Van Diest Medical Center

All Charges

Charge

Type

Setting

Price

SCREW CORTEX 3.5MMX20MM

Facility

$32.00

Service Code	CPT C1713
Hospital Charge Code	8046392
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 3.5MMX20MM

Facility

$32.00

Service Code	CPT C1713
Hospital Charge Code	8046392
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 3.5MMX22MM

Facility

$18.00

Service Code	CPT C1713
Hospital Charge Code	8046722
Hospital Revenue Code	278
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$16.20
Rate for Payer: Aetna of IA Commercial	$16.20
Rate for Payer: Aetna of IA Medical Rental Products	$16.20
Rate for Payer: Aetna of IA Medicare	$10.26
Rate for Payer: Amerigroup Medicaid	$9.08
Rate for Payer: Amerigroup Medicare	$9.09
Rate for Payer: Cash Price	$14.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$13.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$9.00
Rate for Payer: Iowa Total Care Managed Medicaid	$9.00
Rate for Payer: Medical Associates Commercial	$13.50
Rate for Payer: Medical Associates Managed Medicare	$9.00
Rate for Payer: Midlands Choice Commercial	$12.60
Rate for Payer: Molina Healthcare Managed Medicaid	$9.14
Rate for Payer: Molina Healthcare Managed Medicare	$9.13
Rate for Payer: Oscar Health of IA Commercial	$13.50
Rate for Payer: Partners Health Alliance Commercial	$13.50
Rate for Payer: United Healthcare Commercial	$16.20
Rate for Payer: United Healthcare Managed Medicare	$10.62

SCREW CORTEX 3.5MMX22MM

Facility

$18.00

Service Code	CPT C1713
Hospital Charge Code	8046722
Hospital Revenue Code	278
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$16.20
Rate for Payer: Aetna of IA Commercial	$16.20
Rate for Payer: Aetna of IA Medical Rental Products	$16.20
Rate for Payer: Cash Price	$14.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$13.50
Rate for Payer: Medical Associates Commercial	$13.50
Rate for Payer: Midlands Choice Commercial	$12.60
Rate for Payer: United Healthcare Commercial	$16.20

SCREW CORTEX 3.5MMX24MM

Facility

$32.00

Service Code	CPT C1713
Hospital Charge Code	8046921
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 3.5MMX24MM

Facility

$32.00

Service Code	CPT C1713
Hospital Charge Code	8046921
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 3.5MMX26MM

Facility

$23.00

Service Code	CPT C1713
Hospital Charge Code	8047020
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 3.5MMX26MM

Facility

$23.00

Service Code	CPT C1713
Hospital Charge Code	8047020
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 3.5MMX28MM

Facility

$23.00

Service Code	CPT C1713
Hospital Charge Code	8046369
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 3.5MMX28MM

Facility

$23.00

Service Code	CPT C1713
Hospital Charge Code	8046369
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 3.5MMX32MM

Facility

$34.00

Service Code	CPT C1713
Hospital Charge Code	8046370
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 3.5MMX32MM

Facility

$34.00

Service Code	CPT C1713
Hospital Charge Code	8046370
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 3.5MMX34MM

Facility

$32.00

Service Code	CPT C1713
Hospital Charge Code	8046242
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 3.5MMX34MM

Facility

$32.00

Service Code	CPT C1713
Hospital Charge Code	8046242
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 3.5MMX36MM

Facility

$32.00

Service Code	CPT C1713
Hospital Charge Code	8046368
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 3.5MMX36MM

Facility

$32.00

Service Code	CPT C1713
Hospital Charge Code	8046368
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 3.5MMX40MM

Facility

$27.00

Service Code	CPT C1713
Hospital Charge Code	8046371
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 3.5MMX40MM

Facility

$27.00

Service Code	CPT C1713
Hospital Charge Code	8046371
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 3.5MMX45MM

Facility

$27.00

Service Code	CPT C1713
Hospital Charge Code	8046372
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 3.5MMX45MM

Facility

$27.00

Service Code	CPT C1713
Hospital Charge Code	8046372
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 3.5MMX50MM

Facility

$27.00

Service Code	CPT C1713
Hospital Charge Code	8046374
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 3.5MMX50MM

Facility

$27.00

Service Code	CPT C1713
Hospital Charge Code	8046374
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 CORTICAL 2.7X10MM SELF CUTTING

Facility

$34.00

Service Code	CPT C1713
Hospital Charge Code	8046614
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 CORTICAL 2.7X10MM SELF CUTTING

Facility

$34.00

Service Code	CPT C1713
Hospital Charge Code	8046614
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 CORTICAL 2.7X12MM

Facility

$24.00

Service Code	CPT C1713
Hospital Charge Code	8046615
Hospital Revenue Code	278
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$21.60
Rate for Payer: Aetna of IA Commercial	$21.60
Rate for Payer: Aetna of IA Medical Rental Products	$21.60
Rate for Payer: Aetna of IA Medicare	$13.68
Rate for Payer: Amerigroup Medicaid	$12.11
Rate for Payer: Amerigroup Medicare	$12.12
Rate for Payer: Cash Price	$19.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$18.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$12.00
Rate for Payer: Iowa Total Care Managed Medicaid	$12.00
Rate for Payer: Medical Associates Commercial	$18.00
Rate for Payer: Medical Associates Managed Medicare	$12.00
Rate for Payer: Midlands Choice Commercial	$16.80
Rate for Payer: Molina Healthcare Managed Medicaid	$12.18
Rate for Payer: Molina Healthcare Managed Medicare	$12.17
Rate for Payer: Oscar Health of IA Commercial	$18.00
Rate for Payer: Partners Health Alliance Commercial	$18.00
Rate for Payer: United Healthcare Commercial	$21.60
Rate for Payer: United Healthcare Managed Medicare	$14.16

Know your out-of-pocket cost for care.

All Charges