|
CHG HETEROPHILE ANTIBODIES,SCREEN
|
Professional
|
Both
|
$10.36
|
|
|
Service Code
|
CPT 86308
|
| Hospital Charge Code |
z86308
|
| Min. Negotiated Rate |
$2.45 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna Commercial |
$5.18
|
| Rate for Payer: Aetna Medicare |
$5.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$2.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2.45
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$2.45
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2.45
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$5.18
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5.70
|
| Rate for Payer: Cash Price |
$6.22
|
| Rate for Payer: Centivo All Commercial |
$8.03
|
| Rate for Payer: Cigna All Commercial |
$5.18
|
| Rate for Payer: CORVEL All Commercial |
$5.18
|
| Rate for Payer: Coventry All Commercial |
$6.22
|
| Rate for Payer: Encore All Commercial |
$5.18
|
| Rate for Payer: Frontpath All Commercial |
$5.18
|
| Rate for Payer: Humana ChoiceCare |
$5.18
|
| Rate for Payer: Humana Medicare |
$5.18
|
| Rate for Payer: Lucent All Commercial |
$7.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7.00
|
| Rate for Payer: Managed Health Services Medicaid |
$5.18
|
| Rate for Payer: MDWise Medicaid |
$5.18
|
| Rate for Payer: PHCS All Commercial |
$5.18
|
| Rate for Payer: PHP All Commercial |
$4.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5.18
|
| Rate for Payer: Sagamore Health Network All Products |
$5.18
|
| Rate for Payer: Signature Care EPO |
$6.80
|
| Rate for Payer: Signature Care PPO |
$6.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$700.00
|
| Rate for Payer: United Healthcare Commercial |
$7.56
|
|
|
CHG IAADIADOO INFLUENZA
|
Professional
|
Both
|
$33.10
|
|
|
Service Code
|
CPT 87804
|
| Hospital Charge Code |
z87804
|
| Min. Negotiated Rate |
$14.56 |
| Max. Negotiated Rate |
$2,200.00 |
| Rate for Payer: Aetna Commercial |
$16.55
|
| Rate for Payer: Aetna Medicare |
$16.55
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$16.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$16.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$16.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$16.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$16.55
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$19.03
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$18.20
|
| Rate for Payer: Cash Price |
$19.86
|
| Rate for Payer: Centivo All Commercial |
$25.65
|
| Rate for Payer: Cigna All Commercial |
$16.55
|
| Rate for Payer: CORVEL All Commercial |
$16.55
|
| Rate for Payer: Coventry All Commercial |
$19.86
|
| Rate for Payer: Encore All Commercial |
$16.55
|
| Rate for Payer: Frontpath All Commercial |
$16.55
|
| Rate for Payer: Humana ChoiceCare |
$16.55
|
| Rate for Payer: Humana Medicare |
$16.55
|
| Rate for Payer: Lucent All Commercial |
$23.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$23.00
|
| Rate for Payer: Managed Health Services Medicaid |
$16.55
|
| Rate for Payer: MDWise Medicaid |
$16.55
|
| Rate for Payer: PHCS All Commercial |
$16.55
|
| Rate for Payer: PHP All Commercial |
$14.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$16.55
|
| Rate for Payer: Sagamore Health Network All Products |
$16.55
|
| Rate for Payer: Signature Care EPO |
$15.30
|
| Rate for Payer: Signature Care PPO |
$15.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,200.00
|
| Rate for Payer: United Healthcare Commercial |
$17.52
|
|
|
CHG IAADIADOO RESPIRATORY SYNCTIAL VIRUS
|
Professional
|
Both
|
$26.20
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
z87807
|
| Min. Negotiated Rate |
$10.51 |
| Max. Negotiated Rate |
$1,700.00 |
| Rate for Payer: Aetna Commercial |
$13.10
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$11.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$11.68
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$11.68
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$11.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$13.10
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$15.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$14.41
|
| Rate for Payer: Cash Price |
$15.72
|
| Rate for Payer: Centivo All Commercial |
$20.30
|
| Rate for Payer: Cigna All Commercial |
$13.10
|
| Rate for Payer: CORVEL All Commercial |
$13.10
|
| Rate for Payer: Coventry All Commercial |
$15.72
|
| Rate for Payer: Encore All Commercial |
$13.10
|
| Rate for Payer: Frontpath All Commercial |
$13.10
|
| Rate for Payer: Humana ChoiceCare |
$13.10
|
| Rate for Payer: Humana Medicare |
$13.10
|
| Rate for Payer: Lucent All Commercial |
$18.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$18.00
|
| Rate for Payer: Managed Health Services Medicaid |
$13.10
|
| Rate for Payer: MDWise Medicaid |
$13.10
|
| Rate for Payer: PHCS All Commercial |
$13.10
|
| Rate for Payer: PHP All Commercial |
$11.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$13.10
|
| Rate for Payer: Sagamore Health Network All Products |
$13.10
|
| Rate for Payer: Signature Care EPO |
$15.30
|
| Rate for Payer: Signature Care PPO |
$15.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,700.00
|
| Rate for Payer: United Healthcare Commercial |
$10.51
|
|
|
CHG IAADIADOO SEVERE AQT RESPIR SYND CORONAVIRUS
|
Professional
|
Both
|
$87.26
|
|
|
Service Code
|
CPT 87811
|
| Hospital Charge Code |
z87811
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$42.38 |
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$41.38
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$41.38
|
| Rate for Payer: Cash Price |
$52.36
|
| Rate for Payer: Cash Price |
$49.66
|
| Rate for Payer: Frontpath All Commercial |
$36.80
|
| Rate for Payer: Frontpath All Commercial |
$36.80
|
| Rate for Payer: Humana ChoiceCare |
$41.38
|
| Rate for Payer: Humana ChoiceCare |
$41.38
|
| Rate for Payer: Managed Health Services Medicaid |
$41.38
|
| Rate for Payer: Managed Health Services Medicaid |
$41.38
|
| Rate for Payer: MDWise Medicaid |
$41.38
|
| Rate for Payer: MDWise Medicaid |
$41.38
|
| Rate for Payer: PHP All Commercial |
$36.41
|
| Rate for Payer: PHP All Commercial |
$36.41
|
| Rate for Payer: Signature Care EPO |
$0.01
|
| Rate for Payer: Signature Care EPO |
$0.01
|
| Rate for Payer: Signature Care PPO |
$0.01
|
| Rate for Payer: Signature Care PPO |
$0.01
|
| Rate for Payer: United Healthcare Commercial |
$42.38
|
| Rate for Payer: United Healthcare Commercial |
$42.38
|
| Rate for Payer: United Healthcare Medicare |
$41.38
|
| Rate for Payer: United Healthcare Medicare |
$41.38
|
|
|
CHG IAADIADOO STREPTOCOCCUS GROUP A
|
Professional
|
Both
|
$33.06
|
|
|
Service Code
|
CPT 87880
|
| Hospital Charge Code |
z87880
|
| Min. Negotiated Rate |
$14.55 |
| Max. Negotiated Rate |
$2,100.00 |
| Rate for Payer: Aetna Commercial |
$16.53
|
| Rate for Payer: Aetna Medicare |
$16.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$16.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$16.53
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$16.53
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$16.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$16.53
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$19.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$18.18
|
| Rate for Payer: Cash Price |
$19.84
|
| Rate for Payer: Centivo All Commercial |
$25.62
|
| Rate for Payer: Cigna All Commercial |
$16.53
|
| Rate for Payer: CORVEL All Commercial |
$16.53
|
| Rate for Payer: Coventry All Commercial |
$19.84
|
| Rate for Payer: Encore All Commercial |
$16.53
|
| Rate for Payer: Frontpath All Commercial |
$16.53
|
| Rate for Payer: Humana ChoiceCare |
$16.53
|
| Rate for Payer: Humana Medicare |
$16.53
|
| Rate for Payer: Lucent All Commercial |
$23.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$23.00
|
| Rate for Payer: Managed Health Services Medicaid |
$16.53
|
| Rate for Payer: MDWise Medicaid |
$16.53
|
| Rate for Payer: PHCS All Commercial |
$16.53
|
| Rate for Payer: PHP All Commercial |
$14.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$16.53
|
| Rate for Payer: Sagamore Health Network All Products |
$16.53
|
| Rate for Payer: Signature Care EPO |
$15.30
|
| Rate for Payer: Signature Care PPO |
$15.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,100.00
|
| Rate for Payer: United Healthcare Commercial |
$17.52
|
|
|
CHG IAAD IA INFLUENZA A/B EACH
|
Professional
|
Both
|
$28.26
|
|
|
Service Code
|
CPT 87400
|
| Hospital Charge Code |
z87400
|
| Min. Negotiated Rate |
$5.67 |
| Max. Negotiated Rate |
$1,800.00 |
| Rate for Payer: Aetna Commercial |
$14.13
|
| Rate for Payer: Aetna Medicare |
$14.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$5.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5.67
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$5.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$14.13
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$16.25
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$15.54
|
| Rate for Payer: Cash Price |
$16.96
|
| Rate for Payer: Centivo All Commercial |
$21.90
|
| Rate for Payer: Cigna All Commercial |
$14.13
|
| Rate for Payer: CORVEL All Commercial |
$14.13
|
| Rate for Payer: Coventry All Commercial |
$16.96
|
| Rate for Payer: Encore All Commercial |
$14.13
|
| Rate for Payer: Frontpath All Commercial |
$14.13
|
| Rate for Payer: Humana ChoiceCare |
$14.13
|
| Rate for Payer: Humana Medicare |
$14.13
|
| Rate for Payer: Lucent All Commercial |
$19.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$20.00
|
| Rate for Payer: Managed Health Services Medicaid |
$14.13
|
| Rate for Payer: MDWise Medicaid |
$14.13
|
| Rate for Payer: PHCS All Commercial |
$14.13
|
| Rate for Payer: PHP All Commercial |
$12.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$14.13
|
| Rate for Payer: Sagamore Health Network All Products |
$14.13
|
| Rate for Payer: Signature Care EPO |
$15.30
|
| Rate for Payer: Signature Care PPO |
$15.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,800.00
|
| Rate for Payer: United Healthcare Commercial |
$10.51
|
|
|
CHG IAAD IA SEVERE AQT RESPIR SYND CORONAVIRUS
|
Professional
|
Both
|
$70.66
|
|
|
Service Code
|
CPT 87426
|
| Hospital Charge Code |
z87426
|
| Min. Negotiated Rate |
$24.83 |
| Max. Negotiated Rate |
$4,600.00 |
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$25.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$25.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$25.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$25.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$35.33
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Frontpath All Commercial |
$31.59
|
| Rate for Payer: Humana ChoiceCare |
$35.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$49.00
|
| Rate for Payer: Managed Health Services Medicaid |
$35.33
|
| Rate for Payer: MDWise Medicaid |
$35.33
|
| Rate for Payer: PHP All Commercial |
$31.09
|
| Rate for Payer: Signature Care EPO |
$51.00
|
| Rate for Payer: Signature Care PPO |
$51.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,600.00
|
| Rate for Payer: United Healthcare Commercial |
$24.83
|
| Rate for Payer: United Healthcare Medicare |
$35.33
|
|
|
CHG IADNA DNA/RNA RSV AMPLIFIED PROBE TECHNIQUE
|
Professional
|
Both
|
$140.40
|
|
|
Service Code
|
CPT 87634
|
| Hospital Charge Code |
z87634
|
| Min. Negotiated Rate |
$52.00 |
| Max. Negotiated Rate |
$108.81 |
| Rate for Payer: Aetna Commercial |
$70.20
|
| Rate for Payer: Aetna Medicare |
$70.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$70.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$80.73
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$77.22
|
| Rate for Payer: Cash Price |
$84.24
|
| Rate for Payer: Centivo All Commercial |
$108.81
|
| Rate for Payer: Cigna All Commercial |
$70.20
|
| Rate for Payer: CORVEL All Commercial |
$70.20
|
| Rate for Payer: Coventry All Commercial |
$84.24
|
| Rate for Payer: Encore All Commercial |
$70.20
|
| Rate for Payer: Frontpath All Commercial |
$70.20
|
| Rate for Payer: Humana ChoiceCare |
$70.20
|
| Rate for Payer: Humana Medicare |
$70.20
|
| Rate for Payer: Lucent All Commercial |
$98.28
|
| Rate for Payer: Managed Health Services Medicaid |
$70.20
|
| Rate for Payer: MDWise Medicaid |
$70.20
|
| Rate for Payer: PHCS All Commercial |
$70.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$70.20
|
| Rate for Payer: Sagamore Health Network All Products |
$70.20
|
| Rate for Payer: United Healthcare Commercial |
$52.00
|
|
|
CHG IA INFECTIOUS AGT ANTIBODY QUAL/SEMIQ 1STEP METH
|
Professional
|
Both
|
$36.18
|
|
|
Service Code
|
CPT 86318
|
| Hospital Charge Code |
z86318
|
| Min. Negotiated Rate |
$6.12 |
| Max. Negotiated Rate |
$2,400.00 |
| Rate for Payer: Aetna Commercial |
$18.09
|
| Rate for Payer: Aetna Medicare |
$18.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$6.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$6.12
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$6.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$6.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$18.09
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$20.80
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$19.90
|
| Rate for Payer: Cash Price |
$21.71
|
| Rate for Payer: Centivo All Commercial |
$28.04
|
| Rate for Payer: Cigna All Commercial |
$18.09
|
| Rate for Payer: CORVEL All Commercial |
$18.09
|
| Rate for Payer: Coventry All Commercial |
$21.71
|
| Rate for Payer: Encore All Commercial |
$18.09
|
| Rate for Payer: Frontpath All Commercial |
$18.09
|
| Rate for Payer: Humana ChoiceCare |
$18.09
|
| Rate for Payer: Humana Medicare |
$18.09
|
| Rate for Payer: Lucent All Commercial |
$25.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$25.00
|
| Rate for Payer: Managed Health Services Medicaid |
$18.09
|
| Rate for Payer: MDWise Medicaid |
$18.09
|
| Rate for Payer: PHCS All Commercial |
$18.09
|
| Rate for Payer: PHP All Commercial |
$15.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$18.09
|
| Rate for Payer: Sagamore Health Network All Products |
$18.09
|
| Rate for Payer: Signature Care EPO |
$17.00
|
| Rate for Payer: Signature Care PPO |
$17.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,400.00
|
| Rate for Payer: United Healthcare Commercial |
$18.91
|
|
|
CHG INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES
|
Professional
|
Both
|
$191.60
|
|
|
Service Code
|
CPT 87502
|
| Hospital Charge Code |
z87502
|
| Min. Negotiated Rate |
$47.90 |
| Max. Negotiated Rate |
$12,500.00 |
| Rate for Payer: Aetna Commercial |
$95.80
|
| Rate for Payer: Aetna Medicare |
$95.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$47.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$47.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$47.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$47.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$95.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$110.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$105.38
|
| Rate for Payer: Cash Price |
$114.96
|
| Rate for Payer: Centivo All Commercial |
$148.49
|
| Rate for Payer: Cigna All Commercial |
$95.80
|
| Rate for Payer: CORVEL All Commercial |
$95.80
|
| Rate for Payer: Coventry All Commercial |
$114.96
|
| Rate for Payer: Encore All Commercial |
$95.80
|
| Rate for Payer: Frontpath All Commercial |
$95.80
|
| Rate for Payer: Humana ChoiceCare |
$95.80
|
| Rate for Payer: Humana Medicare |
$95.80
|
| Rate for Payer: Lucent All Commercial |
$134.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$134.00
|
| Rate for Payer: Managed Health Services Medicaid |
$95.80
|
| Rate for Payer: MDWise Medicaid |
$95.80
|
| Rate for Payer: PHCS All Commercial |
$95.80
|
| Rate for Payer: PHP All Commercial |
$84.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$95.80
|
| Rate for Payer: Sagamore Health Network All Products |
$95.80
|
| Rate for Payer: Signature Care EPO |
$111.97
|
| Rate for Payer: Signature Care PPO |
$111.97
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,500.00
|
| Rate for Payer: United Healthcare Commercial |
$71.85
|
|
|
CHG MANUAL APPL STRESS PFRMD PHYS/QHP JOINT FILMS
|
Professional
|
Both
|
$99.18
|
|
|
Service Code
|
CPT 77071
|
| Hospital Charge Code |
z77071
|
| Min. Negotiated Rate |
$33.20 |
| Max. Negotiated Rate |
$91.58 |
| Rate for Payer: Aetna Commercial |
$51.60
|
| Rate for Payer: Aetna Commercial |
$51.60
|
| Rate for Payer: Aetna Medicare |
$51.60
|
| Rate for Payer: Aetna Medicare |
$51.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$49.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$49.86
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$59.34
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$59.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$56.76
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$56.76
|
| Rate for Payer: Cash Price |
$60.83
|
| Rate for Payer: Cash Price |
$59.51
|
| Rate for Payer: Centivo All Commercial |
$79.98
|
| Rate for Payer: Centivo All Commercial |
$79.98
|
| Rate for Payer: Cigna All Commercial |
$51.60
|
| Rate for Payer: Cigna All Commercial |
$51.60
|
| Rate for Payer: CORVEL All Commercial |
$51.60
|
| Rate for Payer: CORVEL All Commercial |
$51.60
|
| Rate for Payer: Coventry All Commercial |
$61.92
|
| Rate for Payer: Coventry All Commercial |
$61.92
|
| Rate for Payer: Encore All Commercial |
$51.60
|
| Rate for Payer: Encore All Commercial |
$51.60
|
| Rate for Payer: Frontpath All Commercial |
$91.58
|
| Rate for Payer: Frontpath All Commercial |
$91.58
|
| Rate for Payer: Humana ChoiceCare |
$33.20
|
| Rate for Payer: Humana ChoiceCare |
$33.20
|
| Rate for Payer: Humana Medicare |
$51.60
|
| Rate for Payer: Humana Medicare |
$51.60
|
| Rate for Payer: Lucent All Commercial |
$72.24
|
| Rate for Payer: Lucent All Commercial |
$72.24
|
| Rate for Payer: Managed Health Services Medicaid |
$49.86
|
| Rate for Payer: Managed Health Services Medicaid |
$49.86
|
| Rate for Payer: MDWise Medicaid |
$49.86
|
| Rate for Payer: MDWise Medicaid |
$49.86
|
| Rate for Payer: PHCS All Commercial |
$51.60
|
| Rate for Payer: PHCS All Commercial |
$51.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$51.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$51.60
|
| Rate for Payer: Sagamore Health Network All Products |
$51.60
|
| Rate for Payer: Sagamore Health Network All Products |
$51.60
|
| Rate for Payer: United Healthcare Commercial |
$36.61
|
| Rate for Payer: United Healthcare Commercial |
$36.61
|
| Rate for Payer: United Healthcare Medicare |
$49.59
|
| Rate for Payer: United Healthcare Medicare |
$49.59
|
|
|
CHG MYOCARDIAL SPECT MULTIPLE STUDIES
|
Professional
|
Both
|
$795.48
|
|
|
Service Code
|
CPT 78452
|
| Hospital Charge Code |
z78452
|
| Min. Negotiated Rate |
$389.30 |
| Max. Negotiated Rate |
$59,100.00 |
| Rate for Payer: Aetna Commercial |
$421.32
|
| Rate for Payer: Aetna Commercial |
$421.32
|
| Rate for Payer: Aetna Medicare |
$421.32
|
| Rate for Payer: Aetna Medicare |
$421.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$422.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$422.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$422.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$422.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$422.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$422.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$422.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$422.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$394.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$394.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$484.52
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$484.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$463.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$463.45
|
| Rate for Payer: Cash Price |
$86.12
|
| Rate for Payer: Cash Price |
$477.29
|
| Rate for Payer: Centivo All Commercial |
$653.05
|
| Rate for Payer: Centivo All Commercial |
$653.05
|
| Rate for Payer: Cigna All Commercial |
$421.32
|
| Rate for Payer: Cigna All Commercial |
$421.32
|
| Rate for Payer: CORVEL All Commercial |
$421.32
|
| Rate for Payer: CORVEL All Commercial |
$421.32
|
| Rate for Payer: Coventry All Commercial |
$505.58
|
| Rate for Payer: Coventry All Commercial |
$505.58
|
| Rate for Payer: Encore All Commercial |
$421.32
|
| Rate for Payer: Encore All Commercial |
$421.32
|
| Rate for Payer: Frontpath All Commercial |
$730.71
|
| Rate for Payer: Frontpath All Commercial |
$730.71
|
| Rate for Payer: Humana ChoiceCare |
$501.00
|
| Rate for Payer: Humana ChoiceCare |
$501.00
|
| Rate for Payer: Humana Medicare |
$421.32
|
| Rate for Payer: Humana Medicare |
$421.32
|
| Rate for Payer: Lucent All Commercial |
$589.85
|
| Rate for Payer: Lucent All Commercial |
$589.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$632.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$632.00
|
| Rate for Payer: Managed Health Services Medicaid |
$394.30
|
| Rate for Payer: Managed Health Services Medicaid |
$394.30
|
| Rate for Payer: MDWise Medicaid |
$394.30
|
| Rate for Payer: MDWise Medicaid |
$394.30
|
| Rate for Payer: PHCS All Commercial |
$421.32
|
| Rate for Payer: PHCS All Commercial |
$421.32
|
| Rate for Payer: PHP All Commercial |
$517.07
|
| Rate for Payer: PHP All Commercial |
$517.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$421.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$421.32
|
| Rate for Payer: Sagamore Health Network All Products |
$421.32
|
| Rate for Payer: Sagamore Health Network All Products |
$421.32
|
| Rate for Payer: Signature Care EPO |
$389.30
|
| Rate for Payer: Signature Care EPO |
$389.30
|
| Rate for Payer: Signature Care PPO |
$389.30
|
| Rate for Payer: Signature Care PPO |
$389.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$59,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$59,100.00
|
| Rate for Payer: United Healthcare Commercial |
$514.77
|
| Rate for Payer: United Healthcare Commercial |
$514.77
|
|
|
CHG MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS
|
Professional
|
Both
|
$575.06
|
|
|
Service Code
|
CPT 78451
|
| Hospital Charge Code |
z78451
|
| Min. Negotiated Rate |
$248.24 |
| Max. Negotiated Rate |
$42,700.00 |
| Rate for Payer: Aetna Commercial |
$303.20
|
| Rate for Payer: Aetna Commercial |
$303.20
|
| Rate for Payer: Aetna Medicare |
$303.20
|
| Rate for Payer: Aetna Medicare |
$303.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$248.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$248.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$248.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$248.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$248.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$248.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$248.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$248.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$285.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$285.58
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$348.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$348.68
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$333.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$333.52
|
| Rate for Payer: Cash Price |
$73.03
|
| Rate for Payer: Cash Price |
$345.04
|
| Rate for Payer: Centivo All Commercial |
$469.96
|
| Rate for Payer: Centivo All Commercial |
$469.96
|
| Rate for Payer: Cigna All Commercial |
$303.20
|
| Rate for Payer: Cigna All Commercial |
$303.20
|
| Rate for Payer: CORVEL All Commercial |
$303.20
|
| Rate for Payer: CORVEL All Commercial |
$303.20
|
| Rate for Payer: Coventry All Commercial |
$363.84
|
| Rate for Payer: Coventry All Commercial |
$363.84
|
| Rate for Payer: Encore All Commercial |
$303.20
|
| Rate for Payer: Encore All Commercial |
$303.20
|
| Rate for Payer: Frontpath All Commercial |
$525.38
|
| Rate for Payer: Frontpath All Commercial |
$525.38
|
| Rate for Payer: Humana ChoiceCare |
$359.76
|
| Rate for Payer: Humana ChoiceCare |
$359.76
|
| Rate for Payer: Humana Medicare |
$303.20
|
| Rate for Payer: Humana Medicare |
$303.20
|
| Rate for Payer: Lucent All Commercial |
$424.48
|
| Rate for Payer: Lucent All Commercial |
$424.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$457.00
|
| Rate for Payer: Managed Health Services Medicaid |
$285.58
|
| Rate for Payer: Managed Health Services Medicaid |
$285.58
|
| Rate for Payer: MDWise Medicaid |
$285.58
|
| Rate for Payer: MDWise Medicaid |
$285.58
|
| Rate for Payer: PHCS All Commercial |
$303.20
|
| Rate for Payer: PHCS All Commercial |
$303.20
|
| Rate for Payer: PHP All Commercial |
$373.78
|
| Rate for Payer: PHP All Commercial |
$373.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$303.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$303.20
|
| Rate for Payer: Sagamore Health Network All Products |
$303.20
|
| Rate for Payer: Sagamore Health Network All Products |
$303.20
|
| Rate for Payer: Signature Care EPO |
$279.59
|
| Rate for Payer: Signature Care EPO |
$279.59
|
| Rate for Payer: Signature Care PPO |
$279.59
|
| Rate for Payer: Signature Care PPO |
$279.59
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$42,700.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$42,700.00
|
| Rate for Payer: United Healthcare Commercial |
$332.88
|
| Rate for Payer: United Healthcare Commercial |
$332.88
|
|
|
CHG N-INVAS EST C FFR AUGMNT SW ALYS CTA I&R PHY/QHP
|
Professional
|
Both
|
$64.96
|
|
|
Service Code
|
CPT 75580
|
| Hospital Charge Code |
z75580
|
| Min. Negotiated Rate |
$819.38 |
| Max. Negotiated Rate |
$819.38 |
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$819.38
|
| Rate for Payer: Cash Price |
$38.98
|
| Rate for Payer: Managed Health Services Medicaid |
$819.38
|
| Rate for Payer: MDWise Medicaid |
$819.38
|
|
|
CHG RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS
|
Professional
|
Both
|
$98.12
|
|
|
Service Code
|
CPT 73522
|
| Hospital Charge Code |
z73522
|
| Min. Negotiated Rate |
$45.87 |
| Max. Negotiated Rate |
$87.64 |
| Rate for Payer: Aetna Commercial |
$50.54
|
| Rate for Payer: Aetna Commercial |
$50.54
|
| Rate for Payer: Aetna Medicare |
$50.54
|
| Rate for Payer: Aetna Medicare |
$50.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$49.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$49.36
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$58.12
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$58.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$55.59
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$55.59
|
| Rate for Payer: Cash Price |
$88.03
|
| Rate for Payer: Cash Price |
$58.87
|
| Rate for Payer: Centivo All Commercial |
$78.34
|
| Rate for Payer: Centivo All Commercial |
$78.34
|
| Rate for Payer: Cigna All Commercial |
$50.54
|
| Rate for Payer: Cigna All Commercial |
$50.54
|
| Rate for Payer: CORVEL All Commercial |
$50.54
|
| Rate for Payer: CORVEL All Commercial |
$50.54
|
| Rate for Payer: Coventry All Commercial |
$60.65
|
| Rate for Payer: Coventry All Commercial |
$60.65
|
| Rate for Payer: Encore All Commercial |
$50.54
|
| Rate for Payer: Encore All Commercial |
$50.54
|
| Rate for Payer: Frontpath All Commercial |
$87.64
|
| Rate for Payer: Frontpath All Commercial |
$87.64
|
| Rate for Payer: Humana ChoiceCare |
$57.54
|
| Rate for Payer: Humana ChoiceCare |
$57.54
|
| Rate for Payer: Humana Medicare |
$50.54
|
| Rate for Payer: Humana Medicare |
$50.54
|
| Rate for Payer: Lucent All Commercial |
$70.76
|
| Rate for Payer: Lucent All Commercial |
$70.76
|
| Rate for Payer: Managed Health Services Medicaid |
$49.36
|
| Rate for Payer: Managed Health Services Medicaid |
$49.36
|
| Rate for Payer: MDWise Medicaid |
$49.36
|
| Rate for Payer: MDWise Medicaid |
$49.36
|
| Rate for Payer: PHCS All Commercial |
$50.54
|
| Rate for Payer: PHCS All Commercial |
$50.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$50.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$50.54
|
| Rate for Payer: Sagamore Health Network All Products |
$50.54
|
| Rate for Payer: Sagamore Health Network All Products |
$50.54
|
| Rate for Payer: United Healthcare Commercial |
$45.87
|
| Rate for Payer: United Healthcare Commercial |
$45.87
|
|
|
CHG RADEX HIP UNILATERAL WITH PELVIS 1 VIEW
|
Professional
|
Both
|
$43.26
|
|
|
Service Code
|
CPT 73501
|
| Hospital Charge Code |
z73501
|
| Min. Negotiated Rate |
$27.78 |
| Max. Negotiated Rate |
$53.23 |
| Rate for Payer: Aetna Commercial |
$30.53
|
| Rate for Payer: Aetna Medicare |
$30.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$30.06
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$35.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$33.58
|
| Rate for Payer: Cash Price |
$25.96
|
| Rate for Payer: Centivo All Commercial |
$47.32
|
| Rate for Payer: Cigna All Commercial |
$30.53
|
| Rate for Payer: CORVEL All Commercial |
$30.53
|
| Rate for Payer: Coventry All Commercial |
$36.64
|
| Rate for Payer: Encore All Commercial |
$30.53
|
| Rate for Payer: Frontpath All Commercial |
$53.23
|
| Rate for Payer: Humana ChoiceCare |
$34.85
|
| Rate for Payer: Humana Medicare |
$30.53
|
| Rate for Payer: Lucent All Commercial |
$42.74
|
| Rate for Payer: Managed Health Services Medicaid |
$30.06
|
| Rate for Payer: MDWise Medicaid |
$30.06
|
| Rate for Payer: PHCS All Commercial |
$30.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$30.53
|
| Rate for Payer: Sagamore Health Network All Products |
$30.53
|
| Rate for Payer: United Healthcare Commercial |
$27.78
|
|
|
CHG RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS
|
Professional
|
Both
|
$85.66
|
|
|
Service Code
|
CPT 73502
|
| Hospital Charge Code |
z73502
|
| Min. Negotiated Rate |
$38.83 |
| Max. Negotiated Rate |
$6,400.00 |
| Rate for Payer: Aetna Commercial |
$44.06
|
| Rate for Payer: Aetna Commercial |
$44.06
|
| Rate for Payer: Aetna Medicare |
$44.06
|
| Rate for Payer: Aetna Medicare |
$44.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$50.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$50.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$50.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$50.72
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$50.72
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$50.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$50.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$50.72
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$43.45
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$43.45
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$50.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$50.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$48.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$48.47
|
| Rate for Payer: Cash Price |
$51.40
|
| Rate for Payer: Cash Price |
$40.70
|
| Rate for Payer: Centivo All Commercial |
$68.29
|
| Rate for Payer: Centivo All Commercial |
$68.29
|
| Rate for Payer: Cigna All Commercial |
$44.06
|
| Rate for Payer: Cigna All Commercial |
$44.06
|
| Rate for Payer: CORVEL All Commercial |
$44.06
|
| Rate for Payer: CORVEL All Commercial |
$44.06
|
| Rate for Payer: Coventry All Commercial |
$52.87
|
| Rate for Payer: Coventry All Commercial |
$52.87
|
| Rate for Payer: Encore All Commercial |
$44.06
|
| Rate for Payer: Encore All Commercial |
$44.06
|
| Rate for Payer: Frontpath All Commercial |
$76.53
|
| Rate for Payer: Frontpath All Commercial |
$76.53
|
| Rate for Payer: Humana ChoiceCare |
$48.71
|
| Rate for Payer: Humana ChoiceCare |
$48.71
|
| Rate for Payer: Humana Medicare |
$44.06
|
| Rate for Payer: Humana Medicare |
$44.06
|
| Rate for Payer: Lucent All Commercial |
$61.68
|
| Rate for Payer: Lucent All Commercial |
$61.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$68.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$68.00
|
| Rate for Payer: Managed Health Services Medicaid |
$43.45
|
| Rate for Payer: Managed Health Services Medicaid |
$43.45
|
| Rate for Payer: MDWise Medicaid |
$43.45
|
| Rate for Payer: MDWise Medicaid |
$43.45
|
| Rate for Payer: PHCS All Commercial |
$44.06
|
| Rate for Payer: PHCS All Commercial |
$44.06
|
| Rate for Payer: PHP All Commercial |
$55.67
|
| Rate for Payer: PHP All Commercial |
$55.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$44.06
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$44.06
|
| Rate for Payer: Sagamore Health Network All Products |
$44.06
|
| Rate for Payer: Sagamore Health Network All Products |
$44.06
|
| Rate for Payer: Signature Care EPO |
$49.32
|
| Rate for Payer: Signature Care EPO |
$49.32
|
| Rate for Payer: Signature Care PPO |
$49.32
|
| Rate for Payer: Signature Care PPO |
$49.32
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,400.00
|
| Rate for Payer: United Healthcare Commercial |
$38.83
|
| Rate for Payer: United Healthcare Commercial |
$38.83
|
|
|
CHG RADEX SPINE CERVICAL 2 OR 3 VIEWS
|
Professional
|
Both
|
$72.40
|
|
|
Service Code
|
CPT 72040
|
| Hospital Charge Code |
z72040
|
| Min. Negotiated Rate |
$33.52 |
| Max. Negotiated Rate |
$5,400.00 |
| Rate for Payer: Aetna Commercial |
$37.21
|
| Rate for Payer: Aetna Commercial |
$37.21
|
| Rate for Payer: Aetna Medicare |
$37.21
|
| Rate for Payer: Aetna Medicare |
$37.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$51.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$51.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$51.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$51.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$51.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$51.56
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$51.56
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$51.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$36.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$36.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$42.79
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$42.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$40.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$40.93
|
| Rate for Payer: Cash Price |
$31.87
|
| Rate for Payer: Cash Price |
$43.44
|
| Rate for Payer: Centivo All Commercial |
$57.68
|
| Rate for Payer: Centivo All Commercial |
$57.68
|
| Rate for Payer: Cigna All Commercial |
$37.21
|
| Rate for Payer: Cigna All Commercial |
$37.21
|
| Rate for Payer: CORVEL All Commercial |
$37.21
|
| Rate for Payer: CORVEL All Commercial |
$37.21
|
| Rate for Payer: Coventry All Commercial |
$44.65
|
| Rate for Payer: Coventry All Commercial |
$44.65
|
| Rate for Payer: Encore All Commercial |
$37.21
|
| Rate for Payer: Encore All Commercial |
$37.21
|
| Rate for Payer: Frontpath All Commercial |
$64.72
|
| Rate for Payer: Frontpath All Commercial |
$64.72
|
| Rate for Payer: Humana ChoiceCare |
$41.33
|
| Rate for Payer: Humana ChoiceCare |
$41.33
|
| Rate for Payer: Humana Medicare |
$37.21
|
| Rate for Payer: Humana Medicare |
$37.21
|
| Rate for Payer: Lucent All Commercial |
$52.09
|
| Rate for Payer: Lucent All Commercial |
$52.09
|
| Rate for Payer: Lutheran Preferred All Commercial |
$58.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$58.00
|
| Rate for Payer: Managed Health Services Medicaid |
$36.20
|
| Rate for Payer: Managed Health Services Medicaid |
$36.20
|
| Rate for Payer: MDWise Medicaid |
$36.20
|
| Rate for Payer: MDWise Medicaid |
$36.20
|
| Rate for Payer: PHCS All Commercial |
$37.21
|
| Rate for Payer: PHCS All Commercial |
$37.21
|
| Rate for Payer: PHP All Commercial |
$47.06
|
| Rate for Payer: PHP All Commercial |
$47.06
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$37.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$37.21
|
| Rate for Payer: Sagamore Health Network All Products |
$37.21
|
| Rate for Payer: Sagamore Health Network All Products |
$37.21
|
| Rate for Payer: Signature Care EPO |
$40.80
|
| Rate for Payer: Signature Care EPO |
$40.80
|
| Rate for Payer: Signature Care PPO |
$40.80
|
| Rate for Payer: Signature Care PPO |
$40.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,400.00
|
| Rate for Payer: United Healthcare Commercial |
$33.52
|
| Rate for Payer: United Healthcare Commercial |
$33.52
|
|
|
CHG RADIOLOGIC EXAM ABDOMEN 1 VIEW
|
Professional
|
Both
|
$54.70
|
|
|
Service Code
|
CPT 74018
|
| Hospital Charge Code |
z74018
|
| Min. Negotiated Rate |
$25.41 |
| Max. Negotiated Rate |
$4,100.00 |
| Rate for Payer: Aetna Commercial |
$28.35
|
| Rate for Payer: Aetna Commercial |
$28.35
|
| Rate for Payer: Aetna Medicare |
$28.35
|
| Rate for Payer: Aetna Medicare |
$28.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$25.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$25.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$25.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$25.41
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$25.41
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$25.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$25.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$25.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$27.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$27.65
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$32.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$32.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$31.18
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$31.18
|
| Rate for Payer: Cash Price |
$23.76
|
| Rate for Payer: Cash Price |
$32.82
|
| Rate for Payer: Centivo All Commercial |
$43.94
|
| Rate for Payer: Centivo All Commercial |
$43.94
|
| Rate for Payer: Cigna All Commercial |
$28.35
|
| Rate for Payer: Cigna All Commercial |
$28.35
|
| Rate for Payer: CORVEL All Commercial |
$28.35
|
| Rate for Payer: CORVEL All Commercial |
$28.35
|
| Rate for Payer: Coventry All Commercial |
$34.02
|
| Rate for Payer: Coventry All Commercial |
$34.02
|
| Rate for Payer: Encore All Commercial |
$28.35
|
| Rate for Payer: Encore All Commercial |
$28.35
|
| Rate for Payer: Frontpath All Commercial |
$49.47
|
| Rate for Payer: Frontpath All Commercial |
$49.47
|
| Rate for Payer: Humana ChoiceCare |
$32.02
|
| Rate for Payer: Humana ChoiceCare |
$32.02
|
| Rate for Payer: Humana Medicare |
$28.35
|
| Rate for Payer: Humana Medicare |
$28.35
|
| Rate for Payer: Lucent All Commercial |
$39.69
|
| Rate for Payer: Lucent All Commercial |
$39.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$43.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$43.00
|
| Rate for Payer: Managed Health Services Medicaid |
$27.65
|
| Rate for Payer: Managed Health Services Medicaid |
$27.65
|
| Rate for Payer: MDWise Medicaid |
$27.65
|
| Rate for Payer: MDWise Medicaid |
$27.65
|
| Rate for Payer: PHCS All Commercial |
$28.35
|
| Rate for Payer: PHCS All Commercial |
$28.35
|
| Rate for Payer: PHP All Commercial |
$35.55
|
| Rate for Payer: PHP All Commercial |
$35.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$28.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$28.35
|
| Rate for Payer: Sagamore Health Network All Products |
$28.35
|
| Rate for Payer: Sagamore Health Network All Products |
$28.35
|
| Rate for Payer: Signature Care EPO |
$30.23
|
| Rate for Payer: Signature Care EPO |
$30.23
|
| Rate for Payer: Signature Care PPO |
$30.23
|
| Rate for Payer: Signature Care PPO |
$30.23
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,100.00
|
| Rate for Payer: United Healthcare Commercial |
$25.80
|
| Rate for Payer: United Healthcare Commercial |
$25.80
|
|
|
CHG RADIOLOGIC EXAM ABDOMEN 2 VIEWS
|
Professional
|
Both
|
$67.64
|
|
|
Service Code
|
CPT 74019
|
| Hospital Charge Code |
z74019
|
| Min. Negotiated Rate |
$31.57 |
| Max. Negotiated Rate |
$60.47 |
| Rate for Payer: Aetna Commercial |
$34.76
|
| Rate for Payer: Aetna Commercial |
$34.76
|
| Rate for Payer: Aetna Medicare |
$34.76
|
| Rate for Payer: Aetna Medicare |
$34.76
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$33.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$33.51
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$39.97
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$39.97
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$38.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$38.24
|
| Rate for Payer: Cash Price |
$28.55
|
| Rate for Payer: Cash Price |
$40.58
|
| Rate for Payer: Centivo All Commercial |
$53.88
|
| Rate for Payer: Centivo All Commercial |
$53.88
|
| Rate for Payer: Cigna All Commercial |
$34.76
|
| Rate for Payer: Cigna All Commercial |
$34.76
|
| Rate for Payer: CORVEL All Commercial |
$34.76
|
| Rate for Payer: CORVEL All Commercial |
$34.76
|
| Rate for Payer: Coventry All Commercial |
$41.71
|
| Rate for Payer: Coventry All Commercial |
$41.71
|
| Rate for Payer: Encore All Commercial |
$34.76
|
| Rate for Payer: Encore All Commercial |
$34.76
|
| Rate for Payer: Frontpath All Commercial |
$60.47
|
| Rate for Payer: Frontpath All Commercial |
$60.47
|
| Rate for Payer: Humana ChoiceCare |
$39.21
|
| Rate for Payer: Humana ChoiceCare |
$39.21
|
| Rate for Payer: Humana Medicare |
$34.76
|
| Rate for Payer: Humana Medicare |
$34.76
|
| Rate for Payer: Lucent All Commercial |
$48.66
|
| Rate for Payer: Lucent All Commercial |
$48.66
|
| Rate for Payer: Managed Health Services Medicaid |
$33.51
|
| Rate for Payer: Managed Health Services Medicaid |
$33.51
|
| Rate for Payer: MDWise Medicaid |
$33.51
|
| Rate for Payer: MDWise Medicaid |
$33.51
|
| Rate for Payer: PHCS All Commercial |
$34.76
|
| Rate for Payer: PHCS All Commercial |
$34.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$34.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$34.76
|
| Rate for Payer: Sagamore Health Network All Products |
$34.76
|
| Rate for Payer: Sagamore Health Network All Products |
$34.76
|
| Rate for Payer: United Healthcare Commercial |
$31.57
|
| Rate for Payer: United Healthcare Commercial |
$31.57
|
|
|
CHG RADIOLOGIC EXAM ABDOMEN 3+ VIEWS
|
Professional
|
Both
|
$78.72
|
|
|
Service Code
|
CPT 74021
|
| Hospital Charge Code |
z74021
|
| Min. Negotiated Rate |
$36.87 |
| Max. Negotiated Rate |
$70.89 |
| Rate for Payer: Aetna Commercial |
$40.81
|
| Rate for Payer: Aetna Commercial |
$40.81
|
| Rate for Payer: Aetna Medicare |
$40.81
|
| Rate for Payer: Aetna Medicare |
$40.81
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$39.35
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$39.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$46.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$46.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$44.89
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$44.89
|
| Rate for Payer: Cash Price |
$47.23
|
| Rate for Payer: Cash Price |
$33.34
|
| Rate for Payer: Centivo All Commercial |
$63.26
|
| Rate for Payer: Centivo All Commercial |
$63.26
|
| Rate for Payer: Cigna All Commercial |
$40.81
|
| Rate for Payer: Cigna All Commercial |
$40.81
|
| Rate for Payer: CORVEL All Commercial |
$40.81
|
| Rate for Payer: CORVEL All Commercial |
$40.81
|
| Rate for Payer: Coventry All Commercial |
$48.97
|
| Rate for Payer: Coventry All Commercial |
$48.97
|
| Rate for Payer: Encore All Commercial |
$40.81
|
| Rate for Payer: Encore All Commercial |
$40.81
|
| Rate for Payer: Frontpath All Commercial |
$70.89
|
| Rate for Payer: Frontpath All Commercial |
$70.89
|
| Rate for Payer: Humana ChoiceCare |
$45.73
|
| Rate for Payer: Humana ChoiceCare |
$45.73
|
| Rate for Payer: Humana Medicare |
$40.81
|
| Rate for Payer: Humana Medicare |
$40.81
|
| Rate for Payer: Lucent All Commercial |
$57.13
|
| Rate for Payer: Lucent All Commercial |
$57.13
|
| Rate for Payer: Managed Health Services Medicaid |
$39.35
|
| Rate for Payer: Managed Health Services Medicaid |
$39.35
|
| Rate for Payer: MDWise Medicaid |
$39.35
|
| Rate for Payer: MDWise Medicaid |
$39.35
|
| Rate for Payer: PHCS All Commercial |
$40.81
|
| Rate for Payer: PHCS All Commercial |
$40.81
|
| Rate for Payer: PHP All Commercial |
$51.17
|
| Rate for Payer: PHP All Commercial |
$51.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$40.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$40.81
|
| Rate for Payer: Sagamore Health Network All Products |
$40.81
|
| Rate for Payer: Sagamore Health Network All Products |
$40.81
|
| Rate for Payer: Signature Care EPO |
$43.19
|
| Rate for Payer: Signature Care EPO |
$43.19
|
| Rate for Payer: Signature Care PPO |
$43.19
|
| Rate for Payer: Signature Care PPO |
$43.19
|
| Rate for Payer: United Healthcare Commercial |
$36.87
|
| Rate for Payer: United Healthcare Commercial |
$36.87
|
|
|
CHG RADIOLOGIC EXAM CHEST 2 VIEWS
|
Professional
|
Both
|
$61.56
|
|
|
Service Code
|
CPT 71046
|
| Hospital Charge Code |
z71046
|
| Min. Negotiated Rate |
$28.46 |
| Max. Negotiated Rate |
$4,600.00 |
| Rate for Payer: Aetna Commercial |
$31.61
|
| Rate for Payer: Aetna Commercial |
$31.61
|
| Rate for Payer: Aetna Medicare |
$31.61
|
| Rate for Payer: Aetna Medicare |
$31.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$28.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$28.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$28.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$28.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$28.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$28.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$28.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$28.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$30.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$30.77
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$36.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$36.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$34.77
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$34.77
|
| Rate for Payer: Cash Price |
$25.61
|
| Rate for Payer: Cash Price |
$36.94
|
| Rate for Payer: Centivo All Commercial |
$49.00
|
| Rate for Payer: Centivo All Commercial |
$49.00
|
| Rate for Payer: Cigna All Commercial |
$31.61
|
| Rate for Payer: Cigna All Commercial |
$31.61
|
| Rate for Payer: CORVEL All Commercial |
$31.61
|
| Rate for Payer: CORVEL All Commercial |
$31.61
|
| Rate for Payer: Coventry All Commercial |
$37.93
|
| Rate for Payer: Coventry All Commercial |
$37.93
|
| Rate for Payer: Encore All Commercial |
$31.61
|
| Rate for Payer: Encore All Commercial |
$31.61
|
| Rate for Payer: Frontpath All Commercial |
$55.05
|
| Rate for Payer: Frontpath All Commercial |
$55.05
|
| Rate for Payer: Humana ChoiceCare |
$35.86
|
| Rate for Payer: Humana ChoiceCare |
$35.86
|
| Rate for Payer: Humana Medicare |
$31.61
|
| Rate for Payer: Humana Medicare |
$31.61
|
| Rate for Payer: Lucent All Commercial |
$44.25
|
| Rate for Payer: Lucent All Commercial |
$44.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$49.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$49.00
|
| Rate for Payer: Managed Health Services Medicaid |
$30.77
|
| Rate for Payer: Managed Health Services Medicaid |
$30.77
|
| Rate for Payer: MDWise Medicaid |
$30.77
|
| Rate for Payer: MDWise Medicaid |
$30.77
|
| Rate for Payer: PHCS All Commercial |
$31.61
|
| Rate for Payer: PHCS All Commercial |
$31.61
|
| Rate for Payer: PHP All Commercial |
$40.01
|
| Rate for Payer: PHP All Commercial |
$40.01
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$31.61
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$31.61
|
| Rate for Payer: Sagamore Health Network All Products |
$31.61
|
| Rate for Payer: Sagamore Health Network All Products |
$31.61
|
| Rate for Payer: Signature Care EPO |
$33.86
|
| Rate for Payer: Signature Care EPO |
$33.86
|
| Rate for Payer: Signature Care PPO |
$33.86
|
| Rate for Payer: Signature Care PPO |
$33.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,600.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,600.00
|
| Rate for Payer: United Healthcare Commercial |
$28.89
|
| Rate for Payer: United Healthcare Commercial |
$28.89
|
|
|
CHG RADIOLOGIC EXAM CHEST SINGLE VIEW
|
Professional
|
Both
|
$47.46
|
|
|
Service Code
|
CPT 71045
|
| Hospital Charge Code |
z71045
|
| Min. Negotiated Rate |
$18.84 |
| Max. Negotiated Rate |
$42.50 |
| Rate for Payer: Aetna Commercial |
$24.30
|
| Rate for Payer: Aetna Commercial |
$24.30
|
| Rate for Payer: Aetna Medicare |
$24.30
|
| Rate for Payer: Aetna Medicare |
$24.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$23.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$23.42
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$27.95
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$27.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$26.73
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$26.73
|
| Rate for Payer: Cash Price |
$18.97
|
| Rate for Payer: Cash Price |
$28.48
|
| Rate for Payer: Centivo All Commercial |
$37.66
|
| Rate for Payer: Centivo All Commercial |
$37.66
|
| Rate for Payer: Cigna All Commercial |
$24.30
|
| Rate for Payer: Cigna All Commercial |
$24.30
|
| Rate for Payer: CORVEL All Commercial |
$24.30
|
| Rate for Payer: CORVEL All Commercial |
$24.30
|
| Rate for Payer: Coventry All Commercial |
$29.16
|
| Rate for Payer: Coventry All Commercial |
$29.16
|
| Rate for Payer: Encore All Commercial |
$24.30
|
| Rate for Payer: Encore All Commercial |
$24.30
|
| Rate for Payer: Frontpath All Commercial |
$42.50
|
| Rate for Payer: Frontpath All Commercial |
$42.50
|
| Rate for Payer: Humana ChoiceCare |
$23.26
|
| Rate for Payer: Humana ChoiceCare |
$23.26
|
| Rate for Payer: Humana Medicare |
$24.30
|
| Rate for Payer: Humana Medicare |
$24.30
|
| Rate for Payer: Lucent All Commercial |
$34.02
|
| Rate for Payer: Lucent All Commercial |
$34.02
|
| Rate for Payer: Managed Health Services Medicaid |
$23.42
|
| Rate for Payer: Managed Health Services Medicaid |
$23.42
|
| Rate for Payer: MDWise Medicaid |
$23.42
|
| Rate for Payer: MDWise Medicaid |
$23.42
|
| Rate for Payer: PHCS All Commercial |
$24.30
|
| Rate for Payer: PHCS All Commercial |
$24.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$24.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$24.30
|
| Rate for Payer: Sagamore Health Network All Products |
$24.30
|
| Rate for Payer: Sagamore Health Network All Products |
$24.30
|
| Rate for Payer: United Healthcare Commercial |
$18.84
|
| Rate for Payer: United Healthcare Commercial |
$18.84
|
|
|
CHG RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES
|
Professional
|
Both
|
$91.38
|
|
|
Service Code
|
CPT 74022
|
| Hospital Charge Code |
z74022
|
| Min. Negotiated Rate |
$44.29 |
| Max. Negotiated Rate |
$6,800.00 |
| Rate for Payer: Aetna Commercial |
$47.21
|
| Rate for Payer: Aetna Commercial |
$47.21
|
| Rate for Payer: Aetna Medicare |
$47.21
|
| Rate for Payer: Aetna Medicare |
$47.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$47.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$47.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$47.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$47.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$47.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$47.62
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$47.62
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$47.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$45.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$45.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$54.29
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$54.29
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$51.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$51.93
|
| Rate for Payer: Cash Price |
$38.50
|
| Rate for Payer: Cash Price |
$54.83
|
| Rate for Payer: Centivo All Commercial |
$73.18
|
| Rate for Payer: Centivo All Commercial |
$73.18
|
| Rate for Payer: Cigna All Commercial |
$47.21
|
| Rate for Payer: Cigna All Commercial |
$47.21
|
| Rate for Payer: CORVEL All Commercial |
$47.21
|
| Rate for Payer: CORVEL All Commercial |
$47.21
|
| Rate for Payer: Coventry All Commercial |
$56.65
|
| Rate for Payer: Coventry All Commercial |
$56.65
|
| Rate for Payer: Encore All Commercial |
$47.21
|
| Rate for Payer: Encore All Commercial |
$47.21
|
| Rate for Payer: Frontpath All Commercial |
$81.89
|
| Rate for Payer: Frontpath All Commercial |
$81.89
|
| Rate for Payer: Humana ChoiceCare |
$52.11
|
| Rate for Payer: Humana ChoiceCare |
$52.11
|
| Rate for Payer: Humana Medicare |
$47.21
|
| Rate for Payer: Humana Medicare |
$47.21
|
| Rate for Payer: Lucent All Commercial |
$66.09
|
| Rate for Payer: Lucent All Commercial |
$66.09
|
| Rate for Payer: Lutheran Preferred All Commercial |
$73.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$73.00
|
| Rate for Payer: Managed Health Services Medicaid |
$45.67
|
| Rate for Payer: Managed Health Services Medicaid |
$45.67
|
| Rate for Payer: MDWise Medicaid |
$45.67
|
| Rate for Payer: MDWise Medicaid |
$45.67
|
| Rate for Payer: PHCS All Commercial |
$47.21
|
| Rate for Payer: PHCS All Commercial |
$47.21
|
| Rate for Payer: PHP All Commercial |
$59.39
|
| Rate for Payer: PHP All Commercial |
$59.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$47.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$47.21
|
| Rate for Payer: Sagamore Health Network All Products |
$47.21
|
| Rate for Payer: Sagamore Health Network All Products |
$47.21
|
| Rate for Payer: Signature Care EPO |
$53.55
|
| Rate for Payer: Signature Care EPO |
$53.55
|
| Rate for Payer: Signature Care PPO |
$53.55
|
| Rate for Payer: Signature Care PPO |
$53.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,800.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,800.00
|
| Rate for Payer: United Healthcare Commercial |
$44.29
|
| Rate for Payer: United Healthcare Commercial |
$44.29
|
|
|
CHG RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS
|
Professional
|
Both
|
$73.36
|
|
|
Service Code
|
CPT 73552
|
| Hospital Charge Code |
z73552
|
| Min. Negotiated Rate |
$30.43 |
| Max. Negotiated Rate |
$57.53 |
| Rate for Payer: Aetna Commercial |
$33.02
|
| Rate for Payer: Aetna Commercial |
$33.02
|
| Rate for Payer: Aetna Medicare |
$33.02
|
| Rate for Payer: Aetna Medicare |
$33.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$32.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$32.48
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$37.97
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$37.97
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$36.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$36.32
|
| Rate for Payer: Cash Price |
$44.02
|
| Rate for Payer: Cash Price |
$38.96
|
| Rate for Payer: Centivo All Commercial |
$51.18
|
| Rate for Payer: Centivo All Commercial |
$51.18
|
| Rate for Payer: Cigna All Commercial |
$33.02
|
| Rate for Payer: Cigna All Commercial |
$33.02
|
| Rate for Payer: CORVEL All Commercial |
$33.02
|
| Rate for Payer: CORVEL All Commercial |
$33.02
|
| Rate for Payer: Coventry All Commercial |
$39.62
|
| Rate for Payer: Coventry All Commercial |
$39.62
|
| Rate for Payer: Encore All Commercial |
$33.02
|
| Rate for Payer: Encore All Commercial |
$33.02
|
| Rate for Payer: Frontpath All Commercial |
$57.53
|
| Rate for Payer: Frontpath All Commercial |
$57.53
|
| Rate for Payer: Humana ChoiceCare |
$38.18
|
| Rate for Payer: Humana ChoiceCare |
$38.18
|
| Rate for Payer: Humana Medicare |
$33.02
|
| Rate for Payer: Humana Medicare |
$33.02
|
| Rate for Payer: Lucent All Commercial |
$46.23
|
| Rate for Payer: Lucent All Commercial |
$46.23
|
| Rate for Payer: Managed Health Services Medicaid |
$32.48
|
| Rate for Payer: Managed Health Services Medicaid |
$32.48
|
| Rate for Payer: MDWise Medicaid |
$32.48
|
| Rate for Payer: MDWise Medicaid |
$32.48
|
| Rate for Payer: PHCS All Commercial |
$33.02
|
| Rate for Payer: PHCS All Commercial |
$33.02
|
| Rate for Payer: PHP All Commercial |
$42.21
|
| Rate for Payer: PHP All Commercial |
$42.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$33.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$33.02
|
| Rate for Payer: Sagamore Health Network All Products |
$33.02
|
| Rate for Payer: Sagamore Health Network All Products |
$33.02
|
| Rate for Payer: Signature Care EPO |
$38.63
|
| Rate for Payer: Signature Care EPO |
$38.63
|
| Rate for Payer: Signature Care PPO |
$38.63
|
| Rate for Payer: Signature Care PPO |
$38.63
|
| Rate for Payer: United Healthcare Commercial |
$30.43
|
| Rate for Payer: United Healthcare Commercial |
$30.43
|
|
