|
HC Z SF SCREW 3.5X30 LOCK
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604147
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.32 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$604.01
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
|
|
HC Z SF SCREW 3.5X30 LOCK
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604147
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.70 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$590.03
|
| Rate for Payer: Aetna Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$401.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$437.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$265.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$253.77
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Centivo All Commercial |
$356.54
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Humana Medicare |
$356.54
|
| Rate for Payer: Lucent All Commercial |
$356.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.65
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$594.23
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
| Rate for Payer: United Healthcare Medicare |
$230.70
|
|
|
HC Z SF SCREW 3.5X32 LOCK
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604148
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.32 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$604.01
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
|
|
HC Z SF SCREW 3.5X32 LOCK
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604148
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.70 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$590.03
|
| Rate for Payer: Aetna Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$401.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$437.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$265.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$253.77
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Centivo All Commercial |
$356.54
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Humana Medicare |
$356.54
|
| Rate for Payer: Lucent All Commercial |
$356.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.65
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$594.23
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
| Rate for Payer: United Healthcare Medicare |
$230.70
|
|
|
HC Z SF SCREW 3.5X34 LOCK
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604149
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.32 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$604.01
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
|
|
HC Z SF SCREW 3.5X34 LOCK
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604149
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.70 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$590.03
|
| Rate for Payer: Aetna Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$401.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$437.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$265.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$253.77
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Centivo All Commercial |
$356.54
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Humana Medicare |
$356.54
|
| Rate for Payer: Lucent All Commercial |
$356.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.65
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$594.23
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
| Rate for Payer: United Healthcare Medicare |
$230.70
|
|
|
HC Z SF SCREW 3.5X36 LOCK
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604150
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.32 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$604.01
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
|
|
HC Z SF SCREW 3.5X36 LOCK
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604150
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.70 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$590.03
|
| Rate for Payer: Aetna Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$401.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$437.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$265.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$253.77
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Centivo All Commercial |
$356.54
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Humana Medicare |
$356.54
|
| Rate for Payer: Lucent All Commercial |
$356.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.65
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$594.23
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
| Rate for Payer: United Healthcare Medicare |
$230.70
|
|
|
HC Z SF SCREW 3.5X38 LOCK
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604151
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.70 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$590.03
|
| Rate for Payer: Aetna Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$401.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$437.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$265.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$253.77
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Centivo All Commercial |
$356.54
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Humana Medicare |
$356.54
|
| Rate for Payer: Lucent All Commercial |
$356.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.65
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$594.23
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
| Rate for Payer: United Healthcare Medicare |
$230.70
|
|
|
HC Z SF SCREW 3.5X38 LOCK
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604151
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.32 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$604.01
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
|
|
HC Z SF SCREW 3.5X40 LOCK
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604152
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.70 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$590.03
|
| Rate for Payer: Aetna Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$401.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$437.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$265.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$253.77
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Centivo All Commercial |
$356.54
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Humana Medicare |
$356.54
|
| Rate for Payer: Lucent All Commercial |
$356.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.65
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$594.23
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
| Rate for Payer: United Healthcare Medicare |
$230.70
|
|
|
HC Z SF SCREW 3.5X40 LOCK
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604152
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.32 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$604.01
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
|
|
HC Z SF SCREW 3.5X42 LOCK
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604153
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.32 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$604.01
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
|
|
HC Z SF SCREW 3.5X42 LOCK
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604153
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.70 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$590.03
|
| Rate for Payer: Aetna Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$401.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$437.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$265.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$253.77
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Centivo All Commercial |
$356.54
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Humana Medicare |
$356.54
|
| Rate for Payer: Lucent All Commercial |
$356.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.65
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$594.23
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
| Rate for Payer: United Healthcare Medicare |
$230.70
|
|
|
HC Z SF SCREW 3.5X44 LOCK
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604154
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.32 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$604.01
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
|
|
HC Z SF SCREW 3.5X44 LOCK
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604154
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.70 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$590.03
|
| Rate for Payer: Aetna Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$401.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$437.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$265.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$253.77
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Centivo All Commercial |
$356.54
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Humana Medicare |
$356.54
|
| Rate for Payer: Lucent All Commercial |
$356.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.65
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$594.23
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
| Rate for Payer: United Healthcare Medicare |
$230.70
|
|
|
HC Z SF SCREW 3.5X46 LOCK
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604155
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.32 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$604.01
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
|
|
HC Z SF SCREW 3.5X46 LOCK
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604155
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.70 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$590.03
|
| Rate for Payer: Aetna Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$401.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$437.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$265.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$253.77
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Centivo All Commercial |
$356.54
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Humana Medicare |
$356.54
|
| Rate for Payer: Lucent All Commercial |
$356.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.65
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$594.23
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
| Rate for Payer: United Healthcare Medicare |
$230.70
|
|
|
HC Z SF SCREW 3.5X48 LOCK
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604156
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.70 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$590.03
|
| Rate for Payer: Aetna Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$401.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$437.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$265.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$253.77
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Centivo All Commercial |
$356.54
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Humana Medicare |
$356.54
|
| Rate for Payer: Lucent All Commercial |
$356.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.65
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$594.23
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
| Rate for Payer: United Healthcare Medicare |
$230.70
|
|
|
HC Z SF SCREW 3.5X48 LOCK
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604156
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.32 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$604.01
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
|
|
HC Z SF SCREW 3.5X50 LOCK
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604157
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.32 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$604.01
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
|
|
HC Z SF SCREW 3.5X50 LOCK
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604157
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.70 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$590.03
|
| Rate for Payer: Aetna Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$401.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$437.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$265.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$253.77
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Centivo All Commercial |
$356.54
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Humana Medicare |
$356.54
|
| Rate for Payer: Lucent All Commercial |
$356.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.65
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$594.23
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
| Rate for Payer: United Healthcare Medicare |
$230.70
|
|
|
HC Z SF SCREW 3.5X52 LOCK
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604158
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.32 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$604.01
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
|
|
HC Z SF SCREW 3.5X52 LOCK
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604158
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$230.70 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$590.03
|
| Rate for Payer: Aetna Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$230.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$401.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$437.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$265.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$253.77
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Centivo All Commercial |
$356.54
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Humana Medicare |
$356.54
|
| Rate for Payer: Lucent All Commercial |
$356.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$272.65
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$594.23
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
| Rate for Payer: United Healthcare Medicare |
$230.70
|
|
|
HC Z SF SCREW 3.5X54 LOCK
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604159
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.32 |
| Max. Negotiated Rate |
$650.15 |
| Rate for Payer: Aetna Commercial |
$604.01
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Cigna All Commercial |
$603.31
|
| Rate for Payer: CORVEL All Commercial |
$650.15
|
| Rate for Payer: Coventry All Commercial |
$615.20
|
| Rate for Payer: Encore All Commercial |
$643.51
|
| Rate for Payer: Frontpath All Commercial |
$643.16
|
| Rate for Payer: Humana ChoiceCare |
$603.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$629.18
|
| Rate for Payer: PHCS All Commercial |
$524.32
|
| Rate for Payer: PHP All Commercial |
$530.19
|
| Rate for Payer: Sagamore Health Network All Products |
$539.70
|
| Rate for Payer: Signature Care EPO |
$580.24
|
| Rate for Payer: Signature Care PPO |
$615.20
|
| Rate for Payer: United Healthcare Commercial |
$550.88
|
|
