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Charge Type Price  
Service Code CPT 82075
Hospital Charge Code Z12977
Min. Negotiated Rate $10.56
Max. Negotiated Rate $72.00
Rate for Payer: Coventry/First Health All Products $72.00
Rate for Payer: Frontpath All Products $30.00
Rate for Payer: Humana ChoiceCare $60.00
Rate for Payer: PHCS/Multiplan All Products $45.00
Rate for Payer: PHP All Products $26.40
Rate for Payer: Signature Care EPO $15.30
Rate for Payer: Signature Care PPO $15.30
Rate for Payer: United Healthcare Commercial $10.56
Service Code CPT 83655
Hospital Charge Code Z12985
Min. Negotiated Rate $10.60
Max. Negotiated Rate $29.06
Rate for Payer: Coventry/First Health All Products $29.06
Rate for Payer: Frontpath All Products $12.11
Rate for Payer: Humana ChoiceCare $24.22
Rate for Payer: PHCS/Multiplan All Products $18.16
Rate for Payer: PHP All Products $10.66
Rate for Payer: United Healthcare Commercial $10.60
Service Code CPT 88720
Hospital Charge Code Z13009
Min. Negotiated Rate $2.82
Max. Negotiated Rate $12.05
Rate for Payer: Anthem Exchange $2.82
Rate for Payer: Anthem PPO $2.82
Rate for Payer: Anthem Traditional $2.82
Rate for Payer: Coventry/First Health All Products $12.05
Rate for Payer: Frontpath All Products $5.02
Rate for Payer: Humana ChoiceCare $10.04
Rate for Payer: Lutheran Preferred All Products $7.00
Rate for Payer: PHCS/Multiplan All Products $7.53
Rate for Payer: PHP All Products $4.42
Rate for Payer: Signature Care EPO $8.53
Rate for Payer: Signature Care PPO $8.53
Rate for Payer: Three Rivers Preferred All Products $7.00
Rate for Payer: United Healthcare Commercial $7.33
Service Code CPT 82274
Hospital Charge Code Z12978
Min. Negotiated Rate $14.01
Max. Negotiated Rate $38.21
Rate for Payer: Coventry/First Health All Products $38.21
Rate for Payer: Frontpath All Products $15.92
Rate for Payer: Humana ChoiceCare $31.84
Rate for Payer: Lutheran Preferred All Products $22.00
Rate for Payer: PHCS/Multiplan All Products $23.88
Rate for Payer: PHP All Products $14.01
Rate for Payer: Signature Care EPO $18.40
Rate for Payer: Signature Care PPO $18.40
Rate for Payer: Three Rivers Preferred All Products $21.00
Rate for Payer: United Healthcare Commercial $23.22
Service Code CPT 82274
Hospital Charge Code Z12979
Min. Negotiated Rate $14.01
Max. Negotiated Rate $38.21
Rate for Payer: Coventry/First Health All Products $38.21
Rate for Payer: Frontpath All Products $15.92
Rate for Payer: Humana ChoiceCare $31.84
Rate for Payer: Lutheran Preferred All Products $22.00
Rate for Payer: PHCS/Multiplan All Products $23.88
Rate for Payer: PHP All Products $14.01
Rate for Payer: Signature Care EPO $18.40
Rate for Payer: Signature Care PPO $18.40
Rate for Payer: Three Rivers Preferred All Products $21.00
Rate for Payer: United Healthcare Commercial $23.22
Service Code CPT 88175
Hospital Charge Code Z13008
Min. Negotiated Rate $15.01
Max. Negotiated Rate $63.86
Rate for Payer: Anthem Exchange $15.01
Rate for Payer: Anthem PPO $15.01
Rate for Payer: Anthem Traditional $15.01
Rate for Payer: Coventry/First Health All Products $63.86
Rate for Payer: Frontpath All Products $26.61
Rate for Payer: Humana ChoiceCare $53.22
Rate for Payer: Lutheran Preferred All Products $37.00
Rate for Payer: PHCS/Multiplan All Products $39.91
Rate for Payer: PHP All Products $23.42
Rate for Payer: Signature Care EPO $45.24
Rate for Payer: Signature Care PPO $45.24
Rate for Payer: Three Rivers Preferred All Products $35.00
Rate for Payer: United Healthcare Commercial $37.49
Service Code CPT 87801
Hospital Charge Code Z13001
Min. Negotiated Rate $33.20
Max. Negotiated Rate $168.48
Rate for Payer: Anthem Exchange $33.20
Rate for Payer: Anthem PPO $33.20
Rate for Payer: Anthem Traditional $33.20
Rate for Payer: Coventry/First Health All Products $168.48
Rate for Payer: Frontpath All Products $70.20
Rate for Payer: Humana ChoiceCare $140.40
Rate for Payer: Lutheran Preferred All Products $98.00
Rate for Payer: PHCS/Multiplan All Products $105.30
Rate for Payer: PHP All Products $61.78
Rate for Payer: Signature Care EPO $91.80
Rate for Payer: Signature Care PPO $91.80
Rate for Payer: Three Rivers Preferred All Products $91.00
Rate for Payer: United Healthcare Commercial $61.49
Service Code CPT 76820
Hospital Charge Code Z12956
Min. Negotiated Rate $42.58
Max. Negotiated Rate $99.70
Rate for Payer: Humana Medicare $42.58
Rate for Payer: Aetna Medicare $42.58
Rate for Payer: Anthem Exchange $79.86
Rate for Payer: Anthem Medicare $42.58
Rate for Payer: Anthem PPO $79.86
Rate for Payer: Anthem Traditional $79.86
Rate for Payer: Caresource Just 4 Me $48.97
Rate for Payer: Caresource Medicare $46.84
Rate for Payer: Centivo/Paragon All Products $66.00
Rate for Payer: Coventry/First Health All Products $99.70
Rate for Payer: Frontpath All Products $75.40
Rate for Payer: Humana ChoiceCare $83.08
Rate for Payer: Lucent/Coldwater Veneers $72.39
Rate for Payer: Lutheran Preferred All Products $66.00
Rate for Payer: PHCS/Multiplan All Products $62.31
Rate for Payer: PHP All Products $54.00
Rate for Payer: Plain Church Group Ministry All Products $42.58
Rate for Payer: Signature Care EPO $73.66
Rate for Payer: Signature Care PPO $73.66
Rate for Payer: Three Rivers Preferred All Products $62.00
Rate for Payer: United Healthcare Commercial $50.08
Service Code CPT 76820
Hospital Charge Code Z12955
Min. Negotiated Rate $42.58
Max. Negotiated Rate $99.70
Rate for Payer: Aetna Medicare $42.58
Rate for Payer: Anthem Exchange $79.86
Rate for Payer: Anthem Medicare $42.58
Rate for Payer: Anthem PPO $79.86
Rate for Payer: Anthem Traditional $79.86
Rate for Payer: Caresource Just 4 Me $48.97
Rate for Payer: Caresource Medicare $46.84
Rate for Payer: Centivo/Paragon All Products $66.00
Rate for Payer: Coventry/First Health All Products $99.70
Rate for Payer: Frontpath All Products $75.40
Rate for Payer: Humana ChoiceCare $83.08
Rate for Payer: Humana Medicare $42.58
Rate for Payer: Lucent/Coldwater Veneers $72.39
Rate for Payer: Lutheran Preferred All Products $66.00
Rate for Payer: PHCS/Multiplan All Products $62.31
Rate for Payer: PHP All Products $54.00
Rate for Payer: Plain Church Group Ministry All Products $42.58
Rate for Payer: Signature Care EPO $73.66
Rate for Payer: Signature Care PPO $73.66
Rate for Payer: Three Rivers Preferred All Products $62.00
Rate for Payer: United Healthcare Commercial $50.08
Service Code CPT 80305
Hospital Charge Code Z12971
Min. Negotiated Rate $5.94
Max. Negotiated Rate $30.24
Rate for Payer: Anthem Exchange $5.94
Rate for Payer: Anthem PPO $5.94
Rate for Payer: Anthem Traditional $5.94
Rate for Payer: Coventry/First Health All Products $30.24
Rate for Payer: Frontpath All Products $12.60
Rate for Payer: Humana ChoiceCare $25.20
Rate for Payer: Lutheran Preferred All Products $18.00
Rate for Payer: PHCS/Multiplan All Products $18.90
Rate for Payer: PHP All Products $11.09
Rate for Payer: Signature Care EPO $16.92
Rate for Payer: Signature Care PPO $16.92
Rate for Payer: Three Rivers Preferred All Products $16.00
Rate for Payer: United Healthcare Commercial $8.98
Service Code CPT 80305
Hospital Charge Code Z12972
Min. Negotiated Rate $5.94
Max. Negotiated Rate $30.24
Rate for Payer: Anthem Exchange $5.94
Rate for Payer: Anthem PPO $5.94
Rate for Payer: Anthem Traditional $5.94
Rate for Payer: Coventry/First Health All Products $30.24
Rate for Payer: Frontpath All Products $12.60
Rate for Payer: Humana ChoiceCare $25.20
Rate for Payer: Lutheran Preferred All Products $18.00
Rate for Payer: PHCS/Multiplan All Products $18.90
Rate for Payer: PHP All Products $11.09
Rate for Payer: Signature Care EPO $16.92
Rate for Payer: Signature Care PPO $16.92
Rate for Payer: Three Rivers Preferred All Products $16.00
Rate for Payer: United Healthcare Commercial $8.98
Service Code CPT 76818
Hospital Charge Code Z12952
Min. Negotiated Rate $110.19
Max. Negotiated Rate $258.34
Rate for Payer: Aetna Medicare $110.33
Rate for Payer: Anthem Exchange $110.19
Rate for Payer: Anthem Medicare $110.33
Rate for Payer: Anthem PPO $110.19
Rate for Payer: Anthem Traditional $110.19
Rate for Payer: Caresource Just 4 Me $126.88
Rate for Payer: Caresource Medicare $121.36
Rate for Payer: Centivo/Paragon All Products $171.01
Rate for Payer: Coventry/First Health All Products $258.34
Rate for Payer: Frontpath All Products $189.70
Rate for Payer: Humana ChoiceCare $215.28
Rate for Payer: Humana Medicare $110.33
Rate for Payer: Lucent/Coldwater Veneers $187.56
Rate for Payer: Lutheran Preferred All Products $171.00
Rate for Payer: PHCS/Multiplan All Products $161.46
Rate for Payer: PHP All Products $139.93
Rate for Payer: Plain Church Group Ministry All Products $110.33
Rate for Payer: Signature Care EPO $141.10
Rate for Payer: Signature Care PPO $141.10
Rate for Payer: Three Rivers Preferred All Products $160.00
Rate for Payer: United Healthcare Commercial $111.96
Service Code CPT 76818
Hospital Charge Code Z12951
Min. Negotiated Rate $110.19
Max. Negotiated Rate $258.34
Rate for Payer: Aetna Medicare $110.33
Rate for Payer: Anthem Exchange $110.19
Rate for Payer: Anthem Medicare $110.33
Rate for Payer: Anthem PPO $110.19
Rate for Payer: Anthem Traditional $110.19
Rate for Payer: Caresource Just 4 Me $126.88
Rate for Payer: Caresource Medicare $121.36
Rate for Payer: Centivo/Paragon All Products $171.01
Rate for Payer: Coventry/First Health All Products $258.34
Rate for Payer: Frontpath All Products $189.70
Rate for Payer: Humana ChoiceCare $215.28
Rate for Payer: Humana Medicare $110.33
Rate for Payer: Lucent/Coldwater Veneers $187.56
Rate for Payer: Lutheran Preferred All Products $171.00
Rate for Payer: PHCS/Multiplan All Products $161.46
Rate for Payer: PHP All Products $139.93
Rate for Payer: Plain Church Group Ministry All Products $110.33
Rate for Payer: Signature Care EPO $141.10
Rate for Payer: Signature Care PPO $141.10
Rate for Payer: Three Rivers Preferred All Products $160.00
Rate for Payer: United Healthcare Commercial $111.96
Service Code CPT 76819
Hospital Charge Code Z12954
Min. Negotiated Rate $79.67
Max. Negotiated Rate $186.55
Rate for Payer: Aetna Medicare $79.67
Rate for Payer: Anthem Exchange $95.96
Rate for Payer: Anthem Medicare $79.67
Rate for Payer: Anthem PPO $95.96
Rate for Payer: Anthem Traditional $95.96
Rate for Payer: Caresource Just 4 Me $91.62
Rate for Payer: Caresource Medicare $87.64
Rate for Payer: Centivo/Paragon All Products $123.49
Rate for Payer: Coventry/First Health All Products $186.55
Rate for Payer: Frontpath All Products $138.75
Rate for Payer: Humana ChoiceCare $155.46
Rate for Payer: Humana Medicare $79.67
Rate for Payer: Lucent/Coldwater Veneers $135.44
Rate for Payer: Lutheran Preferred All Products $123.00
Rate for Payer: PHCS/Multiplan All Products $116.59
Rate for Payer: PHP All Products $101.05
Rate for Payer: Plain Church Group Ministry All Products $79.67
Rate for Payer: Signature Care EPO $122.40
Rate for Payer: Signature Care PPO $122.40
Rate for Payer: Three Rivers Preferred All Products $116.00
Rate for Payer: United Healthcare Commercial $86.53
Service Code CPT 76819
Hospital Charge Code Z12953
Min. Negotiated Rate $79.67
Max. Negotiated Rate $186.55
Rate for Payer: Aetna Medicare $79.67
Rate for Payer: Anthem Exchange $95.96
Rate for Payer: Anthem Medicare $79.67
Rate for Payer: Anthem PPO $95.96
Rate for Payer: Anthem Traditional $95.96
Rate for Payer: Caresource Just 4 Me $91.62
Rate for Payer: Caresource Medicare $87.64
Rate for Payer: Centivo/Paragon All Products $123.49
Rate for Payer: Coventry/First Health All Products $186.55
Rate for Payer: Frontpath All Products $138.75
Rate for Payer: Humana ChoiceCare $155.46
Rate for Payer: Humana Medicare $79.67
Rate for Payer: Lucent/Coldwater Veneers $135.44
Rate for Payer: Lutheran Preferred All Products $123.00
Rate for Payer: PHCS/Multiplan All Products $116.59
Rate for Payer: PHP All Products $101.05
Rate for Payer: Plain Church Group Ministry All Products $79.67
Rate for Payer: Signature Care EPO $122.40
Rate for Payer: Signature Care PPO $122.40
Rate for Payer: Three Rivers Preferred All Products $116.00
Rate for Payer: United Healthcare Commercial $86.53
Service Code CPT 82962
Hospital Charge Code Z12980
Min. Negotiated Rate $1.97
Max. Negotiated Rate $7.87
Rate for Payer: Anthem Exchange $1.97
Rate for Payer: Anthem PPO $1.97
Rate for Payer: Anthem Traditional $1.97
Rate for Payer: Coventry/First Health All Products $7.87
Rate for Payer: Frontpath All Products $3.28
Rate for Payer: Humana ChoiceCare $6.56
Rate for Payer: Lutheran Preferred All Products $5.00
Rate for Payer: PHCS/Multiplan All Products $4.92
Rate for Payer: PHP All Products $2.89
Rate for Payer: Signature Care EPO $3.40
Rate for Payer: Signature Care PPO $3.40
Rate for Payer: Three Rivers Preferred All Products $4.00
Rate for Payer: United Healthcare Commercial $3.42
Service Code CPT 83037
Hospital Charge Code Z12983
Min. Negotiated Rate $8.54
Max. Negotiated Rate $23.30
Rate for Payer: Coventry/First Health All Products $23.30
Rate for Payer: Frontpath All Products $9.71
Rate for Payer: Humana ChoiceCare $19.42
Rate for Payer: Lutheran Preferred All Products $14.00
Rate for Payer: PHCS/Multiplan All Products $14.57
Rate for Payer: PHP All Products $8.54
Rate for Payer: Signature Care EPO $16.51
Rate for Payer: Signature Care PPO $16.51
Rate for Payer: Three Rivers Preferred All Products $13.00
Rate for Payer: United Healthcare Commercial $14.17
Service Code CPT 83037
Hospital Charge Code Z12984
Min. Negotiated Rate $8.54
Max. Negotiated Rate $23.30
Rate for Payer: Coventry/First Health All Products $23.30
Rate for Payer: Frontpath All Products $9.71
Rate for Payer: Humana ChoiceCare $19.42
Rate for Payer: Lutheran Preferred All Products $14.00
Rate for Payer: PHCS/Multiplan All Products $14.57
Rate for Payer: PHP All Products $8.54
Rate for Payer: Signature Care EPO $16.51
Rate for Payer: Signature Care PPO $16.51
Rate for Payer: Three Rivers Preferred All Products $13.00
Rate for Payer: United Healthcare Commercial $14.17
Service Code CPT 83036
Hospital Charge Code Z12982
Min. Negotiated Rate $8.50
Max. Negotiated Rate $23.30
Rate for Payer: Coventry/First Health All Products $23.30
Rate for Payer: Frontpath All Products $9.71
Rate for Payer: Humana ChoiceCare $19.42
Rate for Payer: PHCS/Multiplan All Products $14.57
Rate for Payer: PHP All Products $8.54
Rate for Payer: United Healthcare Commercial $8.50
Service Code CPT 83036
Hospital Charge Code Z12981
Min. Negotiated Rate $8.50
Max. Negotiated Rate $23.30
Rate for Payer: Coventry/First Health All Products $23.30
Rate for Payer: Frontpath All Products $9.71
Rate for Payer: Humana ChoiceCare $19.42
Rate for Payer: PHCS/Multiplan All Products $14.57
Rate for Payer: PHP All Products $8.54
Rate for Payer: United Healthcare Commercial $8.50
Service Code CPT 85018
Hospital Charge Code Z12986
Min. Negotiated Rate $2.09
Max. Negotiated Rate $5.69
Rate for Payer: Coventry/First Health All Products $5.69
Rate for Payer: Frontpath All Products $2.37
Rate for Payer: Humana ChoiceCare $4.74
Rate for Payer: Lutheran Preferred All Products $3.00
Rate for Payer: PHCS/Multiplan All Products $3.56
Rate for Payer: PHP All Products $2.09
Rate for Payer: Signature Care EPO $3.40
Rate for Payer: Signature Care PPO $3.40
Rate for Payer: Three Rivers Preferred All Products $3.00
Rate for Payer: United Healthcare Commercial $3.46
Service Code CPT 85018
Hospital Charge Code Z12987
Min. Negotiated Rate $2.09
Max. Negotiated Rate $5.69
Rate for Payer: Coventry/First Health All Products $5.69
Rate for Payer: Frontpath All Products $2.37
Rate for Payer: Humana ChoiceCare $4.74
Rate for Payer: Lutheran Preferred All Products $3.00
Rate for Payer: PHCS/Multiplan All Products $3.56
Rate for Payer: PHP All Products $2.09
Rate for Payer: Signature Care EPO $3.40
Rate for Payer: Signature Care PPO $3.40
Rate for Payer: Three Rivers Preferred All Products $3.00
Rate for Payer: United Healthcare Commercial $3.46
Service Code CPT 86308
Hospital Charge Code Z12988
Min. Negotiated Rate $2.45
Max. Negotiated Rate $12.43
Rate for Payer: Anthem Exchange $2.45
Rate for Payer: Anthem PPO $2.45
Rate for Payer: Anthem Traditional $2.45
Rate for Payer: Coventry/First Health All Products $12.43
Rate for Payer: Frontpath All Products $5.18
Rate for Payer: Humana ChoiceCare $10.36
Rate for Payer: Lutheran Preferred All Products $7.00
Rate for Payer: PHCS/Multiplan All Products $7.77
Rate for Payer: PHP All Products $4.56
Rate for Payer: Signature Care EPO $6.80
Rate for Payer: Signature Care PPO $6.80
Rate for Payer: Three Rivers Preferred All Products $7.00
Rate for Payer: United Healthcare Commercial $7.56
Service Code CPT 87804
Hospital Charge Code Z13003
Min. Negotiated Rate $14.56
Max. Negotiated Rate $39.72
Rate for Payer: Coventry/First Health All Products $39.72
Rate for Payer: Frontpath All Products $16.55
Rate for Payer: Humana ChoiceCare $33.10
Rate for Payer: Lutheran Preferred All Products $23.00
Rate for Payer: PHCS/Multiplan All Products $24.83
Rate for Payer: PHP All Products $14.56
Rate for Payer: Signature Care EPO $15.30
Rate for Payer: Signature Care PPO $15.30
Rate for Payer: Three Rivers Preferred All Products $22.00
Rate for Payer: United Healthcare Commercial $17.52
Service Code CPT 87804
Hospital Charge Code Z13002
Min. Negotiated Rate $14.56
Max. Negotiated Rate $39.72
Rate for Payer: Coventry/First Health All Products $39.72
Rate for Payer: Frontpath All Products $16.55
Rate for Payer: Humana ChoiceCare $33.10
Rate for Payer: Lutheran Preferred All Products $23.00
Rate for Payer: PHCS/Multiplan All Products $24.83
Rate for Payer: PHP All Products $14.56
Rate for Payer: Signature Care EPO $15.30
Rate for Payer: Signature Care PPO $15.30
Rate for Payer: Three Rivers Preferred All Products $22.00
Rate for Payer: United Healthcare Commercial $17.52