Van Diest Medical Center

All Charges

Charge

Type

Setting

Price

SCREW CORTEX 2.0MMX10MM

Facility

$27.00

Service Code	CPT C1713
Hospital Charge Code	8047008
Hospital Revenue Code	278
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$24.30
Rate for Payer: Aetna of IA Commercial	$24.30
Rate for Payer: Aetna of IA Medical Rental Products	$24.30
Rate for Payer: Cash Price	$21.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$20.25
Rate for Payer: Medical Associates Commercial	$20.25
Rate for Payer: Midlands Choice Commercial	$18.90
Rate for Payer: United Healthcare Commercial	$24.30

SCREW CORTEX 2.0MMX10MM

Facility

$27.00

Service Code	CPT C1713
Hospital Charge Code	8047008
Hospital Revenue Code	278
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$24.30
Rate for Payer: Aetna of IA Commercial	$24.30
Rate for Payer: Aetna of IA Medical Rental Products	$24.30
Rate for Payer: Aetna of IA Medicare	$15.39
Rate for Payer: Amerigroup Medicaid	$13.63
Rate for Payer: Amerigroup Medicare	$13.64
Rate for Payer: Cash Price	$21.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$20.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$13.50
Rate for Payer: Iowa Total Care Managed Medicaid	$13.49
Rate for Payer: Medical Associates Commercial	$20.25
Rate for Payer: Medical Associates Managed Medicare	$13.50
Rate for Payer: Midlands Choice Commercial	$18.90
Rate for Payer: Molina Healthcare Managed Medicaid	$13.70
Rate for Payer: Molina Healthcare Managed Medicare	$13.69
Rate for Payer: Oscar Health of IA Commercial	$20.25
Rate for Payer: Partners Health Alliance Commercial	$20.25
Rate for Payer: United Healthcare Commercial	$24.30
Rate for Payer: United Healthcare Managed Medicare	$15.93

SCREW CORTEX 2.0MMX12MM

Facility

$23.00

Service Code	CPT C1713
Hospital Charge Code	8046939
Hospital Revenue Code	278
Min. Negotiated Rate	$11.50
Max. Negotiated Rate	$20.70
Rate for Payer: Aetna of IA Commercial	$20.70
Rate for Payer: Aetna of IA Medical Rental Products	$20.70
Rate for Payer: Aetna of IA Medicare	$13.11
Rate for Payer: Amerigroup Medicaid	$11.61
Rate for Payer: Amerigroup Medicare	$11.62
Rate for Payer: Cash Price	$18.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$17.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$11.50
Rate for Payer: Iowa Total Care Managed Medicaid	$11.50
Rate for Payer: Medical Associates Commercial	$17.25
Rate for Payer: Medical Associates Managed Medicare	$11.50
Rate for Payer: Midlands Choice Commercial	$16.10
Rate for Payer: Molina Healthcare Managed Medicaid	$11.67
Rate for Payer: Molina Healthcare Managed Medicare	$11.67
Rate for Payer: Oscar Health of IA Commercial	$17.25
Rate for Payer: Partners Health Alliance Commercial	$17.25
Rate for Payer: United Healthcare Commercial	$20.70
Rate for Payer: United Healthcare Managed Medicare	$13.57

SCREW CORTEX 2.0MMX12MM

Facility

$23.00

Service Code	CPT C1713
Hospital Charge Code	8046939
Hospital Revenue Code	278
Min. Negotiated Rate	$16.10
Max. Negotiated Rate	$20.70
Rate for Payer: Aetna of IA Commercial	$20.70
Rate for Payer: Aetna of IA Medical Rental Products	$20.70
Rate for Payer: Cash Price	$18.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$17.25
Rate for Payer: Medical Associates Commercial	$17.25
Rate for Payer: Midlands Choice Commercial	$16.10
Rate for Payer: United Healthcare Commercial	$20.70

SCREW CORTEX 2.0MMX14MM

Facility

$23.00

Service Code	CPT C1713
Hospital Charge Code	8046775
Hospital Revenue Code	278
Min. Negotiated Rate	$16.10
Max. Negotiated Rate	$20.70
Rate for Payer: Aetna of IA Commercial	$20.70
Rate for Payer: Aetna of IA Medical Rental Products	$20.70
Rate for Payer: Cash Price	$18.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$17.25
Rate for Payer: Medical Associates Commercial	$17.25
Rate for Payer: Midlands Choice Commercial	$16.10
Rate for Payer: United Healthcare Commercial	$20.70

SCREW CORTEX 2.0MMX14MM

Facility

$23.00

Service Code	CPT C1713
Hospital Charge Code	8046775
Hospital Revenue Code	278
Min. Negotiated Rate	$11.50
Max. Negotiated Rate	$20.70
Rate for Payer: Aetna of IA Commercial	$20.70
Rate for Payer: Aetna of IA Medical Rental Products	$20.70
Rate for Payer: Aetna of IA Medicare	$13.11
Rate for Payer: Amerigroup Medicaid	$11.61
Rate for Payer: Amerigroup Medicare	$11.62
Rate for Payer: Cash Price	$18.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$17.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$11.50
Rate for Payer: Iowa Total Care Managed Medicaid	$11.50
Rate for Payer: Medical Associates Commercial	$17.25
Rate for Payer: Medical Associates Managed Medicare	$11.50
Rate for Payer: Midlands Choice Commercial	$16.10
Rate for Payer: Molina Healthcare Managed Medicaid	$11.67
Rate for Payer: Molina Healthcare Managed Medicare	$11.67
Rate for Payer: Oscar Health of IA Commercial	$17.25
Rate for Payer: Partners Health Alliance Commercial	$17.25
Rate for Payer: United Healthcare Commercial	$20.70
Rate for Payer: United Healthcare Managed Medicare	$13.57

SCREW CORTEX 2.0MMX16MM

Facility

$36.00

Service Code	CPT C1713
Hospital Charge Code	8046899
Hospital Revenue Code	278
Min. Negotiated Rate	$25.20
Max. Negotiated Rate	$32.40
Rate for Payer: Aetna of IA Commercial	$32.40
Rate for Payer: Aetna of IA Medical Rental Products	$32.40
Rate for Payer: Cash Price	$28.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$27.00
Rate for Payer: Medical Associates Commercial	$27.00
Rate for Payer: Midlands Choice Commercial	$25.20
Rate for Payer: United Healthcare Commercial	$32.40

SCREW CORTEX 2.0MMX16MM

Facility

$36.00

Service Code	CPT C1713
Hospital Charge Code	8046899
Hospital Revenue Code	278
Min. Negotiated Rate	$17.99
Max. Negotiated Rate	$32.40
Rate for Payer: Aetna of IA Commercial	$32.40
Rate for Payer: Aetna of IA Medical Rental Products	$32.40
Rate for Payer: Aetna of IA Medicare	$20.52
Rate for Payer: Amerigroup Medicaid	$18.17
Rate for Payer: Amerigroup Medicare	$18.18
Rate for Payer: Cash Price	$28.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$27.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$18.00
Rate for Payer: Iowa Total Care Managed Medicaid	$17.99
Rate for Payer: Medical Associates Commercial	$27.00
Rate for Payer: Medical Associates Managed Medicare	$18.00
Rate for Payer: Midlands Choice Commercial	$25.20
Rate for Payer: Molina Healthcare Managed Medicaid	$18.27
Rate for Payer: Molina Healthcare Managed Medicare	$18.26
Rate for Payer: Oscar Health of IA Commercial	$27.00
Rate for Payer: Partners Health Alliance Commercial	$27.00
Rate for Payer: United Healthcare Commercial	$32.40
Rate for Payer: United Healthcare Managed Medicare	$21.24

SCREW CORTEX 2.0MMX18MM

Facility

$36.00

Service Code	CPT C1713
Hospital Charge Code	8046999
Hospital Revenue Code	278
Min. Negotiated Rate	$25.20
Max. Negotiated Rate	$32.40
Rate for Payer: Aetna of IA Commercial	$32.40
Rate for Payer: Aetna of IA Medical Rental Products	$32.40
Rate for Payer: Cash Price	$28.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$27.00
Rate for Payer: Medical Associates Commercial	$27.00
Rate for Payer: Midlands Choice Commercial	$25.20
Rate for Payer: United Healthcare Commercial	$32.40

SCREW CORTEX 2.0MMX18MM

Facility

$36.00

Service Code	CPT C1713
Hospital Charge Code	8046999
Hospital Revenue Code	278
Min. Negotiated Rate	$17.99
Max. Negotiated Rate	$32.40
Rate for Payer: Aetna of IA Commercial	$32.40
Rate for Payer: Aetna of IA Medical Rental Products	$32.40
Rate for Payer: Aetna of IA Medicare	$20.52
Rate for Payer: Amerigroup Medicaid	$18.17
Rate for Payer: Amerigroup Medicare	$18.18
Rate for Payer: Cash Price	$28.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$27.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$18.00
Rate for Payer: Iowa Total Care Managed Medicaid	$17.99
Rate for Payer: Medical Associates Commercial	$27.00
Rate for Payer: Medical Associates Managed Medicare	$18.00
Rate for Payer: Midlands Choice Commercial	$25.20
Rate for Payer: Molina Healthcare Managed Medicaid	$18.27
Rate for Payer: Molina Healthcare Managed Medicare	$18.26
Rate for Payer: Oscar Health of IA Commercial	$27.00
Rate for Payer: Partners Health Alliance Commercial	$27.00
Rate for Payer: United Healthcare Commercial	$32.40
Rate for Payer: United Healthcare Managed Medicare	$21.24

SCREW CORTEX 2.0MMX20MM

Facility

$36.00

Service Code	CPT C1713
Hospital Charge Code	8046806
Hospital Revenue Code	278
Min. Negotiated Rate	$17.99
Max. Negotiated Rate	$32.40
Rate for Payer: Aetna of IA Commercial	$32.40
Rate for Payer: Aetna of IA Medical Rental Products	$32.40
Rate for Payer: Aetna of IA Medicare	$20.52
Rate for Payer: Amerigroup Medicaid	$18.17
Rate for Payer: Amerigroup Medicare	$18.18
Rate for Payer: Cash Price	$28.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$27.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$18.00
Rate for Payer: Iowa Total Care Managed Medicaid	$17.99
Rate for Payer: Medical Associates Commercial	$27.00
Rate for Payer: Medical Associates Managed Medicare	$18.00
Rate for Payer: Midlands Choice Commercial	$25.20
Rate for Payer: Molina Healthcare Managed Medicaid	$18.27
Rate for Payer: Molina Healthcare Managed Medicare	$18.26
Rate for Payer: Oscar Health of IA Commercial	$27.00
Rate for Payer: Partners Health Alliance Commercial	$27.00
Rate for Payer: United Healthcare Commercial	$32.40
Rate for Payer: United Healthcare Managed Medicare	$21.24

SCREW CORTEX 2.0MMX20MM

Facility

$36.00

Service Code	CPT C1713
Hospital Charge Code	8046806
Hospital Revenue Code	278
Min. Negotiated Rate	$25.20
Max. Negotiated Rate	$32.40
Rate for Payer: Medical Associates Commercial	$27.00
Rate for Payer: Aetna of IA Commercial	$32.40
Rate for Payer: Aetna of IA Medical Rental Products	$32.40
Rate for Payer: Cash Price	$28.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$27.00
Rate for Payer: Midlands Choice Commercial	$25.20
Rate for Payer: United Healthcare Commercial	$32.40

SCREW CORTEX 2.0MMX6MM

Facility

$13.00

Service Code	CPT C1713
Hospital Charge Code	8046791
Hospital Revenue Code	278
Min. Negotiated Rate	$9.10
Max. Negotiated Rate	$11.70
Rate for Payer: Aetna of IA Commercial	$11.70
Rate for Payer: Aetna of IA Medical Rental Products	$11.70
Rate for Payer: Cash Price	$10.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$9.75
Rate for Payer: Medical Associates Commercial	$9.75
Rate for Payer: Midlands Choice Commercial	$9.10
Rate for Payer: United Healthcare Commercial	$11.70

SCREW CORTEX 2.0MMX6MM

Facility

$13.00

Service Code	CPT C1713
Hospital Charge Code	8046791
Hospital Revenue Code	278
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$11.70
Rate for Payer: Aetna of IA Commercial	$11.70
Rate for Payer: Aetna of IA Medical Rental Products	$11.70
Rate for Payer: Aetna of IA Medicare	$7.41
Rate for Payer: Amerigroup Medicaid	$6.56
Rate for Payer: Amerigroup Medicare	$6.56
Rate for Payer: Cash Price	$10.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$9.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$6.50
Rate for Payer: Iowa Total Care Managed Medicaid	$6.50
Rate for Payer: Medical Associates Commercial	$9.75
Rate for Payer: Medical Associates Managed Medicare	$6.50
Rate for Payer: Midlands Choice Commercial	$9.10
Rate for Payer: Molina Healthcare Managed Medicaid	$6.60
Rate for Payer: Molina Healthcare Managed Medicare	$6.59
Rate for Payer: Oscar Health of IA Commercial	$9.75
Rate for Payer: Partners Health Alliance Commercial	$9.75
Rate for Payer: United Healthcare Commercial	$11.70
Rate for Payer: United Healthcare Managed Medicare	$7.67

SCREW CORTEX 2.0MMX8MM

Facility

$34.00

Service Code	CPT C1713
Hospital Charge Code	8047033
Hospital Revenue Code	278
Min. Negotiated Rate	$23.80
Max. Negotiated Rate	$30.60
Rate for Payer: Aetna of IA Commercial	$30.60
Rate for Payer: Aetna of IA Medical Rental Products	$30.60
Rate for Payer: Cash Price	$27.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$25.50
Rate for Payer: Medical Associates Commercial	$25.50
Rate for Payer: Midlands Choice Commercial	$23.80
Rate for Payer: United Healthcare Commercial	$30.60

SCREW CORTEX 2.0MMX8MM

Facility

$34.00

Service Code	CPT C1713
Hospital Charge Code	8047033
Hospital Revenue Code	278
Min. Negotiated Rate	$16.99
Max. Negotiated Rate	$30.60
Rate for Payer: Aetna of IA Commercial	$30.60
Rate for Payer: Aetna of IA Medical Rental Products	$30.60
Rate for Payer: Aetna of IA Medicare	$19.38
Rate for Payer: Amerigroup Medicaid	$17.16
Rate for Payer: Amerigroup Medicare	$17.17
Rate for Payer: Cash Price	$27.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$25.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$17.00
Rate for Payer: Iowa Total Care Managed Medicaid	$16.99
Rate for Payer: Medical Associates Commercial	$25.50
Rate for Payer: Medical Associates Managed Medicare	$17.00
Rate for Payer: Midlands Choice Commercial	$23.80
Rate for Payer: Molina Healthcare Managed Medicaid	$17.26
Rate for Payer: Molina Healthcare Managed Medicare	$17.24
Rate for Payer: Oscar Health of IA Commercial	$25.50
Rate for Payer: Partners Health Alliance Commercial	$25.50
Rate for Payer: United Healthcare Commercial	$30.60
Rate for Payer: United Healthcare Managed Medicare	$20.06

SCREW CORTEX 2.7 14MM

Facility

$37.00

Service Code	CPT C1713
Hospital Charge Code	8046365
Hospital Revenue Code	278
Min. Negotiated Rate	$18.49
Max. Negotiated Rate	$33.30
Rate for Payer: Aetna of IA Commercial	$33.30
Rate for Payer: Aetna of IA Medical Rental Products	$33.30
Rate for Payer: Aetna of IA Medicare	$21.09
Rate for Payer: Amerigroup Medicaid	$18.67
Rate for Payer: Amerigroup Medicare	$18.68
Rate for Payer: Cash Price	$29.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$27.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$18.50
Rate for Payer: Iowa Total Care Managed Medicaid	$18.49
Rate for Payer: Medical Associates Commercial	$27.75
Rate for Payer: Medical Associates Managed Medicare	$18.50
Rate for Payer: Midlands Choice Commercial	$25.90
Rate for Payer: Molina Healthcare Managed Medicaid	$18.78
Rate for Payer: Molina Healthcare Managed Medicare	$18.77
Rate for Payer: Oscar Health of IA Commercial	$27.75
Rate for Payer: Partners Health Alliance Commercial	$27.75
Rate for Payer: United Healthcare Commercial	$33.30
Rate for Payer: United Healthcare Managed Medicare	$21.83

SCREW CORTEX 2.7 14MM

Facility

$37.00

Service Code	CPT C1713
Hospital Charge Code	8046365
Hospital Revenue Code	278
Min. Negotiated Rate	$25.90
Max. Negotiated Rate	$33.30
Rate for Payer: Aetna of IA Commercial	$33.30
Rate for Payer: Aetna of IA Medical Rental Products	$33.30
Rate for Payer: Cash Price	$29.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$27.75
Rate for Payer: Medical Associates Commercial	$27.75
Rate for Payer: Midlands Choice Commercial	$25.90
Rate for Payer: United Healthcare Commercial	$33.30

SCREW CORTEX 2.7 16MM

Facility

$36.00

Service Code	CPT C1713
Hospital Charge Code	8046499
Hospital Revenue Code	278
Min. Negotiated Rate	$25.20
Max. Negotiated Rate	$32.40
Rate for Payer: Aetna of IA Commercial	$32.40
Rate for Payer: Aetna of IA Medical Rental Products	$32.40
Rate for Payer: Cash Price	$28.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$27.00
Rate for Payer: Medical Associates Commercial	$27.00
Rate for Payer: Midlands Choice Commercial	$25.20
Rate for Payer: United Healthcare Commercial	$32.40

SCREW CORTEX 2.7 16MM

Facility

$36.00

Service Code	CPT C1713
Hospital Charge Code	8046499
Hospital Revenue Code	278
Min. Negotiated Rate	$17.99
Max. Negotiated Rate	$32.40
Rate for Payer: Aetna of IA Commercial	$32.40
Rate for Payer: Aetna of IA Medical Rental Products	$32.40
Rate for Payer: Aetna of IA Medicare	$20.52
Rate for Payer: Amerigroup Medicaid	$18.17
Rate for Payer: Amerigroup Medicare	$18.18
Rate for Payer: Cash Price	$28.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$27.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$18.00
Rate for Payer: Iowa Total Care Managed Medicaid	$17.99
Rate for Payer: Medical Associates Commercial	$27.00
Rate for Payer: Medical Associates Managed Medicare	$18.00
Rate for Payer: Midlands Choice Commercial	$25.20
Rate for Payer: Molina Healthcare Managed Medicaid	$18.27
Rate for Payer: Molina Healthcare Managed Medicare	$18.26
Rate for Payer: Oscar Health of IA Commercial	$27.00
Rate for Payer: Partners Health Alliance Commercial	$27.00
Rate for Payer: United Healthcare Commercial	$32.40
Rate for Payer: United Healthcare Managed Medicare	$21.24

SCREW CORTEX 2.7MMX10MM

Facility

$32.00

Service Code	CPT C1713
Hospital Charge Code	8046364
Hospital Revenue Code	278
Min. Negotiated Rate	$15.99
Max. Negotiated Rate	$28.80
Rate for Payer: Aetna of IA Commercial	$28.80
Rate for Payer: Aetna of IA Medical Rental Products	$28.80
Rate for Payer: Aetna of IA Medicare	$18.24
Rate for Payer: Amerigroup Medicaid	$16.15
Rate for Payer: Amerigroup Medicare	$16.16
Rate for Payer: Cash Price	$25.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$24.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$16.00
Rate for Payer: Iowa Total Care Managed Medicaid	$15.99
Rate for Payer: Medical Associates Commercial	$24.00
Rate for Payer: Medical Associates Managed Medicare	$16.00
Rate for Payer: Midlands Choice Commercial	$22.40
Rate for Payer: Molina Healthcare Managed Medicaid	$16.24
Rate for Payer: Molina Healthcare Managed Medicare	$16.23
Rate for Payer: Oscar Health of IA Commercial	$24.00
Rate for Payer: Partners Health Alliance Commercial	$24.00
Rate for Payer: United Healthcare Commercial	$28.80
Rate for Payer: United Healthcare Managed Medicare	$18.88

SCREW CORTEX 2.7MMX10MM

Facility

$32.00

Service Code	CPT C1713
Hospital Charge Code	8046364
Hospital Revenue Code	278
Min. Negotiated Rate	$22.40
Max. Negotiated Rate	$28.80
Rate for Payer: Aetna of IA Commercial	$28.80
Rate for Payer: Aetna of IA Medical Rental Products	$28.80
Rate for Payer: Cash Price	$25.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$24.00
Rate for Payer: Medical Associates Commercial	$24.00
Rate for Payer: Midlands Choice Commercial	$22.40
Rate for Payer: United Healthcare Commercial	$28.80

SCREW CORTEX 2.7MMX12MM

Facility

$23.00

Service Code	CPT C1713
Hospital Charge Code	8046718
Hospital Revenue Code	278
Min. Negotiated Rate	$11.50
Max. Negotiated Rate	$20.70
Rate for Payer: Aetna of IA Commercial	$20.70
Rate for Payer: Aetna of IA Medical Rental Products	$20.70
Rate for Payer: Aetna of IA Medicare	$13.11
Rate for Payer: Amerigroup Medicaid	$11.61
Rate for Payer: Amerigroup Medicare	$11.62
Rate for Payer: Cash Price	$18.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$17.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$11.50
Rate for Payer: Iowa Total Care Managed Medicaid	$11.50
Rate for Payer: Medical Associates Commercial	$17.25
Rate for Payer: Medical Associates Managed Medicare	$11.50
Rate for Payer: Midlands Choice Commercial	$16.10
Rate for Payer: Molina Healthcare Managed Medicaid	$11.67
Rate for Payer: Molina Healthcare Managed Medicare	$11.67
Rate for Payer: Oscar Health of IA Commercial	$17.25
Rate for Payer: Partners Health Alliance Commercial	$17.25
Rate for Payer: United Healthcare Commercial	$20.70
Rate for Payer: United Healthcare Managed Medicare	$13.57

SCREW CORTEX 2.7MMX12MM

Facility

$23.00

Service Code	CPT C1713
Hospital Charge Code	8046718
Hospital Revenue Code	278
Min. Negotiated Rate	$16.10
Max. Negotiated Rate	$20.70
Rate for Payer: Aetna of IA Commercial	$20.70
Rate for Payer: Aetna of IA Medical Rental Products	$20.70
Rate for Payer: Cash Price	$18.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$17.25
Rate for Payer: Medical Associates Commercial	$17.25
Rate for Payer: Midlands Choice Commercial	$16.10
Rate for Payer: United Healthcare Commercial	$20.70

SCREW CORTEX 2.7MMX14MM

Facility

$27.00

Service Code	CPT C1713
Hospital Charge Code	8046465
Hospital Revenue Code	278
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$24.30
Rate for Payer: Aetna of IA Commercial	$24.30
Rate for Payer: Aetna of IA Medical Rental Products	$24.30
Rate for Payer: Aetna of IA Medicare	$15.39
Rate for Payer: Amerigroup Medicaid	$13.63
Rate for Payer: Amerigroup Medicare	$13.64
Rate for Payer: Cash Price	$21.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$20.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$13.50
Rate for Payer: Iowa Total Care Managed Medicaid	$13.49
Rate for Payer: Medical Associates Commercial	$20.25
Rate for Payer: Medical Associates Managed Medicare	$13.50
Rate for Payer: Midlands Choice Commercial	$18.90
Rate for Payer: Molina Healthcare Managed Medicaid	$13.70
Rate for Payer: Molina Healthcare Managed Medicare	$13.69
Rate for Payer: Oscar Health of IA Commercial	$20.25
Rate for Payer: Partners Health Alliance Commercial	$20.25
Rate for Payer: United Healthcare Commercial	$24.30
Rate for Payer: United Healthcare Managed Medicare	$15.93

Know your out-of-pocket cost for care.

All Charges