|
HC Z SCREW LAG 4.0X44 CANN
|
Facility
OP
|
$858.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603883
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$283.30 |
| Max. Negotiated Rate |
$798.40 |
| Rate for Payer: Aetna Commercial |
$724.57
|
| Rate for Payer: Aetna Medicare |
$283.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$283.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$493.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$536.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$325.80
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$311.64
|
| Rate for Payer: Cash Price |
$532.27
|
| Rate for Payer: Cash Price |
$532.27
|
| Rate for Payer: Centivo All Commercial |
$437.84
|
| Rate for Payer: Cigna All Commercial |
$740.89
|
| Rate for Payer: CORVEL All Commercial |
$798.40
|
| Rate for Payer: Coventry All Commercial |
$755.48
|
| Rate for Payer: Encore All Commercial |
$790.25
|
| Rate for Payer: Frontpath All Commercial |
$789.82
|
| Rate for Payer: Humana ChoiceCare |
$741.49
|
| Rate for Payer: Humana Medicare |
$437.84
|
| Rate for Payer: Lucent All Commercial |
$437.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$772.65
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$643.88
|
| Rate for Payer: PHP All Commercial |
$651.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$334.82
|
| Rate for Payer: Sagamore Health Network All Products |
$662.76
|
| Rate for Payer: Signature Care EPO |
$712.56
|
| Rate for Payer: Signature Care PPO |
$755.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$729.72
|
| Rate for Payer: United Healthcare Commercial |
$676.50
|
| Rate for Payer: United Healthcare Medicare |
$283.30
|
|
|
HC Z SCREW PC 2.7X10
|
Facility
OP
|
$354.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604107
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.89 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$298.94
|
| Rate for Payer: Aetna Medicare |
$116.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$116.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$203.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$221.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$134.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$128.57
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Centivo All Commercial |
$180.64
|
| Rate for Payer: Cigna All Commercial |
$305.67
|
| Rate for Payer: CORVEL All Commercial |
$329.41
|
| Rate for Payer: Coventry All Commercial |
$311.70
|
| Rate for Payer: Encore All Commercial |
$326.04
|
| Rate for Payer: Frontpath All Commercial |
$325.86
|
| Rate for Payer: Humana ChoiceCare |
$305.92
|
| Rate for Payer: Humana Medicare |
$180.64
|
| Rate for Payer: Lucent All Commercial |
$180.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$318.78
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$265.65
|
| Rate for Payer: PHP All Commercial |
$268.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$138.14
|
| Rate for Payer: Sagamore Health Network All Products |
$273.44
|
| Rate for Payer: Signature Care EPO |
$293.99
|
| Rate for Payer: Signature Care PPO |
$311.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$301.07
|
| Rate for Payer: United Healthcare Commercial |
$279.11
|
| Rate for Payer: United Healthcare Medicare |
$116.89
|
|
|
HC Z SCREW PC 2.7X10
|
Facility
IP
|
$354.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604107
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$265.65 |
| Max. Negotiated Rate |
$329.41 |
| Rate for Payer: Aetna Commercial |
$306.03
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cigna All Commercial |
$305.67
|
| Rate for Payer: CORVEL All Commercial |
$329.41
|
| Rate for Payer: Coventry All Commercial |
$311.70
|
| Rate for Payer: Encore All Commercial |
$326.04
|
| Rate for Payer: Frontpath All Commercial |
$325.86
|
| Rate for Payer: Humana ChoiceCare |
$305.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$318.78
|
| Rate for Payer: PHCS All Commercial |
$265.65
|
| Rate for Payer: PHP All Commercial |
$268.63
|
| Rate for Payer: Sagamore Health Network All Products |
$273.44
|
| Rate for Payer: Signature Care EPO |
$293.99
|
| Rate for Payer: Signature Care PPO |
$311.70
|
| Rate for Payer: United Healthcare Commercial |
$279.11
|
|
|
HC Z SCREW PC 2.7X12
|
Facility
IP
|
$354.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604109
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$265.65 |
| Max. Negotiated Rate |
$329.41 |
| Rate for Payer: Aetna Commercial |
$306.03
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cigna All Commercial |
$305.67
|
| Rate for Payer: CORVEL All Commercial |
$329.41
|
| Rate for Payer: Coventry All Commercial |
$311.70
|
| Rate for Payer: Encore All Commercial |
$326.04
|
| Rate for Payer: Frontpath All Commercial |
$325.86
|
| Rate for Payer: Humana ChoiceCare |
$305.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$318.78
|
| Rate for Payer: PHCS All Commercial |
$265.65
|
| Rate for Payer: PHP All Commercial |
$268.63
|
| Rate for Payer: Sagamore Health Network All Products |
$273.44
|
| Rate for Payer: Signature Care EPO |
$293.99
|
| Rate for Payer: Signature Care PPO |
$311.70
|
| Rate for Payer: United Healthcare Commercial |
$279.11
|
|
|
HC Z SCREW PC 2.7X12
|
Facility
OP
|
$354.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604109
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.89 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$298.94
|
| Rate for Payer: Aetna Medicare |
$116.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$116.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$203.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$221.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$134.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$128.57
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Centivo All Commercial |
$180.64
|
| Rate for Payer: Cigna All Commercial |
$305.67
|
| Rate for Payer: CORVEL All Commercial |
$329.41
|
| Rate for Payer: Coventry All Commercial |
$311.70
|
| Rate for Payer: Encore All Commercial |
$326.04
|
| Rate for Payer: Frontpath All Commercial |
$325.86
|
| Rate for Payer: Humana ChoiceCare |
$305.92
|
| Rate for Payer: Humana Medicare |
$180.64
|
| Rate for Payer: Lucent All Commercial |
$180.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$318.78
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$265.65
|
| Rate for Payer: PHP All Commercial |
$268.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$138.14
|
| Rate for Payer: Sagamore Health Network All Products |
$273.44
|
| Rate for Payer: Signature Care EPO |
$293.99
|
| Rate for Payer: Signature Care PPO |
$311.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$301.07
|
| Rate for Payer: United Healthcare Commercial |
$279.11
|
| Rate for Payer: United Healthcare Medicare |
$116.89
|
|
|
HC Z SCREW PC 2.7X14
|
Facility
IP
|
$354.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604111
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$265.65 |
| Max. Negotiated Rate |
$329.41 |
| Rate for Payer: Aetna Commercial |
$306.03
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cigna All Commercial |
$305.67
|
| Rate for Payer: CORVEL All Commercial |
$329.41
|
| Rate for Payer: Coventry All Commercial |
$311.70
|
| Rate for Payer: Encore All Commercial |
$326.04
|
| Rate for Payer: Frontpath All Commercial |
$325.86
|
| Rate for Payer: Humana ChoiceCare |
$305.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$318.78
|
| Rate for Payer: PHCS All Commercial |
$265.65
|
| Rate for Payer: PHP All Commercial |
$268.63
|
| Rate for Payer: Sagamore Health Network All Products |
$273.44
|
| Rate for Payer: Signature Care EPO |
$293.99
|
| Rate for Payer: Signature Care PPO |
$311.70
|
| Rate for Payer: United Healthcare Commercial |
$279.11
|
|
|
HC Z SCREW PC 2.7X14
|
Facility
OP
|
$354.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604111
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.89 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$298.94
|
| Rate for Payer: Aetna Medicare |
$116.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$116.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$203.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$221.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$134.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$128.57
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Centivo All Commercial |
$180.64
|
| Rate for Payer: Cigna All Commercial |
$305.67
|
| Rate for Payer: CORVEL All Commercial |
$329.41
|
| Rate for Payer: Coventry All Commercial |
$311.70
|
| Rate for Payer: Encore All Commercial |
$326.04
|
| Rate for Payer: Frontpath All Commercial |
$325.86
|
| Rate for Payer: Humana ChoiceCare |
$305.92
|
| Rate for Payer: Humana Medicare |
$180.64
|
| Rate for Payer: Lucent All Commercial |
$180.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$318.78
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$265.65
|
| Rate for Payer: PHP All Commercial |
$268.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$138.14
|
| Rate for Payer: Sagamore Health Network All Products |
$273.44
|
| Rate for Payer: Signature Care EPO |
$293.99
|
| Rate for Payer: Signature Care PPO |
$311.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$301.07
|
| Rate for Payer: United Healthcare Commercial |
$279.11
|
| Rate for Payer: United Healthcare Medicare |
$116.89
|
|
|
HC Z SCREW PC 2.7X16
|
Facility
OP
|
$354.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604112
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.89 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$298.94
|
| Rate for Payer: Aetna Medicare |
$116.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$116.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$203.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$221.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$134.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$128.57
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Centivo All Commercial |
$180.64
|
| Rate for Payer: Cigna All Commercial |
$305.67
|
| Rate for Payer: CORVEL All Commercial |
$329.41
|
| Rate for Payer: Coventry All Commercial |
$311.70
|
| Rate for Payer: Encore All Commercial |
$326.04
|
| Rate for Payer: Frontpath All Commercial |
$325.86
|
| Rate for Payer: Humana ChoiceCare |
$305.92
|
| Rate for Payer: Humana Medicare |
$180.64
|
| Rate for Payer: Lucent All Commercial |
$180.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$318.78
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$265.65
|
| Rate for Payer: PHP All Commercial |
$268.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$138.14
|
| Rate for Payer: Sagamore Health Network All Products |
$273.44
|
| Rate for Payer: Signature Care EPO |
$293.99
|
| Rate for Payer: Signature Care PPO |
$311.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$301.07
|
| Rate for Payer: United Healthcare Commercial |
$279.11
|
| Rate for Payer: United Healthcare Medicare |
$116.89
|
|
|
HC Z SCREW PC 2.7X16
|
Facility
IP
|
$354.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604112
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$265.65 |
| Max. Negotiated Rate |
$329.41 |
| Rate for Payer: Aetna Commercial |
$306.03
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cigna All Commercial |
$305.67
|
| Rate for Payer: CORVEL All Commercial |
$329.41
|
| Rate for Payer: Coventry All Commercial |
$311.70
|
| Rate for Payer: Encore All Commercial |
$326.04
|
| Rate for Payer: Frontpath All Commercial |
$325.86
|
| Rate for Payer: Humana ChoiceCare |
$305.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$318.78
|
| Rate for Payer: PHCS All Commercial |
$265.65
|
| Rate for Payer: PHP All Commercial |
$268.63
|
| Rate for Payer: Sagamore Health Network All Products |
$273.44
|
| Rate for Payer: Signature Care EPO |
$293.99
|
| Rate for Payer: Signature Care PPO |
$311.70
|
| Rate for Payer: United Healthcare Commercial |
$279.11
|
|
|
HC Z SCREW PC 2.7X18
|
Facility
IP
|
$354.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604113
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$265.65 |
| Max. Negotiated Rate |
$329.41 |
| Rate for Payer: Aetna Commercial |
$306.03
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cigna All Commercial |
$305.67
|
| Rate for Payer: CORVEL All Commercial |
$329.41
|
| Rate for Payer: Coventry All Commercial |
$311.70
|
| Rate for Payer: Encore All Commercial |
$326.04
|
| Rate for Payer: Frontpath All Commercial |
$325.86
|
| Rate for Payer: Humana ChoiceCare |
$305.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$318.78
|
| Rate for Payer: PHCS All Commercial |
$265.65
|
| Rate for Payer: PHP All Commercial |
$268.63
|
| Rate for Payer: Sagamore Health Network All Products |
$273.44
|
| Rate for Payer: Signature Care EPO |
$293.99
|
| Rate for Payer: Signature Care PPO |
$311.70
|
| Rate for Payer: United Healthcare Commercial |
$279.11
|
|
|
HC Z SCREW PC 2.7X18
|
Facility
OP
|
$354.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604113
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.89 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$298.94
|
| Rate for Payer: Aetna Medicare |
$116.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$116.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$203.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$221.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$134.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$128.57
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Centivo All Commercial |
$180.64
|
| Rate for Payer: Cigna All Commercial |
$305.67
|
| Rate for Payer: CORVEL All Commercial |
$329.41
|
| Rate for Payer: Coventry All Commercial |
$311.70
|
| Rate for Payer: Encore All Commercial |
$326.04
|
| Rate for Payer: Frontpath All Commercial |
$325.86
|
| Rate for Payer: Humana ChoiceCare |
$305.92
|
| Rate for Payer: Humana Medicare |
$180.64
|
| Rate for Payer: Lucent All Commercial |
$180.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$318.78
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$265.65
|
| Rate for Payer: PHP All Commercial |
$268.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$138.14
|
| Rate for Payer: Sagamore Health Network All Products |
$273.44
|
| Rate for Payer: Signature Care EPO |
$293.99
|
| Rate for Payer: Signature Care PPO |
$311.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$301.07
|
| Rate for Payer: United Healthcare Commercial |
$279.11
|
| Rate for Payer: United Healthcare Medicare |
$116.89
|
|
|
HC Z SCREW PC 2.7X20
|
Facility
IP
|
$354.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604115
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$265.65 |
| Max. Negotiated Rate |
$329.41 |
| Rate for Payer: Aetna Commercial |
$306.03
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cigna All Commercial |
$305.67
|
| Rate for Payer: CORVEL All Commercial |
$329.41
|
| Rate for Payer: Coventry All Commercial |
$311.70
|
| Rate for Payer: Encore All Commercial |
$326.04
|
| Rate for Payer: Frontpath All Commercial |
$325.86
|
| Rate for Payer: Humana ChoiceCare |
$305.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$318.78
|
| Rate for Payer: PHCS All Commercial |
$265.65
|
| Rate for Payer: PHP All Commercial |
$268.63
|
| Rate for Payer: Sagamore Health Network All Products |
$273.44
|
| Rate for Payer: Signature Care EPO |
$293.99
|
| Rate for Payer: Signature Care PPO |
$311.70
|
| Rate for Payer: United Healthcare Commercial |
$279.11
|
|
|
HC Z SCREW PC 2.7X20
|
Facility
OP
|
$354.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604115
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.89 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$298.94
|
| Rate for Payer: Aetna Medicare |
$116.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$116.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$203.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$221.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$134.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$128.57
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Centivo All Commercial |
$180.64
|
| Rate for Payer: Cigna All Commercial |
$305.67
|
| Rate for Payer: CORVEL All Commercial |
$329.41
|
| Rate for Payer: Coventry All Commercial |
$311.70
|
| Rate for Payer: Encore All Commercial |
$326.04
|
| Rate for Payer: Frontpath All Commercial |
$325.86
|
| Rate for Payer: Humana ChoiceCare |
$305.92
|
| Rate for Payer: Humana Medicare |
$180.64
|
| Rate for Payer: Lucent All Commercial |
$180.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$318.78
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$265.65
|
| Rate for Payer: PHP All Commercial |
$268.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$138.14
|
| Rate for Payer: Sagamore Health Network All Products |
$273.44
|
| Rate for Payer: Signature Care EPO |
$293.99
|
| Rate for Payer: Signature Care PPO |
$311.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$301.07
|
| Rate for Payer: United Healthcare Commercial |
$279.11
|
| Rate for Payer: United Healthcare Medicare |
$116.89
|
|
|
HC Z SCREW PC 2.7X22
|
Facility
OP
|
$354.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604117
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.89 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$298.94
|
| Rate for Payer: Aetna Medicare |
$116.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$116.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$203.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$221.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$134.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$128.57
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Centivo All Commercial |
$180.64
|
| Rate for Payer: Cigna All Commercial |
$305.67
|
| Rate for Payer: CORVEL All Commercial |
$329.41
|
| Rate for Payer: Coventry All Commercial |
$311.70
|
| Rate for Payer: Encore All Commercial |
$326.04
|
| Rate for Payer: Frontpath All Commercial |
$325.86
|
| Rate for Payer: Humana ChoiceCare |
$305.92
|
| Rate for Payer: Humana Medicare |
$180.64
|
| Rate for Payer: Lucent All Commercial |
$180.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$318.78
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$265.65
|
| Rate for Payer: PHP All Commercial |
$268.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$138.14
|
| Rate for Payer: Sagamore Health Network All Products |
$273.44
|
| Rate for Payer: Signature Care EPO |
$293.99
|
| Rate for Payer: Signature Care PPO |
$311.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$301.07
|
| Rate for Payer: United Healthcare Commercial |
$279.11
|
| Rate for Payer: United Healthcare Medicare |
$116.89
|
|
|
HC Z SCREW PC 2.7X22
|
Facility
IP
|
$354.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604117
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$265.65 |
| Max. Negotiated Rate |
$329.41 |
| Rate for Payer: Aetna Commercial |
$306.03
|
| Rate for Payer: Cash Price |
$219.60
|
| Rate for Payer: Cigna All Commercial |
$305.67
|
| Rate for Payer: CORVEL All Commercial |
$329.41
|
| Rate for Payer: Coventry All Commercial |
$311.70
|
| Rate for Payer: Encore All Commercial |
$326.04
|
| Rate for Payer: Frontpath All Commercial |
$325.86
|
| Rate for Payer: Humana ChoiceCare |
$305.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$318.78
|
| Rate for Payer: PHCS All Commercial |
$265.65
|
| Rate for Payer: PHP All Commercial |
$268.63
|
| Rate for Payer: Sagamore Health Network All Products |
$273.44
|
| Rate for Payer: Signature Care EPO |
$293.99
|
| Rate for Payer: Signature Care PPO |
$311.70
|
| Rate for Payer: United Healthcare Commercial |
$279.11
|
|
|
HC Z SCREW T15 3.5X10 CORT LP
|
Facility
OP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607467
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$128.32 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$328.19
|
| Rate for Payer: Aetna Medicare |
$128.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$128.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$223.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$243.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$147.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$141.15
|
| Rate for Payer: Cash Price |
$241.09
|
| Rate for Payer: Cash Price |
$241.09
|
| Rate for Payer: Centivo All Commercial |
$198.31
|
| Rate for Payer: Cigna All Commercial |
$335.58
|
| Rate for Payer: CORVEL All Commercial |
$361.63
|
| Rate for Payer: Coventry All Commercial |
$342.19
|
| Rate for Payer: Encore All Commercial |
$357.94
|
| Rate for Payer: Frontpath All Commercial |
$357.74
|
| Rate for Payer: Humana ChoiceCare |
$335.85
|
| Rate for Payer: Humana Medicare |
$198.31
|
| Rate for Payer: Lucent All Commercial |
$198.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$349.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$291.64
|
| Rate for Payer: PHP All Commercial |
$294.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$151.65
|
| Rate for Payer: Sagamore Health Network All Products |
$300.19
|
| Rate for Payer: Signature Care EPO |
$322.75
|
| Rate for Payer: Signature Care PPO |
$342.19
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$330.52
|
| Rate for Payer: United Healthcare Commercial |
$306.41
|
| Rate for Payer: United Healthcare Medicare |
$128.32
|
|
|
HC Z SCREW T15 3.5X10 CORT LP
|
Facility
IP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607467
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$291.64 |
| Max. Negotiated Rate |
$361.63 |
| Rate for Payer: Aetna Commercial |
$335.97
|
| Rate for Payer: Cash Price |
$241.09
|
| Rate for Payer: Cigna All Commercial |
$335.58
|
| Rate for Payer: CORVEL All Commercial |
$361.63
|
| Rate for Payer: Coventry All Commercial |
$342.19
|
| Rate for Payer: Encore All Commercial |
$357.94
|
| Rate for Payer: Frontpath All Commercial |
$357.74
|
| Rate for Payer: Humana ChoiceCare |
$335.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$349.96
|
| Rate for Payer: PHCS All Commercial |
$291.64
|
| Rate for Payer: PHP All Commercial |
$294.90
|
| Rate for Payer: Sagamore Health Network All Products |
$300.19
|
| Rate for Payer: Signature Care EPO |
$322.75
|
| Rate for Payer: Signature Care PPO |
$342.19
|
| Rate for Payer: United Healthcare Commercial |
$306.41
|
|
|
HC Z SCREW T15 3.5X12 CORT LP
|
Facility
OP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607400
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$128.32 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$328.19
|
| Rate for Payer: Aetna Medicare |
$128.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$128.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$223.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$243.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$147.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$141.15
|
| Rate for Payer: Cash Price |
$241.09
|
| Rate for Payer: Cash Price |
$241.09
|
| Rate for Payer: Centivo All Commercial |
$198.31
|
| Rate for Payer: Cigna All Commercial |
$335.58
|
| Rate for Payer: CORVEL All Commercial |
$361.63
|
| Rate for Payer: Coventry All Commercial |
$342.19
|
| Rate for Payer: Encore All Commercial |
$357.94
|
| Rate for Payer: Frontpath All Commercial |
$357.74
|
| Rate for Payer: Humana ChoiceCare |
$335.85
|
| Rate for Payer: Humana Medicare |
$198.31
|
| Rate for Payer: Lucent All Commercial |
$198.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$349.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$291.64
|
| Rate for Payer: PHP All Commercial |
$294.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$151.65
|
| Rate for Payer: Sagamore Health Network All Products |
$300.19
|
| Rate for Payer: Signature Care EPO |
$322.75
|
| Rate for Payer: Signature Care PPO |
$342.19
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$330.52
|
| Rate for Payer: United Healthcare Commercial |
$306.41
|
| Rate for Payer: United Healthcare Medicare |
$128.32
|
|
|
HC Z SCREW T15 3.5X12 CORT LP
|
Facility
IP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607400
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$291.64 |
| Max. Negotiated Rate |
$361.63 |
| Rate for Payer: Aetna Commercial |
$335.97
|
| Rate for Payer: Cash Price |
$241.09
|
| Rate for Payer: Cigna All Commercial |
$335.58
|
| Rate for Payer: CORVEL All Commercial |
$361.63
|
| Rate for Payer: Coventry All Commercial |
$342.19
|
| Rate for Payer: Encore All Commercial |
$357.94
|
| Rate for Payer: Frontpath All Commercial |
$357.74
|
| Rate for Payer: Humana ChoiceCare |
$335.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$349.96
|
| Rate for Payer: PHCS All Commercial |
$291.64
|
| Rate for Payer: PHP All Commercial |
$294.90
|
| Rate for Payer: Sagamore Health Network All Products |
$300.19
|
| Rate for Payer: Signature Care EPO |
$322.75
|
| Rate for Payer: Signature Care PPO |
$342.19
|
| Rate for Payer: United Healthcare Commercial |
$306.41
|
|
|
HC Z SCREW T15 3.5X14 CORT LP
|
Facility
IP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607401
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$291.64 |
| Max. Negotiated Rate |
$361.63 |
| Rate for Payer: Aetna Commercial |
$335.97
|
| Rate for Payer: Cash Price |
$241.09
|
| Rate for Payer: Cigna All Commercial |
$335.58
|
| Rate for Payer: CORVEL All Commercial |
$361.63
|
| Rate for Payer: Coventry All Commercial |
$342.19
|
| Rate for Payer: Encore All Commercial |
$357.94
|
| Rate for Payer: Frontpath All Commercial |
$357.74
|
| Rate for Payer: Humana ChoiceCare |
$335.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$349.96
|
| Rate for Payer: PHCS All Commercial |
$291.64
|
| Rate for Payer: PHP All Commercial |
$294.90
|
| Rate for Payer: Sagamore Health Network All Products |
$300.19
|
| Rate for Payer: Signature Care EPO |
$322.75
|
| Rate for Payer: Signature Care PPO |
$342.19
|
| Rate for Payer: United Healthcare Commercial |
$306.41
|
|
|
HC Z SCREW T15 3.5X14 CORT LP
|
Facility
OP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607401
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$128.32 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$328.19
|
| Rate for Payer: Aetna Medicare |
$128.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$128.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$223.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$243.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$147.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$141.15
|
| Rate for Payer: Cash Price |
$241.09
|
| Rate for Payer: Cash Price |
$241.09
|
| Rate for Payer: Centivo All Commercial |
$198.31
|
| Rate for Payer: Cigna All Commercial |
$335.58
|
| Rate for Payer: CORVEL All Commercial |
$361.63
|
| Rate for Payer: Coventry All Commercial |
$342.19
|
| Rate for Payer: Encore All Commercial |
$357.94
|
| Rate for Payer: Frontpath All Commercial |
$357.74
|
| Rate for Payer: Humana ChoiceCare |
$335.85
|
| Rate for Payer: Humana Medicare |
$198.31
|
| Rate for Payer: Lucent All Commercial |
$198.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$349.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$291.64
|
| Rate for Payer: PHP All Commercial |
$294.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$151.65
|
| Rate for Payer: Sagamore Health Network All Products |
$300.19
|
| Rate for Payer: Signature Care EPO |
$322.75
|
| Rate for Payer: Signature Care PPO |
$342.19
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$330.52
|
| Rate for Payer: United Healthcare Commercial |
$306.41
|
| Rate for Payer: United Healthcare Medicare |
$128.32
|
|
|
HC Z SCREW T15 3.5X16 CORT LP
|
Facility
IP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607402
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$291.64 |
| Max. Negotiated Rate |
$361.63 |
| Rate for Payer: Aetna Commercial |
$335.97
|
| Rate for Payer: Cash Price |
$241.09
|
| Rate for Payer: Cigna All Commercial |
$335.58
|
| Rate for Payer: CORVEL All Commercial |
$361.63
|
| Rate for Payer: Coventry All Commercial |
$342.19
|
| Rate for Payer: Encore All Commercial |
$357.94
|
| Rate for Payer: Frontpath All Commercial |
$357.74
|
| Rate for Payer: Humana ChoiceCare |
$335.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$349.96
|
| Rate for Payer: PHCS All Commercial |
$291.64
|
| Rate for Payer: PHP All Commercial |
$294.90
|
| Rate for Payer: Sagamore Health Network All Products |
$300.19
|
| Rate for Payer: Signature Care EPO |
$322.75
|
| Rate for Payer: Signature Care PPO |
$342.19
|
| Rate for Payer: United Healthcare Commercial |
$306.41
|
|
|
HC Z SCREW T15 3.5X16 CORT LP
|
Facility
OP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607402
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$128.32 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$328.19
|
| Rate for Payer: Aetna Medicare |
$128.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$128.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$223.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$243.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$147.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$141.15
|
| Rate for Payer: Cash Price |
$241.09
|
| Rate for Payer: Cash Price |
$241.09
|
| Rate for Payer: Centivo All Commercial |
$198.31
|
| Rate for Payer: Cigna All Commercial |
$335.58
|
| Rate for Payer: CORVEL All Commercial |
$361.63
|
| Rate for Payer: Coventry All Commercial |
$342.19
|
| Rate for Payer: Encore All Commercial |
$357.94
|
| Rate for Payer: Frontpath All Commercial |
$357.74
|
| Rate for Payer: Humana ChoiceCare |
$335.85
|
| Rate for Payer: Humana Medicare |
$198.31
|
| Rate for Payer: Lucent All Commercial |
$198.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$349.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$291.64
|
| Rate for Payer: PHP All Commercial |
$294.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$151.65
|
| Rate for Payer: Sagamore Health Network All Products |
$300.19
|
| Rate for Payer: Signature Care EPO |
$322.75
|
| Rate for Payer: Signature Care PPO |
$342.19
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$330.52
|
| Rate for Payer: United Healthcare Commercial |
$306.41
|
| Rate for Payer: United Healthcare Medicare |
$128.32
|
|
|
HC Z SCREW T15 3.5X 18 CORT LP
|
Facility
IP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607684
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$291.64 |
| Max. Negotiated Rate |
$361.63 |
| Rate for Payer: Aetna Commercial |
$335.97
|
| Rate for Payer: Cash Price |
$241.09
|
| Rate for Payer: Cigna All Commercial |
$335.58
|
| Rate for Payer: CORVEL All Commercial |
$361.63
|
| Rate for Payer: Coventry All Commercial |
$342.19
|
| Rate for Payer: Encore All Commercial |
$357.94
|
| Rate for Payer: Frontpath All Commercial |
$357.74
|
| Rate for Payer: Humana ChoiceCare |
$335.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$349.96
|
| Rate for Payer: PHCS All Commercial |
$291.64
|
| Rate for Payer: PHP All Commercial |
$294.90
|
| Rate for Payer: Sagamore Health Network All Products |
$300.19
|
| Rate for Payer: Signature Care EPO |
$322.75
|
| Rate for Payer: Signature Care PPO |
$342.19
|
| Rate for Payer: United Healthcare Commercial |
$306.41
|
|
|
HC Z SCREW T15 3.5X 18 CORT LP
|
Facility
OP
|
$388.85
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607684
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$128.32 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$328.19
|
| Rate for Payer: Aetna Medicare |
$128.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$128.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$223.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$243.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$147.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$141.15
|
| Rate for Payer: Cash Price |
$241.09
|
| Rate for Payer: Cash Price |
$241.09
|
| Rate for Payer: Centivo All Commercial |
$198.31
|
| Rate for Payer: Cigna All Commercial |
$335.58
|
| Rate for Payer: CORVEL All Commercial |
$361.63
|
| Rate for Payer: Coventry All Commercial |
$342.19
|
| Rate for Payer: Encore All Commercial |
$357.94
|
| Rate for Payer: Frontpath All Commercial |
$357.74
|
| Rate for Payer: Humana ChoiceCare |
$335.85
|
| Rate for Payer: Humana Medicare |
$198.31
|
| Rate for Payer: Lucent All Commercial |
$198.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$349.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$291.64
|
| Rate for Payer: PHP All Commercial |
$294.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$151.65
|
| Rate for Payer: Sagamore Health Network All Products |
$300.19
|
| Rate for Payer: Signature Care EPO |
$322.75
|
| Rate for Payer: Signature Care PPO |
$342.19
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$330.52
|
| Rate for Payer: United Healthcare Commercial |
$306.41
|
| Rate for Payer: United Healthcare Medicare |
$128.32
|
|
