|
SCREW INTERFERENCE 8X28MM
|
Facility
|
OP
|
$405.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8026311
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$182.25 |
| Max. Negotiated Rate |
$364.50 |
| Rate for Payer: Aetna of IA Commercial |
$364.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$364.50
|
| Rate for Payer: Aetna of IA Medicare |
$230.85
|
| Rate for Payer: Amerigroup Medicaid |
$233.60
|
| Rate for Payer: Amerigroup Medicare |
$184.07
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$303.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$182.25
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$231.34
|
| Rate for Payer: Medical Associates Commercial |
$303.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$182.25
|
| Rate for Payer: Midlands Choice Commercial |
$283.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$234.74
|
| Rate for Payer: Partners Health Alliance Commercial |
$209.59
|
| Rate for Payer: United Healthcare Commercial |
$364.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$238.95
|
|
|
SCREW INTERFERENCE 8X28MM
|
Facility
|
IP
|
$405.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8026311
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$283.50 |
| Max. Negotiated Rate |
$364.50 |
| Rate for Payer: Aetna of IA Commercial |
$364.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$364.50
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$303.75
|
| Rate for Payer: Medical Associates Commercial |
$303.75
|
| Rate for Payer: Midlands Choice Commercial |
$283.50
|
| Rate for Payer: United Healthcare Commercial |
$364.50
|
|
|
SCREW INTERFERENCE 9
|
Facility
|
IP
|
$414.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8047059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$289.80 |
| Max. Negotiated Rate |
$372.60 |
| Rate for Payer: Aetna of IA Commercial |
$372.60
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$372.60
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$310.50
|
| Rate for Payer: Medical Associates Commercial |
$310.50
|
| Rate for Payer: Midlands Choice Commercial |
$289.80
|
| Rate for Payer: United Healthcare Commercial |
$372.60
|
|
|
SCREW INTERFERENCE 9
|
Facility
|
OP
|
$414.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8047059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$186.30 |
| Max. Negotiated Rate |
$372.60 |
| Rate for Payer: Aetna of IA Commercial |
$372.60
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$372.60
|
| Rate for Payer: Aetna of IA Medicare |
$235.98
|
| Rate for Payer: Amerigroup Medicaid |
$238.80
|
| Rate for Payer: Amerigroup Medicare |
$188.16
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$310.50
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$186.30
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$236.48
|
| Rate for Payer: Medical Associates Commercial |
$310.50
|
| Rate for Payer: Medical Associates Managed Medicare |
$186.30
|
| Rate for Payer: Midlands Choice Commercial |
$289.80
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$239.95
|
| Rate for Payer: Partners Health Alliance Commercial |
$214.24
|
| Rate for Payer: United Healthcare Commercial |
$372.60
|
| Rate for Payer: United Healthcare Managed Medicare |
$244.26
|
|
|
SCREW INTERFERENCE 9X23MM
|
Facility
|
OP
|
$405.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8047060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$182.25 |
| Max. Negotiated Rate |
$364.50 |
| Rate for Payer: Aetna of IA Commercial |
$364.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$364.50
|
| Rate for Payer: Aetna of IA Medicare |
$230.85
|
| Rate for Payer: Amerigroup Medicaid |
$233.60
|
| Rate for Payer: Amerigroup Medicare |
$184.07
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$303.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$182.25
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$231.34
|
| Rate for Payer: Medical Associates Commercial |
$303.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$182.25
|
| Rate for Payer: Midlands Choice Commercial |
$283.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$234.74
|
| Rate for Payer: Partners Health Alliance Commercial |
$209.59
|
| Rate for Payer: United Healthcare Commercial |
$364.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$238.95
|
|
|
SCREW INTERFERENCE 9X23MM
|
Facility
|
IP
|
$405.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8047060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$283.50 |
| Max. Negotiated Rate |
$364.50 |
| Rate for Payer: Aetna of IA Commercial |
$364.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$364.50
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$303.75
|
| Rate for Payer: Medical Associates Commercial |
$303.75
|
| Rate for Payer: Midlands Choice Commercial |
$283.50
|
| Rate for Payer: United Healthcare Commercial |
$364.50
|
|
|
SCREW LAG CANN 2.0MM X 10MM
|
Facility
|
OP
|
$267.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046253
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.15 |
| Max. Negotiated Rate |
$240.30 |
| Rate for Payer: Aetna of IA Commercial |
$240.30
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$240.30
|
| Rate for Payer: Aetna of IA Medicare |
$152.19
|
| Rate for Payer: Amerigroup Medicaid |
$154.01
|
| Rate for Payer: Amerigroup Medicare |
$121.35
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$200.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$120.15
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$152.51
|
| Rate for Payer: Medical Associates Commercial |
$200.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$120.15
|
| Rate for Payer: Midlands Choice Commercial |
$186.90
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$154.75
|
| Rate for Payer: Partners Health Alliance Commercial |
$138.17
|
| Rate for Payer: United Healthcare Commercial |
$240.30
|
| Rate for Payer: United Healthcare Managed Medicare |
$157.53
|
|
|
SCREW LAG CANN 2.0MM X 10MM
|
Facility
|
IP
|
$267.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046253
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$186.90 |
| Max. Negotiated Rate |
$240.30 |
| Rate for Payer: Aetna of IA Commercial |
$240.30
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$240.30
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$200.25
|
| Rate for Payer: Medical Associates Commercial |
$200.25
|
| Rate for Payer: Midlands Choice Commercial |
$186.90
|
| Rate for Payer: United Healthcare Commercial |
$240.30
|
|
|
SCREW LAG CANN 2.0MM X 12MM
|
Facility
|
IP
|
$279.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046254
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$195.30 |
| Max. Negotiated Rate |
$251.10 |
| Rate for Payer: Aetna of IA Commercial |
$251.10
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$251.10
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$209.25
|
| Rate for Payer: Medical Associates Commercial |
$209.25
|
| Rate for Payer: Midlands Choice Commercial |
$195.30
|
| Rate for Payer: United Healthcare Commercial |
$251.10
|
|
|
SCREW LAG CANN 2.0MM X 12MM
|
Facility
|
OP
|
$279.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046254
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$125.55 |
| Max. Negotiated Rate |
$251.10 |
| Rate for Payer: Aetna of IA Commercial |
$251.10
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$251.10
|
| Rate for Payer: Aetna of IA Medicare |
$159.03
|
| Rate for Payer: Amerigroup Medicaid |
$160.93
|
| Rate for Payer: Amerigroup Medicare |
$126.81
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$209.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$125.55
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$159.36
|
| Rate for Payer: Medical Associates Commercial |
$209.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$125.55
|
| Rate for Payer: Midlands Choice Commercial |
$195.30
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$161.71
|
| Rate for Payer: Partners Health Alliance Commercial |
$144.38
|
| Rate for Payer: United Healthcare Commercial |
$251.10
|
| Rate for Payer: United Healthcare Managed Medicare |
$164.61
|
|
|
SCREW LAG CANN 2.0MM X 14MM
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046255
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$182.70 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Aetna of IA Commercial |
$234.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$234.90
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$195.75
|
| Rate for Payer: Medical Associates Commercial |
$195.75
|
| Rate for Payer: Midlands Choice Commercial |
$182.70
|
| Rate for Payer: United Healthcare Commercial |
$234.90
|
|
|
SCREW LAG CANN 2.0MM X 14MM
|
Facility
|
OP
|
$261.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046255
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$117.45 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Aetna of IA Commercial |
$234.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$234.90
|
| Rate for Payer: Aetna of IA Medicare |
$148.77
|
| Rate for Payer: Amerigroup Medicaid |
$150.54
|
| Rate for Payer: Amerigroup Medicare |
$118.62
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$195.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$117.45
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$149.08
|
| Rate for Payer: Medical Associates Commercial |
$195.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$117.45
|
| Rate for Payer: Midlands Choice Commercial |
$182.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$151.28
|
| Rate for Payer: Partners Health Alliance Commercial |
$135.07
|
| Rate for Payer: United Healthcare Commercial |
$234.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$153.99
|
|
|
SCREW LAG CANN 2.0MM X 16MM
|
Facility
|
OP
|
$261.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046256
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$117.45 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Aetna of IA Commercial |
$234.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$234.90
|
| Rate for Payer: Aetna of IA Medicare |
$148.77
|
| Rate for Payer: Amerigroup Medicaid |
$150.54
|
| Rate for Payer: Amerigroup Medicare |
$118.62
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$195.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$117.45
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$149.08
|
| Rate for Payer: Medical Associates Commercial |
$195.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$117.45
|
| Rate for Payer: Midlands Choice Commercial |
$182.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$151.28
|
| Rate for Payer: Partners Health Alliance Commercial |
$135.07
|
| Rate for Payer: United Healthcare Commercial |
$234.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$153.99
|
|
|
SCREW LAG CANN 2.0MM X 16MM
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046256
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$182.70 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Aetna of IA Commercial |
$234.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$234.90
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$195.75
|
| Rate for Payer: Medical Associates Commercial |
$195.75
|
| Rate for Payer: Midlands Choice Commercial |
$182.70
|
| Rate for Payer: United Healthcare Commercial |
$234.90
|
|
|
SCREW LAG CANN 2.0MM X 18MM
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046257
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$182.70 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Aetna of IA Commercial |
$234.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$234.90
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$195.75
|
| Rate for Payer: Medical Associates Commercial |
$195.75
|
| Rate for Payer: Midlands Choice Commercial |
$182.70
|
| Rate for Payer: United Healthcare Commercial |
$234.90
|
|
|
SCREW LAG CANN 2.0MM X 18MM
|
Facility
|
OP
|
$261.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046257
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$117.45 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Aetna of IA Commercial |
$234.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$234.90
|
| Rate for Payer: Aetna of IA Medicare |
$148.77
|
| Rate for Payer: Amerigroup Medicaid |
$150.54
|
| Rate for Payer: Amerigroup Medicare |
$118.62
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$195.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$117.45
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$149.08
|
| Rate for Payer: Medical Associates Commercial |
$195.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$117.45
|
| Rate for Payer: Midlands Choice Commercial |
$182.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$151.28
|
| Rate for Payer: Partners Health Alliance Commercial |
$135.07
|
| Rate for Payer: United Healthcare Commercial |
$234.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$153.99
|
|
|
SCREW LAG CANN 2.0MM X 20MM
|
Facility
|
OP
|
$261.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046258
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$117.45 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Aetna of IA Commercial |
$234.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$234.90
|
| Rate for Payer: Aetna of IA Medicare |
$148.77
|
| Rate for Payer: Amerigroup Medicaid |
$150.54
|
| Rate for Payer: Amerigroup Medicare |
$118.62
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$195.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$117.45
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$149.08
|
| Rate for Payer: Medical Associates Commercial |
$195.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$117.45
|
| Rate for Payer: Midlands Choice Commercial |
$182.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$151.28
|
| Rate for Payer: Partners Health Alliance Commercial |
$135.07
|
| Rate for Payer: United Healthcare Commercial |
$234.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$153.99
|
|
|
SCREW LAG CANN 2.0MM X 20MM
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046258
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$182.70 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Aetna of IA Commercial |
$234.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$234.90
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$195.75
|
| Rate for Payer: Medical Associates Commercial |
$195.75
|
| Rate for Payer: Midlands Choice Commercial |
$182.70
|
| Rate for Payer: United Healthcare Commercial |
$234.90
|
|
|
SCREW LAG CANN 2.0MM X 22MM
|
Facility
|
OP
|
$261.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046259
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$117.45 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Aetna of IA Commercial |
$234.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$234.90
|
| Rate for Payer: Aetna of IA Medicare |
$148.77
|
| Rate for Payer: Amerigroup Medicaid |
$150.54
|
| Rate for Payer: Amerigroup Medicare |
$118.62
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$195.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$117.45
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$149.08
|
| Rate for Payer: Medical Associates Commercial |
$195.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$117.45
|
| Rate for Payer: Midlands Choice Commercial |
$182.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$151.28
|
| Rate for Payer: Partners Health Alliance Commercial |
$135.07
|
| Rate for Payer: United Healthcare Commercial |
$234.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$153.99
|
|
|
SCREW LAG CANN 2.0MM X 22MM
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046259
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$182.70 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Aetna of IA Commercial |
$234.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$234.90
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$195.75
|
| Rate for Payer: Medical Associates Commercial |
$195.75
|
| Rate for Payer: Midlands Choice Commercial |
$182.70
|
| Rate for Payer: United Healthcare Commercial |
$234.90
|
|
|
SCREW LAG CANN 2.0MM X 6MM
|
Facility
|
OP
|
$261.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046251
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$117.45 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Aetna of IA Commercial |
$234.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$234.90
|
| Rate for Payer: Aetna of IA Medicare |
$148.77
|
| Rate for Payer: Amerigroup Medicaid |
$150.54
|
| Rate for Payer: Amerigroup Medicare |
$118.62
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$195.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$117.45
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$149.08
|
| Rate for Payer: Medical Associates Commercial |
$195.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$117.45
|
| Rate for Payer: Midlands Choice Commercial |
$182.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$151.28
|
| Rate for Payer: Partners Health Alliance Commercial |
$135.07
|
| Rate for Payer: United Healthcare Commercial |
$234.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$153.99
|
|
|
SCREW LAG CANN 2.0MM X 6MM
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046251
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$182.70 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Aetna of IA Commercial |
$234.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$234.90
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$195.75
|
| Rate for Payer: Medical Associates Commercial |
$195.75
|
| Rate for Payer: Midlands Choice Commercial |
$182.70
|
| Rate for Payer: United Healthcare Commercial |
$234.90
|
|
|
SCREW LAG CANN 2.0MM X 8MM
|
Facility
|
OP
|
$261.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046252
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$117.45 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Aetna of IA Commercial |
$234.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$234.90
|
| Rate for Payer: Aetna of IA Medicare |
$148.77
|
| Rate for Payer: Amerigroup Medicaid |
$150.54
|
| Rate for Payer: Amerigroup Medicare |
$118.62
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$195.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$117.45
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$149.08
|
| Rate for Payer: Medical Associates Commercial |
$195.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$117.45
|
| Rate for Payer: Midlands Choice Commercial |
$182.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$151.28
|
| Rate for Payer: Partners Health Alliance Commercial |
$135.07
|
| Rate for Payer: United Healthcare Commercial |
$234.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$153.99
|
|
|
SCREW LAG CANN 2.0MM X 8MM
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046252
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$182.70 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Aetna of IA Commercial |
$234.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$234.90
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$195.75
|
| Rate for Payer: Medical Associates Commercial |
$195.75
|
| Rate for Payer: Midlands Choice Commercial |
$182.70
|
| Rate for Payer: United Healthcare Commercial |
$234.90
|
|
|
SCREW LAG CANN 2.4MM X 10MM
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046262
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$182.70 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Aetna of IA Commercial |
$234.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$234.90
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$195.75
|
| Rate for Payer: Medical Associates Commercial |
$195.75
|
| Rate for Payer: Midlands Choice Commercial |
$182.70
|
| Rate for Payer: United Healthcare Commercial |
$234.90
|
|
