Van Diest Medical Center

All Charges

Charge

Type

Setting

Price

SCREW CORTEX 2.7MMX14MM

Facility

$27.00

Service Code	CPT C1713
Hospital Charge Code	8046465
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 2.7MMX16MM

Facility

$19.00

Service Code	CPT C1713
Hospital Charge Code	8046973
Hospital Revenue Code	278
Min. Negotiated Rate	$13.30
Max. Negotiated Rate	$17.10
Rate for Payer: Aetna of IA Commercial	$17.10
Rate for Payer: Aetna of IA Medical Rental Products	$17.10
Rate for Payer: Cash Price	$15.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$14.25
Rate for Payer: Medical Associates Commercial	$14.25
Rate for Payer: Midlands Choice Commercial	$13.30
Rate for Payer: United Healthcare Commercial	$17.10

SCREW CORTEX 2.7MMX16MM

Facility

$19.00

Service Code	CPT C1713
Hospital Charge Code	8046973
Hospital Revenue Code	278
Min. Negotiated Rate	$9.50
Max. Negotiated Rate	$17.10
Rate for Payer: Aetna of IA Commercial	$17.10
Rate for Payer: Aetna of IA Medical Rental Products	$17.10
Rate for Payer: Aetna of IA Medicare	$10.83
Rate for Payer: Amerigroup Medicaid	$9.59
Rate for Payer: Amerigroup Medicare	$9.60
Rate for Payer: Cash Price	$15.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$14.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$9.50
Rate for Payer: Iowa Total Care Managed Medicaid	$9.50
Rate for Payer: Medical Associates Commercial	$14.25
Rate for Payer: Medical Associates Managed Medicare	$9.50
Rate for Payer: Midlands Choice Commercial	$13.30
Rate for Payer: Molina Healthcare Managed Medicaid	$9.64
Rate for Payer: Molina Healthcare Managed Medicare	$9.64
Rate for Payer: Oscar Health of IA Commercial	$14.25
Rate for Payer: Partners Health Alliance Commercial	$14.25
Rate for Payer: United Healthcare Commercial	$17.10
Rate for Payer: United Healthcare Managed Medicare	$11.21

SCREW CORTEX 2.7MMX18MM

Facility

$32.00

Service Code	CPT C1713
Hospital Charge Code	8046311
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 2.7MMX18MM

Facility

$32.00

Service Code	CPT C1713
Hospital Charge Code	8046311
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 2.7MMX20MM

Facility

$13.00

Service Code	CPT C1713
Hospital Charge Code	8047024
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 2.7MMX20MM

Facility

$13.00

Service Code	CPT C1713
Hospital Charge Code	8047024
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 2.7MMX22MM

Facility

$32.00

Service Code	CPT C1713
Hospital Charge Code	8047036
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 2.7MMX22MM

Facility

$32.00

Service Code	CPT C1713
Hospital Charge Code	8047036
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 2.7MMX24MM

Facility

$32.00

Service Code	CPT C1713
Hospital Charge Code	8047030
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 2.7MMX24MM

Facility

$32.00

Service Code	CPT C1713
Hospital Charge Code	8047030
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 2.7MMX6MM

Facility

$13.00

Service Code	CPT C1713
Hospital Charge Code	8046954
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 2.7MMX6MM

Facility

$13.00

Service Code	CPT C1713
Hospital Charge Code	8046954
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 2.7MMX8MM

Facility

$15.00

Service Code	CPT C1713
Hospital Charge Code	8046941
Hospital Revenue Code	278
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$13.50
Rate for Payer: Aetna of IA Commercial	$13.50
Rate for Payer: Aetna of IA Medical Rental Products	$13.50
Rate for Payer: Aetna of IA Medicare	$8.55
Rate for Payer: Amerigroup Medicaid	$7.57
Rate for Payer: Amerigroup Medicare	$7.58
Rate for Payer: Cash Price	$12.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$11.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$7.50
Rate for Payer: Iowa Total Care Managed Medicaid	$7.50
Rate for Payer: Medical Associates Commercial	$11.25
Rate for Payer: Medical Associates Managed Medicare	$7.50
Rate for Payer: Midlands Choice Commercial	$10.50
Rate for Payer: Molina Healthcare Managed Medicaid	$7.61
Rate for Payer: Molina Healthcare Managed Medicare	$7.61
Rate for Payer: Oscar Health of IA Commercial	$11.25
Rate for Payer: Partners Health Alliance Commercial	$11.25
Rate for Payer: United Healthcare Commercial	$13.50
Rate for Payer: United Healthcare Managed Medicare	$8.85

SCREW CORTEX 2.7MMX8MM

Facility

$15.00

Service Code	CPT C1713
Hospital Charge Code	8046941
Hospital Revenue Code	278
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$13.50
Rate for Payer: Aetna of IA Commercial	$13.50
Rate for Payer: Aetna of IA Medical Rental Products	$13.50
Rate for Payer: Cash Price	$12.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$11.25
Rate for Payer: Medical Associates Commercial	$11.25
Rate for Payer: Midlands Choice Commercial	$10.50
Rate for Payer: United Healthcare Commercial	$13.50

SCREW CORTEX 3.5MMX10MM

Facility

$17.00

Service Code	CPT C1713
Hospital Charge Code	8046994
Hospital Revenue Code	278
Min. Negotiated Rate	$11.90
Max. Negotiated Rate	$15.30
Rate for Payer: Aetna of IA Commercial	$15.30
Rate for Payer: Aetna of IA Medical Rental Products	$15.30
Rate for Payer: Cash Price	$13.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$12.75
Rate for Payer: Medical Associates Commercial	$12.75
Rate for Payer: Midlands Choice Commercial	$11.90
Rate for Payer: United Healthcare Commercial	$15.30

SCREW CORTEX 3.5MMX10MM

Facility

$17.00

Service Code	CPT C1713
Hospital Charge Code	8046994
Hospital Revenue Code	278
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$15.30
Rate for Payer: Aetna of IA Commercial	$15.30
Rate for Payer: Aetna of IA Medical Rental Products	$15.30
Rate for Payer: Aetna of IA Medicare	$9.69
Rate for Payer: Amerigroup Medicaid	$8.58
Rate for Payer: Amerigroup Medicare	$8.58
Rate for Payer: Cash Price	$13.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$12.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$8.50
Rate for Payer: Iowa Total Care Managed Medicaid	$8.50
Rate for Payer: Medical Associates Commercial	$12.75
Rate for Payer: Medical Associates Managed Medicare	$8.50
Rate for Payer: Midlands Choice Commercial	$11.90
Rate for Payer: Molina Healthcare Managed Medicaid	$8.63
Rate for Payer: Molina Healthcare Managed Medicare	$8.62
Rate for Payer: Oscar Health of IA Commercial	$12.75
Rate for Payer: Partners Health Alliance Commercial	$12.75
Rate for Payer: United Healthcare Commercial	$15.30
Rate for Payer: United Healthcare Managed Medicare	$10.03

SCREW CORTEX 3.5MMX12MM

Facility

$32.00

Service Code	CPT C1713
Hospital Charge Code	8046378
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 3.5MMX12MM

Facility

$32.00

Service Code	CPT C1713
Hospital Charge Code	8046378
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 3.5MMX14MM

Facility

$36.00

Service Code	CPT C1713
Hospital Charge Code	8046796
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 3.5MMX14MM

Facility

$36.00

Service Code	CPT C1713
Hospital Charge Code	8046796
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 3.5MMX16MM

Facility

$32.00

Service Code	CPT C1713
Hospital Charge Code	8047009
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 3.5MMX16MM

Facility

$32.00

Service Code	CPT C1713
Hospital Charge Code	8047009
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 3.5MMX18MM

Facility

$17.00

Service Code	CPT C1713
Hospital Charge Code	8046965
Hospital Revenue Code	278
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$15.30
Rate for Payer: Aetna of IA Commercial	$15.30
Rate for Payer: Aetna of IA Medical Rental Products	$15.30
Rate for Payer: Aetna of IA Medicare	$9.69
Rate for Payer: Amerigroup Medicaid	$8.58
Rate for Payer: Amerigroup Medicare	$8.58
Rate for Payer: Cash Price	$13.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$12.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$8.50
Rate for Payer: Iowa Total Care Managed Medicaid	$8.50
Rate for Payer: Medical Associates Commercial	$12.75
Rate for Payer: Medical Associates Managed Medicare	$8.50
Rate for Payer: Midlands Choice Commercial	$11.90
Rate for Payer: Molina Healthcare Managed Medicaid	$8.63
Rate for Payer: Molina Healthcare Managed Medicare	$8.62
Rate for Payer: Oscar Health of IA Commercial	$12.75
Rate for Payer: Partners Health Alliance Commercial	$12.75
Rate for Payer: United Healthcare Commercial	$15.30
Rate for Payer: United Healthcare Managed Medicare	$10.03

SCREW CORTEX 3.5MMX18MM

Facility

$17.00

Service Code	CPT C1713
Hospital Charge Code	8046965
Hospital Revenue Code	278
Min. Negotiated Rate	$11.90
Max. Negotiated Rate	$15.30
Rate for Payer: Aetna of IA Commercial	$15.30
Rate for Payer: Aetna of IA Medical Rental Products	$15.30
Rate for Payer: Cash Price	$13.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$12.75
Rate for Payer: Medical Associates Commercial	$12.75
Rate for Payer: Midlands Choice Commercial	$11.90
Rate for Payer: United Healthcare Commercial	$15.30

Know your out-of-pocket cost for care.

All Charges