|
HC AR KIT DISP INST MINI SUT TAK
|
Facility
OP
|
$875.00
|
|
| Hospital Charge Code |
41603476
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$813.75 |
| Rate for Payer: Aetna Commercial |
$738.50
|
| Rate for Payer: Aetna Medicare |
$288.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$288.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$502.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$546.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$332.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$317.62
|
| Rate for Payer: Cash Price |
$542.50
|
| Rate for Payer: Cash Price |
$542.50
|
| Rate for Payer: Centivo All Commercial |
$446.25
|
| Rate for Payer: Cigna All Commercial |
$755.12
|
| Rate for Payer: CORVEL All Commercial |
$813.75
|
| Rate for Payer: Coventry All Commercial |
$770.00
|
| Rate for Payer: Encore All Commercial |
$805.44
|
| Rate for Payer: Frontpath All Commercial |
$805.00
|
| Rate for Payer: Humana ChoiceCare |
$755.74
|
| Rate for Payer: Humana Medicare |
$446.25
|
| Rate for Payer: Lucent All Commercial |
$446.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$787.50
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$656.25
|
| Rate for Payer: PHP All Commercial |
$663.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$341.25
|
| Rate for Payer: Sagamore Health Network All Products |
$675.50
|
| Rate for Payer: Signature Care EPO |
$726.25
|
| Rate for Payer: Signature Care PPO |
$770.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$743.75
|
| Rate for Payer: United Healthcare Commercial |
$689.50
|
| Rate for Payer: United Healthcare Medicare |
$288.75
|
|
|
HC AR KIT DISP RC FIBERTAK
|
Facility
OP
|
$1,072.50
|
|
| Hospital Charge Code |
41606988
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$997.42 |
| Rate for Payer: Aetna Commercial |
$905.19
|
| Rate for Payer: Aetna Medicare |
$353.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$353.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$615.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$670.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$407.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$389.32
|
| Rate for Payer: Cash Price |
$664.95
|
| Rate for Payer: Cash Price |
$664.95
|
| Rate for Payer: Centivo All Commercial |
$546.98
|
| Rate for Payer: Cigna All Commercial |
$925.57
|
| Rate for Payer: CORVEL All Commercial |
$997.42
|
| Rate for Payer: Coventry All Commercial |
$943.80
|
| Rate for Payer: Encore All Commercial |
$987.24
|
| Rate for Payer: Frontpath All Commercial |
$986.70
|
| Rate for Payer: Humana ChoiceCare |
$926.32
|
| Rate for Payer: Humana Medicare |
$546.98
|
| Rate for Payer: Lucent All Commercial |
$546.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$965.25
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$804.38
|
| Rate for Payer: PHP All Commercial |
$813.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$418.28
|
| Rate for Payer: Sagamore Health Network All Products |
$827.97
|
| Rate for Payer: Signature Care EPO |
$890.18
|
| Rate for Payer: Signature Care PPO |
$943.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$911.62
|
| Rate for Payer: United Healthcare Commercial |
$845.13
|
| Rate for Payer: United Healthcare Medicare |
$353.92
|
|
|
HC AR KIT DISP RC FIBERTAK
|
Facility
IP
|
$1,072.50
|
|
| Hospital Charge Code |
41606988
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$804.38 |
| Max. Negotiated Rate |
$997.42 |
| Rate for Payer: Aetna Commercial |
$926.64
|
| Rate for Payer: Cash Price |
$664.95
|
| Rate for Payer: Cigna All Commercial |
$925.57
|
| Rate for Payer: CORVEL All Commercial |
$997.42
|
| Rate for Payer: Coventry All Commercial |
$943.80
|
| Rate for Payer: Encore All Commercial |
$987.24
|
| Rate for Payer: Frontpath All Commercial |
$986.70
|
| Rate for Payer: Humana ChoiceCare |
$926.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$965.25
|
| Rate for Payer: PHCS All Commercial |
$804.38
|
| Rate for Payer: PHP All Commercial |
$813.38
|
| Rate for Payer: Sagamore Health Network All Products |
$827.97
|
| Rate for Payer: Signature Care EPO |
$890.18
|
| Rate for Payer: Signature Care PPO |
$943.80
|
| Rate for Payer: United Healthcare Commercial |
$845.13
|
|
|
HC AR KIT DX SWIVELOCK SL 3.5X8.5
|
Facility
IP
|
$1,965.00
|
|
| Hospital Charge Code |
41602622
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,473.75 |
| Max. Negotiated Rate |
$1,827.45 |
| Rate for Payer: Aetna Commercial |
$1,697.76
|
| Rate for Payer: Cash Price |
$1,218.30
|
| Rate for Payer: Cigna All Commercial |
$1,695.80
|
| Rate for Payer: CORVEL All Commercial |
$1,827.45
|
| Rate for Payer: Coventry All Commercial |
$1,729.20
|
| Rate for Payer: Encore All Commercial |
$1,808.78
|
| Rate for Payer: Frontpath All Commercial |
$1,807.80
|
| Rate for Payer: Humana ChoiceCare |
$1,697.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,768.50
|
| Rate for Payer: PHCS All Commercial |
$1,473.75
|
| Rate for Payer: PHP All Commercial |
$1,490.26
|
| Rate for Payer: Sagamore Health Network All Products |
$1,516.98
|
| Rate for Payer: Signature Care EPO |
$1,630.95
|
| Rate for Payer: Signature Care PPO |
$1,729.20
|
| Rate for Payer: United Healthcare Commercial |
$1,548.42
|
|
|
HC AR KIT DX SWIVELOCK SL 3.5X8.5
|
Facility
OP
|
$1,965.00
|
|
| Hospital Charge Code |
41602622
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,827.45 |
| Rate for Payer: Aetna Commercial |
$1,658.46
|
| Rate for Payer: Aetna Medicare |
$648.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$648.45
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,128.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,228.32
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$745.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$713.30
|
| Rate for Payer: Cash Price |
$1,218.30
|
| Rate for Payer: Cash Price |
$1,218.30
|
| Rate for Payer: Centivo All Commercial |
$1,002.15
|
| Rate for Payer: Cigna All Commercial |
$1,695.80
|
| Rate for Payer: CORVEL All Commercial |
$1,827.45
|
| Rate for Payer: Coventry All Commercial |
$1,729.20
|
| Rate for Payer: Encore All Commercial |
$1,808.78
|
| Rate for Payer: Frontpath All Commercial |
$1,807.80
|
| Rate for Payer: Humana ChoiceCare |
$1,697.17
|
| Rate for Payer: Humana Medicare |
$1,002.15
|
| Rate for Payer: Lucent All Commercial |
$1,002.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,768.50
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,473.75
|
| Rate for Payer: PHP All Commercial |
$1,490.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$766.35
|
| Rate for Payer: Sagamore Health Network All Products |
$1,516.98
|
| Rate for Payer: Signature Care EPO |
$1,630.95
|
| Rate for Payer: Signature Care PPO |
$1,729.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,670.25
|
| Rate for Payer: United Healthcare Commercial |
$1,548.42
|
| Rate for Payer: United Healthcare Medicare |
$648.45
|
|
|
HC AR KIT INST SM JOINT SUT TAK
|
Facility
OP
|
$797.50
|
|
| Hospital Charge Code |
41605567
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$741.68 |
| Rate for Payer: Aetna Commercial |
$673.09
|
| Rate for Payer: Aetna Medicare |
$263.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$263.18
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$458.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$498.52
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$302.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$289.49
|
| Rate for Payer: Cash Price |
$494.45
|
| Rate for Payer: Cash Price |
$494.45
|
| Rate for Payer: Centivo All Commercial |
$406.72
|
| Rate for Payer: Cigna All Commercial |
$688.24
|
| Rate for Payer: CORVEL All Commercial |
$741.68
|
| Rate for Payer: Coventry All Commercial |
$701.80
|
| Rate for Payer: Encore All Commercial |
$734.10
|
| Rate for Payer: Frontpath All Commercial |
$733.70
|
| Rate for Payer: Humana ChoiceCare |
$688.80
|
| Rate for Payer: Humana Medicare |
$406.72
|
| Rate for Payer: Lucent All Commercial |
$406.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$717.75
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$598.12
|
| Rate for Payer: PHP All Commercial |
$604.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$311.02
|
| Rate for Payer: Sagamore Health Network All Products |
$615.67
|
| Rate for Payer: Signature Care EPO |
$661.92
|
| Rate for Payer: Signature Care PPO |
$701.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$677.88
|
| Rate for Payer: United Healthcare Commercial |
$628.43
|
| Rate for Payer: United Healthcare Medicare |
$263.18
|
|
|
HC AR KIT INST SM JOINT SUT TAK
|
Facility
IP
|
$797.50
|
|
| Hospital Charge Code |
41605567
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$598.12 |
| Max. Negotiated Rate |
$741.68 |
| Rate for Payer: Aetna Commercial |
$689.04
|
| Rate for Payer: Cash Price |
$494.45
|
| Rate for Payer: Cigna All Commercial |
$688.24
|
| Rate for Payer: CORVEL All Commercial |
$741.68
|
| Rate for Payer: Coventry All Commercial |
$701.80
|
| Rate for Payer: Encore All Commercial |
$734.10
|
| Rate for Payer: Frontpath All Commercial |
$733.70
|
| Rate for Payer: Humana ChoiceCare |
$688.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$717.75
|
| Rate for Payer: PHCS All Commercial |
$598.12
|
| Rate for Payer: PHP All Commercial |
$604.82
|
| Rate for Payer: Sagamore Health Network All Products |
$615.67
|
| Rate for Payer: Signature Care EPO |
$661.92
|
| Rate for Payer: Signature Care PPO |
$701.80
|
| Rate for Payer: United Healthcare Commercial |
$628.43
|
|
|
HC AR KIT INST TENODESIS SCREW
|
Facility
OP
|
$1,072.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603248
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$353.92 |
| Max. Negotiated Rate |
$997.42 |
| Rate for Payer: Aetna Commercial |
$905.19
|
| Rate for Payer: Aetna Medicare |
$353.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$353.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$615.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$670.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$407.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$389.32
|
| Rate for Payer: Cash Price |
$664.95
|
| Rate for Payer: Cash Price |
$664.95
|
| Rate for Payer: Centivo All Commercial |
$546.98
|
| Rate for Payer: Cigna All Commercial |
$925.57
|
| Rate for Payer: CORVEL All Commercial |
$997.42
|
| Rate for Payer: Coventry All Commercial |
$943.80
|
| Rate for Payer: Encore All Commercial |
$987.24
|
| Rate for Payer: Frontpath All Commercial |
$986.70
|
| Rate for Payer: Humana ChoiceCare |
$926.32
|
| Rate for Payer: Humana Medicare |
$546.98
|
| Rate for Payer: Lucent All Commercial |
$546.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$965.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$804.38
|
| Rate for Payer: PHP All Commercial |
$813.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$418.28
|
| Rate for Payer: Sagamore Health Network All Products |
$827.97
|
| Rate for Payer: Signature Care EPO |
$890.18
|
| Rate for Payer: Signature Care PPO |
$943.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$911.62
|
| Rate for Payer: United Healthcare Commercial |
$845.13
|
| Rate for Payer: United Healthcare Medicare |
$353.92
|
|
|
HC AR KIT INST TENODESIS SCREW
|
Facility
IP
|
$1,072.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603248
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$804.38 |
| Max. Negotiated Rate |
$997.42 |
| Rate for Payer: Aetna Commercial |
$926.64
|
| Rate for Payer: Cash Price |
$664.95
|
| Rate for Payer: Cigna All Commercial |
$925.57
|
| Rate for Payer: CORVEL All Commercial |
$997.42
|
| Rate for Payer: Coventry All Commercial |
$943.80
|
| Rate for Payer: Encore All Commercial |
$987.24
|
| Rate for Payer: Frontpath All Commercial |
$986.70
|
| Rate for Payer: Humana ChoiceCare |
$926.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$965.25
|
| Rate for Payer: PHCS All Commercial |
$804.38
|
| Rate for Payer: PHP All Commercial |
$813.38
|
| Rate for Payer: Sagamore Health Network All Products |
$827.97
|
| Rate for Payer: Signature Care EPO |
$890.18
|
| Rate for Payer: Signature Care PPO |
$943.80
|
| Rate for Payer: United Healthcare Commercial |
$845.13
|
|
|
HC AR KIT SPEEDBRIDGE JUMPSTART
|
Facility
IP
|
$7,900.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603569
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,925.15 |
| Max. Negotiated Rate |
$7,347.19 |
| Rate for Payer: Aetna Commercial |
$6,825.77
|
| Rate for Payer: Cash Price |
$4,898.12
|
| Rate for Payer: Cigna All Commercial |
$6,817.87
|
| Rate for Payer: CORVEL All Commercial |
$7,347.19
|
| Rate for Payer: Coventry All Commercial |
$6,952.18
|
| Rate for Payer: Encore All Commercial |
$7,272.13
|
| Rate for Payer: Frontpath All Commercial |
$7,268.18
|
| Rate for Payer: Humana ChoiceCare |
$6,823.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,110.18
|
| Rate for Payer: PHCS All Commercial |
$5,925.15
|
| Rate for Payer: PHP All Commercial |
$5,991.51
|
| Rate for Payer: Sagamore Health Network All Products |
$6,098.95
|
| Rate for Payer: Signature Care EPO |
$6,557.17
|
| Rate for Payer: Signature Care PPO |
$6,952.18
|
| Rate for Payer: United Healthcare Commercial |
$6,225.36
|
|
|
HC AR KIT SPEEDBRIDGE JUMPSTART
|
Facility
OP
|
$7,900.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603569
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,347.19 |
| Rate for Payer: Aetna Commercial |
$6,667.77
|
| Rate for Payer: Aetna Medicare |
$2,607.07
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,607.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,537.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,938.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,998.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,867.77
|
| Rate for Payer: Cash Price |
$4,898.12
|
| Rate for Payer: Cash Price |
$4,898.12
|
| Rate for Payer: Centivo All Commercial |
$4,029.10
|
| Rate for Payer: Cigna All Commercial |
$6,817.87
|
| Rate for Payer: CORVEL All Commercial |
$7,347.19
|
| Rate for Payer: Coventry All Commercial |
$6,952.18
|
| Rate for Payer: Encore All Commercial |
$7,272.13
|
| Rate for Payer: Frontpath All Commercial |
$7,268.18
|
| Rate for Payer: Humana ChoiceCare |
$6,823.40
|
| Rate for Payer: Humana Medicare |
$4,029.10
|
| Rate for Payer: Lucent All Commercial |
$4,029.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,110.18
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,925.15
|
| Rate for Payer: PHP All Commercial |
$5,991.51
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,081.08
|
| Rate for Payer: Sagamore Health Network All Products |
$6,098.95
|
| Rate for Payer: Signature Care EPO |
$6,557.17
|
| Rate for Payer: Signature Care PPO |
$6,952.18
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,715.17
|
| Rate for Payer: United Healthcare Commercial |
$6,225.36
|
| Rate for Payer: United Healthcare Medicare |
$2,607.07
|
|
|
HC AR KNEE BUTTON 2.6
|
Facility
IP
|
$2,970.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608298
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,227.50 |
| Max. Negotiated Rate |
$2,762.10 |
| Rate for Payer: Aetna Commercial |
$2,566.08
|
| Rate for Payer: Cash Price |
$1,841.40
|
| Rate for Payer: Cigna All Commercial |
$2,563.11
|
| Rate for Payer: CORVEL All Commercial |
$2,762.10
|
| Rate for Payer: Coventry All Commercial |
$2,613.60
|
| Rate for Payer: Encore All Commercial |
$2,733.88
|
| Rate for Payer: Frontpath All Commercial |
$2,732.40
|
| Rate for Payer: Humana ChoiceCare |
$2,565.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,673.00
|
| Rate for Payer: PHCS All Commercial |
$2,227.50
|
| Rate for Payer: PHP All Commercial |
$2,252.45
|
| Rate for Payer: Sagamore Health Network All Products |
$2,292.84
|
| Rate for Payer: Signature Care EPO |
$2,465.10
|
| Rate for Payer: Signature Care PPO |
$2,613.60
|
| Rate for Payer: United Healthcare Commercial |
$2,340.36
|
|
|
HC AR KNEE BUTTON 2.6
|
Facility
OP
|
$2,970.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608298
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,762.10 |
| Rate for Payer: Aetna Commercial |
$2,506.68
|
| Rate for Payer: Aetna Medicare |
$980.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$980.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,705.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,856.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,127.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,078.11
|
| Rate for Payer: Cash Price |
$1,841.40
|
| Rate for Payer: Cash Price |
$1,841.40
|
| Rate for Payer: Centivo All Commercial |
$1,514.70
|
| Rate for Payer: Cigna All Commercial |
$2,563.11
|
| Rate for Payer: CORVEL All Commercial |
$2,762.10
|
| Rate for Payer: Coventry All Commercial |
$2,613.60
|
| Rate for Payer: Encore All Commercial |
$2,733.88
|
| Rate for Payer: Frontpath All Commercial |
$2,732.40
|
| Rate for Payer: Humana ChoiceCare |
$2,565.19
|
| Rate for Payer: Humana Medicare |
$1,514.70
|
| Rate for Payer: Lucent All Commercial |
$1,514.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,673.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,227.50
|
| Rate for Payer: PHP All Commercial |
$2,252.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,158.30
|
| Rate for Payer: Sagamore Health Network All Products |
$2,292.84
|
| Rate for Payer: Signature Care EPO |
$2,465.10
|
| Rate for Payer: Signature Care PPO |
$2,613.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,524.50
|
| Rate for Payer: United Healthcare Commercial |
$2,340.36
|
| Rate for Payer: United Healthcare Medicare |
$980.10
|
|
|
HC AR KNEE LIGAMENT AUG SYSTEM
|
Facility
IP
|
$4,732.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607076
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,549.15 |
| Max. Negotiated Rate |
$4,400.95 |
| Rate for Payer: Aetna Commercial |
$4,088.62
|
| Rate for Payer: Cash Price |
$2,933.96
|
| Rate for Payer: Cigna All Commercial |
$4,083.89
|
| Rate for Payer: CORVEL All Commercial |
$4,400.95
|
| Rate for Payer: Coventry All Commercial |
$4,164.34
|
| Rate for Payer: Encore All Commercial |
$4,355.99
|
| Rate for Payer: Frontpath All Commercial |
$4,353.62
|
| Rate for Payer: Humana ChoiceCare |
$4,087.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,258.98
|
| Rate for Payer: PHCS All Commercial |
$3,549.15
|
| Rate for Payer: PHP All Commercial |
$3,588.90
|
| Rate for Payer: Sagamore Health Network All Products |
$3,653.26
|
| Rate for Payer: Signature Care EPO |
$3,927.73
|
| Rate for Payer: Signature Care PPO |
$4,164.34
|
| Rate for Payer: United Healthcare Commercial |
$3,728.97
|
|
|
HC AR KNEE LIGAMENT AUG SYSTEM
|
Facility
OP
|
$4,732.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607076
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,400.95 |
| Rate for Payer: Aetna Commercial |
$3,993.98
|
| Rate for Payer: Aetna Medicare |
$1,561.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,561.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,717.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,958.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,795.87
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,717.79
|
| Rate for Payer: Cash Price |
$2,933.96
|
| Rate for Payer: Cash Price |
$2,933.96
|
| Rate for Payer: Centivo All Commercial |
$2,413.42
|
| Rate for Payer: Cigna All Commercial |
$4,083.89
|
| Rate for Payer: CORVEL All Commercial |
$4,400.95
|
| Rate for Payer: Coventry All Commercial |
$4,164.34
|
| Rate for Payer: Encore All Commercial |
$4,355.99
|
| Rate for Payer: Frontpath All Commercial |
$4,353.62
|
| Rate for Payer: Humana ChoiceCare |
$4,087.20
|
| Rate for Payer: Humana Medicare |
$2,413.42
|
| Rate for Payer: Lucent All Commercial |
$2,413.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,258.98
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,549.15
|
| Rate for Payer: PHP All Commercial |
$3,588.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,845.56
|
| Rate for Payer: Sagamore Health Network All Products |
$3,653.26
|
| Rate for Payer: Signature Care EPO |
$3,927.73
|
| Rate for Payer: Signature Care PPO |
$4,164.34
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,022.37
|
| Rate for Payer: United Healthcare Commercial |
$3,728.97
|
| Rate for Payer: United Healthcare Medicare |
$1,561.63
|
|
|
HC AR KNOTLESS FIBERTAK 2.56 BLUE
|
Facility
IP
|
$3,182.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608163
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,386.80 |
| Max. Negotiated Rate |
$2,959.63 |
| Rate for Payer: Aetna Commercial |
$2,749.59
|
| Rate for Payer: Cash Price |
$1,973.09
|
| Rate for Payer: Cigna All Commercial |
$2,746.41
|
| Rate for Payer: CORVEL All Commercial |
$2,959.63
|
| Rate for Payer: Coventry All Commercial |
$2,800.51
|
| Rate for Payer: Encore All Commercial |
$2,929.40
|
| Rate for Payer: Frontpath All Commercial |
$2,927.81
|
| Rate for Payer: Humana ChoiceCare |
$2,748.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,864.16
|
| Rate for Payer: PHCS All Commercial |
$2,386.80
|
| Rate for Payer: PHP All Commercial |
$2,413.53
|
| Rate for Payer: Sagamore Health Network All Products |
$2,456.81
|
| Rate for Payer: Signature Care EPO |
$2,641.39
|
| Rate for Payer: Signature Care PPO |
$2,800.51
|
| Rate for Payer: United Healthcare Commercial |
$2,507.73
|
|
|
HC AR KNOTLESS FIBERTAK 2.56 BLUE
|
Facility
OP
|
$3,182.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608163
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,959.63 |
| Rate for Payer: Aetna Commercial |
$2,685.95
|
| Rate for Payer: Aetna Medicare |
$1,050.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,050.19
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,827.65
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,989.32
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,207.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,155.21
|
| Rate for Payer: Cash Price |
$1,973.09
|
| Rate for Payer: Cash Price |
$1,973.09
|
| Rate for Payer: Centivo All Commercial |
$1,623.02
|
| Rate for Payer: Cigna All Commercial |
$2,746.41
|
| Rate for Payer: CORVEL All Commercial |
$2,959.63
|
| Rate for Payer: Coventry All Commercial |
$2,800.51
|
| Rate for Payer: Encore All Commercial |
$2,929.40
|
| Rate for Payer: Frontpath All Commercial |
$2,927.81
|
| Rate for Payer: Humana ChoiceCare |
$2,748.64
|
| Rate for Payer: Humana Medicare |
$1,623.02
|
| Rate for Payer: Lucent All Commercial |
$1,623.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,864.16
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,386.80
|
| Rate for Payer: PHP All Commercial |
$2,413.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,241.14
|
| Rate for Payer: Sagamore Health Network All Products |
$2,456.81
|
| Rate for Payer: Signature Care EPO |
$2,641.39
|
| Rate for Payer: Signature Care PPO |
$2,800.51
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,705.04
|
| Rate for Payer: United Healthcare Commercial |
$2,507.73
|
| Rate for Payer: United Healthcare Medicare |
$1,050.19
|
|
|
HC AR KNOTLESS FIBERTAK 2.6 B/B
|
Facility
OP
|
$2,098.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607776
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,951.88 |
| Rate for Payer: Aetna Commercial |
$1,771.39
|
| Rate for Payer: Aetna Medicare |
$692.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$692.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,205.34
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,311.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$796.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$761.86
|
| Rate for Payer: Cash Price |
$1,301.26
|
| Rate for Payer: Cash Price |
$1,301.26
|
| Rate for Payer: Centivo All Commercial |
$1,070.39
|
| Rate for Payer: Cigna All Commercial |
$1,811.26
|
| Rate for Payer: CORVEL All Commercial |
$1,951.88
|
| Rate for Payer: Coventry All Commercial |
$1,846.94
|
| Rate for Payer: Encore All Commercial |
$1,931.95
|
| Rate for Payer: Frontpath All Commercial |
$1,930.90
|
| Rate for Payer: Humana ChoiceCare |
$1,812.73
|
| Rate for Payer: Humana Medicare |
$1,070.39
|
| Rate for Payer: Lucent All Commercial |
$1,070.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,888.92
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,574.10
|
| Rate for Payer: PHP All Commercial |
$1,591.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$818.53
|
| Rate for Payer: Sagamore Health Network All Products |
$1,620.27
|
| Rate for Payer: Signature Care EPO |
$1,742.00
|
| Rate for Payer: Signature Care PPO |
$1,846.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,783.98
|
| Rate for Payer: United Healthcare Commercial |
$1,653.85
|
| Rate for Payer: United Healthcare Medicare |
$692.60
|
|
|
HC AR KNOTLESS FIBERTAK 2.6 B/B
|
Facility
IP
|
$2,098.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607776
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,574.10 |
| Max. Negotiated Rate |
$1,951.88 |
| Rate for Payer: Aetna Commercial |
$1,813.36
|
| Rate for Payer: Cash Price |
$1,301.26
|
| Rate for Payer: Cigna All Commercial |
$1,811.26
|
| Rate for Payer: CORVEL All Commercial |
$1,951.88
|
| Rate for Payer: Coventry All Commercial |
$1,846.94
|
| Rate for Payer: Encore All Commercial |
$1,931.95
|
| Rate for Payer: Frontpath All Commercial |
$1,930.90
|
| Rate for Payer: Humana ChoiceCare |
$1,812.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,888.92
|
| Rate for Payer: PHCS All Commercial |
$1,574.10
|
| Rate for Payer: PHP All Commercial |
$1,591.73
|
| Rate for Payer: Sagamore Health Network All Products |
$1,620.27
|
| Rate for Payer: Signature Care EPO |
$1,742.00
|
| Rate for Payer: Signature Care PPO |
$1,846.94
|
| Rate for Payer: United Healthcare Commercial |
$1,653.85
|
|
|
HC AR KNOTLESS FIBERTAK 2.6 W/B
|
Facility
IP
|
$2,098.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607775
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,574.10 |
| Max. Negotiated Rate |
$1,951.88 |
| Rate for Payer: Aetna Commercial |
$1,813.36
|
| Rate for Payer: Cash Price |
$1,301.26
|
| Rate for Payer: Cigna All Commercial |
$1,811.26
|
| Rate for Payer: CORVEL All Commercial |
$1,951.88
|
| Rate for Payer: Coventry All Commercial |
$1,846.94
|
| Rate for Payer: Encore All Commercial |
$1,931.95
|
| Rate for Payer: Frontpath All Commercial |
$1,930.90
|
| Rate for Payer: Humana ChoiceCare |
$1,812.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,888.92
|
| Rate for Payer: PHCS All Commercial |
$1,574.10
|
| Rate for Payer: PHP All Commercial |
$1,591.73
|
| Rate for Payer: Sagamore Health Network All Products |
$1,620.27
|
| Rate for Payer: Signature Care EPO |
$1,742.00
|
| Rate for Payer: Signature Care PPO |
$1,846.94
|
| Rate for Payer: United Healthcare Commercial |
$1,653.85
|
|
|
HC AR KNOTLESS FIBERTAK 2.6 W/B
|
Facility
OP
|
$2,098.80
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607775
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,951.88 |
| Rate for Payer: Aetna Commercial |
$1,771.39
|
| Rate for Payer: Aetna Medicare |
$692.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$692.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,205.34
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,311.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$796.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$761.86
|
| Rate for Payer: Cash Price |
$1,301.26
|
| Rate for Payer: Cash Price |
$1,301.26
|
| Rate for Payer: Centivo All Commercial |
$1,070.39
|
| Rate for Payer: Cigna All Commercial |
$1,811.26
|
| Rate for Payer: CORVEL All Commercial |
$1,951.88
|
| Rate for Payer: Coventry All Commercial |
$1,846.94
|
| Rate for Payer: Encore All Commercial |
$1,931.95
|
| Rate for Payer: Frontpath All Commercial |
$1,930.90
|
| Rate for Payer: Humana ChoiceCare |
$1,812.73
|
| Rate for Payer: Humana Medicare |
$1,070.39
|
| Rate for Payer: Lucent All Commercial |
$1,070.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,888.92
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,574.10
|
| Rate for Payer: PHP All Commercial |
$1,591.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$818.53
|
| Rate for Payer: Sagamore Health Network All Products |
$1,620.27
|
| Rate for Payer: Signature Care EPO |
$1,742.00
|
| Rate for Payer: Signature Care PPO |
$1,846.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,783.98
|
| Rate for Payer: United Healthcare Commercial |
$1,653.85
|
| Rate for Payer: United Healthcare Medicare |
$692.60
|
|
|
HC AR KNOTLESS FIBERTAK 3638
|
Facility
OP
|
$2,310.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607614
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,148.30 |
| Rate for Payer: Aetna Commercial |
$1,949.64
|
| Rate for Payer: Aetna Medicare |
$762.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$762.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,326.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,443.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$876.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$838.53
|
| Rate for Payer: Cash Price |
$1,432.20
|
| Rate for Payer: Cash Price |
$1,432.20
|
| Rate for Payer: Centivo All Commercial |
$1,178.10
|
| Rate for Payer: Cigna All Commercial |
$1,993.53
|
| Rate for Payer: CORVEL All Commercial |
$2,148.30
|
| Rate for Payer: Coventry All Commercial |
$2,032.80
|
| Rate for Payer: Encore All Commercial |
$2,126.36
|
| Rate for Payer: Frontpath All Commercial |
$2,125.20
|
| Rate for Payer: Humana ChoiceCare |
$1,995.15
|
| Rate for Payer: Humana Medicare |
$1,178.10
|
| Rate for Payer: Lucent All Commercial |
$1,178.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,079.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,732.50
|
| Rate for Payer: PHP All Commercial |
$1,751.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$900.90
|
| Rate for Payer: Sagamore Health Network All Products |
$1,783.32
|
| Rate for Payer: Signature Care EPO |
$1,917.30
|
| Rate for Payer: Signature Care PPO |
$2,032.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,963.50
|
| Rate for Payer: United Healthcare Commercial |
$1,820.28
|
| Rate for Payer: United Healthcare Medicare |
$762.30
|
|
|
HC AR KNOTLESS FIBERTAK 3638
|
Facility
IP
|
$2,310.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607614
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,732.50 |
| Max. Negotiated Rate |
$2,148.30 |
| Rate for Payer: Aetna Commercial |
$1,995.84
|
| Rate for Payer: Cash Price |
$1,432.20
|
| Rate for Payer: Cigna All Commercial |
$1,993.53
|
| Rate for Payer: CORVEL All Commercial |
$2,148.30
|
| Rate for Payer: Coventry All Commercial |
$2,032.80
|
| Rate for Payer: Encore All Commercial |
$2,126.36
|
| Rate for Payer: Frontpath All Commercial |
$2,125.20
|
| Rate for Payer: Humana ChoiceCare |
$1,995.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,079.00
|
| Rate for Payer: PHCS All Commercial |
$1,732.50
|
| Rate for Payer: PHP All Commercial |
$1,751.90
|
| Rate for Payer: Sagamore Health Network All Products |
$1,783.32
|
| Rate for Payer: Signature Care EPO |
$1,917.30
|
| Rate for Payer: Signature Care PPO |
$2,032.80
|
| Rate for Payer: United Healthcare Commercial |
$1,820.28
|
|
|
HC AR KNOTLESS FIBERTAK ANCH 2.6
|
Facility
IP
|
$2,475.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606987
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,856.25 |
| Max. Negotiated Rate |
$2,301.75 |
| Rate for Payer: Aetna Commercial |
$2,138.40
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Cigna All Commercial |
$2,135.92
|
| Rate for Payer: CORVEL All Commercial |
$2,301.75
|
| Rate for Payer: Coventry All Commercial |
$2,178.00
|
| Rate for Payer: Encore All Commercial |
$2,278.24
|
| Rate for Payer: Frontpath All Commercial |
$2,277.00
|
| Rate for Payer: Humana ChoiceCare |
$2,137.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,227.50
|
| Rate for Payer: PHCS All Commercial |
$1,856.25
|
| Rate for Payer: PHP All Commercial |
$1,877.04
|
| Rate for Payer: Sagamore Health Network All Products |
$1,910.70
|
| Rate for Payer: Signature Care EPO |
$2,054.25
|
| Rate for Payer: Signature Care PPO |
$2,178.00
|
| Rate for Payer: United Healthcare Commercial |
$1,950.30
|
|
|
HC AR KNOTLESS FIBERTAK ANCH 2.6
|
Facility
OP
|
$2,475.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606987
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,301.75 |
| Rate for Payer: Aetna Commercial |
$2,088.90
|
| Rate for Payer: Aetna Medicare |
$816.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$816.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,421.39
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,547.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$939.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$898.42
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Centivo All Commercial |
$1,262.25
|
| Rate for Payer: Cigna All Commercial |
$2,135.92
|
| Rate for Payer: CORVEL All Commercial |
$2,301.75
|
| Rate for Payer: Coventry All Commercial |
$2,178.00
|
| Rate for Payer: Encore All Commercial |
$2,278.24
|
| Rate for Payer: Frontpath All Commercial |
$2,277.00
|
| Rate for Payer: Humana ChoiceCare |
$2,137.66
|
| Rate for Payer: Humana Medicare |
$1,262.25
|
| Rate for Payer: Lucent All Commercial |
$1,262.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,227.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,856.25
|
| Rate for Payer: PHP All Commercial |
$1,877.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$965.25
|
| Rate for Payer: Sagamore Health Network All Products |
$1,910.70
|
| Rate for Payer: Signature Care EPO |
$2,054.25
|
| Rate for Payer: Signature Care PPO |
$2,178.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,103.75
|
| Rate for Payer: United Healthcare Commercial |
$1,950.30
|
| Rate for Payer: United Healthcare Medicare |
$816.75
|
|
