Rate for Payer: Signature Care PPO |
$114.82
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$110.91
|
| Rate for Payer: United Healthcare Commercial |
$102.82
|
| Rate for Payer: United Healthcare Medicare |
$43.06
|
|
