|
SCREW LAG CANN 3.0MM X 34MM
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046277
|
|
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 3.0MM X 36MM
|
Facility
|
OP
|
$261.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046278
|
|
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 3.0MM X 36MM
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046278
|
|
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 3.0MM X 38MM
|
Facility
|
OP
|
$261.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046279
|
|
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 3.0MM X 38MM
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046279
|
|
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 3.0MM X 40MM
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046281
|
|
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 3.0MM X 40MM
|
Facility
|
OP
|
$261.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046281
|
|
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 4.0MM X 12MM
|
Facility
|
OP
|
$252.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046283
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$113.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Aetna of IA Commercial |
$226.80
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$226.80
|
| Rate for Payer: Aetna of IA Medicare |
$143.64
|
| Rate for Payer: Amerigroup Medicaid |
$145.35
|
| Rate for Payer: Amerigroup Medicare |
$114.53
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$189.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$113.40
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$143.94
|
| Rate for Payer: Medical Associates Commercial |
$189.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$113.40
|
| Rate for Payer: Midlands Choice Commercial |
$176.40
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$146.06
|
| Rate for Payer: Partners Health Alliance Commercial |
$130.41
|
| Rate for Payer: United Healthcare Commercial |
$226.80
|
| Rate for Payer: United Healthcare Managed Medicare |
$148.68
|
|
|
SCREW LAG CANN 4.0MM X 12MM
|
Facility
|
IP
|
$252.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046283
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$176.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Aetna of IA Commercial |
$226.80
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$226.80
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$189.00
|
| Rate for Payer: Medical Associates Commercial |
$189.00
|
| Rate for Payer: Midlands Choice Commercial |
$176.40
|
| Rate for Payer: United Healthcare Commercial |
$226.80
|
|
|
SCREW LAG CANN 4.0MM X 14MM
|
Facility
|
OP
|
$252.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046284
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$113.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Aetna of IA Commercial |
$226.80
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$226.80
|
| Rate for Payer: Aetna of IA Medicare |
$143.64
|
| Rate for Payer: Amerigroup Medicaid |
$145.35
|
| Rate for Payer: Amerigroup Medicare |
$114.53
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$189.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$113.40
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$143.94
|
| Rate for Payer: Medical Associates Commercial |
$189.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$113.40
|
| Rate for Payer: Midlands Choice Commercial |
$176.40
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$146.06
|
| Rate for Payer: Partners Health Alliance Commercial |
$130.41
|
| Rate for Payer: United Healthcare Commercial |
$226.80
|
| Rate for Payer: United Healthcare Managed Medicare |
$148.68
|
|
|
SCREW LAG CANN 4.0MM X 14MM
|
Facility
|
IP
|
$252.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046284
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$176.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Aetna of IA Commercial |
$226.80
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$226.80
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$189.00
|
| Rate for Payer: Medical Associates Commercial |
$189.00
|
| Rate for Payer: Midlands Choice Commercial |
$176.40
|
| Rate for Payer: United Healthcare Commercial |
$226.80
|
|
|
SCREW LAG CANN 4.0MM X 16MM
|
Facility
|
OP
|
$252.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$113.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Aetna of IA Commercial |
$226.80
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$226.80
|
| Rate for Payer: Aetna of IA Medicare |
$143.64
|
| Rate for Payer: Amerigroup Medicaid |
$145.35
|
| Rate for Payer: Amerigroup Medicare |
$114.53
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$189.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$113.40
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$143.94
|
| Rate for Payer: Medical Associates Commercial |
$189.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$113.40
|
| Rate for Payer: Midlands Choice Commercial |
$176.40
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$146.06
|
| Rate for Payer: Partners Health Alliance Commercial |
$130.41
|
| Rate for Payer: United Healthcare Commercial |
$226.80
|
| Rate for Payer: United Healthcare Managed Medicare |
$148.68
|
|
|
SCREW LAG CANN 4.0MM X 16MM
|
Facility
|
IP
|
$252.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046285
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$176.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Aetna of IA Commercial |
$226.80
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$226.80
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$189.00
|
| Rate for Payer: Medical Associates Commercial |
$189.00
|
| Rate for Payer: Midlands Choice Commercial |
$176.40
|
| Rate for Payer: United Healthcare Commercial |
$226.80
|
|
|
SCREW LAG CANN 4.0MM X 18MM
|
Facility
|
OP
|
$252.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046286
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$113.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Aetna of IA Commercial |
$226.80
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$226.80
|
| Rate for Payer: Aetna of IA Medicare |
$143.64
|
| Rate for Payer: Amerigroup Medicaid |
$145.35
|
| Rate for Payer: Amerigroup Medicare |
$114.53
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$189.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$113.40
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$143.94
|
| Rate for Payer: Medical Associates Commercial |
$189.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$113.40
|
| Rate for Payer: Midlands Choice Commercial |
$176.40
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$146.06
|
| Rate for Payer: Partners Health Alliance Commercial |
$130.41
|
| Rate for Payer: United Healthcare Commercial |
$226.80
|
| Rate for Payer: United Healthcare Managed Medicare |
$148.68
|
|
|
SCREW LAG CANN 4.0MM X 18MM
|
Facility
|
IP
|
$252.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046286
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$176.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Aetna of IA Commercial |
$226.80
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$226.80
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$189.00
|
| Rate for Payer: Medical Associates Commercial |
$189.00
|
| Rate for Payer: Midlands Choice Commercial |
$176.40
|
| Rate for Payer: United Healthcare Commercial |
$226.80
|
|
|
SCREW LAG CANN 4.0MM X 20MM
|
Facility
|
OP
|
$252.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046282
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$113.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Aetna of IA Commercial |
$226.80
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$226.80
|
| Rate for Payer: Aetna of IA Medicare |
$143.64
|
| Rate for Payer: Amerigroup Medicaid |
$145.35
|
| Rate for Payer: Amerigroup Medicare |
$114.53
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$189.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$113.40
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$143.94
|
| Rate for Payer: Medical Associates Commercial |
$189.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$113.40
|
| Rate for Payer: Midlands Choice Commercial |
$176.40
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$146.06
|
| Rate for Payer: Partners Health Alliance Commercial |
$130.41
|
| Rate for Payer: United Healthcare Commercial |
$226.80
|
| Rate for Payer: United Healthcare Managed Medicare |
$148.68
|
|
|
SCREW LAG CANN 4.0MM X 20MM
|
Facility
|
IP
|
$252.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046282
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$176.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Aetna of IA Commercial |
$226.80
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$226.80
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$189.00
|
| Rate for Payer: Medical Associates Commercial |
$189.00
|
| Rate for Payer: Midlands Choice Commercial |
$176.40
|
| Rate for Payer: United Healthcare Commercial |
$226.80
|
|
|
SCREW LAG CANN 4.0MM X 22MM
|
Facility
|
OP
|
$252.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046287
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$113.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Aetna of IA Commercial |
$226.80
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$226.80
|
| Rate for Payer: Aetna of IA Medicare |
$143.64
|
| Rate for Payer: Amerigroup Medicaid |
$145.35
|
| Rate for Payer: Amerigroup Medicare |
$114.53
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$189.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$113.40
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$143.94
|
| Rate for Payer: Medical Associates Commercial |
$189.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$113.40
|
| Rate for Payer: Midlands Choice Commercial |
$176.40
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$146.06
|
| Rate for Payer: Partners Health Alliance Commercial |
$130.41
|
| Rate for Payer: United Healthcare Commercial |
$226.80
|
| Rate for Payer: United Healthcare Managed Medicare |
$148.68
|
|
|
SCREW LAG CANN 4.0MM X 22MM
|
Facility
|
IP
|
$252.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046287
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$176.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Aetna of IA Commercial |
$226.80
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$226.80
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$189.00
|
| Rate for Payer: Medical Associates Commercial |
$189.00
|
| Rate for Payer: Midlands Choice Commercial |
$176.40
|
| Rate for Payer: United Healthcare Commercial |
$226.80
|
|
|
SCREW LAG CANN 4.0MM X 24MM
|
Facility
|
OP
|
$252.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046288
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$113.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Aetna of IA Commercial |
$226.80
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$226.80
|
| Rate for Payer: Aetna of IA Medicare |
$143.64
|
| Rate for Payer: Amerigroup Medicaid |
$145.35
|
| Rate for Payer: Amerigroup Medicare |
$114.53
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$189.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$113.40
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$143.94
|
| Rate for Payer: Medical Associates Commercial |
$189.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$113.40
|
| Rate for Payer: Midlands Choice Commercial |
$176.40
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$146.06
|
| Rate for Payer: Partners Health Alliance Commercial |
$130.41
|
| Rate for Payer: United Healthcare Commercial |
$226.80
|
| Rate for Payer: United Healthcare Managed Medicare |
$148.68
|
|
|
SCREW LAG CANN 4.0MM X 24MM
|
Facility
|
IP
|
$252.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046288
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$176.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Aetna of IA Commercial |
$226.80
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$226.80
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$189.00
|
| Rate for Payer: Medical Associates Commercial |
$189.00
|
| Rate for Payer: Midlands Choice Commercial |
$176.40
|
| Rate for Payer: United Healthcare Commercial |
$226.80
|
|
|
SCREW LAG CANN 4.0MM X 26MM
|
Facility
|
OP
|
$252.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046289
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$113.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Aetna of IA Commercial |
$226.80
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$226.80
|
| Rate for Payer: Aetna of IA Medicare |
$143.64
|
| Rate for Payer: Amerigroup Medicaid |
$145.35
|
| Rate for Payer: Amerigroup Medicare |
$114.53
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$189.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$113.40
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$143.94
|
| Rate for Payer: Medical Associates Commercial |
$189.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$113.40
|
| Rate for Payer: Midlands Choice Commercial |
$176.40
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$146.06
|
| Rate for Payer: Partners Health Alliance Commercial |
$130.41
|
| Rate for Payer: United Healthcare Commercial |
$226.80
|
| Rate for Payer: United Healthcare Managed Medicare |
$148.68
|
|
|
SCREW LAG CANN 4.0MM X 26MM
|
Facility
|
IP
|
$252.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046289
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$176.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Aetna of IA Commercial |
$226.80
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$226.80
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$189.00
|
| Rate for Payer: Medical Associates Commercial |
$189.00
|
| Rate for Payer: Midlands Choice Commercial |
$176.40
|
| Rate for Payer: United Healthcare Commercial |
$226.80
|
|
|
SCREW LAG CANN 4.0MM X 28MM
|
Facility
|
OP
|
$252.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046290
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$113.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Aetna of IA Commercial |
$226.80
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$226.80
|
| Rate for Payer: Aetna of IA Medicare |
$143.64
|
| Rate for Payer: Amerigroup Medicaid |
$145.35
|
| Rate for Payer: Amerigroup Medicare |
$114.53
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$189.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$113.40
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$143.94
|
| Rate for Payer: Medical Associates Commercial |
$189.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$113.40
|
| Rate for Payer: Midlands Choice Commercial |
$176.40
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$146.06
|
| Rate for Payer: Partners Health Alliance Commercial |
$130.41
|
| Rate for Payer: United Healthcare Commercial |
$226.80
|
| Rate for Payer: United Healthcare Managed Medicare |
$148.68
|
|
|
SCREW LAG CANN 4.0MM X 28MM
|
Facility
|
IP
|
$252.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
8046290
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$176.40 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Aetna of IA Commercial |
$226.80
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$226.80
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$189.00
|
| Rate for Payer: Medical Associates Commercial |
$189.00
|
| Rate for Payer: Midlands Choice Commercial |
$176.40
|
| Rate for Payer: United Healthcare Commercial |
$226.80
|
|
