|
HC Z SF SCREW 3.5X54 LOCK
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604159
|
|
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 3.5X56 LOCK
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604160
|
|
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 3.5X56 LOCK
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604160
|
|
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 3.5X58 LOCK
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604161
|
|
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 3.5X58 LOCK
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604161
|
|
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 3.5X60 LOCK
|
Facility
IP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604162
|
|
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 3.5X60 LOCK
|
Facility
OP
|
$699.09
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604162
|
|
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 3.5X65 LOCK
|
Facility
IP
|
$792.33
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604163
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$594.25 |
| Max. Negotiated Rate |
$736.87 |
| Rate for Payer: Aetna Commercial |
$684.57
|
| Rate for Payer: Cash Price |
$491.25
|
| Rate for Payer: Cigna All Commercial |
$683.78
|
| Rate for Payer: CORVEL All Commercial |
$736.87
|
| Rate for Payer: Coventry All Commercial |
$697.25
|
| Rate for Payer: Encore All Commercial |
$729.34
|
| Rate for Payer: Frontpath All Commercial |
$728.94
|
| Rate for Payer: Humana ChoiceCare |
$684.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$713.10
|
| Rate for Payer: PHCS All Commercial |
$594.25
|
| Rate for Payer: PHP All Commercial |
$600.90
|
| Rate for Payer: Sagamore Health Network All Products |
$611.68
|
| Rate for Payer: Signature Care EPO |
$657.63
|
| Rate for Payer: Signature Care PPO |
$697.25
|
| Rate for Payer: United Healthcare Commercial |
$624.36
|
|
|
HC Z SF SCREW 3.5X65 LOCK
|
Facility
OP
|
$792.33
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604163
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$261.47 |
| Max. Negotiated Rate |
$736.87 |
| Rate for Payer: Aetna Commercial |
$668.73
|
| Rate for Payer: Aetna Medicare |
$261.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$261.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$455.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$495.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$300.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$287.62
|
| Rate for Payer: Cash Price |
$491.25
|
| Rate for Payer: Cash Price |
$491.25
|
| Rate for Payer: Centivo All Commercial |
$404.09
|
| Rate for Payer: Cigna All Commercial |
$683.78
|
| Rate for Payer: CORVEL All Commercial |
$736.87
|
| Rate for Payer: Coventry All Commercial |
$697.25
|
| Rate for Payer: Encore All Commercial |
$729.34
|
| Rate for Payer: Frontpath All Commercial |
$728.94
|
| Rate for Payer: Humana ChoiceCare |
$684.34
|
| Rate for Payer: Humana Medicare |
$404.09
|
| Rate for Payer: Lucent All Commercial |
$404.09
|
| Rate for Payer: Lutheran Preferred All Commercial |
$713.10
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$594.25
|
| Rate for Payer: PHP All Commercial |
$600.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$309.01
|
| Rate for Payer: Sagamore Health Network All Products |
$611.68
|
| Rate for Payer: Signature Care EPO |
$657.63
|
| Rate for Payer: Signature Care PPO |
$697.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$673.48
|
| Rate for Payer: United Healthcare Commercial |
$624.36
|
| Rate for Payer: United Healthcare Medicare |
$261.47
|
|
|
HC Z SF SCREW 3.5X70 LOCK
|
Facility
IP
|
$792.33
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604164
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$594.25 |
| Max. Negotiated Rate |
$736.87 |
| Rate for Payer: Aetna Commercial |
$684.57
|
| Rate for Payer: Cash Price |
$491.25
|
| Rate for Payer: Cigna All Commercial |
$683.78
|
| Rate for Payer: CORVEL All Commercial |
$736.87
|
| Rate for Payer: Coventry All Commercial |
$697.25
|
| Rate for Payer: Encore All Commercial |
$729.34
|
| Rate for Payer: Frontpath All Commercial |
$728.94
|
| Rate for Payer: Humana ChoiceCare |
$684.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$713.10
|
| Rate for Payer: PHCS All Commercial |
$594.25
|
| Rate for Payer: PHP All Commercial |
$600.90
|
| Rate for Payer: Sagamore Health Network All Products |
$611.68
|
| Rate for Payer: Signature Care EPO |
$657.63
|
| Rate for Payer: Signature Care PPO |
$697.25
|
| Rate for Payer: United Healthcare Commercial |
$624.36
|
|
|
HC Z SF SCREW 3.5X70 LOCK
|
Facility
OP
|
$792.33
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604164
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$261.47 |
| Max. Negotiated Rate |
$736.87 |
| Rate for Payer: Aetna Commercial |
$668.73
|
| Rate for Payer: Aetna Medicare |
$261.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$261.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$455.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$495.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$300.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$287.62
|
| Rate for Payer: Cash Price |
$491.25
|
| Rate for Payer: Cash Price |
$491.25
|
| Rate for Payer: Centivo All Commercial |
$404.09
|
| Rate for Payer: Cigna All Commercial |
$683.78
|
| Rate for Payer: CORVEL All Commercial |
$736.87
|
| Rate for Payer: Coventry All Commercial |
$697.25
|
| Rate for Payer: Encore All Commercial |
$729.34
|
| Rate for Payer: Frontpath All Commercial |
$728.94
|
| Rate for Payer: Humana ChoiceCare |
$684.34
|
| Rate for Payer: Humana Medicare |
$404.09
|
| Rate for Payer: Lucent All Commercial |
$404.09
|
| Rate for Payer: Lutheran Preferred All Commercial |
$713.10
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$594.25
|
| Rate for Payer: PHP All Commercial |
$600.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$309.01
|
| Rate for Payer: Sagamore Health Network All Products |
$611.68
|
| Rate for Payer: Signature Care EPO |
$657.63
|
| Rate for Payer: Signature Care PPO |
$697.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$673.48
|
| Rate for Payer: United Healthcare Commercial |
$624.36
|
| Rate for Payer: United Healthcare Medicare |
$261.47
|
|
|
HC Z SF SCREW 3.5X75 LOCK
|
Facility
IP
|
$792.33
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604165
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$594.25 |
| Max. Negotiated Rate |
$736.87 |
| Rate for Payer: Aetna Commercial |
$684.57
|
| Rate for Payer: Cash Price |
$491.25
|
| Rate for Payer: Cigna All Commercial |
$683.78
|
| Rate for Payer: CORVEL All Commercial |
$736.87
|
| Rate for Payer: Coventry All Commercial |
$697.25
|
| Rate for Payer: Encore All Commercial |
$729.34
|
| Rate for Payer: Frontpath All Commercial |
$728.94
|
| Rate for Payer: Humana ChoiceCare |
$684.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$713.10
|
| Rate for Payer: PHCS All Commercial |
$594.25
|
| Rate for Payer: PHP All Commercial |
$600.90
|
| Rate for Payer: Sagamore Health Network All Products |
$611.68
|
| Rate for Payer: Signature Care EPO |
$657.63
|
| Rate for Payer: Signature Care PPO |
$697.25
|
| Rate for Payer: United Healthcare Commercial |
$624.36
|
|
|
HC Z SF SCREW 3.5X75 LOCK
|
Facility
OP
|
$792.33
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604165
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$261.47 |
| Max. Negotiated Rate |
$736.87 |
| Rate for Payer: Aetna Commercial |
$668.73
|
| Rate for Payer: Aetna Medicare |
$261.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$261.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$455.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$495.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$300.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$287.62
|
| Rate for Payer: Cash Price |
$491.25
|
| Rate for Payer: Cash Price |
$491.25
|
| Rate for Payer: Centivo All Commercial |
$404.09
|
| Rate for Payer: Cigna All Commercial |
$683.78
|
| Rate for Payer: CORVEL All Commercial |
$736.87
|
| Rate for Payer: Coventry All Commercial |
$697.25
|
| Rate for Payer: Encore All Commercial |
$729.34
|
| Rate for Payer: Frontpath All Commercial |
$728.94
|
| Rate for Payer: Humana ChoiceCare |
$684.34
|
| Rate for Payer: Humana Medicare |
$404.09
|
| Rate for Payer: Lucent All Commercial |
$404.09
|
| Rate for Payer: Lutheran Preferred All Commercial |
$713.10
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$594.25
|
| Rate for Payer: PHP All Commercial |
$600.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$309.01
|
| Rate for Payer: Sagamore Health Network All Products |
$611.68
|
| Rate for Payer: Signature Care EPO |
$657.63
|
| Rate for Payer: Signature Care PPO |
$697.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$673.48
|
| Rate for Payer: United Healthcare Commercial |
$624.36
|
| Rate for Payer: United Healthcare Medicare |
$261.47
|
|
|
HC Z SF SCREW 3.5X80 LOCK
|
Facility
IP
|
$792.33
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604166
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$594.25 |
| Max. Negotiated Rate |
$736.87 |
| Rate for Payer: Aetna Commercial |
$684.57
|
| Rate for Payer: Cash Price |
$491.25
|
| Rate for Payer: Cigna All Commercial |
$683.78
|
| Rate for Payer: CORVEL All Commercial |
$736.87
|
| Rate for Payer: Coventry All Commercial |
$697.25
|
| Rate for Payer: Encore All Commercial |
$729.34
|
| Rate for Payer: Frontpath All Commercial |
$728.94
|
| Rate for Payer: Humana ChoiceCare |
$684.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$713.10
|
| Rate for Payer: PHCS All Commercial |
$594.25
|
| Rate for Payer: PHP All Commercial |
$600.90
|
| Rate for Payer: Sagamore Health Network All Products |
$611.68
|
| Rate for Payer: Signature Care EPO |
$657.63
|
| Rate for Payer: Signature Care PPO |
$697.25
|
| Rate for Payer: United Healthcare Commercial |
$624.36
|
|
|
HC Z SF SCREW 3.5X80 LOCK
|
Facility
OP
|
$792.33
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604166
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$261.47 |
| Max. Negotiated Rate |
$736.87 |
| Rate for Payer: Aetna Commercial |
$668.73
|
| Rate for Payer: Aetna Medicare |
$261.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$261.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$455.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$495.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$300.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$287.62
|
| Rate for Payer: Cash Price |
$491.25
|
| Rate for Payer: Cash Price |
$491.25
|
| Rate for Payer: Centivo All Commercial |
$404.09
|
| Rate for Payer: Cigna All Commercial |
$683.78
|
| Rate for Payer: CORVEL All Commercial |
$736.87
|
| Rate for Payer: Coventry All Commercial |
$697.25
|
| Rate for Payer: Encore All Commercial |
$729.34
|
| Rate for Payer: Frontpath All Commercial |
$728.94
|
| Rate for Payer: Humana ChoiceCare |
$684.34
|
| Rate for Payer: Humana Medicare |
$404.09
|
| Rate for Payer: Lucent All Commercial |
$404.09
|
| Rate for Payer: Lutheran Preferred All Commercial |
$713.10
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$594.25
|
| Rate for Payer: PHP All Commercial |
$600.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$309.01
|
| Rate for Payer: Sagamore Health Network All Products |
$611.68
|
| Rate for Payer: Signature Care EPO |
$657.63
|
| Rate for Payer: Signature Care PPO |
$697.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$673.48
|
| Rate for Payer: United Healthcare Commercial |
$624.36
|
| Rate for Payer: United Healthcare Medicare |
$261.47
|
|
|
HC Z SF SCREW 3.5X85 LOCK
|
Facility
IP
|
$792.33
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604167
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$594.25 |
| Max. Negotiated Rate |
$736.87 |
| Rate for Payer: Aetna Commercial |
$684.57
|
| Rate for Payer: Cash Price |
$491.25
|
| Rate for Payer: Cigna All Commercial |
$683.78
|
| Rate for Payer: CORVEL All Commercial |
$736.87
|
| Rate for Payer: Coventry All Commercial |
$697.25
|
| Rate for Payer: Encore All Commercial |
$729.34
|
| Rate for Payer: Frontpath All Commercial |
$728.94
|
| Rate for Payer: Humana ChoiceCare |
$684.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$713.10
|
| Rate for Payer: PHCS All Commercial |
$594.25
|
| Rate for Payer: PHP All Commercial |
$600.90
|
| Rate for Payer: Sagamore Health Network All Products |
$611.68
|
| Rate for Payer: Signature Care EPO |
$657.63
|
| Rate for Payer: Signature Care PPO |
$697.25
|
| Rate for Payer: United Healthcare Commercial |
$624.36
|
|
|
HC Z SF SCREW 3.5X85 LOCK
|
Facility
OP
|
$792.33
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604167
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$261.47 |
| Max. Negotiated Rate |
$736.87 |
| Rate for Payer: Aetna Commercial |
$668.73
|
| Rate for Payer: Aetna Medicare |
$261.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$261.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$455.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$495.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$300.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$287.62
|
| Rate for Payer: Cash Price |
$491.25
|
| Rate for Payer: Cash Price |
$491.25
|
| Rate for Payer: Centivo All Commercial |
$404.09
|
| Rate for Payer: Cigna All Commercial |
$683.78
|
| Rate for Payer: CORVEL All Commercial |
$736.87
|
| Rate for Payer: Coventry All Commercial |
$697.25
|
| Rate for Payer: Encore All Commercial |
$729.34
|
| Rate for Payer: Frontpath All Commercial |
$728.94
|
| Rate for Payer: Humana ChoiceCare |
$684.34
|
| Rate for Payer: Humana Medicare |
$404.09
|
| Rate for Payer: Lucent All Commercial |
$404.09
|
| Rate for Payer: Lutheran Preferred All Commercial |
$713.10
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$594.25
|
| Rate for Payer: PHP All Commercial |
$600.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$309.01
|
| Rate for Payer: Sagamore Health Network All Products |
$611.68
|
| Rate for Payer: Signature Care EPO |
$657.63
|
| Rate for Payer: Signature Care PPO |
$697.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$673.48
|
| Rate for Payer: United Healthcare Commercial |
$624.36
|
| Rate for Payer: United Healthcare Medicare |
$261.47
|
|
|
HC Z SF SCREW 3.5X90 LOCK
|
Facility
IP
|
$792.33
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604168
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$594.25 |
| Max. Negotiated Rate |
$736.87 |
| Rate for Payer: Aetna Commercial |
$684.57
|
| Rate for Payer: Cash Price |
$491.25
|
| Rate for Payer: Cigna All Commercial |
$683.78
|
| Rate for Payer: CORVEL All Commercial |
$736.87
|
| Rate for Payer: Coventry All Commercial |
$697.25
|
| Rate for Payer: Encore All Commercial |
$729.34
|
| Rate for Payer: Frontpath All Commercial |
$728.94
|
| Rate for Payer: Humana ChoiceCare |
$684.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$713.10
|
| Rate for Payer: PHCS All Commercial |
$594.25
|
| Rate for Payer: PHP All Commercial |
$600.90
|
| Rate for Payer: Sagamore Health Network All Products |
$611.68
|
| Rate for Payer: Signature Care EPO |
$657.63
|
| Rate for Payer: Signature Care PPO |
$697.25
|
| Rate for Payer: United Healthcare Commercial |
$624.36
|
|
|
HC Z SF SCREW 3.5X90 LOCK
|
Facility
OP
|
$792.33
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604168
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$261.47 |
| Max. Negotiated Rate |
$736.87 |
| Rate for Payer: Aetna Commercial |
$668.73
|
| Rate for Payer: Aetna Medicare |
$261.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$261.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$455.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$495.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$300.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$287.62
|
| Rate for Payer: Cash Price |
$491.25
|
| Rate for Payer: Cash Price |
$491.25
|
| Rate for Payer: Centivo All Commercial |
$404.09
|
| Rate for Payer: Cigna All Commercial |
$683.78
|
| Rate for Payer: CORVEL All Commercial |
$736.87
|
| Rate for Payer: Coventry All Commercial |
$697.25
|
| Rate for Payer: Encore All Commercial |
$729.34
|
| Rate for Payer: Frontpath All Commercial |
$728.94
|
| Rate for Payer: Humana ChoiceCare |
$684.34
|
| Rate for Payer: Humana Medicare |
$404.09
|
| Rate for Payer: Lucent All Commercial |
$404.09
|
| Rate for Payer: Lutheran Preferred All Commercial |
$713.10
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$594.25
|
| Rate for Payer: PHP All Commercial |
$600.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$309.01
|
| Rate for Payer: Sagamore Health Network All Products |
$611.68
|
| Rate for Payer: Signature Care EPO |
$657.63
|
| Rate for Payer: Signature Care PPO |
$697.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$673.48
|
| Rate for Payer: United Healthcare Commercial |
$624.36
|
| Rate for Payer: United Healthcare Medicare |
$261.47
|
|
|
HC Z SF SCREW HEX 3.5X10
|
Facility
IP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604169
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$129.36 |
| Max. Negotiated Rate |
$160.41 |
| Rate for Payer: Aetna Commercial |
$149.02
|
| Rate for Payer: Cash Price |
$106.94
|
| Rate for Payer: Cigna All Commercial |
$148.85
|
| Rate for Payer: CORVEL All Commercial |
$160.41
|
| Rate for Payer: Coventry All Commercial |
$151.78
|
| Rate for Payer: Encore All Commercial |
$158.77
|
| Rate for Payer: Frontpath All Commercial |
$158.68
|
| Rate for Payer: Humana ChoiceCare |
$148.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$155.23
|
| Rate for Payer: PHCS All Commercial |
$129.36
|
| Rate for Payer: PHP All Commercial |
$130.81
|
| Rate for Payer: Sagamore Health Network All Products |
$133.15
|
| Rate for Payer: Signature Care EPO |
$143.16
|
| Rate for Payer: Signature Care PPO |
$151.78
|
| Rate for Payer: United Healthcare Commercial |
$135.91
|
|
|
HC Z SF SCREW HEX 3.5X10
|
Facility
OP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604169
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$56.92 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$145.57
|
| Rate for Payer: Aetna Medicare |
$56.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$56.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$99.06
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$107.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$65.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$62.61
|
| Rate for Payer: Cash Price |
$106.94
|
| Rate for Payer: Cash Price |
$106.94
|
| Rate for Payer: Centivo All Commercial |
$87.96
|
| Rate for Payer: Cigna All Commercial |
$148.85
|
| Rate for Payer: CORVEL All Commercial |
$160.41
|
| Rate for Payer: Coventry All Commercial |
$151.78
|
| Rate for Payer: Encore All Commercial |
$158.77
|
| Rate for Payer: Frontpath All Commercial |
$158.68
|
| Rate for Payer: Humana ChoiceCare |
$148.97
|
| Rate for Payer: Humana Medicare |
$87.96
|
| Rate for Payer: Lucent All Commercial |
$87.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$155.23
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$129.36
|
| Rate for Payer: PHP All Commercial |
$130.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$67.27
|
| Rate for Payer: Sagamore Health Network All Products |
$133.15
|
| Rate for Payer: Signature Care EPO |
$143.16
|
| Rate for Payer: Signature Care PPO |
$151.78
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$146.61
|
| Rate for Payer: United Healthcare Commercial |
$135.91
|
| Rate for Payer: United Healthcare Medicare |
$56.92
|
|
|
HC Z SF SCREW HEX 3.5X12
|
Facility
OP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604170
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$56.92 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$145.57
|
| Rate for Payer: Aetna Medicare |
$56.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$56.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$99.06
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$107.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$65.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$62.61
|
| Rate for Payer: Cash Price |
$106.94
|
| Rate for Payer: Cash Price |
$106.94
|
| Rate for Payer: Centivo All Commercial |
$87.96
|
| Rate for Payer: Cigna All Commercial |
$148.85
|
| Rate for Payer: CORVEL All Commercial |
$160.41
|
| Rate for Payer: Coventry All Commercial |
$151.78
|
| Rate for Payer: Encore All Commercial |
$158.77
|
| Rate for Payer: Frontpath All Commercial |
$158.68
|
| Rate for Payer: Humana ChoiceCare |
$148.97
|
| Rate for Payer: Humana Medicare |
$87.96
|
| Rate for Payer: Lucent All Commercial |
$87.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$155.23
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$129.36
|
| Rate for Payer: PHP All Commercial |
$130.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$67.27
|
| Rate for Payer: Sagamore Health Network All Products |
$133.15
|
| Rate for Payer: Signature Care EPO |
$143.16
|
| Rate for Payer: Signature Care PPO |
$151.78
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$146.61
|
| Rate for Payer: United Healthcare Commercial |
$135.91
|
| Rate for Payer: United Healthcare Medicare |
$56.92
|
|
|
HC Z SF SCREW HEX 3.5X12
|
Facility
IP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604170
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$129.36 |
| Max. Negotiated Rate |
$160.41 |
| Rate for Payer: Aetna Commercial |
$149.02
|
| Rate for Payer: Cash Price |
$106.94
|
| Rate for Payer: Cigna All Commercial |
$148.85
|
| Rate for Payer: CORVEL All Commercial |
$160.41
|
| Rate for Payer: Coventry All Commercial |
$151.78
|
| Rate for Payer: Encore All Commercial |
$158.77
|
| Rate for Payer: Frontpath All Commercial |
$158.68
|
| Rate for Payer: Humana ChoiceCare |
$148.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$155.23
|
| Rate for Payer: PHCS All Commercial |
$129.36
|
| Rate for Payer: PHP All Commercial |
$130.81
|
| Rate for Payer: Sagamore Health Network All Products |
$133.15
|
| Rate for Payer: Signature Care EPO |
$143.16
|
| Rate for Payer: Signature Care PPO |
$151.78
|
| Rate for Payer: United Healthcare Commercial |
$135.91
|
|
|
HC Z SF SCREW HEX 3.5X14
|
Facility
IP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604171
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$129.36 |
| Max. Negotiated Rate |
$160.41 |
| Rate for Payer: Aetna Commercial |
$149.02
|
| Rate for Payer: Cash Price |
$106.94
|
| Rate for Payer: Cigna All Commercial |
$148.85
|
| Rate for Payer: CORVEL All Commercial |
$160.41
|
| Rate for Payer: Coventry All Commercial |
$151.78
|
| Rate for Payer: Encore All Commercial |
$158.77
|
| Rate for Payer: Frontpath All Commercial |
$158.68
|
| Rate for Payer: Humana ChoiceCare |
$148.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$155.23
|
| Rate for Payer: PHCS All Commercial |
$129.36
|
| Rate for Payer: PHP All Commercial |
$130.81
|
| Rate for Payer: Sagamore Health Network All Products |
$133.15
|
| Rate for Payer: Signature Care EPO |
$143.16
|
| Rate for Payer: Signature Care PPO |
$151.78
|
| Rate for Payer: United Healthcare Commercial |
$135.91
|
|
|
HC Z SF SCREW HEX 3.5X14
|
Facility
OP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604171
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$56.92 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$145.57
|
| Rate for Payer: Aetna Medicare |
$56.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$56.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$99.06
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$107.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$65.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$62.61
|
| Rate for Payer: Cash Price |
$106.94
|
| Rate for Payer: Cash Price |
$106.94
|
| Rate for Payer: Centivo All Commercial |
$87.96
|
| Rate for Payer: Cigna All Commercial |
$148.85
|
| Rate for Payer: CORVEL All Commercial |
$160.41
|
| Rate for Payer: Coventry All Commercial |
$151.78
|
| Rate for Payer: Encore All Commercial |
$158.77
|
| Rate for Payer: Frontpath All Commercial |
$158.68
|
| Rate for Payer: Humana ChoiceCare |
$148.97
|
| Rate for Payer: Humana Medicare |
$87.96
|
| Rate for Payer: Lucent All Commercial |
$87.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$155.23
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$129.36
|
| Rate for Payer: PHP All Commercial |
$130.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$67.27
|
| Rate for Payer: Sagamore Health Network All Products |
$133.15
|
| Rate for Payer: Signature Care EPO |
$143.16
|
| Rate for Payer: Signature Care PPO |
$151.78
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$146.61
|
| Rate for Payer: United Healthcare Commercial |
$135.91
|
| Rate for Payer: United Healthcare Medicare |
$56.92
|
|
