|
PR REMOVAL OF HEEL BONE
|
Professional
|
$1,095.14
|
|
|
Service Code
|
CPT 28118
|
| Hospital Charge Code |
z28118
|
| Min. Negotiated Rate |
$394.87 |
| Max. Negotiated Rate |
$821.36 |
| Rate for Payer: Aetna Medicare |
$394.87
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$454.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$434.36
|
| Rate for Payer: Cash Price |
$678.99
|
| Rate for Payer: Cash Price |
$678.99
|
| Rate for Payer: Coventry All Commercial |
$473.84
|
| Rate for Payer: Frontpath All Commercial |
$540.89
|
| Rate for Payer: Humana ChoiceCare |
$447.82
|
| Rate for Payer: Humana Medicare |
$394.87
|
| Rate for Payer: Lucent All Commercial |
$671.28
|
| Rate for Payer: PHCS All Commercial |
$821.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$394.87
|
| Rate for Payer: United Healthcare Commercial |
$465.84
|
| Rate for Payer: United Healthcare Medicare |
$394.87
|
|
|
PR REMOVAL OF HEEL SPUR
|
Professional
|
$955.66
|
|
|
Service Code
|
CPT 28119
|
| Hospital Charge Code |
z28119
|
| Min. Negotiated Rate |
$343.14 |
| Max. Negotiated Rate |
$716.74 |
| Rate for Payer: Aetna Medicare |
$343.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$499.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$499.70
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$394.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$377.45
|
| Rate for Payer: Cash Price |
$592.51
|
| Rate for Payer: Cash Price |
$592.51
|
| Rate for Payer: Coventry All Commercial |
$411.77
|
| Rate for Payer: Frontpath All Commercial |
$465.89
|
| Rate for Payer: Humana ChoiceCare |
$395.74
|
| Rate for Payer: Humana Medicare |
$343.14
|
| Rate for Payer: Lucent All Commercial |
$583.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$549.00
|
| Rate for Payer: PHCS All Commercial |
$716.74
|
| Rate for Payer: PHP All Commercial |
$582.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$343.14
|
| Rate for Payer: Signature Care EPO |
$668.95
|
| Rate for Payer: Signature Care PPO |
$668.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$515.00
|
| Rate for Payer: United Healthcare Commercial |
$412.36
|
| Rate for Payer: United Healthcare Medicare |
$343.14
|
|
|
PR REMOVAL OF HIP PROSTHESIS,COMPLEX
|
Professional
|
$2,867.78
|
|
|
Service Code
|
CPT 27091
|
| Hospital Charge Code |
z27091
|
| Min. Negotiated Rate |
$1,469.73 |
| Max. Negotiated Rate |
$2,498.54 |
| Rate for Payer: Aetna Medicare |
$1,469.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,023.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,023.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,690.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,616.70
|
| Rate for Payer: Cash Price |
$1,778.02
|
| Rate for Payer: Cash Price |
$1,778.02
|
| Rate for Payer: Coventry All Commercial |
$1,763.68
|
| Rate for Payer: Frontpath All Commercial |
$2,072.75
|
| Rate for Payer: Humana ChoiceCare |
$1,593.32
|
| Rate for Payer: Humana Medicare |
$1,469.73
|
| Rate for Payer: Lucent All Commercial |
$2,498.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,352.00
|
| Rate for Payer: PHCS All Commercial |
$2,150.84
|
| Rate for Payer: PHP All Commercial |
$2,494.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,469.73
|
| Rate for Payer: Signature Care EPO |
$2,125.85
|
| Rate for Payer: Signature Care PPO |
$2,125.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,205.00
|
| Rate for Payer: United Healthcare Commercial |
$1,757.24
|
| Rate for Payer: United Healthcare Medicare |
$1,469.73
|
|
|
PR REMOVAL OF HYDROCELE,TUNICA,UNILAT
|
Professional
|
$616.92
|
|
|
Service Code
|
CPT 55040
|
| Hospital Charge Code |
z55040
|
| Min. Negotiated Rate |
$316.18 |
| Max. Negotiated Rate |
$537.51 |
| Rate for Payer: Aetna Medicare |
$316.18
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$424.88
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$424.88
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$363.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$347.80
|
| Rate for Payer: Cash Price |
$382.49
|
| Rate for Payer: Cash Price |
$382.49
|
| Rate for Payer: Coventry All Commercial |
$379.42
|
| Rate for Payer: Frontpath All Commercial |
$435.55
|
| Rate for Payer: Humana ChoiceCare |
$392.67
|
| Rate for Payer: Humana Medicare |
$316.18
|
| Rate for Payer: Lucent All Commercial |
$537.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$443.00
|
| Rate for Payer: PHCS All Commercial |
$462.69
|
| Rate for Payer: PHP All Commercial |
$407.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$316.18
|
| Rate for Payer: Signature Care EPO |
$378.25
|
| Rate for Payer: Signature Care PPO |
$378.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$411.00
|
| Rate for Payer: United Healthcare Commercial |
$411.88
|
| Rate for Payer: United Healthcare Medicare |
$316.18
|
|
|
PR REMOVAL OF NAIL BED
|
Professional
|
$293.16
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
z11750
|
| Min. Negotiated Rate |
$95.30 |
| Max. Negotiated Rate |
$219.87 |
| Rate for Payer: Aetna Medicare |
$95.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$190.62
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$190.62
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$109.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$104.83
|
| Rate for Payer: Cash Price |
$181.76
|
| Rate for Payer: Cash Price |
$181.76
|
| Rate for Payer: Coventry All Commercial |
$114.36
|
| Rate for Payer: Frontpath All Commercial |
$129.16
|
| Rate for Payer: Humana ChoiceCare |
$134.55
|
| Rate for Payer: Humana Medicare |
$95.30
|
| Rate for Payer: Lucent All Commercial |
$162.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$124.00
|
| Rate for Payer: PHCS All Commercial |
$219.87
|
| Rate for Payer: PHP All Commercial |
$130.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$95.30
|
| Rate for Payer: Signature Care EPO |
$180.87
|
| Rate for Payer: Signature Care PPO |
$180.87
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$114.00
|
| Rate for Payer: United Healthcare Commercial |
$189.46
|
| Rate for Payer: United Healthcare Medicare |
$95.30
|
|
|
PR REMOVAL OF NAIL PLATE
|
Professional
|
$211.12
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
z11730
|
| Min. Negotiated Rate |
$50.77 |
| Max. Negotiated Rate |
$158.34 |
| Rate for Payer: Aetna Medicare |
$50.77
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$103.06
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$103.06
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$58.39
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$55.85
|
| Rate for Payer: Cash Price |
$130.89
|
| Rate for Payer: Cash Price |
$130.89
|
| Rate for Payer: Coventry All Commercial |
$60.92
|
| Rate for Payer: Frontpath All Commercial |
$69.33
|
| Rate for Payer: Humana ChoiceCare |
$59.90
|
| Rate for Payer: Humana Medicare |
$50.77
|
| Rate for Payer: Lucent All Commercial |
$86.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$66.00
|
| Rate for Payer: PHCS All Commercial |
$158.34
|
| Rate for Payer: PHP All Commercial |
$69.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$50.77
|
| Rate for Payer: Signature Care EPO |
$92.74
|
| Rate for Payer: Signature Care PPO |
$92.74
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$61.00
|
| Rate for Payer: United Healthcare Commercial |
$66.61
|
| Rate for Payer: United Healthcare Medicare |
$50.77
|
|
|
PR REMOVAL OF OMENTUM
|
Professional
|
$1,423.66
|
|
|
Service Code
|
CPT 49255
|
| Hospital Charge Code |
z49255
|
| Min. Negotiated Rate |
$729.62 |
| Max. Negotiated Rate |
$1,245.70 |
| Rate for Payer: Aetna Medicare |
$729.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$850.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$850.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$839.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$802.58
|
| Rate for Payer: Cash Price |
$882.67
|
| Rate for Payer: Cash Price |
$882.67
|
| Rate for Payer: Coventry All Commercial |
$875.54
|
| Rate for Payer: Frontpath All Commercial |
$1,037.45
|
| Rate for Payer: Humana ChoiceCare |
$763.70
|
| Rate for Payer: Humana Medicare |
$729.62
|
| Rate for Payer: Lucent All Commercial |
$1,240.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,094.00
|
| Rate for Payer: PHCS All Commercial |
$1,067.74
|
| Rate for Payer: PHP All Commercial |
$1,245.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$729.62
|
| Rate for Payer: Signature Care EPO |
$969.00
|
| Rate for Payer: Signature Care PPO |
$969.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,021.00
|
| Rate for Payer: United Healthcare Commercial |
$836.49
|
| Rate for Payer: United Healthcare Medicare |
$729.62
|
|
|
PR REMOVAL OF OVARIAN CYST(S)
|
Professional
|
$1,396.76
|
|
|
Service Code
|
CPT 58925
|
| Hospital Charge Code |
z58925
|
| Min. Negotiated Rate |
$715.84 |
| Max. Negotiated Rate |
$1,216.93 |
| Rate for Payer: Aetna Medicare |
$715.84
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$903.11
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$903.11
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$823.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$787.42
|
| Rate for Payer: Cash Price |
$865.99
|
| Rate for Payer: Cash Price |
$865.99
|
| Rate for Payer: Coventry All Commercial |
$859.01
|
| Rate for Payer: Frontpath All Commercial |
$1,006.75
|
| Rate for Payer: Humana ChoiceCare |
$759.06
|
| Rate for Payer: Humana Medicare |
$715.84
|
| Rate for Payer: Lucent All Commercial |
$1,216.93
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,002.00
|
| Rate for Payer: PHCS All Commercial |
$1,047.57
|
| Rate for Payer: PHP All Commercial |
$921.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$715.84
|
| Rate for Payer: Signature Care EPO |
$853.40
|
| Rate for Payer: Signature Care PPO |
$853.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$931.00
|
| Rate for Payer: United Healthcare Commercial |
$822.83
|
| Rate for Payer: United Healthcare Medicare |
$715.84
|
|
|
PR REMOVAL OF OVARY(S)
|
Professional
|
$1,012.04
|
|
|
Service Code
|
CPT 58940
|
| Hospital Charge Code |
z58940
|
| Min. Negotiated Rate |
$505.50 |
| Max. Negotiated Rate |
$881.74 |
| Rate for Payer: Aetna Medicare |
$518.67
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$602.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$602.07
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$596.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$570.54
|
| Rate for Payer: Cash Price |
$627.46
|
| Rate for Payer: Cash Price |
$627.46
|
| Rate for Payer: Coventry All Commercial |
$622.40
|
| Rate for Payer: Frontpath All Commercial |
$726.87
|
| Rate for Payer: Humana ChoiceCare |
$505.50
|
| Rate for Payer: Humana Medicare |
$518.67
|
| Rate for Payer: Lucent All Commercial |
$881.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$726.00
|
| Rate for Payer: PHCS All Commercial |
$759.03
|
| Rate for Payer: PHP All Commercial |
$667.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$518.67
|
| Rate for Payer: Signature Care EPO |
$568.65
|
| Rate for Payer: Signature Care PPO |
$568.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$674.00
|
| Rate for Payer: United Healthcare Commercial |
$562.40
|
| Rate for Payer: United Healthcare Medicare |
$518.67
|
|
|
PR REMOVAL OF OVARY/TUBE(S)
|
Professional
|
$1,381.98
|
|
|
Service Code
|
CPT 58720
|
| Hospital Charge Code |
z58720
|
| Min. Negotiated Rate |
$708.26 |
| Max. Negotiated Rate |
$1,204.04 |
| Rate for Payer: Aetna Medicare |
$708.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$906.53
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$906.53
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$814.50
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$779.09
|
| Rate for Payer: Cash Price |
$856.83
|
| Rate for Payer: Cash Price |
$856.83
|
| Rate for Payer: Coventry All Commercial |
$849.91
|
| Rate for Payer: Frontpath All Commercial |
$991.65
|
| Rate for Payer: Humana ChoiceCare |
$762.29
|
| Rate for Payer: Humana Medicare |
$708.26
|
| Rate for Payer: Lucent All Commercial |
$1,204.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$992.00
|
| Rate for Payer: PHCS All Commercial |
$1,036.48
|
| Rate for Payer: PHP All Commercial |
$912.11
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$708.26
|
| Rate for Payer: Signature Care EPO |
$914.60
|
| Rate for Payer: Signature Care PPO |
$914.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$921.00
|
| Rate for Payer: United Healthcare Commercial |
$806.46
|
| Rate for Payer: United Healthcare Medicare |
$708.26
|
|
|
PR REMOVAL OF RECTAL MARKER
|
Professional
|
$467.14
|
|
|
Service Code
|
CPT 46030
|
| Hospital Charge Code |
z46030
|
| Min. Negotiated Rate |
$80.73 |
| Max. Negotiated Rate |
$350.36 |
| Rate for Payer: Aetna Medicare |
$80.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$137.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$137.90
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$92.84
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$88.80
|
| Rate for Payer: Cash Price |
$289.63
|
| Rate for Payer: Cash Price |
$289.63
|
| Rate for Payer: Coventry All Commercial |
$96.88
|
| Rate for Payer: Frontpath All Commercial |
$113.39
|
| Rate for Payer: Humana ChoiceCare |
$87.75
|
| Rate for Payer: Humana Medicare |
$80.73
|
| Rate for Payer: Lucent All Commercial |
$137.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$121.00
|
| Rate for Payer: PHCS All Commercial |
$350.36
|
| Rate for Payer: PHP All Commercial |
$137.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$80.73
|
| Rate for Payer: Signature Care EPO |
$208.18
|
| Rate for Payer: Signature Care PPO |
$208.18
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$113.00
|
| Rate for Payer: United Healthcare Commercial |
$92.38
|
| Rate for Payer: United Healthcare Medicare |
$80.73
|
|
|
PR REMOVAL OF SPERM DUCT(S)
|
Professional
|
$611.26
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
z55250
|
| Min. Negotiated Rate |
$214.18 |
| Max. Negotiated Rate |
$736.19 |
| Rate for Payer: Aetna Medicare |
$214.18
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$736.19
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$736.19
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$246.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$235.60
|
| Rate for Payer: Cash Price |
$378.98
|
| Rate for Payer: Cash Price |
$378.98
|
| Rate for Payer: Coventry All Commercial |
$257.02
|
| Rate for Payer: Frontpath All Commercial |
$291.64
|
| Rate for Payer: Humana ChoiceCare |
$260.20
|
| Rate for Payer: Humana Medicare |
$214.18
|
| Rate for Payer: Lucent All Commercial |
$364.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$300.00
|
| Rate for Payer: PHCS All Commercial |
$458.44
|
| Rate for Payer: PHP All Commercial |
$275.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$214.18
|
| Rate for Payer: Signature Care EPO |
$538.05
|
| Rate for Payer: Signature Care PPO |
$538.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$278.00
|
| Rate for Payer: United Healthcare Commercial |
$276.04
|
| Rate for Payer: United Healthcare Medicare |
$214.18
|
|
|
PR REMOVAL OF TONSILS,<12 Y/O
|
Professional
|
$494.16
|
|
|
Service Code
|
CPT 42825
|
| Hospital Charge Code |
z42825
|
| Min. Negotiated Rate |
$253.26 |
| Max. Negotiated Rate |
$432.39 |
| Rate for Payer: Aetna Medicare |
$253.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$317.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$317.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$291.25
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$278.59
|
| Rate for Payer: Cash Price |
$306.38
|
| Rate for Payer: Cash Price |
$306.38
|
| Rate for Payer: Coventry All Commercial |
$303.91
|
| Rate for Payer: Frontpath All Commercial |
$343.94
|
| Rate for Payer: Humana ChoiceCare |
$290.33
|
| Rate for Payer: Humana Medicare |
$253.26
|
| Rate for Payer: Lucent All Commercial |
$430.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$380.00
|
| Rate for Payer: PHCS All Commercial |
$370.62
|
| Rate for Payer: PHP All Commercial |
$432.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$253.26
|
| Rate for Payer: Signature Care EPO |
$377.40
|
| Rate for Payer: Signature Care PPO |
$377.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$355.00
|
| Rate for Payer: United Healthcare Commercial |
$286.45
|
| Rate for Payer: United Healthcare Medicare |
$253.26
|
|
|
PR REMOVAL OF TONSILS,12+ Y/O
|
Professional
|
$470.32
|
|
|
Service Code
|
CPT 42826
|
| Hospital Charge Code |
z42826
|
| Min. Negotiated Rate |
$241.03 |
| Max. Negotiated Rate |
$411.52 |
| Rate for Payer: Aetna Medicare |
$241.03
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$341.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$341.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$277.18
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$265.13
|
| Rate for Payer: Cash Price |
$291.60
|
| Rate for Payer: Cash Price |
$291.60
|
| Rate for Payer: Coventry All Commercial |
$289.24
|
| Rate for Payer: Frontpath All Commercial |
$328.09
|
| Rate for Payer: Humana ChoiceCare |
$283.15
|
| Rate for Payer: Humana Medicare |
$241.03
|
| Rate for Payer: Lucent All Commercial |
$409.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$362.00
|
| Rate for Payer: PHCS All Commercial |
$352.74
|
| Rate for Payer: PHP All Commercial |
$411.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$241.03
|
| Rate for Payer: Signature Care EPO |
$368.90
|
| Rate for Payer: Signature Care PPO |
$368.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$337.00
|
| Rate for Payer: United Healthcare Commercial |
$276.88
|
| Rate for Payer: United Healthcare Medicare |
$241.03
|
|
|
PR REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY
|
Professional
|
$416.06
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
z33233
|
| Min. Negotiated Rate |
$213.23 |
| Max. Negotiated Rate |
$365.50 |
| Rate for Payer: Aetna Medicare |
$213.23
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$245.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$234.55
|
| Rate for Payer: Cash Price |
$257.96
|
| Rate for Payer: Cash Price |
$257.96
|
| Rate for Payer: Coventry All Commercial |
$255.88
|
| Rate for Payer: Frontpath All Commercial |
$302.87
|
| Rate for Payer: Humana ChoiceCare |
$314.43
|
| Rate for Payer: Humana Medicare |
$213.23
|
| Rate for Payer: Lucent All Commercial |
$362.49
|
| Rate for Payer: PHCS All Commercial |
$312.04
|
| Rate for Payer: PHP All Commercial |
$291.24
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$213.23
|
| Rate for Payer: Signature Care EPO |
$365.50
|
| Rate for Payer: Signature Care PPO |
$365.50
|
| Rate for Payer: United Healthcare Commercial |
$289.75
|
| Rate for Payer: United Healthcare Medicare |
$213.23
|
|
|
PR REMOVAL PREPATELLA BURSA
|
Professional
|
$686.42
|
|
|
Service Code
|
CPT 27340
|
| Hospital Charge Code |
z27340
|
| Min. Negotiated Rate |
$351.79 |
| Max. Negotiated Rate |
$598.04 |
| Rate for Payer: Aetna Medicare |
$351.79
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$431.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$431.50
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$404.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$386.97
|
| Rate for Payer: Cash Price |
$425.58
|
| Rate for Payer: Cash Price |
$425.58
|
| Rate for Payer: Coventry All Commercial |
$422.15
|
| Rate for Payer: Frontpath All Commercial |
$484.60
|
| Rate for Payer: Humana ChoiceCare |
$376.52
|
| Rate for Payer: Humana Medicare |
$351.79
|
| Rate for Payer: Lucent All Commercial |
$598.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$563.00
|
| Rate for Payer: PHCS All Commercial |
$514.82
|
| Rate for Payer: PHP All Commercial |
$597.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$351.79
|
| Rate for Payer: Signature Care EPO |
$503.20
|
| Rate for Payer: Signature Care PPO |
$503.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$528.00
|
| Rate for Payer: United Healthcare Commercial |
$384.80
|
| Rate for Payer: United Healthcare Medicare |
$351.79
|
|
|
PR REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR
|
Professional
|
$236.36
|
|
|
Service Code
|
CPT 33286
|
| Hospital Charge Code |
z33286
|
| Min. Negotiated Rate |
$78.22 |
| Max. Negotiated Rate |
$177.27 |
| Rate for Payer: Aetna Medicare |
$78.22
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$123.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$123.42
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$89.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$86.04
|
| Rate for Payer: Cash Price |
$146.54
|
| Rate for Payer: Cash Price |
$146.54
|
| Rate for Payer: Coventry All Commercial |
$93.86
|
| Rate for Payer: Frontpath All Commercial |
$113.37
|
| Rate for Payer: Humana ChoiceCare |
$106.61
|
| Rate for Payer: Humana Medicare |
$78.22
|
| Rate for Payer: Lucent All Commercial |
$132.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$125.00
|
| Rate for Payer: PHCS All Commercial |
$177.27
|
| Rate for Payer: PHP All Commercial |
$106.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$78.22
|
| Rate for Payer: Signature Care EPO |
$174.15
|
| Rate for Payer: Signature Care PPO |
$174.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$117.00
|
| Rate for Payer: United Healthcare Commercial |
$105.64
|
| Rate for Payer: United Healthcare Medicare |
$78.22
|
|
|
PR REMOVAL SUTURES/STAPLES NOT REQUIRING ANESTHESIA
|
Professional
|
$20.20
|
|
|
Service Code
|
CPT 15853
|
| Hospital Charge Code |
z15853
|
| Min. Negotiated Rate |
$10.35 |
| Max. Negotiated Rate |
$17.60 |
| Rate for Payer: Aetna Medicare |
$10.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$11.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$11.38
|
| Rate for Payer: Cash Price |
$12.52
|
| Rate for Payer: Cash Price |
$12.52
|
| Rate for Payer: Coventry All Commercial |
$12.42
|
| Rate for Payer: Humana ChoiceCare |
$10.35
|
| Rate for Payer: Humana Medicare |
$10.35
|
| Rate for Payer: Lucent All Commercial |
$17.60
|
| Rate for Payer: PHCS All Commercial |
$15.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$10.35
|
| Rate for Payer: United Healthcare Commercial |
$13.93
|
| Rate for Payer: United Healthcare Medicare |
$10.35
|
|
|
PR REMOVAL VAGINAL FOR.BODY W ANESTH
|
Professional
|
$321.14
|
|
|
Service Code
|
CPT 57415
|
| Hospital Charge Code |
z57415
|
| Min. Negotiated Rate |
$157.90 |
| Max. Negotiated Rate |
$279.80 |
| Rate for Payer: Aetna Medicare |
$164.59
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$189.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$181.05
|
| Rate for Payer: Cash Price |
$199.11
|
| Rate for Payer: Cash Price |
$199.11
|
| Rate for Payer: Coventry All Commercial |
$197.51
|
| Rate for Payer: Frontpath All Commercial |
$228.15
|
| Rate for Payer: Humana ChoiceCare |
$157.90
|
| Rate for Payer: Humana Medicare |
$164.59
|
| Rate for Payer: Lucent All Commercial |
$279.80
|
| Rate for Payer: PHCS All Commercial |
$240.86
|
| Rate for Payer: PHP All Commercial |
$211.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$164.59
|
| Rate for Payer: Signature Care EPO |
$177.65
|
| Rate for Payer: Signature Care PPO |
$177.65
|
| Rate for Payer: United Healthcare Commercial |
$179.39
|
| Rate for Payer: United Healthcare Medicare |
$164.59
|
|
|
PR REMOVAL W/ REINSERT DRUG IMPLANT DEVICE
|
Professional
|
$258.04
|
|
|
Service Code
|
CPT 11983
|
| Hospital Charge Code |
z11983
|
| Min. Negotiated Rate |
$95.82 |
| Max. Negotiated Rate |
$277.60 |
| Rate for Payer: Aetna Medicare |
$95.82
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$277.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$277.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$110.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$105.40
|
| Rate for Payer: Cash Price |
$159.98
|
| Rate for Payer: Cash Price |
$159.98
|
| Rate for Payer: Coventry All Commercial |
$114.98
|
| Rate for Payer: Frontpath All Commercial |
$135.43
|
| Rate for Payer: Humana ChoiceCare |
$179.33
|
| Rate for Payer: Humana Medicare |
$95.82
|
| Rate for Payer: Lucent All Commercial |
$162.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$125.00
|
| Rate for Payer: PHCS All Commercial |
$193.53
|
| Rate for Payer: PHP All Commercial |
$130.88
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$95.82
|
| Rate for Payer: Signature Care EPO |
$226.76
|
| Rate for Payer: Signature Care PPO |
$226.76
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$115.00
|
| Rate for Payer: United Healthcare Commercial |
$214.59
|
| Rate for Payer: United Healthcare Medicare |
$95.82
|
|
|
PR REMOVE ABD LYMPH NODES RAD REGNL
|
Professional
|
$469.92
|
|
|
Service Code
|
CPT 38747
|
| Hospital Charge Code |
z38747
|
| Min. Negotiated Rate |
$240.83 |
| Max. Negotiated Rate |
$409.41 |
| Rate for Payer: Aetna Medicare |
$240.83
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$358.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$358.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$276.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$264.91
|
| Rate for Payer: Cash Price |
$291.35
|
| Rate for Payer: Cash Price |
$291.35
|
| Rate for Payer: Coventry All Commercial |
$289.00
|
| Rate for Payer: Frontpath All Commercial |
$352.70
|
| Rate for Payer: Humana ChoiceCare |
$329.97
|
| Rate for Payer: Humana Medicare |
$240.83
|
| Rate for Payer: Lucent All Commercial |
$409.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$385.00
|
| Rate for Payer: PHCS All Commercial |
$352.44
|
| Rate for Payer: PHP All Commercial |
$328.94
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$240.83
|
| Rate for Payer: Signature Care EPO |
$355.30
|
| Rate for Payer: Signature Care PPO |
$355.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$361.00
|
| Rate for Payer: United Healthcare Commercial |
$296.89
|
| Rate for Payer: United Healthcare Medicare |
$240.83
|
|
|
PR REMOVE ADDITIONAL NAIL PLATE
|
Professional
|
$61.32
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
z11732
|
| Min. Negotiated Rate |
$16.30 |
| Max. Negotiated Rate |
$48.34 |
| Rate for Payer: Aetna Medicare |
$16.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$48.34
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$48.34
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$18.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$17.93
|
| Rate for Payer: Cash Price |
$38.02
|
| Rate for Payer: Cash Price |
$38.02
|
| Rate for Payer: Coventry All Commercial |
$19.56
|
| Rate for Payer: Frontpath All Commercial |
$22.76
|
| Rate for Payer: Humana ChoiceCare |
$30.31
|
| Rate for Payer: Humana Medicare |
$16.30
|
| Rate for Payer: Lucent All Commercial |
$27.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$21.00
|
| Rate for Payer: PHCS All Commercial |
$45.99
|
| Rate for Payer: PHP All Commercial |
$22.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$16.30
|
| Rate for Payer: Signature Care EPO |
$41.65
|
| Rate for Payer: Signature Care PPO |
$41.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$20.00
|
| Rate for Payer: United Healthcare Commercial |
$34.63
|
| Rate for Payer: United Healthcare Medicare |
$16.30
|
|
|
PR REMOVE ARMPIT LYMPH NODES SUPERFIC
|
Professional
|
$1,253.90
|
|
|
Service Code
|
CPT 38740
|
| Hospital Charge Code |
z38740
|
| Min. Negotiated Rate |
$575.00 |
| Max. Negotiated Rate |
$1,092.45 |
| Rate for Payer: Aetna Medicare |
$642.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$575.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$575.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$739.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$706.88
|
| Rate for Payer: Cash Price |
$777.42
|
| Rate for Payer: Cash Price |
$777.42
|
| Rate for Payer: Coventry All Commercial |
$771.14
|
| Rate for Payer: Frontpath All Commercial |
$922.08
|
| Rate for Payer: Humana ChoiceCare |
$745.31
|
| Rate for Payer: Humana Medicare |
$642.62
|
| Rate for Payer: Lucent All Commercial |
$1,092.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,028.00
|
| Rate for Payer: PHCS All Commercial |
$940.42
|
| Rate for Payer: PHP All Commercial |
$877.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$642.62
|
| Rate for Payer: Signature Care EPO |
$795.60
|
| Rate for Payer: Signature Care PPO |
$795.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$964.00
|
| Rate for Payer: United Healthcare Commercial |
$724.08
|
| Rate for Payer: United Healthcare Medicare |
$642.62
|
|
|
PR REMOVE ARMPITS LYMPH NODES COMPLT
|
Professional
|
$1,574.12
|
|
|
Service Code
|
CPT 38745
|
| Hospital Charge Code |
z38745
|
| Min. Negotiated Rate |
$806.73 |
| Max. Negotiated Rate |
$1,371.44 |
| Rate for Payer: Aetna Medicare |
$806.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$820.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$820.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$927.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$887.40
|
| Rate for Payer: Cash Price |
$975.95
|
| Rate for Payer: Cash Price |
$975.95
|
| Rate for Payer: Coventry All Commercial |
$968.08
|
| Rate for Payer: Frontpath All Commercial |
$1,161.49
|
| Rate for Payer: Humana ChoiceCare |
$957.07
|
| Rate for Payer: Humana Medicare |
$806.73
|
| Rate for Payer: Lucent All Commercial |
$1,371.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,291.00
|
| Rate for Payer: PHCS All Commercial |
$1,180.59
|
| Rate for Payer: PHP All Commercial |
$1,101.88
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$806.73
|
| Rate for Payer: Signature Care EPO |
$1,022.55
|
| Rate for Payer: Signature Care PPO |
$1,022.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,210.00
|
| Rate for Payer: United Healthcare Commercial |
$922.09
|
| Rate for Payer: United Healthcare Medicare |
$806.73
|
|
|
PR REMOVE CERCLAGE SUTURE
|
Professional
|
$233.54
|
|
|
Service Code
|
CPT 59871
|
| Hospital Charge Code |
z59871
|
| Min. Negotiated Rate |
$119.69 |
| Max. Negotiated Rate |
$214.40 |
| Rate for Payer: Aetna Medicare |
$119.69
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$214.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$214.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$137.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$131.66
|
| Rate for Payer: Cash Price |
$144.79
|
| Rate for Payer: Cash Price |
$144.79
|
| Rate for Payer: Coventry All Commercial |
$143.63
|
| Rate for Payer: Frontpath All Commercial |
$170.74
|
| Rate for Payer: Humana ChoiceCare |
$127.78
|
| Rate for Payer: Humana Medicare |
$119.69
|
| Rate for Payer: Lucent All Commercial |
$203.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$168.00
|
| Rate for Payer: PHCS All Commercial |
$175.16
|
| Rate for Payer: PHP All Commercial |
$154.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$119.69
|
| Rate for Payer: Signature Care EPO |
$192.10
|
| Rate for Payer: Signature Care PPO |
$192.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$156.00
|
| Rate for Payer: United Healthcare Commercial |
$150.91
|
| Rate for Payer: United Healthcare Medicare |
$119.69
|
|
