|
HC ACU 3.5X60 NON-LOCK HEX SCREW
|
Facility
IP
|
$798.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602667
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$598.50 |
| Max. Negotiated Rate |
$742.14 |
| Rate for Payer: Aetna Commercial |
$689.47
|
| Rate for Payer: Cash Price |
$494.76
|
| Rate for Payer: Cigna All Commercial |
$688.67
|
| Rate for Payer: CORVEL All Commercial |
$742.14
|
| Rate for Payer: Coventry All Commercial |
$702.24
|
| Rate for Payer: Encore All Commercial |
$734.56
|
| Rate for Payer: Frontpath All Commercial |
$734.16
|
| Rate for Payer: Humana ChoiceCare |
$689.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$718.20
|
| Rate for Payer: PHCS All Commercial |
$598.50
|
| Rate for Payer: PHP All Commercial |
$605.20
|
| Rate for Payer: Sagamore Health Network All Products |
$616.06
|
| Rate for Payer: Signature Care EPO |
$662.34
|
| Rate for Payer: Signature Care PPO |
$702.24
|
| Rate for Payer: United Healthcare Commercial |
$628.82
|
|
|
HC ACU 3.5X65 LOCK HEX SCREW
|
Facility
OP
|
$1,380.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602653
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$455.40 |
| Max. Negotiated Rate |
$1,283.40 |
| Rate for Payer: Aetna Commercial |
$1,164.72
|
| Rate for Payer: Aetna Medicare |
$455.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$455.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$792.53
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$862.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$523.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$500.94
|
| Rate for Payer: Cash Price |
$855.60
|
| Rate for Payer: Cash Price |
$855.60
|
| Rate for Payer: Centivo All Commercial |
$703.80
|
| Rate for Payer: Cigna All Commercial |
$1,190.94
|
| Rate for Payer: CORVEL All Commercial |
$1,283.40
|
| Rate for Payer: Coventry All Commercial |
$1,214.40
|
| Rate for Payer: Encore All Commercial |
$1,270.29
|
| Rate for Payer: Frontpath All Commercial |
$1,269.60
|
| Rate for Payer: Humana ChoiceCare |
$1,191.91
|
| Rate for Payer: Humana Medicare |
$703.80
|
| Rate for Payer: Lucent All Commercial |
$703.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,242.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,035.00
|
| Rate for Payer: PHP All Commercial |
$1,046.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$538.20
|
| Rate for Payer: Sagamore Health Network All Products |
$1,065.36
|
| Rate for Payer: Signature Care EPO |
$1,145.40
|
| Rate for Payer: Signature Care PPO |
$1,214.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,173.00
|
| Rate for Payer: United Healthcare Commercial |
$1,087.44
|
| Rate for Payer: United Healthcare Medicare |
$455.40
|
|
|
HC ACU 3.5X65 LOCK HEX SCREW
|
Facility
IP
|
$1,380.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602653
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,035.00 |
| Max. Negotiated Rate |
$1,283.40 |
| Rate for Payer: Aetna Commercial |
$1,192.32
|
| Rate for Payer: Cash Price |
$855.60
|
| Rate for Payer: Cigna All Commercial |
$1,190.94
|
| Rate for Payer: CORVEL All Commercial |
$1,283.40
|
| Rate for Payer: Coventry All Commercial |
$1,214.40
|
| Rate for Payer: Encore All Commercial |
$1,270.29
|
| Rate for Payer: Frontpath All Commercial |
$1,269.60
|
| Rate for Payer: Humana ChoiceCare |
$1,191.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,242.00
|
| Rate for Payer: PHCS All Commercial |
$1,035.00
|
| Rate for Payer: PHP All Commercial |
$1,046.59
|
| Rate for Payer: Sagamore Health Network All Products |
$1,065.36
|
| Rate for Payer: Signature Care EPO |
$1,145.40
|
| Rate for Payer: Signature Care PPO |
$1,214.40
|
| Rate for Payer: United Healthcare Commercial |
$1,087.44
|
|
|
HC ACU 3.5X65 NON-LOCK HEX SCREW
|
Facility
IP
|
$890.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602668
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$667.50 |
| Max. Negotiated Rate |
$827.70 |
| Rate for Payer: Aetna Commercial |
$768.96
|
| Rate for Payer: Cash Price |
$551.80
|
| Rate for Payer: Cigna All Commercial |
$768.07
|
| Rate for Payer: CORVEL All Commercial |
$827.70
|
| Rate for Payer: Coventry All Commercial |
$783.20
|
| Rate for Payer: Encore All Commercial |
$819.24
|
| Rate for Payer: Frontpath All Commercial |
$818.80
|
| Rate for Payer: Humana ChoiceCare |
$768.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$801.00
|
| Rate for Payer: PHCS All Commercial |
$667.50
|
| Rate for Payer: PHP All Commercial |
$674.98
|
| Rate for Payer: Sagamore Health Network All Products |
$687.08
|
| Rate for Payer: Signature Care EPO |
$738.70
|
| Rate for Payer: Signature Care PPO |
$783.20
|
| Rate for Payer: United Healthcare Commercial |
$701.32
|
|
|
HC ACU 3.5X65 NON-LOCK HEX SCREW
|
Facility
OP
|
$890.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602668
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$293.70 |
| Max. Negotiated Rate |
$827.70 |
| Rate for Payer: Aetna Commercial |
$751.16
|
| Rate for Payer: Aetna Medicare |
$293.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$293.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$511.13
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$556.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$337.76
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$323.07
|
| Rate for Payer: Cash Price |
$551.80
|
| Rate for Payer: Cash Price |
$551.80
|
| Rate for Payer: Centivo All Commercial |
$453.90
|
| Rate for Payer: Cigna All Commercial |
$768.07
|
| Rate for Payer: CORVEL All Commercial |
$827.70
|
| Rate for Payer: Coventry All Commercial |
$783.20
|
| Rate for Payer: Encore All Commercial |
$819.24
|
| Rate for Payer: Frontpath All Commercial |
$818.80
|
| Rate for Payer: Humana ChoiceCare |
$768.69
|
| Rate for Payer: Humana Medicare |
$453.90
|
| Rate for Payer: Lucent All Commercial |
$453.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$801.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$667.50
|
| Rate for Payer: PHP All Commercial |
$674.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$347.10
|
| Rate for Payer: Sagamore Health Network All Products |
$687.08
|
| Rate for Payer: Signature Care EPO |
$738.70
|
| Rate for Payer: Signature Care PPO |
$783.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$756.50
|
| Rate for Payer: United Healthcare Commercial |
$701.32
|
| Rate for Payer: United Healthcare Medicare |
$293.70
|
|
|
HC ACU 3.5X70 NON-LOCK HEX SCREW
|
Facility
OP
|
$952.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602669
|
|
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 3.5X70 NON-LOCK HEX SCREW
|
Facility
IP
|
$952.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602669
|
|
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 3.5X75 NON-LOCK HEX SCREW
|
Facility
IP
|
$952.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602670
|
|
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 3.5X75 NON-LOCK HEX SCREW
|
Facility
OP
|
$952.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602670
|
|
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 3.5X80 NON-LOCK HEX SCREW
|
Facility
OP
|
$952.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602671
|
|
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 3.5X80 NON-LOCK HEX SCREW
|
Facility
IP
|
$952.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602671
|
|
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 3.5X8 LOCK HEX SCREW
|
Facility
OP
|
$1,022.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602826
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$337.26 |
| Max. Negotiated Rate |
$950.46 |
| Rate for Payer: Aetna Commercial |
$862.57
|
| Rate for Payer: Aetna Medicare |
$337.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$337.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$586.93
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$638.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$387.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$370.99
|
| Rate for Payer: Cash Price |
$633.64
|
| Rate for Payer: Cash Price |
$633.64
|
| Rate for Payer: Centivo All Commercial |
$521.22
|
| Rate for Payer: Cigna All Commercial |
$881.99
|
| Rate for Payer: CORVEL All Commercial |
$950.46
|
| Rate for Payer: Coventry All Commercial |
$899.36
|
| Rate for Payer: Encore All Commercial |
$940.75
|
| Rate for Payer: Frontpath All Commercial |
$940.24
|
| Rate for Payer: Humana ChoiceCare |
$882.70
|
| Rate for Payer: Humana Medicare |
$521.22
|
| Rate for Payer: Lucent All Commercial |
$521.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$919.80
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$766.50
|
| Rate for Payer: PHP All Commercial |
$775.08
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$398.58
|
| Rate for Payer: Sagamore Health Network All Products |
$788.98
|
| Rate for Payer: Signature Care EPO |
$848.26
|
| Rate for Payer: Signature Care PPO |
$899.36
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$868.70
|
| Rate for Payer: United Healthcare Commercial |
$805.34
|
| Rate for Payer: United Healthcare Medicare |
$337.26
|
|
|
HC ACU 3.5X8 LOCK HEX SCREW
|
Facility
IP
|
$1,022.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602826
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$766.50 |
| Max. Negotiated Rate |
$950.46 |
| Rate for Payer: Aetna Commercial |
$883.01
|
| Rate for Payer: Cash Price |
$633.64
|
| Rate for Payer: Cigna All Commercial |
$881.99
|
| Rate for Payer: CORVEL All Commercial |
$950.46
|
| Rate for Payer: Coventry All Commercial |
$899.36
|
| Rate for Payer: Encore All Commercial |
$940.75
|
| Rate for Payer: Frontpath All Commercial |
$940.24
|
| Rate for Payer: Humana ChoiceCare |
$882.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$919.80
|
| Rate for Payer: PHCS All Commercial |
$766.50
|
| Rate for Payer: PHP All Commercial |
$775.08
|
| Rate for Payer: Sagamore Health Network All Products |
$788.98
|
| Rate for Payer: Signature Care EPO |
$848.26
|
| Rate for Payer: Signature Care PPO |
$899.36
|
| Rate for Payer: United Healthcare Commercial |
$805.34
|
|
|
HC ACU 4.0X10 CAN HEX SCREW
|
Facility
IP
|
$616.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602732
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$462.00 |
| Max. Negotiated Rate |
$572.88 |
| Rate for Payer: Aetna Commercial |
$532.22
|
| Rate for Payer: Cash Price |
$381.92
|
| Rate for Payer: Cigna All Commercial |
$531.61
|
| Rate for Payer: CORVEL All Commercial |
$572.88
|
| Rate for Payer: Coventry All Commercial |
$542.08
|
| Rate for Payer: Encore All Commercial |
$567.03
|
| Rate for Payer: Frontpath All Commercial |
$566.72
|
| Rate for Payer: Humana ChoiceCare |
$532.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$554.40
|
| Rate for Payer: PHCS All Commercial |
$462.00
|
| Rate for Payer: PHP All Commercial |
$467.17
|
| Rate for Payer: Sagamore Health Network All Products |
$475.55
|
| Rate for Payer: Signature Care EPO |
$511.28
|
| Rate for Payer: Signature Care PPO |
$542.08
|
| Rate for Payer: United Healthcare Commercial |
$485.41
|
|
|
HC ACU 4.0X10 CAN HEX SCREW
|
Facility
OP
|
$616.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602732
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$203.28 |
| Max. Negotiated Rate |
$572.88 |
| Rate for Payer: Aetna Commercial |
$519.90
|
| Rate for Payer: Aetna Medicare |
$203.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$203.28
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$353.77
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$385.06
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$233.77
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$223.61
|
| Rate for Payer: Cash Price |
$381.92
|
| Rate for Payer: Cash Price |
$381.92
|
| Rate for Payer: Centivo All Commercial |
$314.16
|
| Rate for Payer: Cigna All Commercial |
$531.61
|
| Rate for Payer: CORVEL All Commercial |
$572.88
|
| Rate for Payer: Coventry All Commercial |
$542.08
|
| Rate for Payer: Encore All Commercial |
$567.03
|
| Rate for Payer: Frontpath All Commercial |
$566.72
|
| Rate for Payer: Humana ChoiceCare |
$532.04
|
| Rate for Payer: Humana Medicare |
$314.16
|
| Rate for Payer: Lucent All Commercial |
$314.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$554.40
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$462.00
|
| Rate for Payer: PHP All Commercial |
$467.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$240.24
|
| Rate for Payer: Sagamore Health Network All Products |
$475.55
|
| Rate for Payer: Signature Care EPO |
$511.28
|
| Rate for Payer: Signature Care PPO |
$542.08
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$523.60
|
| Rate for Payer: United Healthcare Commercial |
$485.41
|
| Rate for Payer: United Healthcare Medicare |
$203.28
|
|
|
HC ACU 4.0X12 CAN HEX SCREW
|
Facility
OP
|
$931.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602733
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$307.23 |
| Max. Negotiated Rate |
$865.83 |
| Rate for Payer: Aetna Commercial |
$785.76
|
| Rate for Payer: Aetna Medicare |
$307.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$307.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$534.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$581.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$353.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$337.95
|
| Rate for Payer: Cash Price |
$577.22
|
| Rate for Payer: Cash Price |
$577.22
|
| Rate for Payer: Centivo All Commercial |
$474.81
|
| Rate for Payer: Cigna All Commercial |
$803.45
|
| Rate for Payer: CORVEL All Commercial |
$865.83
|
| Rate for Payer: Coventry All Commercial |
$819.28
|
| Rate for Payer: Encore All Commercial |
$856.99
|
| Rate for Payer: Frontpath All Commercial |
$856.52
|
| Rate for Payer: Humana ChoiceCare |
$804.10
|
| Rate for Payer: Humana Medicare |
$474.81
|
| Rate for Payer: Lucent All Commercial |
$474.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$837.90
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$698.25
|
| Rate for Payer: PHP All Commercial |
$706.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$363.09
|
| Rate for Payer: Sagamore Health Network All Products |
$718.73
|
| Rate for Payer: Signature Care EPO |
$772.73
|
| Rate for Payer: Signature Care PPO |
$819.28
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$791.35
|
| Rate for Payer: United Healthcare Commercial |
$733.63
|
| Rate for Payer: United Healthcare Medicare |
$307.23
|
|
|
HC ACU 4.0X12 CAN HEX SCREW
|
Facility
IP
|
$931.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602733
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$698.25 |
| Max. Negotiated Rate |
$865.83 |
| Rate for Payer: Aetna Commercial |
$804.38
|
| Rate for Payer: Cash Price |
$577.22
|
| Rate for Payer: Cigna All Commercial |
$803.45
|
| Rate for Payer: CORVEL All Commercial |
$865.83
|
| Rate for Payer: Coventry All Commercial |
$819.28
|
| Rate for Payer: Encore All Commercial |
$856.99
|
| Rate for Payer: Frontpath All Commercial |
$856.52
|
| Rate for Payer: Humana ChoiceCare |
$804.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$837.90
|
| Rate for Payer: PHCS All Commercial |
$698.25
|
| Rate for Payer: PHP All Commercial |
$706.07
|
| Rate for Payer: Sagamore Health Network All Products |
$718.73
|
| Rate for Payer: Signature Care EPO |
$772.73
|
| Rate for Payer: Signature Care PPO |
$819.28
|
| Rate for Payer: United Healthcare Commercial |
$733.63
|
|
|
HC ACU 4.0X12 PT CAN HXLB SCREW
|
Facility
OP
|
$616.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602749
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$203.28 |
| Max. Negotiated Rate |
$572.88 |
| Rate for Payer: Aetna Commercial |
$519.90
|
| Rate for Payer: Aetna Medicare |
$203.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$203.28
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$353.77
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$385.06
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$233.77
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$223.61
|
| Rate for Payer: Cash Price |
$381.92
|
| Rate for Payer: Cash Price |
$381.92
|
| Rate for Payer: Centivo All Commercial |
$314.16
|
| Rate for Payer: Cigna All Commercial |
$531.61
|
| Rate for Payer: CORVEL All Commercial |
$572.88
|
| Rate for Payer: Coventry All Commercial |
$542.08
|
| Rate for Payer: Encore All Commercial |
$567.03
|
| Rate for Payer: Frontpath All Commercial |
$566.72
|
| Rate for Payer: Humana ChoiceCare |
$532.04
|
| Rate for Payer: Humana Medicare |
$314.16
|
| Rate for Payer: Lucent All Commercial |
$314.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$554.40
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$462.00
|
| Rate for Payer: PHP All Commercial |
$467.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$240.24
|
| Rate for Payer: Sagamore Health Network All Products |
$475.55
|
| Rate for Payer: Signature Care EPO |
$511.28
|
| Rate for Payer: Signature Care PPO |
$542.08
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$523.60
|
| Rate for Payer: United Healthcare Commercial |
$485.41
|
| Rate for Payer: United Healthcare Medicare |
$203.28
|
|
|
HC ACU 4.0X12 PT CAN HXLB SCREW
|
Facility
IP
|
$616.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602749
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$462.00 |
| Max. Negotiated Rate |
$572.88 |
| Rate for Payer: Aetna Commercial |
$532.22
|
| Rate for Payer: Cash Price |
$381.92
|
| Rate for Payer: Cigna All Commercial |
$531.61
|
| Rate for Payer: CORVEL All Commercial |
$572.88
|
| Rate for Payer: Coventry All Commercial |
$542.08
|
| Rate for Payer: Encore All Commercial |
$567.03
|
| Rate for Payer: Frontpath All Commercial |
$566.72
|
| Rate for Payer: Humana ChoiceCare |
$532.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$554.40
|
| Rate for Payer: PHCS All Commercial |
$462.00
|
| Rate for Payer: PHP All Commercial |
$467.17
|
| Rate for Payer: Sagamore Health Network All Products |
$475.55
|
| Rate for Payer: Signature Care EPO |
$511.28
|
| Rate for Payer: Signature Care PPO |
$542.08
|
| Rate for Payer: United Healthcare Commercial |
$485.41
|
|
|
HC ACU 4.0X14 CAN HEX SCREW
|
Facility
IP
|
$931.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602734
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$698.25 |
| Max. Negotiated Rate |
$865.83 |
| Rate for Payer: Aetna Commercial |
$804.38
|
| Rate for Payer: Cash Price |
$577.22
|
| Rate for Payer: Cigna All Commercial |
$803.45
|
| Rate for Payer: CORVEL All Commercial |
$865.83
|
| Rate for Payer: Coventry All Commercial |
$819.28
|
| Rate for Payer: Encore All Commercial |
$856.99
|
| Rate for Payer: Frontpath All Commercial |
$856.52
|
| Rate for Payer: Humana ChoiceCare |
$804.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$837.90
|
| Rate for Payer: PHCS All Commercial |
$698.25
|
| Rate for Payer: PHP All Commercial |
$706.07
|
| Rate for Payer: Sagamore Health Network All Products |
$718.73
|
| Rate for Payer: Signature Care EPO |
$772.73
|
| Rate for Payer: Signature Care PPO |
$819.28
|
| Rate for Payer: United Healthcare Commercial |
$733.63
|
|
|
HC ACU 4.0X14 CAN HEX SCREW
|
Facility
OP
|
$931.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602734
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$307.23 |
| Max. Negotiated Rate |
$865.83 |
| Rate for Payer: Aetna Commercial |
$785.76
|
| Rate for Payer: Aetna Medicare |
$307.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$307.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$534.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$581.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$353.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$337.95
|
| Rate for Payer: Cash Price |
$577.22
|
| Rate for Payer: Cash Price |
$577.22
|
| Rate for Payer: Centivo All Commercial |
$474.81
|
| Rate for Payer: Cigna All Commercial |
$803.45
|
| Rate for Payer: CORVEL All Commercial |
$865.83
|
| Rate for Payer: Coventry All Commercial |
$819.28
|
| Rate for Payer: Encore All Commercial |
$856.99
|
| Rate for Payer: Frontpath All Commercial |
$856.52
|
| Rate for Payer: Humana ChoiceCare |
$804.10
|
| Rate for Payer: Humana Medicare |
$474.81
|
| Rate for Payer: Lucent All Commercial |
$474.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$837.90
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$698.25
|
| Rate for Payer: PHP All Commercial |
$706.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$363.09
|
| Rate for Payer: Sagamore Health Network All Products |
$718.73
|
| Rate for Payer: Signature Care EPO |
$772.73
|
| Rate for Payer: Signature Care PPO |
$819.28
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$791.35
|
| Rate for Payer: United Healthcare Commercial |
$733.63
|
| Rate for Payer: United Healthcare Medicare |
$307.23
|
|
|
HC ACU 4.0X14 PT CAN HXLB SCREW
|
Facility
IP
|
$931.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602750
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$698.25 |
| Max. Negotiated Rate |
$865.83 |
| Rate for Payer: Aetna Commercial |
$804.38
|
| Rate for Payer: Cash Price |
$577.22
|
| Rate for Payer: Cigna All Commercial |
$803.45
|
| Rate for Payer: CORVEL All Commercial |
$865.83
|
| Rate for Payer: Coventry All Commercial |
$819.28
|
| Rate for Payer: Encore All Commercial |
$856.99
|
| Rate for Payer: Frontpath All Commercial |
$856.52
|
| Rate for Payer: Humana ChoiceCare |
$804.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$837.90
|
| Rate for Payer: PHCS All Commercial |
$698.25
|
| Rate for Payer: PHP All Commercial |
$706.07
|
| Rate for Payer: Sagamore Health Network All Products |
$718.73
|
| Rate for Payer: Signature Care EPO |
$772.73
|
| Rate for Payer: Signature Care PPO |
$819.28
|
| Rate for Payer: United Healthcare Commercial |
$733.63
|
|
|
HC ACU 4.0X14 PT CAN HXLB SCREW
|
Facility
OP
|
$931.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602750
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$307.23 |
| Max. Negotiated Rate |
$865.83 |
| Rate for Payer: Aetna Commercial |
$785.76
|
| Rate for Payer: Aetna Medicare |
$307.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$307.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$534.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$581.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$353.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$337.95
|
| Rate for Payer: Cash Price |
$577.22
|
| Rate for Payer: Cash Price |
$577.22
|
| Rate for Payer: Centivo All Commercial |
$474.81
|
| Rate for Payer: Cigna All Commercial |
$803.45
|
| Rate for Payer: CORVEL All Commercial |
$865.83
|
| Rate for Payer: Coventry All Commercial |
$819.28
|
| Rate for Payer: Encore All Commercial |
$856.99
|
| Rate for Payer: Frontpath All Commercial |
$856.52
|
| Rate for Payer: Humana ChoiceCare |
$804.10
|
| Rate for Payer: Humana Medicare |
$474.81
|
| Rate for Payer: Lucent All Commercial |
$474.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$837.90
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$698.25
|
| Rate for Payer: PHP All Commercial |
$706.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$363.09
|
| Rate for Payer: Sagamore Health Network All Products |
$718.73
|
| Rate for Payer: Signature Care EPO |
$772.73
|
| Rate for Payer: Signature Care PPO |
$819.28
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$791.35
|
| Rate for Payer: United Healthcare Commercial |
$733.63
|
| Rate for Payer: United Healthcare Medicare |
$307.23
|
|
|
HC ACU 4.0X16 CAN HEX SCREW
|
Facility
OP
|
$931.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602735
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$307.23 |
| Max. Negotiated Rate |
$865.83 |
| Rate for Payer: Aetna Commercial |
$785.76
|
| Rate for Payer: Aetna Medicare |
$307.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$307.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$534.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$581.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$353.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$337.95
|
| Rate for Payer: Cash Price |
$577.22
|
| Rate for Payer: Cash Price |
$577.22
|
| Rate for Payer: Centivo All Commercial |
$474.81
|
| Rate for Payer: Cigna All Commercial |
$803.45
|
| Rate for Payer: CORVEL All Commercial |
$865.83
|
| Rate for Payer: Coventry All Commercial |
$819.28
|
| Rate for Payer: Encore All Commercial |
$856.99
|
| Rate for Payer: Frontpath All Commercial |
$856.52
|
| Rate for Payer: Humana ChoiceCare |
$804.10
|
| Rate for Payer: Humana Medicare |
$474.81
|
| Rate for Payer: Lucent All Commercial |
$474.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$837.90
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$698.25
|
| Rate for Payer: PHP All Commercial |
$706.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$363.09
|
| Rate for Payer: Sagamore Health Network All Products |
$718.73
|
| Rate for Payer: Signature Care EPO |
$772.73
|
| Rate for Payer: Signature Care PPO |
$819.28
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$791.35
|
| Rate for Payer: United Healthcare Commercial |
$733.63
|
| Rate for Payer: United Healthcare Medicare |
$307.23
|
|
|
HC ACU 4.0X16 CAN HEX SCREW
|
Facility
IP
|
$931.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41602735
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$698.25 |
| Max. Negotiated Rate |
$865.83 |
| Rate for Payer: Aetna Commercial |
$804.38
|
| Rate for Payer: Cash Price |
$577.22
|
| Rate for Payer: Cigna All Commercial |
$803.45
|
| Rate for Payer: CORVEL All Commercial |
$865.83
|
| Rate for Payer: Coventry All Commercial |
$819.28
|
| Rate for Payer: Encore All Commercial |
$856.99
|
| Rate for Payer: Frontpath All Commercial |
$856.52
|
| Rate for Payer: Humana ChoiceCare |
$804.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$837.90
|
| Rate for Payer: PHCS All Commercial |
$698.25
|
| Rate for Payer: PHP All Commercial |
$706.07
|
| Rate for Payer: Sagamore Health Network All Products |
$718.73
|
| Rate for Payer: Signature Care EPO |
$772.73
|
| Rate for Payer: Signature Care PPO |
$819.28
|
| Rate for Payer: United Healthcare Commercial |
$733.63
|
|
