|
HC Z SF SCREW HEX 3.5X16
|
Facility
IP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604172
|
|
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 3.5X16
|
Facility
OP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604172
|
|
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 3.5X18
|
Facility
OP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604173
|
|
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 3.5X18
|
Facility
IP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604173
|
|
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 3.5X20
|
Facility
IP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604174
|
|
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 3.5X20
|
Facility
OP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604174
|
|
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 3.5X22
|
Facility
IP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604175
|
|
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 3.5X22
|
Facility
OP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604175
|
|
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 3.5X24
|
Facility
IP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604176
|
|
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 3.5X24
|
Facility
OP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604176
|
|
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 3.5X26
|
Facility
IP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604177
|
|
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 3.5X26
|
Facility
OP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604177
|
|
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 3.5X28
|
Facility
IP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604178
|
|
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 3.5X28
|
Facility
OP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604178
|
|
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 3.5X30
|
Facility
IP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604179
|
|
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 3.5X30
|
Facility
OP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604179
|
|
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 3.5X32
|
Facility
OP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604180
|
|
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 3.5X32
|
Facility
IP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604180
|
|
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 3.5X34
|
Facility
OP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604181
|
|
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 3.5X34
|
Facility
IP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604181
|
|
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 3.5X36
|
Facility
IP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604182
|
|
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 3.5X36
|
Facility
OP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604182
|
|
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 3.5X38
|
Facility
OP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604183
|
|
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 3.5X38
|
Facility
IP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604183
|
|
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 3.5X40
|
Facility
OP
|
$172.48
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604184
|
|
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
|
|
