|
CHG X-RAY ANKLE 3+ VW
|
Professional
|
Both
|
$67.28
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
z73610
|
| Min. Negotiated Rate |
$27.97 |
| Max. Negotiated Rate |
$5,000.00 |
| Rate for Payer: Aetna Commercial |
$34.55
|
| Rate for Payer: Aetna Commercial |
$34.55
|
| Rate for Payer: Aetna Medicare |
$34.55
|
| Rate for Payer: Aetna Medicare |
$34.55
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$51.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$51.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$51.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$51.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$51.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$51.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$51.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$51.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$33.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$33.36
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$39.73
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$39.73
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$38.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$38.01
|
| Rate for Payer: Cash Price |
$31.13
|
| Rate for Payer: Cash Price |
$40.37
|
| Rate for Payer: Centivo All Commercial |
$53.55
|
| Rate for Payer: Centivo All Commercial |
$53.55
|
| Rate for Payer: Cigna All Commercial |
$34.55
|
| Rate for Payer: Cigna All Commercial |
$34.55
|
| Rate for Payer: CORVEL All Commercial |
$34.55
|
| Rate for Payer: CORVEL All Commercial |
$34.55
|
| Rate for Payer: Coventry All Commercial |
$41.46
|
| Rate for Payer: Coventry All Commercial |
$41.46
|
| Rate for Payer: Encore All Commercial |
$34.55
|
| Rate for Payer: Encore All Commercial |
$34.55
|
| Rate for Payer: Frontpath All Commercial |
$60.16
|
| Rate for Payer: Frontpath All Commercial |
$60.16
|
| Rate for Payer: Humana ChoiceCare |
$38.46
|
| Rate for Payer: Humana ChoiceCare |
$38.46
|
| Rate for Payer: Humana Medicare |
$34.55
|
| Rate for Payer: Humana Medicare |
$34.55
|
| Rate for Payer: Lucent All Commercial |
$48.37
|
| Rate for Payer: Lucent All Commercial |
$48.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$53.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$53.00
|
| Rate for Payer: Managed Health Services Medicaid |
$33.36
|
| Rate for Payer: Managed Health Services Medicaid |
$33.36
|
| Rate for Payer: MDWise Medicaid |
$33.36
|
| Rate for Payer: MDWise Medicaid |
$33.36
|
| Rate for Payer: PHCS All Commercial |
$34.55
|
| Rate for Payer: PHCS All Commercial |
$34.55
|
| Rate for Payer: PHP All Commercial |
$43.74
|
| Rate for Payer: PHP All Commercial |
$43.74
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$34.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$34.55
|
| Rate for Payer: Sagamore Health Network All Products |
$34.55
|
| Rate for Payer: Sagamore Health Network All Products |
$34.55
|
| Rate for Payer: Signature Care EPO |
$34.85
|
| Rate for Payer: Signature Care EPO |
$34.85
|
| Rate for Payer: Signature Care PPO |
$34.85
|
| Rate for Payer: Signature Care PPO |
$34.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,000.00
|
| Rate for Payer: United Healthcare Commercial |
$27.97
|
| Rate for Payer: United Healthcare Commercial |
$27.97
|
|
|
CHG X-RAY ARM, INFANT
|
Professional
|
Both
|
$43.90
|
|
|
Service Code
|
CPT 73092
|
| Hospital Charge Code |
z73092
|
| Min. Negotiated Rate |
$25.29 |
| Max. Negotiated Rate |
$52.05 |
| Rate for Payer: Aetna Commercial |
$29.84
|
| Rate for Payer: Aetna Commercial |
$29.84
|
| Rate for Payer: Aetna Medicare |
$29.84
|
| Rate for Payer: Aetna Medicare |
$29.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$28.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$28.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$34.32
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$34.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$32.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$32.82
|
| Rate for Payer: Cash Price |
$25.85
|
| Rate for Payer: Cash Price |
$26.34
|
| Rate for Payer: Centivo All Commercial |
$46.25
|
| Rate for Payer: Centivo All Commercial |
$46.25
|
| Rate for Payer: Cigna All Commercial |
$29.84
|
| Rate for Payer: Cigna All Commercial |
$29.84
|
| Rate for Payer: CORVEL All Commercial |
$29.84
|
| Rate for Payer: CORVEL All Commercial |
$29.84
|
| Rate for Payer: Coventry All Commercial |
$35.81
|
| Rate for Payer: Coventry All Commercial |
$35.81
|
| Rate for Payer: Encore All Commercial |
$29.84
|
| Rate for Payer: Encore All Commercial |
$29.84
|
| Rate for Payer: Frontpath All Commercial |
$52.05
|
| Rate for Payer: Frontpath All Commercial |
$52.05
|
| Rate for Payer: Humana ChoiceCare |
$33.06
|
| Rate for Payer: Humana ChoiceCare |
$33.06
|
| Rate for Payer: Humana Medicare |
$29.84
|
| Rate for Payer: Humana Medicare |
$29.84
|
| Rate for Payer: Lucent All Commercial |
$41.78
|
| Rate for Payer: Lucent All Commercial |
$41.78
|
| Rate for Payer: Managed Health Services Medicaid |
$28.80
|
| Rate for Payer: Managed Health Services Medicaid |
$28.80
|
| Rate for Payer: MDWise Medicaid |
$28.80
|
| Rate for Payer: MDWise Medicaid |
$28.80
|
| Rate for Payer: PHCS All Commercial |
$29.84
|
| Rate for Payer: PHCS All Commercial |
$29.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$29.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$29.84
|
| Rate for Payer: Sagamore Health Network All Products |
$29.84
|
| Rate for Payer: Sagamore Health Network All Products |
$29.84
|
| Rate for Payer: United Healthcare Commercial |
$25.29
|
| Rate for Payer: United Healthcare Commercial |
$25.29
|
|
|
CHG X-RAY CERV SPINE 4 VW
|
Professional
|
Both
|
$97.40
|
|
|
Service Code
|
CPT 72050
|
| Hospital Charge Code |
z72050
|
| Min. Negotiated Rate |
$47.46 |
| Max. Negotiated Rate |
$7,200.00 |
| Rate for Payer: Aetna Commercial |
$50.15
|
| Rate for Payer: Aetna Commercial |
$50.15
|
| Rate for Payer: Aetna Medicare |
$50.15
|
| Rate for Payer: Aetna Medicare |
$50.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$110.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$110.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$110.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$110.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$110.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$110.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$110.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$110.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$49.01
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$49.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$57.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$57.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$55.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$55.16
|
| Rate for Payer: Cash Price |
$45.12
|
| Rate for Payer: Cash Price |
$58.44
|
| Rate for Payer: Centivo All Commercial |
$77.73
|
| Rate for Payer: Centivo All Commercial |
$77.73
|
| Rate for Payer: Cigna All Commercial |
$50.15
|
| Rate for Payer: Cigna All Commercial |
$50.15
|
| Rate for Payer: CORVEL All Commercial |
$50.15
|
| Rate for Payer: CORVEL All Commercial |
$50.15
|
| Rate for Payer: Coventry All Commercial |
$60.18
|
| Rate for Payer: Coventry All Commercial |
$60.18
|
| Rate for Payer: Encore All Commercial |
$50.15
|
| Rate for Payer: Encore All Commercial |
$50.15
|
| Rate for Payer: Frontpath All Commercial |
$86.99
|
| Rate for Payer: Frontpath All Commercial |
$86.99
|
| Rate for Payer: Humana ChoiceCare |
$55.35
|
| Rate for Payer: Humana ChoiceCare |
$55.35
|
| Rate for Payer: Humana Medicare |
$50.15
|
| Rate for Payer: Humana Medicare |
$50.15
|
| Rate for Payer: Lucent All Commercial |
$70.21
|
| Rate for Payer: Lucent All Commercial |
$70.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$77.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$77.00
|
| Rate for Payer: Managed Health Services Medicaid |
$49.01
|
| Rate for Payer: Managed Health Services Medicaid |
$49.01
|
| Rate for Payer: MDWise Medicaid |
$49.01
|
| Rate for Payer: MDWise Medicaid |
$49.01
|
| Rate for Payer: PHCS All Commercial |
$50.15
|
| Rate for Payer: PHCS All Commercial |
$50.15
|
| Rate for Payer: PHP All Commercial |
$63.30
|
| Rate for Payer: PHP All Commercial |
$63.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$50.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$50.15
|
| Rate for Payer: Sagamore Health Network All Products |
$50.15
|
| Rate for Payer: Sagamore Health Network All Products |
$50.15
|
| Rate for Payer: Signature Care EPO |
$60.35
|
| Rate for Payer: Signature Care EPO |
$60.35
|
| Rate for Payer: Signature Care PPO |
$60.35
|
| Rate for Payer: Signature Care PPO |
$60.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,200.00
|
| Rate for Payer: United Healthcare Commercial |
$47.46
|
| Rate for Payer: United Healthcare Commercial |
$47.46
|
|
|
CHG X-RAY CLAVICLE
|
Professional
|
Both
|
$58.80
|
|
|
Service Code
|
CPT 73000
|
| Hospital Charge Code |
z73000
|
| Min. Negotiated Rate |
$24.96 |
| Max. Negotiated Rate |
$4,400.00 |
| Rate for Payer: Aetna Commercial |
$30.15
|
| Rate for Payer: Aetna Commercial |
$30.15
|
| Rate for Payer: Aetna Commercial |
$30.15
|
| Rate for Payer: Aetna Medicare |
$30.15
|
| Rate for Payer: Aetna Medicare |
$30.15
|
| Rate for Payer: Aetna Medicare |
$30.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$28.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$28.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$28.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$28.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$28.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$28.37
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$28.37
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$28.37
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$28.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$28.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$28.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$28.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$29.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$29.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$29.71
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$34.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$34.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$34.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$33.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$33.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$33.16
|
| Rate for Payer: Cash Price |
$35.28
|
| Rate for Payer: Cash Price |
$54.17
|
| Rate for Payer: Cash Price |
$27.08
|
| Rate for Payer: Centivo All Commercial |
$46.73
|
| Rate for Payer: Centivo All Commercial |
$46.73
|
| Rate for Payer: Centivo All Commercial |
$46.73
|
| Rate for Payer: Cigna All Commercial |
$30.15
|
| Rate for Payer: Cigna All Commercial |
$30.15
|
| Rate for Payer: Cigna All Commercial |
$30.15
|
| Rate for Payer: CORVEL All Commercial |
$30.15
|
| Rate for Payer: CORVEL All Commercial |
$30.15
|
| Rate for Payer: CORVEL All Commercial |
$30.15
|
| Rate for Payer: Coventry All Commercial |
$36.18
|
| Rate for Payer: Coventry All Commercial |
$36.18
|
| Rate for Payer: Coventry All Commercial |
$36.18
|
| Rate for Payer: Encore All Commercial |
$30.15
|
| Rate for Payer: Encore All Commercial |
$30.15
|
| Rate for Payer: Encore All Commercial |
$30.15
|
| Rate for Payer: Frontpath All Commercial |
$52.60
|
| Rate for Payer: Frontpath All Commercial |
$52.60
|
| Rate for Payer: Frontpath All Commercial |
$52.60
|
| Rate for Payer: Humana ChoiceCare |
$33.78
|
| Rate for Payer: Humana ChoiceCare |
$33.78
|
| Rate for Payer: Humana ChoiceCare |
$33.78
|
| Rate for Payer: Humana Medicare |
$30.15
|
| Rate for Payer: Humana Medicare |
$30.15
|
| Rate for Payer: Humana Medicare |
$30.15
|
| Rate for Payer: Lucent All Commercial |
$42.21
|
| Rate for Payer: Lucent All Commercial |
$42.21
|
| Rate for Payer: Lucent All Commercial |
$42.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$47.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$47.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$47.00
|
| Rate for Payer: Managed Health Services Medicaid |
$29.71
|
| Rate for Payer: Managed Health Services Medicaid |
$29.71
|
| Rate for Payer: Managed Health Services Medicaid |
$29.71
|
| Rate for Payer: MDWise Medicaid |
$29.71
|
| Rate for Payer: MDWise Medicaid |
$29.71
|
| Rate for Payer: MDWise Medicaid |
$29.71
|
| Rate for Payer: PHCS All Commercial |
$30.15
|
| Rate for Payer: PHCS All Commercial |
$30.15
|
| Rate for Payer: PHCS All Commercial |
$30.15
|
| Rate for Payer: PHP All Commercial |
$38.22
|
| Rate for Payer: PHP All Commercial |
$38.22
|
| Rate for Payer: PHP All Commercial |
$38.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$30.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$30.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$30.15
|
| Rate for Payer: Sagamore Health Network All Products |
$30.15
|
| Rate for Payer: Sagamore Health Network All Products |
$30.15
|
| Rate for Payer: Sagamore Health Network All Products |
$30.15
|
| Rate for Payer: Signature Care EPO |
$33.15
|
| Rate for Payer: Signature Care EPO |
$33.15
|
| Rate for Payer: Signature Care EPO |
$33.15
|
| Rate for Payer: Signature Care PPO |
$33.15
|
| Rate for Payer: Signature Care PPO |
$33.15
|
| Rate for Payer: Signature Care PPO |
$33.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,400.00
|
| Rate for Payer: United Healthcare Commercial |
$24.96
|
| Rate for Payer: United Healthcare Commercial |
$24.96
|
| Rate for Payer: United Healthcare Commercial |
$24.96
|
|
|
CHG X-RAY ELBOW 2 VW
|
Professional
|
Both
|
$53.38
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
z73070
|
| Min. Negotiated Rate |
$24.27 |
| Max. Negotiated Rate |
$4,000.00 |
| Rate for Payer: Aetna Commercial |
$27.35
|
| Rate for Payer: Aetna Commercial |
$27.35
|
| Rate for Payer: Aetna Commercial |
$27.35
|
| Rate for Payer: Aetna Medicare |
$27.35
|
| Rate for Payer: Aetna Medicare |
$27.35
|
| Rate for Payer: Aetna Medicare |
$27.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$27.87
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$27.87
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$27.87
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$27.87
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$27.87
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$27.87
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$27.87
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$27.87
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$27.87
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$27.87
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$27.87
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$27.87
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$26.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$26.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$26.69
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$31.45
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$31.45
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$31.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$30.09
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$30.09
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$30.09
|
| Rate for Payer: Cash Price |
$32.03
|
| Rate for Payer: Cash Price |
$46.80
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Centivo All Commercial |
$42.39
|
| Rate for Payer: Centivo All Commercial |
$42.39
|
| Rate for Payer: Centivo All Commercial |
$42.39
|
| Rate for Payer: Cigna All Commercial |
$27.35
|
| Rate for Payer: Cigna All Commercial |
$27.35
|
| Rate for Payer: Cigna All Commercial |
$27.35
|
| Rate for Payer: CORVEL All Commercial |
$27.35
|
| Rate for Payer: CORVEL All Commercial |
$27.35
|
| Rate for Payer: CORVEL All Commercial |
$27.35
|
| Rate for Payer: Coventry All Commercial |
$32.82
|
| Rate for Payer: Coventry All Commercial |
$32.82
|
| Rate for Payer: Coventry All Commercial |
$32.82
|
| Rate for Payer: Encore All Commercial |
$27.35
|
| Rate for Payer: Encore All Commercial |
$27.35
|
| Rate for Payer: Encore All Commercial |
$27.35
|
| Rate for Payer: Frontpath All Commercial |
$47.77
|
| Rate for Payer: Frontpath All Commercial |
$47.77
|
| Rate for Payer: Frontpath All Commercial |
$47.77
|
| Rate for Payer: Humana ChoiceCare |
$30.55
|
| Rate for Payer: Humana ChoiceCare |
$30.55
|
| Rate for Payer: Humana ChoiceCare |
$30.55
|
| Rate for Payer: Humana Medicare |
$27.35
|
| Rate for Payer: Humana Medicare |
$27.35
|
| Rate for Payer: Humana Medicare |
$27.35
|
| Rate for Payer: Lucent All Commercial |
$38.29
|
| Rate for Payer: Lucent All Commercial |
$38.29
|
| Rate for Payer: Lucent All Commercial |
$38.29
|
| Rate for Payer: Lutheran Preferred All Commercial |
$42.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$42.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$42.00
|
| Rate for Payer: Managed Health Services Medicaid |
$26.69
|
| Rate for Payer: Managed Health Services Medicaid |
$26.69
|
| Rate for Payer: Managed Health Services Medicaid |
$26.69
|
| Rate for Payer: MDWise Medicaid |
$26.69
|
| Rate for Payer: MDWise Medicaid |
$26.69
|
| Rate for Payer: MDWise Medicaid |
$26.69
|
| Rate for Payer: PHCS All Commercial |
$27.35
|
| Rate for Payer: PHCS All Commercial |
$27.35
|
| Rate for Payer: PHCS All Commercial |
$27.35
|
| Rate for Payer: PHP All Commercial |
$34.69
|
| Rate for Payer: PHP All Commercial |
$34.69
|
| Rate for Payer: PHP All Commercial |
$34.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$27.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$27.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$27.35
|
| Rate for Payer: Sagamore Health Network All Products |
$27.35
|
| Rate for Payer: Sagamore Health Network All Products |
$27.35
|
| Rate for Payer: Sagamore Health Network All Products |
$27.35
|
| Rate for Payer: Signature Care EPO |
$33.15
|
| Rate for Payer: Signature Care EPO |
$33.15
|
| Rate for Payer: Signature Care EPO |
$33.15
|
| Rate for Payer: Signature Care PPO |
$33.15
|
| Rate for Payer: Signature Care PPO |
$33.15
|
| Rate for Payer: Signature Care PPO |
$33.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,000.00
|
| Rate for Payer: United Healthcare Commercial |
$24.27
|
| Rate for Payer: United Healthcare Commercial |
$24.27
|
| Rate for Payer: United Healthcare Commercial |
$24.27
|
|
|
CHG X-RAY ELBOW 3+ VW
|
Professional
|
Both
|
$59.46
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
z73080
|
| Min. Negotiated Rate |
$30.04 |
| Max. Negotiated Rate |
$4,400.00 |
| Rate for Payer: Aetna Commercial |
$30.50
|
| Rate for Payer: Aetna Commercial |
$30.50
|
| Rate for Payer: Aetna Medicare |
$30.50
|
| Rate for Payer: Aetna Medicare |
$30.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$32.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$32.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$32.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$32.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$32.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$32.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$32.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$32.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$30.04
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$30.04
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$35.08
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$35.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$33.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$33.55
|
| Rate for Payer: Cash Price |
$27.08
|
| Rate for Payer: Cash Price |
$35.68
|
| Rate for Payer: Centivo All Commercial |
$47.27
|
| Rate for Payer: Centivo All Commercial |
$47.27
|
| Rate for Payer: Cigna All Commercial |
$30.50
|
| Rate for Payer: Cigna All Commercial |
$30.50
|
| Rate for Payer: CORVEL All Commercial |
$30.50
|
| Rate for Payer: CORVEL All Commercial |
$30.50
|
| Rate for Payer: Coventry All Commercial |
$36.60
|
| Rate for Payer: Coventry All Commercial |
$36.60
|
| Rate for Payer: Encore All Commercial |
$30.50
|
| Rate for Payer: Encore All Commercial |
$30.50
|
| Rate for Payer: Frontpath All Commercial |
$53.18
|
| Rate for Payer: Frontpath All Commercial |
$53.18
|
| Rate for Payer: Humana ChoiceCare |
$33.78
|
| Rate for Payer: Humana ChoiceCare |
$33.78
|
| Rate for Payer: Humana Medicare |
$30.50
|
| Rate for Payer: Humana Medicare |
$30.50
|
| Rate for Payer: Lucent All Commercial |
$42.70
|
| Rate for Payer: Lucent All Commercial |
$42.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$47.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$47.00
|
| Rate for Payer: Managed Health Services Medicaid |
$30.04
|
| Rate for Payer: Managed Health Services Medicaid |
$30.04
|
| Rate for Payer: MDWise Medicaid |
$30.04
|
| Rate for Payer: MDWise Medicaid |
$30.04
|
| Rate for Payer: PHCS All Commercial |
$30.50
|
| Rate for Payer: PHCS All Commercial |
$30.50
|
| Rate for Payer: PHP All Commercial |
$38.65
|
| Rate for Payer: PHP All Commercial |
$38.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$30.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$30.50
|
| Rate for Payer: Sagamore Health Network All Products |
$30.50
|
| Rate for Payer: Sagamore Health Network All Products |
$30.50
|
| Rate for Payer: Signature Care EPO |
$36.55
|
| Rate for Payer: Signature Care EPO |
$36.55
|
| Rate for Payer: Signature Care PPO |
$36.55
|
| Rate for Payer: Signature Care PPO |
$36.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,400.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,400.00
|
| Rate for Payer: United Healthcare Commercial |
$31.05
|
| Rate for Payer: United Healthcare Commercial |
$31.05
|
|
|
CHG X-RAY EXAM OF FINGER(S)
|
Professional
|
Both
|
$68.86
|
|
|
Service Code
|
CPT 73140
|
| Hospital Charge Code |
z73140
|
| Min. Negotiated Rate |
$25.86 |
| Max. Negotiated Rate |
$5,100.00 |
| Rate for Payer: Aetna Commercial |
$35.03
|
| Rate for Payer: Aetna Commercial |
$35.03
|
| Rate for Payer: Aetna Medicare |
$35.03
|
| Rate for Payer: Aetna Medicare |
$35.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$49.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$49.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$49.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$49.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$49.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$49.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$49.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$49.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$34.76
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$34.76
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$40.28
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$40.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$38.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$38.53
|
| Rate for Payer: Cash Price |
$34.81
|
| Rate for Payer: Cash Price |
$41.32
|
| Rate for Payer: Centivo All Commercial |
$54.30
|
| Rate for Payer: Centivo All Commercial |
$54.30
|
| Rate for Payer: Cigna All Commercial |
$35.03
|
| Rate for Payer: Cigna All Commercial |
$35.03
|
| Rate for Payer: CORVEL All Commercial |
$35.03
|
| Rate for Payer: CORVEL All Commercial |
$35.03
|
| Rate for Payer: Coventry All Commercial |
$42.04
|
| Rate for Payer: Coventry All Commercial |
$42.04
|
| Rate for Payer: Encore All Commercial |
$35.03
|
| Rate for Payer: Encore All Commercial |
$35.03
|
| Rate for Payer: Frontpath All Commercial |
$61.03
|
| Rate for Payer: Frontpath All Commercial |
$61.03
|
| Rate for Payer: Humana ChoiceCare |
$39.17
|
| Rate for Payer: Humana ChoiceCare |
$39.17
|
| Rate for Payer: Humana Medicare |
$35.03
|
| Rate for Payer: Humana Medicare |
$35.03
|
| Rate for Payer: Lucent All Commercial |
$49.04
|
| Rate for Payer: Lucent All Commercial |
$49.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$55.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$55.00
|
| Rate for Payer: Managed Health Services Medicaid |
$34.76
|
| Rate for Payer: Managed Health Services Medicaid |
$34.76
|
| Rate for Payer: MDWise Medicaid |
$34.76
|
| Rate for Payer: MDWise Medicaid |
$34.76
|
| Rate for Payer: PHCS All Commercial |
$35.03
|
| Rate for Payer: PHCS All Commercial |
$35.03
|
| Rate for Payer: PHP All Commercial |
$44.76
|
| Rate for Payer: PHP All Commercial |
$44.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$35.03
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$35.03
|
| Rate for Payer: Sagamore Health Network All Products |
$35.03
|
| Rate for Payer: Sagamore Health Network All Products |
$35.03
|
| Rate for Payer: Signature Care EPO |
$29.78
|
| Rate for Payer: Signature Care EPO |
$29.78
|
| Rate for Payer: Signature Care PPO |
$29.78
|
| Rate for Payer: Signature Care PPO |
$29.78
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,100.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,100.00
|
| Rate for Payer: United Healthcare Commercial |
$25.86
|
| Rate for Payer: United Healthcare Commercial |
$25.86
|
|
|
CHG X-RAY FACIAL BONES <3 VW
|
Professional
|
Both
|
$58.98
|
|
|
Service Code
|
CPT 70140
|
| Hospital Charge Code |
z70140
|
| Min. Negotiated Rate |
$27.14 |
| Max. Negotiated Rate |
$52.75 |
| Rate for Payer: Aetna Commercial |
$30.26
|
| Rate for Payer: Aetna Commercial |
$30.26
|
| Rate for Payer: Aetna Medicare |
$30.26
|
| Rate for Payer: Aetna Medicare |
$30.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$29.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$29.18
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$34.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$34.80
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$33.29
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$33.29
|
| Rate for Payer: Cash Price |
$24.86
|
| Rate for Payer: Cash Price |
$35.39
|
| Rate for Payer: Centivo All Commercial |
$46.90
|
| Rate for Payer: Centivo All Commercial |
$46.90
|
| Rate for Payer: Cigna All Commercial |
$30.26
|
| Rate for Payer: Cigna All Commercial |
$30.26
|
| Rate for Payer: CORVEL All Commercial |
$30.26
|
| Rate for Payer: CORVEL All Commercial |
$30.26
|
| Rate for Payer: Coventry All Commercial |
$36.31
|
| Rate for Payer: Coventry All Commercial |
$36.31
|
| Rate for Payer: Encore All Commercial |
$30.26
|
| Rate for Payer: Encore All Commercial |
$30.26
|
| Rate for Payer: Frontpath All Commercial |
$52.75
|
| Rate for Payer: Frontpath All Commercial |
$52.75
|
| Rate for Payer: Humana ChoiceCare |
$33.78
|
| Rate for Payer: Humana ChoiceCare |
$33.78
|
| Rate for Payer: Humana Medicare |
$30.26
|
| Rate for Payer: Humana Medicare |
$30.26
|
| Rate for Payer: Lucent All Commercial |
$42.36
|
| Rate for Payer: Lucent All Commercial |
$42.36
|
| Rate for Payer: Managed Health Services Medicaid |
$29.18
|
| Rate for Payer: Managed Health Services Medicaid |
$29.18
|
| Rate for Payer: MDWise Medicaid |
$29.18
|
| Rate for Payer: MDWise Medicaid |
$29.18
|
| Rate for Payer: PHCS All Commercial |
$30.26
|
| Rate for Payer: PHCS All Commercial |
$30.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$30.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$30.26
|
| Rate for Payer: Sagamore Health Network All Products |
$30.26
|
| Rate for Payer: Sagamore Health Network All Products |
$30.26
|
| Rate for Payer: United Healthcare Commercial |
$27.14
|
| Rate for Payer: United Healthcare Commercial |
$27.14
|
|
|
CHG X-RAY FACIAL BONES 3+ VW
|
Professional
|
Both
|
$85.88
|
|
|
Service Code
|
CPT 70150
|
| Hospital Charge Code |
z70150
|
| Min. Negotiated Rate |
$38.82 |
| Max. Negotiated Rate |
$77.81 |
| Rate for Payer: Aetna Commercial |
$44.83
|
| Rate for Payer: Aetna Commercial |
$44.83
|
| Rate for Payer: Aetna Medicare |
$44.83
|
| Rate for Payer: Aetna Medicare |
$44.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$43.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$43.25
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$51.55
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$51.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$49.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$49.31
|
| Rate for Payer: Cash Price |
$51.53
|
| Rate for Payer: Cash Price |
$38.50
|
| Rate for Payer: Centivo All Commercial |
$69.49
|
| Rate for Payer: Centivo All Commercial |
$69.49
|
| Rate for Payer: Cigna All Commercial |
$44.83
|
| Rate for Payer: Cigna All Commercial |
$44.83
|
| Rate for Payer: CORVEL All Commercial |
$44.83
|
| Rate for Payer: CORVEL All Commercial |
$44.83
|
| Rate for Payer: Coventry All Commercial |
$53.80
|
| Rate for Payer: Coventry All Commercial |
$53.80
|
| Rate for Payer: Encore All Commercial |
$44.83
|
| Rate for Payer: Encore All Commercial |
$44.83
|
| Rate for Payer: Frontpath All Commercial |
$77.81
|
| Rate for Payer: Frontpath All Commercial |
$77.81
|
| Rate for Payer: Humana ChoiceCare |
$49.59
|
| Rate for Payer: Humana ChoiceCare |
$49.59
|
| Rate for Payer: Humana Medicare |
$44.83
|
| Rate for Payer: Humana Medicare |
$44.83
|
| Rate for Payer: Lucent All Commercial |
$62.76
|
| Rate for Payer: Lucent All Commercial |
$62.76
|
| Rate for Payer: Managed Health Services Medicaid |
$43.25
|
| Rate for Payer: Managed Health Services Medicaid |
$43.25
|
| Rate for Payer: MDWise Medicaid |
$43.25
|
| Rate for Payer: MDWise Medicaid |
$43.25
|
| Rate for Payer: PHCS All Commercial |
$44.83
|
| Rate for Payer: PHCS All Commercial |
$44.83
|
| Rate for Payer: PHP All Commercial |
$55.83
|
| Rate for Payer: PHP All Commercial |
$55.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$44.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$44.83
|
| Rate for Payer: Sagamore Health Network All Products |
$44.83
|
| Rate for Payer: Sagamore Health Network All Products |
$44.83
|
| Rate for Payer: Signature Care EPO |
$52.70
|
| Rate for Payer: Signature Care EPO |
$52.70
|
| Rate for Payer: Signature Care PPO |
$52.70
|
| Rate for Payer: Signature Care PPO |
$52.70
|
| Rate for Payer: United Healthcare Commercial |
$38.82
|
| Rate for Payer: United Healthcare Commercial |
$38.82
|
|
|
CHG X-RAY FOOT 2 VW
|
Professional
|
Both
|
$51.56
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
z73620
|
| Min. Negotiated Rate |
$23.64 |
| Max. Negotiated Rate |
$46.15 |
| Rate for Payer: Aetna Commercial |
$26.41
|
| Rate for Payer: Aetna Commercial |
$26.41
|
| Rate for Payer: Aetna Medicare |
$26.41
|
| Rate for Payer: Aetna Medicare |
$26.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$26.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$26.09
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$30.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$30.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$29.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$29.05
|
| Rate for Payer: Cash Price |
$30.94
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Centivo All Commercial |
$40.94
|
| Rate for Payer: Centivo All Commercial |
$40.94
|
| Rate for Payer: Cigna All Commercial |
$26.41
|
| Rate for Payer: Cigna All Commercial |
$26.41
|
| Rate for Payer: CORVEL All Commercial |
$26.41
|
| Rate for Payer: CORVEL All Commercial |
$26.41
|
| Rate for Payer: Coventry All Commercial |
$31.69
|
| Rate for Payer: Coventry All Commercial |
$31.69
|
| Rate for Payer: Encore All Commercial |
$26.41
|
| Rate for Payer: Encore All Commercial |
$26.41
|
| Rate for Payer: Frontpath All Commercial |
$46.15
|
| Rate for Payer: Frontpath All Commercial |
$46.15
|
| Rate for Payer: Humana ChoiceCare |
$29.83
|
| Rate for Payer: Humana ChoiceCare |
$29.83
|
| Rate for Payer: Humana Medicare |
$26.41
|
| Rate for Payer: Humana Medicare |
$26.41
|
| Rate for Payer: Lucent All Commercial |
$36.97
|
| Rate for Payer: Lucent All Commercial |
$36.97
|
| Rate for Payer: Managed Health Services Medicaid |
$26.09
|
| Rate for Payer: Managed Health Services Medicaid |
$26.09
|
| Rate for Payer: MDWise Medicaid |
$26.09
|
| Rate for Payer: MDWise Medicaid |
$26.09
|
| Rate for Payer: PHCS All Commercial |
$26.41
|
| Rate for Payer: PHCS All Commercial |
$26.41
|
| Rate for Payer: PHP All Commercial |
$33.52
|
| Rate for Payer: PHP All Commercial |
$33.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$26.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$26.41
|
| Rate for Payer: Sagamore Health Network All Products |
$26.41
|
| Rate for Payer: Sagamore Health Network All Products |
$26.41
|
| Rate for Payer: Signature Care EPO |
$32.30
|
| Rate for Payer: Signature Care EPO |
$32.30
|
| Rate for Payer: Signature Care PPO |
$32.30
|
| Rate for Payer: Signature Care PPO |
$32.30
|
| Rate for Payer: United Healthcare Commercial |
$23.64
|
| Rate for Payer: United Healthcare Commercial |
$23.64
|
|
|
CHG X-RAY FOOT 3+ VW
|
Professional
|
Both
|
$62.46
|
|
|
Service Code
|
CPT 73630
|
| Hospital Charge Code |
z73630
|
| Min. Negotiated Rate |
$27.64 |
| Max. Negotiated Rate |
$4,600.00 |
| Rate for Payer: Aetna Commercial |
$32.37
|
| Rate for Payer: Aetna Commercial |
$32.37
|
| Rate for Payer: Aetna Medicare |
$32.37
|
| Rate for Payer: Aetna Medicare |
$32.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$34.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$34.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$34.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$34.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$34.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$34.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$34.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$34.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$37.23
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$37.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$35.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$35.61
|
| Rate for Payer: Cash Price |
$28.92
|
| Rate for Payer: Cash Price |
$37.48
|
| Rate for Payer: Centivo All Commercial |
$50.17
|
| Rate for Payer: Centivo All Commercial |
$50.17
|
| Rate for Payer: Cigna All Commercial |
$32.37
|
| Rate for Payer: Cigna All Commercial |
$32.37
|
| Rate for Payer: CORVEL All Commercial |
$32.37
|
| Rate for Payer: CORVEL All Commercial |
$32.37
|
| Rate for Payer: Coventry All Commercial |
$38.84
|
| Rate for Payer: Coventry All Commercial |
$38.84
|
| Rate for Payer: Encore All Commercial |
$32.37
|
| Rate for Payer: Encore All Commercial |
$32.37
|
| Rate for Payer: Frontpath All Commercial |
$56.41
|
| Rate for Payer: Frontpath All Commercial |
$56.41
|
| Rate for Payer: Humana ChoiceCare |
$35.94
|
| Rate for Payer: Humana ChoiceCare |
$35.94
|
| Rate for Payer: Humana Medicare |
$32.37
|
| Rate for Payer: Humana Medicare |
$32.37
|
| Rate for Payer: Lucent All Commercial |
$45.32
|
| Rate for Payer: Lucent All Commercial |
$45.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$50.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$50.00
|
| Rate for Payer: Managed Health Services Medicaid |
$31.24
|
| Rate for Payer: Managed Health Services Medicaid |
$31.24
|
| Rate for Payer: MDWise Medicaid |
$31.24
|
| Rate for Payer: MDWise Medicaid |
$31.24
|
| Rate for Payer: PHCS All Commercial |
$32.37
|
| Rate for Payer: PHCS All Commercial |
$32.37
|
| Rate for Payer: PHP All Commercial |
$40.60
|
| Rate for Payer: PHP All Commercial |
$40.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$32.37
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$32.37
|
| Rate for Payer: Sagamore Health Network All Products |
$32.37
|
| Rate for Payer: Sagamore Health Network All Products |
$32.37
|
| Rate for Payer: Signature Care EPO |
$34.85
|
| Rate for Payer: Signature Care EPO |
$34.85
|
| Rate for Payer: Signature Care PPO |
$34.85
|
| Rate for Payer: Signature Care PPO |
$34.85
|
| 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 |
$27.64
|
| Rate for Payer: United Healthcare Commercial |
$27.64
|
|
|
CHG X-RAY FOREARM 2 VW
|
Professional
|
Both
|
$53.38
|
|
|
Service Code
|
CPT 73090
|
| Hospital Charge Code |
z73090
|
| Min. Negotiated Rate |
$24.63 |
| Max. Negotiated Rate |
$4,000.00 |
| Rate for Payer: Aetna Commercial |
$27.35
|
| Rate for Payer: Aetna Commercial |
$27.35
|
| Rate for Payer: Aetna Medicare |
$27.35
|
| Rate for Payer: Aetna Medicare |
$27.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$28.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$28.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$28.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$28.37
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$28.37
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$28.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$28.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$28.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$26.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$26.69
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$31.45
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$31.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$30.09
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$30.09
|
| Rate for Payer: Cash Price |
$23.76
|
| Rate for Payer: Cash Price |
$32.03
|
| Rate for Payer: Centivo All Commercial |
$42.39
|
| Rate for Payer: Centivo All Commercial |
$42.39
|
| Rate for Payer: Cigna All Commercial |
$27.35
|
| Rate for Payer: Cigna All Commercial |
$27.35
|
| Rate for Payer: CORVEL All Commercial |
$27.35
|
| Rate for Payer: CORVEL All Commercial |
$27.35
|
| Rate for Payer: Coventry All Commercial |
$32.82
|
| Rate for Payer: Coventry All Commercial |
$32.82
|
| Rate for Payer: Encore All Commercial |
$27.35
|
| Rate for Payer: Encore All Commercial |
$27.35
|
| Rate for Payer: Frontpath All Commercial |
$47.77
|
| Rate for Payer: Frontpath All Commercial |
$47.77
|
| Rate for Payer: Humana ChoiceCare |
$30.55
|
| Rate for Payer: Humana ChoiceCare |
$30.55
|
| Rate for Payer: Humana Medicare |
$27.35
|
| Rate for Payer: Humana Medicare |
$27.35
|
| Rate for Payer: Lucent All Commercial |
$38.29
|
| Rate for Payer: Lucent All Commercial |
$38.29
|
| Rate for Payer: Lutheran Preferred All Commercial |
$42.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$42.00
|
| Rate for Payer: Managed Health Services Medicaid |
$26.69
|
| Rate for Payer: Managed Health Services Medicaid |
$26.69
|
| Rate for Payer: MDWise Medicaid |
$26.69
|
| Rate for Payer: MDWise Medicaid |
$26.69
|
| Rate for Payer: PHCS All Commercial |
$27.35
|
| Rate for Payer: PHCS All Commercial |
$27.35
|
| Rate for Payer: PHP All Commercial |
$34.69
|
| Rate for Payer: PHP All Commercial |
$34.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$27.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$27.35
|
| Rate for Payer: Sagamore Health Network All Products |
$27.35
|
| Rate for Payer: Sagamore Health Network All Products |
$27.35
|
| Rate for Payer: Signature Care EPO |
$33.15
|
| Rate for Payer: Signature Care EPO |
$33.15
|
| Rate for Payer: Signature Care PPO |
$33.15
|
| Rate for Payer: Signature Care PPO |
$33.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,000.00
|
| Rate for Payer: United Healthcare Commercial |
$24.63
|
| Rate for Payer: United Healthcare Commercial |
$24.63
|
|
|
CHG X-RAY HAND 2 VW
|
Professional
|
Both
|
$56.98
|
|
|
Service Code
|
CPT 73120
|
| Hospital Charge Code |
z73120
|
| Min. Negotiated Rate |
$24.30 |
| Max. Negotiated Rate |
$50.98 |
| Rate for Payer: Aetna Commercial |
$29.22
|
| Rate for Payer: Aetna Commercial |
$29.22
|
| Rate for Payer: Aetna Medicare |
$29.22
|
| Rate for Payer: Aetna Medicare |
$29.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$28.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$28.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$33.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$33.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$32.14
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$32.14
|
| Rate for Payer: Cash Price |
$34.19
|
| Rate for Payer: Cash Price |
$25.98
|
| Rate for Payer: Centivo All Commercial |
$45.29
|
| Rate for Payer: Centivo All Commercial |
$45.29
|
| Rate for Payer: Cigna All Commercial |
$29.22
|
| Rate for Payer: Cigna All Commercial |
$29.22
|
| Rate for Payer: CORVEL All Commercial |
$29.22
|
| Rate for Payer: CORVEL All Commercial |
$29.22
|
| Rate for Payer: Coventry All Commercial |
$35.06
|
| Rate for Payer: Coventry All Commercial |
$35.06
|
| Rate for Payer: Encore All Commercial |
$29.22
|
| Rate for Payer: Encore All Commercial |
$29.22
|
| Rate for Payer: Frontpath All Commercial |
$50.98
|
| Rate for Payer: Frontpath All Commercial |
$50.98
|
| Rate for Payer: Humana ChoiceCare |
$32.70
|
| Rate for Payer: Humana ChoiceCare |
$32.70
|
| Rate for Payer: Humana Medicare |
$29.22
|
| Rate for Payer: Humana Medicare |
$29.22
|
| Rate for Payer: Lucent All Commercial |
$40.91
|
| Rate for Payer: Lucent All Commercial |
$40.91
|
| Rate for Payer: Managed Health Services Medicaid |
$28.80
|
| Rate for Payer: Managed Health Services Medicaid |
$28.80
|
| Rate for Payer: MDWise Medicaid |
$28.80
|
| Rate for Payer: MDWise Medicaid |
$28.80
|
| Rate for Payer: PHCS All Commercial |
$29.22
|
| Rate for Payer: PHCS All Commercial |
$29.22
|
| Rate for Payer: PHP All Commercial |
$37.04
|
| Rate for Payer: PHP All Commercial |
$37.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$29.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$29.22
|
| Rate for Payer: Sagamore Health Network All Products |
$29.22
|
| Rate for Payer: Sagamore Health Network All Products |
$29.22
|
| Rate for Payer: Signature Care EPO |
$32.30
|
| Rate for Payer: Signature Care EPO |
$32.30
|
| Rate for Payer: Signature Care PPO |
$32.30
|
| Rate for Payer: Signature Care PPO |
$32.30
|
| Rate for Payer: United Healthcare Commercial |
$24.30
|
| Rate for Payer: United Healthcare Commercial |
$24.30
|
|
|
CHG X-RAY HAND 3+ VW
|
Professional
|
Both
|
$67.28
|
|
|
Service Code
|
CPT 73130
|
| Hospital Charge Code |
z73130
|
| Min. Negotiated Rate |
$27.97 |
| Max. Negotiated Rate |
$5,000.00 |
| Rate for Payer: Aetna Commercial |
$34.24
|
| Rate for Payer: Aetna Commercial |
$34.24
|
| Rate for Payer: Aetna Medicare |
$34.24
|
| Rate for Payer: Aetna Medicare |
$34.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$51.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$51.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$51.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$51.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$51.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$51.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$51.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$51.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$33.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$33.96
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$39.38
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$39.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$37.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$37.66
|
| Rate for Payer: Cash Price |
$31.87
|
| Rate for Payer: Cash Price |
$40.37
|
| Rate for Payer: Centivo All Commercial |
$53.07
|
| Rate for Payer: Centivo All Commercial |
$53.07
|
| Rate for Payer: Cigna All Commercial |
$34.24
|
| Rate for Payer: Cigna All Commercial |
$34.24
|
| Rate for Payer: CORVEL All Commercial |
$34.24
|
| Rate for Payer: CORVEL All Commercial |
$34.24
|
| Rate for Payer: Coventry All Commercial |
$41.09
|
| Rate for Payer: Coventry All Commercial |
$41.09
|
| Rate for Payer: Encore All Commercial |
$34.24
|
| Rate for Payer: Encore All Commercial |
$34.24
|
| Rate for Payer: Frontpath All Commercial |
$59.64
|
| Rate for Payer: Frontpath All Commercial |
$59.64
|
| Rate for Payer: Humana ChoiceCare |
$38.10
|
| Rate for Payer: Humana ChoiceCare |
$38.10
|
| Rate for Payer: Humana Medicare |
$34.24
|
| Rate for Payer: Humana Medicare |
$34.24
|
| Rate for Payer: Lucent All Commercial |
$47.94
|
| Rate for Payer: Lucent All Commercial |
$47.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$53.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$53.00
|
| Rate for Payer: Managed Health Services Medicaid |
$33.96
|
| Rate for Payer: Managed Health Services Medicaid |
$33.96
|
| Rate for Payer: MDWise Medicaid |
$33.96
|
| Rate for Payer: MDWise Medicaid |
$33.96
|
| Rate for Payer: PHCS All Commercial |
$34.24
|
| Rate for Payer: PHCS All Commercial |
$34.24
|
| Rate for Payer: PHP All Commercial |
$43.74
|
| Rate for Payer: PHP All Commercial |
$43.74
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$34.24
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$34.24
|
| Rate for Payer: Sagamore Health Network All Products |
$34.24
|
| Rate for Payer: Sagamore Health Network All Products |
$34.24
|
| Rate for Payer: Signature Care EPO |
$34.85
|
| Rate for Payer: Signature Care EPO |
$34.85
|
| Rate for Payer: Signature Care PPO |
$34.85
|
| Rate for Payer: Signature Care PPO |
$34.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,000.00
|
| Rate for Payer: United Healthcare Commercial |
$27.97
|
| Rate for Payer: United Healthcare Commercial |
$27.97
|
|
|
CHG X-RAY HEEL
|
Professional
|
Both
|
$52.16
|
|
|
Service Code
|
CPT 73650
|
| Hospital Charge Code |
z73650
|
| Min. Negotiated Rate |
$23.97 |
| Max. Negotiated Rate |
$3,900.00 |
| Rate for Payer: Aetna Commercial |
$27.04
|
| Rate for Payer: Aetna Commercial |
$27.04
|
| Rate for Payer: Aetna Medicare |
$27.04
|
| Rate for Payer: Aetna Medicare |
$27.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$27.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$27.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$27.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$27.74
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$27.74
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$27.74
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$27.74
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$27.74
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$26.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$26.09
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$31.10
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$31.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$29.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$29.74
|
| Rate for Payer: Cash Price |
$23.03
|
| Rate for Payer: Cash Price |
$31.30
|
| Rate for Payer: Centivo All Commercial |
$41.91
|
| Rate for Payer: Centivo All Commercial |
$41.91
|
| Rate for Payer: Cigna All Commercial |
$27.04
|
| Rate for Payer: Cigna All Commercial |
$27.04
|
| Rate for Payer: CORVEL All Commercial |
$27.04
|
| Rate for Payer: CORVEL All Commercial |
$27.04
|
| Rate for Payer: Coventry All Commercial |
$32.45
|
| Rate for Payer: Coventry All Commercial |
$32.45
|
| Rate for Payer: Encore All Commercial |
$27.04
|
| Rate for Payer: Encore All Commercial |
$27.04
|
| Rate for Payer: Frontpath All Commercial |
$47.23
|
| Rate for Payer: Frontpath All Commercial |
$47.23
|
| Rate for Payer: Humana ChoiceCare |
$30.19
|
| Rate for Payer: Humana ChoiceCare |
$30.19
|
| Rate for Payer: Humana Medicare |
$27.04
|
| Rate for Payer: Humana Medicare |
$27.04
|
| Rate for Payer: Lucent All Commercial |
$37.86
|
| Rate for Payer: Lucent All Commercial |
$37.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$41.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$41.00
|
| Rate for Payer: Managed Health Services Medicaid |
$26.09
|
| Rate for Payer: Managed Health Services Medicaid |
$26.09
|
| Rate for Payer: MDWise Medicaid |
$26.09
|
| Rate for Payer: MDWise Medicaid |
$26.09
|
| Rate for Payer: PHCS All Commercial |
$27.04
|
| Rate for Payer: PHCS All Commercial |
$27.04
|
| Rate for Payer: PHP All Commercial |
$33.91
|
| Rate for Payer: PHP All Commercial |
$33.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$27.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$27.04
|
| Rate for Payer: Sagamore Health Network All Products |
$27.04
|
| Rate for Payer: Sagamore Health Network All Products |
$27.04
|
| Rate for Payer: Signature Care EPO |
$31.45
|
| Rate for Payer: Signature Care EPO |
$31.45
|
| Rate for Payer: Signature Care PPO |
$31.45
|
| Rate for Payer: Signature Care PPO |
$31.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,900.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,900.00
|
| Rate for Payer: United Healthcare Commercial |
$23.97
|
| Rate for Payer: United Healthcare Commercial |
$23.97
|
|
|
CHG X-RAY HUMERUS
|
Professional
|
Both
|
$58.80
|
|
|
Service Code
|
CPT 73060
|
| Hospital Charge Code |
z73060
|
| Min. Negotiated Rate |
$26.41 |
| Max. Negotiated Rate |
$52.05 |
| Rate for Payer: Aetna Commercial |
$29.84
|
| Rate for Payer: Aetna Commercial |
$29.84
|
| Rate for Payer: Aetna Medicare |
$29.84
|
| Rate for Payer: Aetna Medicare |
$29.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$29.11
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$29.11
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$34.32
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$34.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$32.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$32.82
|
| Rate for Payer: Cash Price |
$35.28
|
| Rate for Payer: Cash Price |
$26.71
|
| Rate for Payer: Centivo All Commercial |
$46.25
|
| Rate for Payer: Centivo All Commercial |
$46.25
|
| Rate for Payer: Cigna All Commercial |
$29.84
|
| Rate for Payer: Cigna All Commercial |
$29.84
|
| Rate for Payer: CORVEL All Commercial |
$29.84
|
| Rate for Payer: CORVEL All Commercial |
$29.84
|
| Rate for Payer: Coventry All Commercial |
$35.81
|
| Rate for Payer: Coventry All Commercial |
$35.81
|
| Rate for Payer: Encore All Commercial |
$29.84
|
| Rate for Payer: Encore All Commercial |
$29.84
|
| Rate for Payer: Frontpath All Commercial |
$52.05
|
| Rate for Payer: Frontpath All Commercial |
$52.05
|
| Rate for Payer: Humana ChoiceCare |
$33.78
|
| Rate for Payer: Humana ChoiceCare |
$33.78
|
| Rate for Payer: Humana Medicare |
$29.84
|
| Rate for Payer: Humana Medicare |
$29.84
|
| Rate for Payer: Lucent All Commercial |
$41.78
|
| Rate for Payer: Lucent All Commercial |
$41.78
|
| Rate for Payer: Managed Health Services Medicaid |
$29.11
|
| Rate for Payer: Managed Health Services Medicaid |
$29.11
|
| Rate for Payer: MDWise Medicaid |
$29.11
|
| Rate for Payer: MDWise Medicaid |
$29.11
|
| Rate for Payer: PHCS All Commercial |
$29.84
|
| Rate for Payer: PHCS All Commercial |
$29.84
|
| Rate for Payer: PHP All Commercial |
$38.22
|
| Rate for Payer: PHP All Commercial |
$38.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$29.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$29.84
|
| Rate for Payer: Sagamore Health Network All Products |
$29.84
|
| Rate for Payer: Sagamore Health Network All Products |
$29.84
|
| Rate for Payer: Signature Care EPO |
$36.55
|
| Rate for Payer: Signature Care EPO |
$36.55
|
| Rate for Payer: Signature Care PPO |
$36.55
|
| Rate for Payer: Signature Care PPO |
$36.55
|
| Rate for Payer: United Healthcare Commercial |
$26.41
|
| Rate for Payer: United Healthcare Commercial |
$26.41
|
|
|
CHG X-RAY HYSTEROSALPINGOGRAM
|
Professional
|
Both
|
$174.86
|
|
|
Service Code
|
CPT 74740
|
| Hospital Charge Code |
z74740
|
| Min. Negotiated Rate |
$70.94 |
| Max. Negotiated Rate |
$13,000.00 |
| Rate for Payer: Aetna Commercial |
$92.43
|
| Rate for Payer: Aetna Commercial |
$92.43
|
| Rate for Payer: Aetna Medicare |
$92.43
|
| Rate for Payer: Aetna Medicare |
$92.43
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$73.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$73.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$73.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$73.38
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$73.38
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$73.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$73.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$73.38
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$85.38
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$85.38
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$106.29
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$106.29
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$101.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$101.67
|
| Rate for Payer: Cash Price |
$104.92
|
| Rate for Payer: Cash Price |
$83.42
|
| Rate for Payer: Centivo All Commercial |
$143.27
|
| Rate for Payer: Centivo All Commercial |
$143.27
|
| Rate for Payer: Cigna All Commercial |
$92.43
|
| Rate for Payer: Cigna All Commercial |
$92.43
|
| Rate for Payer: CORVEL All Commercial |
$92.43
|
| Rate for Payer: CORVEL All Commercial |
$92.43
|
| Rate for Payer: Coventry All Commercial |
$110.92
|
| Rate for Payer: Coventry All Commercial |
$110.92
|
| Rate for Payer: Encore All Commercial |
$92.43
|
| Rate for Payer: Encore All Commercial |
$92.43
|
| Rate for Payer: Frontpath All Commercial |
$160.17
|
| Rate for Payer: Frontpath All Commercial |
$160.17
|
| Rate for Payer: Humana ChoiceCare |
$102.78
|
| Rate for Payer: Humana ChoiceCare |
$102.78
|
| Rate for Payer: Humana Medicare |
$92.43
|
| Rate for Payer: Humana Medicare |
$92.43
|
| Rate for Payer: Lucent All Commercial |
$129.40
|
| Rate for Payer: Lucent All Commercial |
$129.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$139.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$139.00
|
| Rate for Payer: Managed Health Services Medicaid |
$85.38
|
| Rate for Payer: Managed Health Services Medicaid |
$85.38
|
| Rate for Payer: MDWise Medicaid |
$85.38
|
| Rate for Payer: MDWise Medicaid |
$85.38
|
| Rate for Payer: PHCS All Commercial |
$92.43
|
| Rate for Payer: PHCS All Commercial |
$92.43
|
| Rate for Payer: PHP All Commercial |
$113.65
|
| Rate for Payer: PHP All Commercial |
$113.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$92.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$92.43
|
| Rate for Payer: Sagamore Health Network All Products |
$92.43
|
| Rate for Payer: Sagamore Health Network All Products |
$92.43
|
| Rate for Payer: Signature Care EPO |
$83.30
|
| Rate for Payer: Signature Care EPO |
$83.30
|
| Rate for Payer: Signature Care PPO |
$83.30
|
| Rate for Payer: Signature Care PPO |
$83.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,000.00
|
| Rate for Payer: United Healthcare Commercial |
$70.94
|
| Rate for Payer: United Healthcare Commercial |
$70.94
|
|
|
CHG X-RAY JAW <4 VW
|
Professional
|
Both
|
$55.56
|
|
|
Service Code
|
CPT 70100
|
| Hospital Charge Code |
z70100
|
| Min. Negotiated Rate |
$27.67 |
| Max. Negotiated Rate |
$62.90 |
| Rate for Payer: Aetna Commercial |
$36.14
|
| Rate for Payer: Aetna Commercial |
$36.14
|
| Rate for Payer: Aetna Medicare |
$36.14
|
| Rate for Payer: Aetna Medicare |
$36.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$35.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$35.50
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$41.56
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$41.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$39.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$39.75
|
| Rate for Payer: Cash Price |
$32.35
|
| Rate for Payer: Cash Price |
$33.34
|
| Rate for Payer: Centivo All Commercial |
$56.02
|
| Rate for Payer: Centivo All Commercial |
$56.02
|
| Rate for Payer: Cigna All Commercial |
$36.14
|
| Rate for Payer: Cigna All Commercial |
$36.14
|
| Rate for Payer: CORVEL All Commercial |
$36.14
|
| Rate for Payer: CORVEL All Commercial |
$36.14
|
| Rate for Payer: Coventry All Commercial |
$43.37
|
| Rate for Payer: Coventry All Commercial |
$43.37
|
| Rate for Payer: Encore All Commercial |
$36.14
|
| Rate for Payer: Encore All Commercial |
$36.14
|
| Rate for Payer: Frontpath All Commercial |
$62.90
|
| Rate for Payer: Frontpath All Commercial |
$62.90
|
| Rate for Payer: Humana ChoiceCare |
$40.25
|
| Rate for Payer: Humana ChoiceCare |
$40.25
|
| Rate for Payer: Humana Medicare |
$36.14
|
| Rate for Payer: Humana Medicare |
$36.14
|
| Rate for Payer: Lucent All Commercial |
$50.60
|
| Rate for Payer: Lucent All Commercial |
$50.60
|
| Rate for Payer: Managed Health Services Medicaid |
$35.50
|
| Rate for Payer: Managed Health Services Medicaid |
$35.50
|
| Rate for Payer: MDWise Medicaid |
$35.50
|
| Rate for Payer: MDWise Medicaid |
$35.50
|
| Rate for Payer: PHCS All Commercial |
$36.14
|
| Rate for Payer: PHCS All Commercial |
$36.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$36.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$36.14
|
| Rate for Payer: Sagamore Health Network All Products |
$36.14
|
| Rate for Payer: Sagamore Health Network All Products |
$36.14
|
| Rate for Payer: United Healthcare Commercial |
$27.67
|
| Rate for Payer: United Healthcare Commercial |
$27.67
|
|
|
CHG X-RAY JAW 4+ VW
|
Professional
|
Both
|
$79.20
|
|
|
Service Code
|
CPT 70110
|
| Hospital Charge Code |
z70110
|
| Min. Negotiated Rate |
$35.92 |
| Max. Negotiated Rate |
$71.86 |
| Rate for Payer: Aetna Commercial |
$41.36
|
| Rate for Payer: Aetna Commercial |
$41.36
|
| Rate for Payer: Aetna Medicare |
$41.36
|
| Rate for Payer: Aetna Medicare |
$41.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$39.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$39.90
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$47.56
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$47.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$45.50
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$45.50
|
| Rate for Payer: Cash Price |
$35.18
|
| Rate for Payer: Cash Price |
$47.52
|
| Rate for Payer: Centivo All Commercial |
$64.11
|
| Rate for Payer: Centivo All Commercial |
$64.11
|
| Rate for Payer: Cigna All Commercial |
$41.36
|
| Rate for Payer: Cigna All Commercial |
$41.36
|
| Rate for Payer: CORVEL All Commercial |
$41.36
|
| Rate for Payer: CORVEL All Commercial |
$41.36
|
| Rate for Payer: Coventry All Commercial |
$49.63
|
| Rate for Payer: Coventry All Commercial |
$49.63
|
| Rate for Payer: Encore All Commercial |
$41.36
|
| Rate for Payer: Encore All Commercial |
$41.36
|
| Rate for Payer: Frontpath All Commercial |
$71.86
|
| Rate for Payer: Frontpath All Commercial |
$71.86
|
| Rate for Payer: Humana ChoiceCare |
$45.64
|
| Rate for Payer: Humana ChoiceCare |
$45.64
|
| Rate for Payer: Humana Medicare |
$41.36
|
| Rate for Payer: Humana Medicare |
$41.36
|
| Rate for Payer: Lucent All Commercial |
$57.90
|
| Rate for Payer: Lucent All Commercial |
$57.90
|
| Rate for Payer: Managed Health Services Medicaid |
$39.90
|
| Rate for Payer: Managed Health Services Medicaid |
$39.90
|
| Rate for Payer: MDWise Medicaid |
$39.90
|
| Rate for Payer: MDWise Medicaid |
$39.90
|
| Rate for Payer: PHCS All Commercial |
$41.36
|
| Rate for Payer: PHCS All Commercial |
$41.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$41.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$41.36
|
| Rate for Payer: Sagamore Health Network All Products |
$41.36
|
| Rate for Payer: Sagamore Health Network All Products |
$41.36
|
| Rate for Payer: United Healthcare Commercial |
$35.92
|
| Rate for Payer: United Healthcare Commercial |
$35.92
|
|
|
CHG X-RAY KNEE 1 OR 2 VIEW
|
Professional
|
Both
|
$62.40
|
|
|
Service Code
|
CPT 73560
|
| Hospital Charge Code |
z73560
|
| Min. Negotiated Rate |
$25.65 |
| Max. Negotiated Rate |
$55.81 |
| Rate for Payer: Aetna Commercial |
$32.02
|
| Rate for Payer: Aetna Commercial |
$32.02
|
| Rate for Payer: Aetna Medicare |
$32.02
|
| Rate for Payer: Aetna Medicare |
$32.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.22
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$36.82
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$36.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$35.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$35.22
|
| Rate for Payer: Cash Price |
$37.44
|
| Rate for Payer: Cash Price |
$28.92
|
| Rate for Payer: Centivo All Commercial |
$49.63
|
| Rate for Payer: Centivo All Commercial |
$49.63
|
| Rate for Payer: Cigna All Commercial |
$32.02
|
| Rate for Payer: Cigna All Commercial |
$32.02
|
| Rate for Payer: CORVEL All Commercial |
$32.02
|
| Rate for Payer: CORVEL All Commercial |
$32.02
|
| Rate for Payer: Coventry All Commercial |
$38.42
|
| Rate for Payer: Coventry All Commercial |
$38.42
|
| Rate for Payer: Encore All Commercial |
$32.02
|
| Rate for Payer: Encore All Commercial |
$32.02
|
| Rate for Payer: Frontpath All Commercial |
$55.81
|
| Rate for Payer: Frontpath All Commercial |
$55.81
|
| Rate for Payer: Humana ChoiceCare |
$35.94
|
| Rate for Payer: Humana ChoiceCare |
$35.94
|
| Rate for Payer: Humana Medicare |
$32.02
|
| Rate for Payer: Humana Medicare |
$32.02
|
| Rate for Payer: Lucent All Commercial |
$44.83
|
| Rate for Payer: Lucent All Commercial |
$44.83
|
| Rate for Payer: Managed Health Services Medicaid |
$31.22
|
| Rate for Payer: Managed Health Services Medicaid |
$31.22
|
| Rate for Payer: MDWise Medicaid |
$31.22
|
| Rate for Payer: MDWise Medicaid |
$31.22
|
| Rate for Payer: PHCS All Commercial |
$32.02
|
| Rate for Payer: PHCS All Commercial |
$32.02
|
| Rate for Payer: PHP All Commercial |
$40.57
|
| Rate for Payer: PHP All Commercial |
$40.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$32.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$32.02
|
| Rate for Payer: Sagamore Health Network All Products |
$32.02
|
| Rate for Payer: Sagamore Health Network All Products |
$32.02
|
| Rate for Payer: Signature Care EPO |
$34.00
|
| Rate for Payer: Signature Care EPO |
$34.00
|
| Rate for Payer: Signature Care PPO |
$34.00
|
| Rate for Payer: Signature Care PPO |
$34.00
|
| Rate for Payer: United Healthcare Commercial |
$25.65
|
| Rate for Payer: United Healthcare Commercial |
$25.65
|
|
|
CHG X-RAY KNEE 3 VIEW
|
Professional
|
Both
|
$73.98
|
|
|
Service Code
|
CPT 73562
|
| Hospital Charge Code |
z73562
|
| Min. Negotiated Rate |
$30.75 |
| Max. Negotiated Rate |
$5,500.00 |
| Rate for Payer: Aetna Commercial |
$38.32
|
| Rate for Payer: Aetna Commercial |
$38.32
|
| Rate for Payer: Aetna Medicare |
$38.32
|
| Rate for Payer: Aetna Medicare |
$38.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$72.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$72.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$72.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$72.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$72.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$72.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$72.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$72.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$37.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$37.31
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$44.07
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$44.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$42.15
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$42.15
|
| Rate for Payer: Cash Price |
$35.18
|
| Rate for Payer: Cash Price |
$44.39
|
| Rate for Payer: Centivo All Commercial |
$59.40
|
| Rate for Payer: Centivo All Commercial |
$59.40
|
| Rate for Payer: Cigna All Commercial |
$38.32
|
| Rate for Payer: Cigna All Commercial |
$38.32
|
| Rate for Payer: CORVEL All Commercial |
$38.32
|
| Rate for Payer: CORVEL All Commercial |
$38.32
|
| Rate for Payer: Coventry All Commercial |
$45.98
|
| Rate for Payer: Coventry All Commercial |
$45.98
|
| Rate for Payer: Encore All Commercial |
$38.32
|
| Rate for Payer: Encore All Commercial |
$38.32
|
| Rate for Payer: Frontpath All Commercial |
$66.66
|
| Rate for Payer: Frontpath All Commercial |
$66.66
|
| Rate for Payer: Humana ChoiceCare |
$42.41
|
| Rate for Payer: Humana ChoiceCare |
$42.41
|
| Rate for Payer: Humana Medicare |
$38.32
|
| Rate for Payer: Humana Medicare |
$38.32
|
| Rate for Payer: Lucent All Commercial |
$53.65
|
| Rate for Payer: Lucent All Commercial |
$53.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$59.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$59.00
|
| Rate for Payer: Managed Health Services Medicaid |
$37.31
|
| Rate for Payer: Managed Health Services Medicaid |
$37.31
|
| Rate for Payer: MDWise Medicaid |
$37.31
|
| Rate for Payer: MDWise Medicaid |
$37.31
|
| Rate for Payer: PHCS All Commercial |
$38.32
|
| Rate for Payer: PHCS All Commercial |
$38.32
|
| Rate for Payer: PHP All Commercial |
$48.08
|
| Rate for Payer: PHP All Commercial |
$48.08
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$38.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$38.32
|
| Rate for Payer: Sagamore Health Network All Products |
$38.32
|
| Rate for Payer: Sagamore Health Network All Products |
$38.32
|
| Rate for Payer: Signature Care EPO |
$37.40
|
| Rate for Payer: Signature Care EPO |
$37.40
|
| Rate for Payer: Signature Care PPO |
$37.40
|
| Rate for Payer: Signature Care PPO |
$37.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,500.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,500.00
|
| Rate for Payer: United Healthcare Commercial |
$30.75
|
| Rate for Payer: United Healthcare Commercial |
$30.75
|
|
|
CHG X-RAY KNEE 4+ VIEW
|
Professional
|
Both
|
$85.04
|
|
|
Service Code
|
CPT 73564
|
| Hospital Charge Code |
z73564
|
| Min. Negotiated Rate |
$35.83 |
| Max. Negotiated Rate |
$6,300.00 |
| Rate for Payer: Aetna Commercial |
$43.44
|
| Rate for Payer: Aetna Commercial |
$43.44
|
| Rate for Payer: Aetna Medicare |
$43.44
|
| Rate for Payer: Aetna Medicare |
$43.44
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$54.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$54.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$54.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$54.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$54.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$54.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$54.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$54.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$43.15
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$43.15
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$49.96
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$49.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$47.78
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$47.78
|
| Rate for Payer: Cash Price |
$39.97
|
| Rate for Payer: Cash Price |
$51.02
|
| Rate for Payer: Centivo All Commercial |
$67.33
|
| Rate for Payer: Centivo All Commercial |
$67.33
|
| Rate for Payer: Cigna All Commercial |
$43.44
|
| Rate for Payer: Cigna All Commercial |
$43.44
|
| Rate for Payer: CORVEL All Commercial |
$43.44
|
| Rate for Payer: CORVEL All Commercial |
$43.44
|
| Rate for Payer: Coventry All Commercial |
$52.13
|
| Rate for Payer: Coventry All Commercial |
$52.13
|
| Rate for Payer: Encore All Commercial |
$43.44
|
| Rate for Payer: Encore All Commercial |
$43.44
|
| Rate for Payer: Frontpath All Commercial |
$75.46
|
| Rate for Payer: Frontpath All Commercial |
$75.46
|
| Rate for Payer: Humana ChoiceCare |
$48.16
|
| Rate for Payer: Humana ChoiceCare |
$48.16
|
| Rate for Payer: Humana Medicare |
$43.44
|
| Rate for Payer: Humana Medicare |
$43.44
|
| Rate for Payer: Lucent All Commercial |
$60.82
|
| Rate for Payer: Lucent All Commercial |
$60.82
|
| 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 |
$43.15
|
| Rate for Payer: Managed Health Services Medicaid |
$43.15
|
| Rate for Payer: MDWise Medicaid |
$43.15
|
| Rate for Payer: MDWise Medicaid |
$43.15
|
| Rate for Payer: PHCS All Commercial |
$43.44
|
| Rate for Payer: PHCS All Commercial |
$43.44
|
| Rate for Payer: PHP All Commercial |
$55.28
|
| Rate for Payer: PHP All Commercial |
$55.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$43.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$43.44
|
| Rate for Payer: Sagamore Health Network All Products |
$43.44
|
| Rate for Payer: Sagamore Health Network All Products |
$43.44
|
| Rate for Payer: Signature Care EPO |
$42.50
|
| Rate for Payer: Signature Care EPO |
$42.50
|
| Rate for Payer: Signature Care PPO |
$42.50
|
| Rate for Payer: Signature Care PPO |
$42.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,300.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,300.00
|
| Rate for Payer: United Healthcare Commercial |
$35.83
|
| Rate for Payer: United Healthcare Commercial |
$35.83
|
|
|
CHG X-RAY LUMBAR SPINE 2/3 VW
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
CPT 72100
|
| Hospital Charge Code |
z72100
|
| Min. Negotiated Rate |
$35.17 |
| Max. Negotiated Rate |
$5,400.00 |
| Rate for Payer: Aetna Commercial |
$37.52
|
| Rate for Payer: Aetna Commercial |
$37.52
|
| Rate for Payer: Aetna Medicare |
$37.52
|
| Rate for Payer: Aetna Medicare |
$37.52
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$39.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$39.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$39.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$39.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$39.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$39.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$39.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$39.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$36.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$36.50
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$43.15
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$43.15
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$41.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$41.27
|
| Rate for Payer: Cash Price |
$32.23
|
| Rate for Payer: Cash Price |
$43.80
|
| Rate for Payer: Centivo All Commercial |
$58.16
|
| Rate for Payer: Centivo All Commercial |
$58.16
|
| Rate for Payer: Cigna All Commercial |
$37.52
|
| Rate for Payer: Cigna All Commercial |
$37.52
|
| Rate for Payer: CORVEL All Commercial |
$37.52
|
| Rate for Payer: CORVEL All Commercial |
$37.52
|
| Rate for Payer: Coventry All Commercial |
$45.02
|
| Rate for Payer: Coventry All Commercial |
$45.02
|
| Rate for Payer: Encore All Commercial |
$37.52
|
| Rate for Payer: Encore All Commercial |
$37.52
|
| Rate for Payer: Frontpath All Commercial |
$65.26
|
| Rate for Payer: Frontpath All Commercial |
$65.26
|
| Rate for Payer: Humana ChoiceCare |
$41.69
|
| Rate for Payer: Humana ChoiceCare |
$41.69
|
| Rate for Payer: Humana Medicare |
$37.52
|
| Rate for Payer: Humana Medicare |
$37.52
|
| Rate for Payer: Lucent All Commercial |
$52.53
|
| Rate for Payer: Lucent All Commercial |
$52.53
|
| 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 |
$36.50
|
| Rate for Payer: Managed Health Services Medicaid |
$36.50
|
| Rate for Payer: MDWise Medicaid |
$36.50
|
| Rate for Payer: MDWise Medicaid |
$36.50
|
| Rate for Payer: PHCS All Commercial |
$37.52
|
| Rate for Payer: PHCS All Commercial |
$37.52
|
| Rate for Payer: PHP All Commercial |
$47.45
|
| Rate for Payer: PHP All Commercial |
$47.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$37.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$37.52
|
| Rate for Payer: Sagamore Health Network All Products |
$37.52
|
| Rate for Payer: Sagamore Health Network All Products |
$37.52
|
| Rate for Payer: Signature Care EPO |
$44.20
|
| Rate for Payer: Signature Care EPO |
$44.20
|
| Rate for Payer: Signature Care PPO |
$44.20
|
| Rate for Payer: Signature Care PPO |
$44.20
|
| 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 |
$35.17
|
| Rate for Payer: United Healthcare Commercial |
$35.17
|
|
|
CHG X-RAY LUMBAR SPINE 4 VW
|
Professional
|
Both
|
$93.72
|
|
|
Service Code
|
CPT 72110
|
| Hospital Charge Code |
z72110
|
| Min. Negotiated Rate |
$47.47 |
| Max. Negotiated Rate |
$7,000.00 |
| Rate for Payer: Aetna Commercial |
$48.25
|
| Rate for Payer: Aetna Commercial |
$48.25
|
| Rate for Payer: Aetna Medicare |
$48.25
|
| Rate for Payer: Aetna Medicare |
$48.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$62.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$62.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$62.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$62.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$62.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$62.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$62.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$62.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$47.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$47.47
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$55.49
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$55.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$53.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$53.08
|
| Rate for Payer: Cash Price |
$43.66
|
| Rate for Payer: Cash Price |
$56.23
|
| Rate for Payer: Centivo All Commercial |
$74.79
|
| Rate for Payer: Centivo All Commercial |
$74.79
|
| Rate for Payer: Cigna All Commercial |
$48.25
|
| Rate for Payer: Cigna All Commercial |
$48.25
|
| Rate for Payer: CORVEL All Commercial |
$48.25
|
| Rate for Payer: CORVEL All Commercial |
$48.25
|
| Rate for Payer: Coventry All Commercial |
$57.90
|
| Rate for Payer: Coventry All Commercial |
$57.90
|
| Rate for Payer: Encore All Commercial |
$48.25
|
| Rate for Payer: Encore All Commercial |
$48.25
|
| Rate for Payer: Frontpath All Commercial |
$83.72
|
| Rate for Payer: Frontpath All Commercial |
$83.72
|
| Rate for Payer: Humana ChoiceCare |
$53.19
|
| Rate for Payer: Humana ChoiceCare |
$53.19
|
| Rate for Payer: Humana Medicare |
$48.25
|
| Rate for Payer: Humana Medicare |
$48.25
|
| Rate for Payer: Lucent All Commercial |
$67.55
|
| Rate for Payer: Lucent All Commercial |
$67.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$74.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$74.00
|
| Rate for Payer: Managed Health Services Medicaid |
$47.47
|
| Rate for Payer: Managed Health Services Medicaid |
$47.47
|
| Rate for Payer: MDWise Medicaid |
$47.47
|
| Rate for Payer: MDWise Medicaid |
$47.47
|
| Rate for Payer: PHCS All Commercial |
$48.25
|
| Rate for Payer: PHCS All Commercial |
$48.25
|
| Rate for Payer: PHP All Commercial |
$60.92
|
| Rate for Payer: PHP All Commercial |
$60.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$48.25
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$48.25
|
| Rate for Payer: Sagamore Health Network All Products |
$48.25
|
| Rate for Payer: Sagamore Health Network All Products |
$48.25
|
| Rate for Payer: Signature Care EPO |
$61.20
|
| Rate for Payer: Signature Care EPO |
$61.20
|
| Rate for Payer: Signature Care PPO |
$61.20
|
| Rate for Payer: Signature Care PPO |
$61.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,000.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,000.00
|
| Rate for Payer: United Healthcare Commercial |
$49.11
|
| Rate for Payer: United Healthcare Commercial |
$49.11
|
|
|
CHG X-RAY NASAL BONES
|
Professional
|
Both
|
$69.70
|
|
|
Service Code
|
CPT 70160
|
| Hospital Charge Code |
z70160
|
| Min. Negotiated Rate |
$28.96 |
| Max. Negotiated Rate |
$5,200.00 |
| Rate for Payer: Aetna Commercial |
$35.79
|
| Rate for Payer: Aetna Commercial |
$35.79
|
| Rate for Payer: Aetna Medicare |
$35.79
|
| Rate for Payer: Aetna Medicare |
$35.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$30.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$30.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$30.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$30.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$30.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$30.31
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$30.31
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$30.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$34.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$34.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$41.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$41.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$39.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$39.37
|
| Rate for Payer: Cash Price |
$32.60
|
| Rate for Payer: Cash Price |
$41.82
|
| Rate for Payer: Centivo All Commercial |
$55.47
|
| Rate for Payer: Centivo All Commercial |
$55.47
|
| Rate for Payer: Cigna All Commercial |
$35.79
|
| Rate for Payer: Cigna All Commercial |
$35.79
|
| Rate for Payer: CORVEL All Commercial |
$35.79
|
| Rate for Payer: CORVEL All Commercial |
$35.79
|
| Rate for Payer: Coventry All Commercial |
$42.95
|
| Rate for Payer: Coventry All Commercial |
$42.95
|
| Rate for Payer: Encore All Commercial |
$35.79
|
| Rate for Payer: Encore All Commercial |
$35.79
|
| Rate for Payer: Frontpath All Commercial |
$62.32
|
| Rate for Payer: Frontpath All Commercial |
$62.32
|
| Rate for Payer: Humana ChoiceCare |
$39.89
|
| Rate for Payer: Humana ChoiceCare |
$39.89
|
| Rate for Payer: Humana Medicare |
$35.79
|
| Rate for Payer: Humana Medicare |
$35.79
|
| Rate for Payer: Lucent All Commercial |
$50.11
|
| Rate for Payer: Lucent All Commercial |
$50.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$55.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$55.00
|
| Rate for Payer: Managed Health Services Medicaid |
$34.26
|
| Rate for Payer: Managed Health Services Medicaid |
$34.26
|
| Rate for Payer: MDWise Medicaid |
$34.26
|
| Rate for Payer: MDWise Medicaid |
$34.26
|
| Rate for Payer: PHCS All Commercial |
$35.79
|
| Rate for Payer: PHCS All Commercial |
$35.79
|
| Rate for Payer: PHP All Commercial |
$45.30
|
| Rate for Payer: PHP All Commercial |
$45.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$35.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$35.79
|
| Rate for Payer: Sagamore Health Network All Products |
$35.79
|
| Rate for Payer: Sagamore Health Network All Products |
$35.79
|
| Rate for Payer: Signature Care EPO |
$34.00
|
| Rate for Payer: Signature Care EPO |
$34.00
|
| Rate for Payer: Signature Care PPO |
$34.00
|
| Rate for Payer: Signature Care PPO |
$34.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,200.00
|
| Rate for Payer: United Healthcare Commercial |
$28.96
|
| Rate for Payer: United Healthcare Commercial |
$28.96
|
|
