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Service Code CPT C1713
Hospital Charge Code 41603300
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $4,400.95
Rate for Payer: Aetna Commercial $3,993.98
Rate for Payer: Aetna Medicare $1,561.63
Rate for Payer: Anthem Blue Cross of IN Medicare $1,561.63
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $2,717.70
Rate for Payer: Anthem Blue Cross of IN Traditional $2,958.10
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $1,795.87
Rate for Payer: CareSource Indiana of IN Medicare $1,717.79
Rate for Payer: Cash Price $2,933.96
Rate for Payer: Cash Price $2,933.96
Rate for Payer: Centivo All Commercial $2,413.42
Rate for Payer: Cigna All Commercial $4,083.89
Rate for Payer: CORVEL All Commercial $4,400.95
Rate for Payer: Coventry All Commercial $4,164.34
Rate for Payer: Encore All Commercial $4,355.99
Rate for Payer: Frontpath All Commercial $4,353.62
Rate for Payer: Humana ChoiceCare $4,087.20
Rate for Payer: Humana Medicare $2,413.42
Rate for Payer: Lucent All Commercial $2,413.42
Rate for Payer: Lutheran Preferred All Commercial $4,258.98
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $3,549.15
Rate for Payer: PHP All Commercial $3,588.90
Rate for Payer: Plain Church Group Ministry All Commercial $1,845.56
Rate for Payer: Sagamore Health Network All Products $3,653.26
Rate for Payer: Signature Care EPO $3,927.73
Rate for Payer: Signature Care PPO $4,164.34
Rate for Payer: Three Rivers Preferred All Commercial $4,022.37
Rate for Payer: United Healthcare Commercial $3,728.97
Rate for Payer: United Healthcare Medicare $1,561.63
Service Code CPT C1713
Hospital Charge Code 41603300
Hospital Revenue Code 278
Min. Negotiated Rate $3,549.15
Max. Negotiated Rate $4,400.95
Rate for Payer: Aetna Commercial $4,088.62
Rate for Payer: Cash Price $2,933.96
Rate for Payer: Cigna All Commercial $4,083.89
Rate for Payer: CORVEL All Commercial $4,400.95
Rate for Payer: Coventry All Commercial $4,164.34
Rate for Payer: Encore All Commercial $4,355.99
Rate for Payer: Frontpath All Commercial $4,353.62
Rate for Payer: Humana ChoiceCare $4,087.20
Rate for Payer: Lutheran Preferred All Commercial $4,258.98
Rate for Payer: PHCS All Commercial $3,549.15
Rate for Payer: PHP All Commercial $3,588.90
Rate for Payer: Sagamore Health Network All Products $3,653.26
Rate for Payer: Signature Care EPO $3,927.73
Rate for Payer: Signature Care PPO $4,164.34
Rate for Payer: United Healthcare Commercial $3,728.97
Service Code CPT C1713
Hospital Charge Code 41603301
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $4,400.95
Rate for Payer: Aetna Commercial $3,993.98
Rate for Payer: Aetna Medicare $1,561.63
Rate for Payer: Anthem Blue Cross of IN Medicare $1,561.63
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $2,717.70
Rate for Payer: Anthem Blue Cross of IN Traditional $2,958.10
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $1,795.87
Rate for Payer: CareSource Indiana of IN Medicare $1,717.79
Rate for Payer: Cash Price $2,933.96
Rate for Payer: Cash Price $2,933.96
Rate for Payer: Centivo All Commercial $2,413.42
Rate for Payer: Cigna All Commercial $4,083.89
Rate for Payer: CORVEL All Commercial $4,400.95
Rate for Payer: Coventry All Commercial $4,164.34
Rate for Payer: Encore All Commercial $4,355.99
Rate for Payer: Frontpath All Commercial $4,353.62
Rate for Payer: Humana ChoiceCare $4,087.20
Rate for Payer: Humana Medicare $2,413.42
Rate for Payer: Lucent All Commercial $2,413.42
Rate for Payer: Lutheran Preferred All Commercial $4,258.98
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $3,549.15
Rate for Payer: PHP All Commercial $3,588.90
Rate for Payer: Plain Church Group Ministry All Commercial $1,845.56
Rate for Payer: Sagamore Health Network All Products $3,653.26
Rate for Payer: Signature Care EPO $3,927.73
Rate for Payer: Signature Care PPO $4,164.34
Rate for Payer: Three Rivers Preferred All Commercial $4,022.37
Rate for Payer: United Healthcare Commercial $3,728.97
Rate for Payer: United Healthcare Medicare $1,561.63
Service Code CPT C1713
Hospital Charge Code 41603301
Hospital Revenue Code 278
Min. Negotiated Rate $3,549.15
Max. Negotiated Rate $4,400.95
Rate for Payer: Aetna Commercial $4,088.62
Rate for Payer: Cash Price $2,933.96
Rate for Payer: Cigna All Commercial $4,083.89
Rate for Payer: CORVEL All Commercial $4,400.95
Rate for Payer: Coventry All Commercial $4,164.34
Rate for Payer: Encore All Commercial $4,355.99
Rate for Payer: Frontpath All Commercial $4,353.62
Rate for Payer: Humana ChoiceCare $4,087.20
Rate for Payer: Lutheran Preferred All Commercial $4,258.98
Rate for Payer: PHCS All Commercial $3,549.15
Rate for Payer: PHP All Commercial $3,588.90
Rate for Payer: Sagamore Health Network All Products $3,653.26
Rate for Payer: Signature Care EPO $3,927.73
Rate for Payer: Signature Care PPO $4,164.34
Rate for Payer: United Healthcare Commercial $3,728.97
Service Code CPT C1713
Hospital Charge Code 41603297
Hospital Revenue Code 278
Min. Negotiated Rate $3,549.15
Max. Negotiated Rate $4,400.95
Rate for Payer: Aetna Commercial $4,088.62
Rate for Payer: Cash Price $2,933.96
Rate for Payer: Cigna All Commercial $4,083.89
Rate for Payer: CORVEL All Commercial $4,400.95
Rate for Payer: Coventry All Commercial $4,164.34
Rate for Payer: Encore All Commercial $4,355.99
Rate for Payer: Frontpath All Commercial $4,353.62
Rate for Payer: Humana ChoiceCare $4,087.20
Rate for Payer: Lutheran Preferred All Commercial $4,258.98
Rate for Payer: PHCS All Commercial $3,549.15
Rate for Payer: PHP All Commercial $3,588.90
Rate for Payer: Sagamore Health Network All Products $3,653.26
Rate for Payer: Signature Care EPO $3,927.73
Rate for Payer: Signature Care PPO $4,164.34
Rate for Payer: United Healthcare Commercial $3,728.97
Service Code CPT C1713
Hospital Charge Code 41603297
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $4,400.95
Rate for Payer: Aetna Commercial $3,993.98
Rate for Payer: Aetna Medicare $1,561.63
Rate for Payer: Anthem Blue Cross of IN Medicare $1,561.63
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $2,717.70
Rate for Payer: Anthem Blue Cross of IN Traditional $2,958.10
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $1,795.87
Rate for Payer: CareSource Indiana of IN Medicare $1,717.79
Rate for Payer: Cash Price $2,933.96
Rate for Payer: Cash Price $2,933.96
Rate for Payer: Centivo All Commercial $2,413.42
Rate for Payer: Cigna All Commercial $4,083.89
Rate for Payer: CORVEL All Commercial $4,400.95
Rate for Payer: Coventry All Commercial $4,164.34
Rate for Payer: Encore All Commercial $4,355.99
Rate for Payer: Frontpath All Commercial $4,353.62
Rate for Payer: Humana ChoiceCare $4,087.20
Rate for Payer: Humana Medicare $2,413.42
Rate for Payer: Lucent All Commercial $2,413.42
Rate for Payer: Lutheran Preferred All Commercial $4,258.98
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $3,549.15
Rate for Payer: PHP All Commercial $3,588.90
Rate for Payer: Plain Church Group Ministry All Commercial $1,845.56
Rate for Payer: Sagamore Health Network All Products $3,653.26
Rate for Payer: Signature Care EPO $3,927.73
Rate for Payer: Signature Care PPO $4,164.34
Rate for Payer: Three Rivers Preferred All Commercial $4,022.37
Rate for Payer: United Healthcare Commercial $3,728.97
Rate for Payer: United Healthcare Medicare $1,561.63
Service Code CPT C1713
Hospital Charge Code 41603296
Hospital Revenue Code 278
Min. Negotiated Rate $3,549.15
Max. Negotiated Rate $4,400.95
Rate for Payer: Aetna Commercial $4,088.62
Rate for Payer: Cash Price $2,933.96
Rate for Payer: Cigna All Commercial $4,083.89
Rate for Payer: CORVEL All Commercial $4,400.95
Rate for Payer: Coventry All Commercial $4,164.34
Rate for Payer: Encore All Commercial $4,355.99
Rate for Payer: Frontpath All Commercial $4,353.62
Rate for Payer: Humana ChoiceCare $4,087.20
Rate for Payer: Lutheran Preferred All Commercial $4,258.98
Rate for Payer: PHCS All Commercial $3,549.15
Rate for Payer: PHP All Commercial $3,588.90
Rate for Payer: Sagamore Health Network All Products $3,653.26
Rate for Payer: Signature Care EPO $3,927.73
Rate for Payer: Signature Care PPO $4,164.34
Rate for Payer: United Healthcare Commercial $3,728.97
Service Code CPT C1713
Hospital Charge Code 41603296
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $4,400.95
Rate for Payer: Aetna Commercial $3,993.98
Rate for Payer: Aetna Medicare $1,561.63
Rate for Payer: Anthem Blue Cross of IN Medicare $1,561.63
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $2,717.70
Rate for Payer: Anthem Blue Cross of IN Traditional $2,958.10
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $1,795.87
Rate for Payer: CareSource Indiana of IN Medicare $1,717.79
Rate for Payer: Cash Price $2,933.96
Rate for Payer: Cash Price $2,933.96
Rate for Payer: Centivo All Commercial $2,413.42
Rate for Payer: Cigna All Commercial $4,083.89
Rate for Payer: CORVEL All Commercial $4,400.95
Rate for Payer: Coventry All Commercial $4,164.34
Rate for Payer: Encore All Commercial $4,355.99
Rate for Payer: Frontpath All Commercial $4,353.62
Rate for Payer: Humana ChoiceCare $4,087.20
Rate for Payer: Humana Medicare $2,413.42
Rate for Payer: Lucent All Commercial $2,413.42
Rate for Payer: Lutheran Preferred All Commercial $4,258.98
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $3,549.15
Rate for Payer: PHP All Commercial $3,588.90
Rate for Payer: Plain Church Group Ministry All Commercial $1,845.56
Rate for Payer: Sagamore Health Network All Products $3,653.26
Rate for Payer: Signature Care EPO $3,927.73
Rate for Payer: Signature Care PPO $4,164.34
Rate for Payer: Three Rivers Preferred All Commercial $4,022.37
Rate for Payer: United Healthcare Commercial $3,728.97
Rate for Payer: United Healthcare Medicare $1,561.63
Service Code CPT C1713
Hospital Charge Code 41603298
Hospital Revenue Code 278
Min. Negotiated Rate $3,549.15
Max. Negotiated Rate $4,400.95
Rate for Payer: Aetna Commercial $4,088.62
Rate for Payer: Cash Price $2,933.96
Rate for Payer: Cigna All Commercial $4,083.89
Rate for Payer: CORVEL All Commercial $4,400.95
Rate for Payer: Coventry All Commercial $4,164.34
Rate for Payer: Encore All Commercial $4,355.99
Rate for Payer: Frontpath All Commercial $4,353.62
Rate for Payer: Humana ChoiceCare $4,087.20
Rate for Payer: Lutheran Preferred All Commercial $4,258.98
Rate for Payer: PHCS All Commercial $3,549.15
Rate for Payer: PHP All Commercial $3,588.90
Rate for Payer: Sagamore Health Network All Products $3,653.26
Rate for Payer: Signature Care EPO $3,927.73
Rate for Payer: Signature Care PPO $4,164.34
Rate for Payer: United Healthcare Commercial $3,728.97
Service Code CPT C1713
Hospital Charge Code 41603298
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $4,400.95
Rate for Payer: Aetna Commercial $3,993.98
Rate for Payer: Aetna Medicare $1,561.63
Rate for Payer: Anthem Blue Cross of IN Medicare $1,561.63
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $2,717.70
Rate for Payer: Anthem Blue Cross of IN Traditional $2,958.10
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $1,795.87
Rate for Payer: CareSource Indiana of IN Medicare $1,717.79
Rate for Payer: Cash Price $2,933.96
Rate for Payer: Cash Price $2,933.96
Rate for Payer: Centivo All Commercial $2,413.42
Rate for Payer: Cigna All Commercial $4,083.89
Rate for Payer: CORVEL All Commercial $4,400.95
Rate for Payer: Coventry All Commercial $4,164.34
Rate for Payer: Encore All Commercial $4,355.99
Rate for Payer: Frontpath All Commercial $4,353.62
Rate for Payer: Humana ChoiceCare $4,087.20
Rate for Payer: Humana Medicare $2,413.42
Rate for Payer: Lucent All Commercial $2,413.42
Rate for Payer: Lutheran Preferred All Commercial $4,258.98
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $3,549.15
Rate for Payer: PHP All Commercial $3,588.90
Rate for Payer: Plain Church Group Ministry All Commercial $1,845.56
Rate for Payer: Sagamore Health Network All Products $3,653.26
Rate for Payer: Signature Care EPO $3,927.73
Rate for Payer: Signature Care PPO $4,164.34
Rate for Payer: Three Rivers Preferred All Commercial $4,022.37
Rate for Payer: United Healthcare Commercial $3,728.97
Rate for Payer: United Healthcare Medicare $1,561.63
Service Code CPT C1713
Hospital Charge Code 41603374
Hospital Revenue Code 278
Min. Negotiated Rate $202.12
Max. Negotiated Rate $250.64
Rate for Payer: Aetna Commercial $232.85
Rate for Payer: Cash Price $167.09
Rate for Payer: Cigna All Commercial $232.58
Rate for Payer: CORVEL All Commercial $250.64
Rate for Payer: Coventry All Commercial $237.16
Rate for Payer: Encore All Commercial $248.07
Rate for Payer: Frontpath All Commercial $247.94
Rate for Payer: Humana ChoiceCare $232.77
Rate for Payer: Lutheran Preferred All Commercial $242.55
Rate for Payer: PHCS All Commercial $202.12
Rate for Payer: PHP All Commercial $204.39
Rate for Payer: Sagamore Health Network All Products $208.05
Rate for Payer: Signature Care EPO $223.68
Rate for Payer: Signature Care PPO $237.16
Rate for Payer: United Healthcare Commercial $212.37
Service Code CPT C1713
Hospital Charge Code 41603374
Hospital Revenue Code 278
Min. Negotiated Rate $88.94
Max. Negotiated Rate $524.16
Rate for Payer: Aetna Commercial $227.46
Rate for Payer: Aetna Medicare $88.94
Rate for Payer: Anthem Blue Cross of IN Medicare $88.94
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $154.77
Rate for Payer: Anthem Blue Cross of IN Traditional $168.46
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $102.28
Rate for Payer: CareSource Indiana of IN Medicare $97.83
Rate for Payer: Cash Price $167.09
Rate for Payer: Cash Price $167.09
Rate for Payer: Centivo All Commercial $137.44
Rate for Payer: Cigna All Commercial $232.58
Rate for Payer: CORVEL All Commercial $250.64
Rate for Payer: Coventry All Commercial $237.16
Rate for Payer: Encore All Commercial $248.07
Rate for Payer: Frontpath All Commercial $247.94
Rate for Payer: Humana ChoiceCare $232.77
Rate for Payer: Humana Medicare $137.44
Rate for Payer: Lucent All Commercial $137.44
Rate for Payer: Lutheran Preferred All Commercial $242.55
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $202.12
Rate for Payer: PHP All Commercial $204.39
Rate for Payer: Plain Church Group Ministry All Commercial $105.10
Rate for Payer: Sagamore Health Network All Products $208.05
Rate for Payer: Signature Care EPO $223.68
Rate for Payer: Signature Care PPO $237.16
Rate for Payer: Three Rivers Preferred All Commercial $229.08
Rate for Payer: United Healthcare Commercial $212.37
Rate for Payer: United Healthcare Medicare $88.94
Service Code CPT C1713
Hospital Charge Code 41603329
Hospital Revenue Code 278
Min. Negotiated Rate $88.94
Max. Negotiated Rate $524.16
Rate for Payer: Aetna Commercial $227.46
Rate for Payer: Aetna Medicare $88.94
Rate for Payer: Anthem Blue Cross of IN Medicare $88.94
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $154.77
Rate for Payer: Anthem Blue Cross of IN Traditional $168.46
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $102.28
Rate for Payer: CareSource Indiana of IN Medicare $97.83
Rate for Payer: Cash Price $167.09
Rate for Payer: Cash Price $167.09
Rate for Payer: Centivo All Commercial $137.44
Rate for Payer: Cigna All Commercial $232.58
Rate for Payer: CORVEL All Commercial $250.64
Rate for Payer: Coventry All Commercial $237.16
Rate for Payer: Encore All Commercial $248.07
Rate for Payer: Frontpath All Commercial $247.94
Rate for Payer: Humana ChoiceCare $232.77
Rate for Payer: Humana Medicare $137.44
Rate for Payer: Lucent All Commercial $137.44
Rate for Payer: Lutheran Preferred All Commercial $242.55
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $202.12
Rate for Payer: PHP All Commercial $204.39
Rate for Payer: Plain Church Group Ministry All Commercial $105.10
Rate for Payer: Sagamore Health Network All Products $208.05
Rate for Payer: Signature Care EPO $223.68
Rate for Payer: Signature Care PPO $237.16
Rate for Payer: Three Rivers Preferred All Commercial $229.08
Rate for Payer: United Healthcare Commercial $212.37
Rate for Payer: United Healthcare Medicare $88.94
Service Code CPT C1713
Hospital Charge Code 41603329
Hospital Revenue Code 278
Min. Negotiated Rate $202.12
Max. Negotiated Rate $250.64
Rate for Payer: Aetna Commercial $232.85
Rate for Payer: Cash Price $167.09
Rate for Payer: Cigna All Commercial $232.58
Rate for Payer: CORVEL All Commercial $250.64
Rate for Payer: Coventry All Commercial $237.16
Rate for Payer: Encore All Commercial $248.07
Rate for Payer: Frontpath All Commercial $247.94
Rate for Payer: Humana ChoiceCare $232.77
Rate for Payer: Lutheran Preferred All Commercial $242.55
Rate for Payer: PHCS All Commercial $202.12
Rate for Payer: PHP All Commercial $204.39
Rate for Payer: Sagamore Health Network All Products $208.05
Rate for Payer: Signature Care EPO $223.68
Rate for Payer: Signature Care PPO $237.16
Rate for Payer: United Healthcare Commercial $212.37
Service Code CPT C1713
Hospital Charge Code 41603308
Hospital Revenue Code 278
Min. Negotiated Rate $618.75
Max. Negotiated Rate $767.25
Rate for Payer: Aetna Commercial $712.80
Rate for Payer: Cash Price $511.50
Rate for Payer: Cigna All Commercial $711.98
Rate for Payer: CORVEL All Commercial $767.25
Rate for Payer: Coventry All Commercial $726.00
Rate for Payer: Encore All Commercial $759.41
Rate for Payer: Frontpath All Commercial $759.00
Rate for Payer: Humana ChoiceCare $712.55
Rate for Payer: Lutheran Preferred All Commercial $742.50
Rate for Payer: PHCS All Commercial $618.75
Rate for Payer: PHP All Commercial $625.68
Rate for Payer: Sagamore Health Network All Products $636.90
Rate for Payer: Signature Care EPO $684.75
Rate for Payer: Signature Care PPO $726.00
Rate for Payer: United Healthcare Commercial $650.10
Service Code CPT C1713
Hospital Charge Code 41603308
Hospital Revenue Code 278
Min. Negotiated Rate $272.25
Max. Negotiated Rate $767.25
Rate for Payer: Aetna Commercial $696.30
Rate for Payer: Aetna Medicare $272.25
Rate for Payer: Anthem Blue Cross of IN Medicare $272.25
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $473.80
Rate for Payer: Anthem Blue Cross of IN Traditional $515.71
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $313.09
Rate for Payer: CareSource Indiana of IN Medicare $299.48
Rate for Payer: Cash Price $511.50
Rate for Payer: Cash Price $511.50
Rate for Payer: Centivo All Commercial $420.75
Rate for Payer: Cigna All Commercial $711.98
Rate for Payer: CORVEL All Commercial $767.25
Rate for Payer: Coventry All Commercial $726.00
Rate for Payer: Encore All Commercial $759.41
Rate for Payer: Frontpath All Commercial $759.00
Rate for Payer: Humana ChoiceCare $712.55
Rate for Payer: Humana Medicare $420.75
Rate for Payer: Lucent All Commercial $420.75
Rate for Payer: Lutheran Preferred All Commercial $742.50
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $618.75
Rate for Payer: PHP All Commercial $625.68
Rate for Payer: Plain Church Group Ministry All Commercial $321.75
Rate for Payer: Sagamore Health Network All Products $636.90
Rate for Payer: Signature Care EPO $684.75
Rate for Payer: Signature Care PPO $726.00
Rate for Payer: Three Rivers Preferred All Commercial $701.25
Rate for Payer: United Healthcare Commercial $650.10
Rate for Payer: United Healthcare Medicare $272.25
Service Code CPT C1713
Hospital Charge Code 41603352
Hospital Revenue Code 278
Min. Negotiated Rate $88.94
Max. Negotiated Rate $524.16
Rate for Payer: Aetna Commercial $227.46
Rate for Payer: Aetna Medicare $88.94
Rate for Payer: Anthem Blue Cross of IN Medicare $88.94
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $154.77
Rate for Payer: Anthem Blue Cross of IN Traditional $168.46
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $102.28
Rate for Payer: CareSource Indiana of IN Medicare $97.83
Rate for Payer: Cash Price $167.09
Rate for Payer: Cash Price $167.09
Rate for Payer: Centivo All Commercial $137.44
Rate for Payer: Cigna All Commercial $232.58
Rate for Payer: CORVEL All Commercial $250.64
Rate for Payer: Coventry All Commercial $237.16
Rate for Payer: Encore All Commercial $248.07
Rate for Payer: Frontpath All Commercial $247.94
Rate for Payer: Humana ChoiceCare $232.77
Rate for Payer: Humana Medicare $137.44
Rate for Payer: Lucent All Commercial $137.44
Rate for Payer: Lutheran Preferred All Commercial $242.55
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $202.12
Rate for Payer: PHP All Commercial $204.39
Rate for Payer: Plain Church Group Ministry All Commercial $105.10
Rate for Payer: Sagamore Health Network All Products $208.05
Rate for Payer: Signature Care EPO $223.68
Rate for Payer: Signature Care PPO $237.16
Rate for Payer: Three Rivers Preferred All Commercial $229.08
Rate for Payer: United Healthcare Commercial $212.37
Rate for Payer: United Healthcare Medicare $88.94
Service Code CPT C1713
Hospital Charge Code 41603352
Hospital Revenue Code 278
Min. Negotiated Rate $202.12
Max. Negotiated Rate $250.64
Rate for Payer: Aetna Commercial $232.85
Rate for Payer: Cash Price $167.09
Rate for Payer: Cigna All Commercial $232.58
Rate for Payer: CORVEL All Commercial $250.64
Rate for Payer: Coventry All Commercial $237.16
Rate for Payer: Encore All Commercial $248.07
Rate for Payer: Frontpath All Commercial $247.94
Rate for Payer: Humana ChoiceCare $232.77
Rate for Payer: Lutheran Preferred All Commercial $242.55
Rate for Payer: PHCS All Commercial $202.12
Rate for Payer: PHP All Commercial $204.39
Rate for Payer: Sagamore Health Network All Products $208.05
Rate for Payer: Signature Care EPO $223.68
Rate for Payer: Signature Care PPO $237.16
Rate for Payer: United Healthcare Commercial $212.37
Service Code CPT C1713
Hospital Charge Code 41603330
Hospital Revenue Code 278
Min. Negotiated Rate $202.12
Max. Negotiated Rate $250.64
Rate for Payer: Aetna Commercial $232.85
Rate for Payer: Cash Price $167.09
Rate for Payer: Cigna All Commercial $232.58
Rate for Payer: CORVEL All Commercial $250.64
Rate for Payer: Coventry All Commercial $237.16
Rate for Payer: Encore All Commercial $248.07
Rate for Payer: Frontpath All Commercial $247.94
Rate for Payer: Humana ChoiceCare $232.77
Rate for Payer: Lutheran Preferred All Commercial $242.55
Rate for Payer: PHCS All Commercial $202.12
Rate for Payer: PHP All Commercial $204.39
Rate for Payer: Sagamore Health Network All Products $208.05
Rate for Payer: Signature Care EPO $223.68
Rate for Payer: Signature Care PPO $237.16
Rate for Payer: United Healthcare Commercial $212.37
Service Code CPT C1713
Hospital Charge Code 41603330
Hospital Revenue Code 278
Min. Negotiated Rate $88.94
Max. Negotiated Rate $524.16
Rate for Payer: Aetna Commercial $227.46
Rate for Payer: Aetna Medicare $88.94
Rate for Payer: Anthem Blue Cross of IN Medicare $88.94
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $154.77
Rate for Payer: Anthem Blue Cross of IN Traditional $168.46
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $102.28
Rate for Payer: CareSource Indiana of IN Medicare $97.83
Rate for Payer: Cash Price $167.09
Rate for Payer: Cash Price $167.09
Rate for Payer: Centivo All Commercial $137.44
Rate for Payer: Cigna All Commercial $232.58
Rate for Payer: CORVEL All Commercial $250.64
Rate for Payer: Coventry All Commercial $237.16
Rate for Payer: Encore All Commercial $248.07
Rate for Payer: Frontpath All Commercial $247.94
Rate for Payer: Humana ChoiceCare $232.77
Rate for Payer: Humana Medicare $137.44
Rate for Payer: Lucent All Commercial $137.44
Rate for Payer: Lutheran Preferred All Commercial $242.55
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $202.12
Rate for Payer: PHP All Commercial $204.39
Rate for Payer: Plain Church Group Ministry All Commercial $105.10
Rate for Payer: Sagamore Health Network All Products $208.05
Rate for Payer: Signature Care EPO $223.68
Rate for Payer: Signature Care PPO $237.16
Rate for Payer: Three Rivers Preferred All Commercial $229.08
Rate for Payer: United Healthcare Commercial $212.37
Rate for Payer: United Healthcare Medicare $88.94
Service Code CPT C1713
Hospital Charge Code 41603309
Hospital Revenue Code 278
Min. Negotiated Rate $618.75
Max. Negotiated Rate $767.25
Rate for Payer: Aetna Commercial $712.80
Rate for Payer: Cash Price $511.50
Rate for Payer: Cigna All Commercial $711.98
Rate for Payer: CORVEL All Commercial $767.25
Rate for Payer: Coventry All Commercial $726.00
Rate for Payer: Encore All Commercial $759.41
Rate for Payer: Frontpath All Commercial $759.00
Rate for Payer: Humana ChoiceCare $712.55
Rate for Payer: Lutheran Preferred All Commercial $742.50
Rate for Payer: PHCS All Commercial $618.75
Rate for Payer: PHP All Commercial $625.68
Rate for Payer: Sagamore Health Network All Products $636.90
Rate for Payer: Signature Care EPO $684.75
Rate for Payer: Signature Care PPO $726.00
Rate for Payer: United Healthcare Commercial $650.10
Service Code CPT C1713
Hospital Charge Code 41603309
Hospital Revenue Code 278
Min. Negotiated Rate $272.25
Max. Negotiated Rate $767.25
Rate for Payer: Aetna Commercial $696.30
Rate for Payer: Aetna Medicare $272.25
Rate for Payer: Anthem Blue Cross of IN Medicare $272.25
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $473.80
Rate for Payer: Anthem Blue Cross of IN Traditional $515.71
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $313.09
Rate for Payer: CareSource Indiana of IN Medicare $299.48
Rate for Payer: Cash Price $511.50
Rate for Payer: Cash Price $511.50
Rate for Payer: Centivo All Commercial $420.75
Rate for Payer: Cigna All Commercial $711.98
Rate for Payer: CORVEL All Commercial $767.25
Rate for Payer: Coventry All Commercial $726.00
Rate for Payer: Encore All Commercial $759.41
Rate for Payer: Frontpath All Commercial $759.00
Rate for Payer: Humana ChoiceCare $712.55
Rate for Payer: Humana Medicare $420.75
Rate for Payer: Lucent All Commercial $420.75
Rate for Payer: Lutheran Preferred All Commercial $742.50
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $618.75
Rate for Payer: PHP All Commercial $625.68
Rate for Payer: Plain Church Group Ministry All Commercial $321.75
Rate for Payer: Sagamore Health Network All Products $636.90
Rate for Payer: Signature Care EPO $684.75
Rate for Payer: Signature Care PPO $726.00
Rate for Payer: Three Rivers Preferred All Commercial $701.25
Rate for Payer: United Healthcare Commercial $650.10
Rate for Payer: United Healthcare Medicare $272.25
Service Code CPT C1713
Hospital Charge Code 41603353
Hospital Revenue Code 278
Min. Negotiated Rate $88.94
Max. Negotiated Rate $524.16
Rate for Payer: Aetna Commercial $227.46
Rate for Payer: Aetna Medicare $88.94
Rate for Payer: Anthem Blue Cross of IN Medicare $88.94
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $154.77
Rate for Payer: Anthem Blue Cross of IN Traditional $168.46
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $102.28
Rate for Payer: CareSource Indiana of IN Medicare $97.83
Rate for Payer: Cash Price $167.09
Rate for Payer: Cash Price $167.09
Rate for Payer: Centivo All Commercial $137.44
Rate for Payer: Cigna All Commercial $232.58
Rate for Payer: CORVEL All Commercial $250.64
Rate for Payer: Coventry All Commercial $237.16
Rate for Payer: Encore All Commercial $248.07
Rate for Payer: Frontpath All Commercial $247.94
Rate for Payer: Humana ChoiceCare $232.77
Rate for Payer: Humana Medicare $137.44
Rate for Payer: Lucent All Commercial $137.44
Rate for Payer: Lutheran Preferred All Commercial $242.55
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $202.12
Rate for Payer: PHP All Commercial $204.39
Rate for Payer: Plain Church Group Ministry All Commercial $105.10
Rate for Payer: Sagamore Health Network All Products $208.05
Rate for Payer: Signature Care EPO $223.68
Rate for Payer: Signature Care PPO $237.16
Rate for Payer: Three Rivers Preferred All Commercial $229.08
Rate for Payer: United Healthcare Commercial $212.37
Rate for Payer: United Healthcare Medicare $88.94
Service Code CPT C1713
Hospital Charge Code 41603353
Hospital Revenue Code 278
Min. Negotiated Rate $202.12
Max. Negotiated Rate $250.64
Rate for Payer: Aetna Commercial $232.85
Rate for Payer: Cash Price $167.09
Rate for Payer: Cigna All Commercial $232.58
Rate for Payer: CORVEL All Commercial $250.64
Rate for Payer: Coventry All Commercial $237.16
Rate for Payer: Encore All Commercial $248.07
Rate for Payer: Frontpath All Commercial $247.94
Rate for Payer: Humana ChoiceCare $232.77
Rate for Payer: Lutheran Preferred All Commercial $242.55
Rate for Payer: PHCS All Commercial $202.12
Rate for Payer: PHP All Commercial $204.39
Rate for Payer: Sagamore Health Network All Products $208.05
Rate for Payer: Signature Care EPO $223.68
Rate for Payer: Signature Care PPO $237.16
Rate for Payer: United Healthcare Commercial $212.37
Service Code CPT C1713
Hospital Charge Code 41603331
Hospital Revenue Code 278
Min. Negotiated Rate $88.94
Max. Negotiated Rate $524.16
Rate for Payer: Aetna Commercial $227.46
Rate for Payer: Aetna Medicare $88.94
Rate for Payer: Anthem Blue Cross of IN Medicare $88.94
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $154.77
Rate for Payer: Anthem Blue Cross of IN Traditional $168.46
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $102.28
Rate for Payer: CareSource Indiana of IN Medicare $97.83
Rate for Payer: Cash Price $167.09
Rate for Payer: Cash Price $167.09
Rate for Payer: Centivo All Commercial $137.44
Rate for Payer: Cigna All Commercial $232.58
Rate for Payer: CORVEL All Commercial $250.64
Rate for Payer: Coventry All Commercial $237.16
Rate for Payer: Encore All Commercial $248.07
Rate for Payer: Frontpath All Commercial $247.94
Rate for Payer: Humana ChoiceCare $232.77
Rate for Payer: Humana Medicare $137.44
Rate for Payer: Lucent All Commercial $137.44
Rate for Payer: Lutheran Preferred All Commercial $242.55
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $202.12
Rate for Payer: PHP All Commercial $204.39
Rate for Payer: Plain Church Group Ministry All Commercial $105.10
Rate for Payer: Sagamore Health Network All Products $208.05
Rate for Payer: Signature Care EPO $223.68
Rate for Payer: Signature Care PPO $237.16
Rate for Payer: Three Rivers Preferred All Commercial $229.08
Rate for Payer: United Healthcare Commercial $212.37
Rate for Payer: United Healthcare Medicare $88.94