|
HC AR PLATE DIST FIB 5H LOCK L
|
Facility
OP
|
$4,201.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608307
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,907.12 |
| Rate for Payer: Centivo All Commercial |
$2,142.61
|
| Rate for Payer: Cigna All Commercial |
$3,625.64
|
| Rate for Payer: CORVEL All Commercial |
$3,907.12
|
| Rate for Payer: Coventry All Commercial |
$3,697.06
|
| Rate for Payer: Encore All Commercial |
$3,867.20
|
| Rate for Payer: Frontpath All Commercial |
$3,865.10
|
| Rate for Payer: Humana ChoiceCare |
$3,628.58
|
| Rate for Payer: Humana Medicare |
$2,142.61
|
| Rate for Payer: Lucent All Commercial |
$2,142.61
|
| Rate for Payer: Aetna Commercial |
$3,545.81
|
| Rate for Payer: Aetna Medicare |
$1,386.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,386.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,412.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,626.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,594.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,525.04
|
| Rate for Payer: Cash Price |
$2,604.74
|
| Rate for Payer: Cash Price |
$2,604.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,781.08
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,150.90
|
| Rate for Payer: PHP All Commercial |
$3,186.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,638.47
|
| Rate for Payer: Sagamore Health Network All Products |
$3,243.33
|
| Rate for Payer: Signature Care EPO |
$3,487.00
|
| Rate for Payer: Signature Care PPO |
$3,697.06
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,571.02
|
| Rate for Payer: United Healthcare Commercial |
$3,310.55
|
| Rate for Payer: United Healthcare Medicare |
$1,386.40
|
|
|
HC AR PLATE DIST FIB 5H LOCK R
|
Facility
IP
|
$4,201.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608360
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,150.90 |
| Max. Negotiated Rate |
$3,907.12 |
| Rate for Payer: Aetna Commercial |
$3,629.84
|
| Rate for Payer: Cash Price |
$2,604.74
|
| Rate for Payer: Cigna All Commercial |
$3,625.64
|
| Rate for Payer: CORVEL All Commercial |
$3,907.12
|
| Rate for Payer: Coventry All Commercial |
$3,697.06
|
| Rate for Payer: Encore All Commercial |
$3,867.20
|
| Rate for Payer: Frontpath All Commercial |
$3,865.10
|
| Rate for Payer: Humana ChoiceCare |
$3,628.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,781.08
|
| Rate for Payer: PHCS All Commercial |
$3,150.90
|
| Rate for Payer: PHP All Commercial |
$3,186.19
|
| Rate for Payer: Sagamore Health Network All Products |
$3,243.33
|
| Rate for Payer: Signature Care EPO |
$3,487.00
|
| Rate for Payer: Signature Care PPO |
$3,697.06
|
| Rate for Payer: United Healthcare Commercial |
$3,310.55
|
|
|
HC AR PLATE DIST FIB 5H LOCK R
|
Facility
OP
|
$4,201.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608360
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,907.12 |
| Rate for Payer: Aetna Commercial |
$3,545.81
|
| Rate for Payer: Aetna Medicare |
$1,386.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,386.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,412.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,626.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,594.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,525.04
|
| Rate for Payer: Cash Price |
$2,604.74
|
| Rate for Payer: Cash Price |
$2,604.74
|
| Rate for Payer: Centivo All Commercial |
$2,142.61
|
| Rate for Payer: Cigna All Commercial |
$3,625.64
|
| Rate for Payer: CORVEL All Commercial |
$3,907.12
|
| Rate for Payer: Coventry All Commercial |
$3,697.06
|
| Rate for Payer: Encore All Commercial |
$3,867.20
|
| Rate for Payer: Frontpath All Commercial |
$3,865.10
|
| Rate for Payer: Humana ChoiceCare |
$3,628.58
|
| Rate for Payer: Humana Medicare |
$2,142.61
|
| Rate for Payer: Lucent All Commercial |
$2,142.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,781.08
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,150.90
|
| Rate for Payer: PHP All Commercial |
$3,186.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,638.47
|
| Rate for Payer: Sagamore Health Network All Products |
$3,243.33
|
| Rate for Payer: Signature Care EPO |
$3,487.00
|
| Rate for Payer: Signature Care PPO |
$3,697.06
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,571.02
|
| Rate for Payer: United Healthcare Commercial |
$3,310.55
|
| Rate for Payer: United Healthcare Medicare |
$1,386.40
|
|
|
HC AR PLATE DIST FIB 6H LOCK L
|
Facility
IP
|
$4,651.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608193
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,488.40 |
| Max. Negotiated Rate |
$4,325.62 |
| Rate for Payer: Aetna Commercial |
$4,018.64
|
| Rate for Payer: Cash Price |
$2,883.74
|
| Rate for Payer: Cigna All Commercial |
$4,013.99
|
| Rate for Payer: CORVEL All Commercial |
$4,325.62
|
| Rate for Payer: Coventry All Commercial |
$4,093.06
|
| Rate for Payer: Encore All Commercial |
$4,281.43
|
| Rate for Payer: Frontpath All Commercial |
$4,279.10
|
| Rate for Payer: Humana ChoiceCare |
$4,017.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,186.08
|
| Rate for Payer: PHCS All Commercial |
$3,488.40
|
| Rate for Payer: PHP All Commercial |
$3,527.47
|
| Rate for Payer: Sagamore Health Network All Products |
$3,590.73
|
| Rate for Payer: Signature Care EPO |
$3,860.50
|
| Rate for Payer: Signature Care PPO |
$4,093.06
|
| Rate for Payer: United Healthcare Commercial |
$3,665.15
|
|
|
HC AR PLATE DIST FIB 6H LOCK L
|
Facility
OP
|
$4,651.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608193
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,325.62 |
| Rate for Payer: Aetna Commercial |
$3,925.61
|
| Rate for Payer: Aetna Medicare |
$1,534.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,534.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,671.18
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,907.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,765.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,688.39
|
| Rate for Payer: Cash Price |
$2,883.74
|
| Rate for Payer: Cash Price |
$2,883.74
|
| Rate for Payer: Centivo All Commercial |
$2,372.11
|
| Rate for Payer: Cigna All Commercial |
$4,013.99
|
| Rate for Payer: CORVEL All Commercial |
$4,325.62
|
| Rate for Payer: Coventry All Commercial |
$4,093.06
|
| Rate for Payer: Encore All Commercial |
$4,281.43
|
| Rate for Payer: Frontpath All Commercial |
$4,279.10
|
| Rate for Payer: Humana ChoiceCare |
$4,017.24
|
| Rate for Payer: Humana Medicare |
$2,372.11
|
| Rate for Payer: Lucent All Commercial |
$2,372.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,186.08
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,488.40
|
| Rate for Payer: PHP All Commercial |
$3,527.47
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,813.97
|
| Rate for Payer: Sagamore Health Network All Products |
$3,590.73
|
| Rate for Payer: Signature Care EPO |
$3,860.50
|
| Rate for Payer: Signature Care PPO |
$4,093.06
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,953.52
|
| Rate for Payer: United Healthcare Commercial |
$3,665.15
|
| Rate for Payer: United Healthcare Medicare |
$1,534.90
|
|
|
HC AR PLATE DIST FIB 8 H L
|
Facility
IP
|
$5,072.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608079
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,804.30 |
| Max. Negotiated Rate |
$4,717.33 |
| Rate for Payer: Aetna Commercial |
$4,382.55
|
| Rate for Payer: Cash Price |
$3,144.89
|
| Rate for Payer: Cigna All Commercial |
$4,377.48
|
| Rate for Payer: CORVEL All Commercial |
$4,717.33
|
| Rate for Payer: Coventry All Commercial |
$4,463.71
|
| Rate for Payer: Encore All Commercial |
$4,669.14
|
| Rate for Payer: Frontpath All Commercial |
$4,666.61
|
| Rate for Payer: Humana ChoiceCare |
$4,381.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,565.16
|
| Rate for Payer: PHCS All Commercial |
$3,804.30
|
| Rate for Payer: PHP All Commercial |
$3,846.91
|
| Rate for Payer: Sagamore Health Network All Products |
$3,915.89
|
| Rate for Payer: Signature Care EPO |
$4,210.09
|
| Rate for Payer: Signature Care PPO |
$4,463.71
|
| Rate for Payer: United Healthcare Commercial |
$3,997.05
|
|
|
HC AR PLATE DIST FIB 8 H L
|
Facility
OP
|
$5,072.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608288
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,717.33 |
| Rate for Payer: Signature Care EPO |
$4,210.09
|
| Rate for Payer: Signature Care PPO |
$4,463.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,311.54
|
| Rate for Payer: United Healthcare Commercial |
$3,997.05
|
| Rate for Payer: United Healthcare Medicare |
$1,673.89
|
| Rate for Payer: Aetna Commercial |
$4,281.11
|
| Rate for Payer: Aetna Medicare |
$1,673.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,673.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,913.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,170.76
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,924.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,841.28
|
| Rate for Payer: Cash Price |
$3,144.89
|
| Rate for Payer: Cash Price |
$3,144.89
|
| Rate for Payer: Centivo All Commercial |
$2,586.92
|
| Rate for Payer: Cigna All Commercial |
$4,377.48
|
| Rate for Payer: CORVEL All Commercial |
$4,717.33
|
| Rate for Payer: Coventry All Commercial |
$4,463.71
|
| Rate for Payer: Encore All Commercial |
$4,669.14
|
| Rate for Payer: Frontpath All Commercial |
$4,666.61
|
| Rate for Payer: Humana ChoiceCare |
$4,381.03
|
| Rate for Payer: Humana Medicare |
$2,586.92
|
| Rate for Payer: Lucent All Commercial |
$2,586.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,565.16
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,804.30
|
| Rate for Payer: PHP All Commercial |
$3,846.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,978.24
|
| Rate for Payer: Sagamore Health Network All Products |
$3,915.89
|
|
|
HC AR PLATE DIST FIB 8 H L
|
Facility
OP
|
$5,072.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608079
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,717.33 |
| Rate for Payer: Aetna Commercial |
$4,281.11
|
| Rate for Payer: Aetna Medicare |
$1,673.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,673.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,913.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,170.76
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,924.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,841.28
|
| Rate for Payer: Cash Price |
$3,144.89
|
| Rate for Payer: Cash Price |
$3,144.89
|
| Rate for Payer: Centivo All Commercial |
$2,586.92
|
| Rate for Payer: Cigna All Commercial |
$4,377.48
|
| Rate for Payer: CORVEL All Commercial |
$4,717.33
|
| Rate for Payer: Coventry All Commercial |
$4,463.71
|
| Rate for Payer: Encore All Commercial |
$4,669.14
|
| Rate for Payer: Frontpath All Commercial |
$4,666.61
|
| Rate for Payer: Humana ChoiceCare |
$4,381.03
|
| Rate for Payer: Humana Medicare |
$2,586.92
|
| Rate for Payer: Lucent All Commercial |
$2,586.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,565.16
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,804.30
|
| Rate for Payer: PHP All Commercial |
$3,846.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,978.24
|
| Rate for Payer: Sagamore Health Network All Products |
$3,915.89
|
| Rate for Payer: Signature Care EPO |
$4,210.09
|
| Rate for Payer: Signature Care PPO |
$4,463.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,311.54
|
| Rate for Payer: United Healthcare Commercial |
$3,997.05
|
| Rate for Payer: United Healthcare Medicare |
$1,673.89
|
|
|
HC AR PLATE DIST FIB 8 H L
|
Facility
IP
|
$5,072.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608288
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,804.30 |
| Max. Negotiated Rate |
$4,717.33 |
| Rate for Payer: Aetna Commercial |
$4,382.55
|
| Rate for Payer: Cash Price |
$3,144.89
|
| Rate for Payer: Cigna All Commercial |
$4,377.48
|
| Rate for Payer: CORVEL All Commercial |
$4,717.33
|
| Rate for Payer: Coventry All Commercial |
$4,463.71
|
| Rate for Payer: Encore All Commercial |
$4,669.14
|
| Rate for Payer: Frontpath All Commercial |
$4,666.61
|
| Rate for Payer: Humana ChoiceCare |
$4,381.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,565.16
|
| Rate for Payer: PHCS All Commercial |
$3,804.30
|
| Rate for Payer: PHP All Commercial |
$3,846.91
|
| Rate for Payer: Sagamore Health Network All Products |
$3,915.89
|
| Rate for Payer: Signature Care EPO |
$4,210.09
|
| Rate for Payer: Signature Care PPO |
$4,463.71
|
| Rate for Payer: United Healthcare Commercial |
$3,997.05
|
|
|
HC AR PLATE DIST FIB 8H LOCK L
|
Facility
OP
|
$5,072.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608319
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,717.33 |
| Rate for Payer: Aetna Commercial |
$4,281.11
|
| Rate for Payer: Aetna Medicare |
$1,673.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,673.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,913.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,170.76
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,924.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,841.28
|
| Rate for Payer: Cash Price |
$3,144.89
|
| Rate for Payer: Cash Price |
$3,144.89
|
| Rate for Payer: Centivo All Commercial |
$2,586.92
|
| Rate for Payer: Cigna All Commercial |
$4,377.48
|
| Rate for Payer: CORVEL All Commercial |
$4,717.33
|
| Rate for Payer: Coventry All Commercial |
$4,463.71
|
| Rate for Payer: Encore All Commercial |
$4,669.14
|
| Rate for Payer: Frontpath All Commercial |
$4,666.61
|
| Rate for Payer: Humana ChoiceCare |
$4,381.03
|
| Rate for Payer: Humana Medicare |
$2,586.92
|
| Rate for Payer: Lucent All Commercial |
$2,586.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,565.16
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,804.30
|
| Rate for Payer: PHP All Commercial |
$3,846.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,978.24
|
| Rate for Payer: Sagamore Health Network All Products |
$3,915.89
|
| Rate for Payer: Signature Care EPO |
$4,210.09
|
| Rate for Payer: Signature Care PPO |
$4,463.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,311.54
|
| Rate for Payer: United Healthcare Commercial |
$3,997.05
|
| Rate for Payer: United Healthcare Medicare |
$1,673.89
|
|
|
HC AR PLATE DIST FIB 8H LOCK L
|
Facility
IP
|
$5,072.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608319
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,804.30 |
| Max. Negotiated Rate |
$4,717.33 |
| Rate for Payer: Aetna Commercial |
$4,382.55
|
| Rate for Payer: Cash Price |
$3,144.89
|
| Rate for Payer: Cigna All Commercial |
$4,377.48
|
| Rate for Payer: CORVEL All Commercial |
$4,717.33
|
| Rate for Payer: Coventry All Commercial |
$4,463.71
|
| Rate for Payer: Encore All Commercial |
$4,669.14
|
| Rate for Payer: Frontpath All Commercial |
$4,666.61
|
| Rate for Payer: Humana ChoiceCare |
$4,381.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,565.16
|
| Rate for Payer: PHCS All Commercial |
$3,804.30
|
| Rate for Payer: PHP All Commercial |
$3,846.91
|
| Rate for Payer: Sagamore Health Network All Products |
$3,915.89
|
| Rate for Payer: Signature Care EPO |
$4,210.09
|
| Rate for Payer: Signature Care PPO |
$4,463.71
|
| Rate for Payer: United Healthcare Commercial |
$3,997.05
|
|
|
HC AR PLATE MTP SHRT
|
Facility
IP
|
$3,544.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604396
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,658.15 |
| Max. Negotiated Rate |
$3,296.11 |
| Rate for Payer: Aetna Commercial |
$3,062.19
|
| Rate for Payer: Cash Price |
$2,197.40
|
| Rate for Payer: Cigna All Commercial |
$3,058.64
|
| Rate for Payer: CORVEL All Commercial |
$3,296.11
|
| Rate for Payer: Coventry All Commercial |
$3,118.90
|
| Rate for Payer: Encore All Commercial |
$3,262.44
|
| Rate for Payer: Frontpath All Commercial |
$3,260.66
|
| Rate for Payer: Humana ChoiceCare |
$3,061.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,189.78
|
| Rate for Payer: PHCS All Commercial |
$2,658.15
|
| Rate for Payer: PHP All Commercial |
$2,687.92
|
| Rate for Payer: Sagamore Health Network All Products |
$2,736.12
|
| Rate for Payer: Signature Care EPO |
$2,941.69
|
| Rate for Payer: Signature Care PPO |
$3,118.90
|
| Rate for Payer: United Healthcare Commercial |
$2,792.83
|
|
|
HC AR PLATE MTP SHRT
|
Facility
OP
|
$3,544.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604396
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,296.11 |
| Rate for Payer: Aetna Commercial |
$2,991.30
|
| Rate for Payer: Aetna Medicare |
$1,169.59
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,169.59
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,035.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,215.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,345.02
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,286.54
|
| Rate for Payer: Cash Price |
$2,197.40
|
| Rate for Payer: Cash Price |
$2,197.40
|
| Rate for Payer: Centivo All Commercial |
$1,807.54
|
| Rate for Payer: Cigna All Commercial |
$3,058.64
|
| Rate for Payer: CORVEL All Commercial |
$3,296.11
|
| Rate for Payer: Coventry All Commercial |
$3,118.90
|
| Rate for Payer: Encore All Commercial |
$3,262.44
|
| Rate for Payer: Frontpath All Commercial |
$3,260.66
|
| Rate for Payer: Humana ChoiceCare |
$3,061.13
|
| Rate for Payer: Humana Medicare |
$1,807.54
|
| Rate for Payer: Lucent All Commercial |
$1,807.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,189.78
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,658.15
|
| Rate for Payer: PHP All Commercial |
$2,687.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,382.24
|
| Rate for Payer: Sagamore Health Network All Products |
$2,736.12
|
| Rate for Payer: Signature Care EPO |
$2,941.69
|
| Rate for Payer: Signature Care PPO |
$3,118.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,012.57
|
| Rate for Payer: United Healthcare Commercial |
$2,792.83
|
| Rate for Payer: United Healthcare Medicare |
$1,169.59
|
|
|
HC AR PLATE TUB 12H LOCK
|
Facility
IP
|
$2,500.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608334
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,875.00 |
| Max. Negotiated Rate |
$2,325.00 |
| Rate for Payer: Aetna Commercial |
$2,160.00
|
| Rate for Payer: Cash Price |
$1,550.00
|
| Rate for Payer: Cigna All Commercial |
$2,157.50
|
| Rate for Payer: CORVEL All Commercial |
$2,325.00
|
| Rate for Payer: Coventry All Commercial |
$2,200.00
|
| Rate for Payer: Encore All Commercial |
$2,301.25
|
| Rate for Payer: Frontpath All Commercial |
$2,300.00
|
| Rate for Payer: Humana ChoiceCare |
$2,159.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,250.00
|
| Rate for Payer: PHCS All Commercial |
$1,875.00
|
| Rate for Payer: PHP All Commercial |
$1,896.00
|
| Rate for Payer: Sagamore Health Network All Products |
$1,930.00
|
| Rate for Payer: Signature Care EPO |
$2,075.00
|
| Rate for Payer: Signature Care PPO |
$2,200.00
|
| Rate for Payer: United Healthcare Commercial |
$1,970.00
|
|
|
HC AR PLATE TUB 12H LOCK
|
Facility
OP
|
$2,500.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608334
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,325.00 |
| Rate for Payer: Aetna Commercial |
$2,110.00
|
| Rate for Payer: Aetna Medicare |
$825.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$825.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,435.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,562.75
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$948.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$907.50
|
| Rate for Payer: Cash Price |
$1,550.00
|
| Rate for Payer: Cash Price |
$1,550.00
|
| Rate for Payer: Centivo All Commercial |
$1,275.00
|
| Rate for Payer: Cigna All Commercial |
$2,157.50
|
| Rate for Payer: CORVEL All Commercial |
$2,325.00
|
| Rate for Payer: Coventry All Commercial |
$2,200.00
|
| Rate for Payer: Encore All Commercial |
$2,301.25
|
| Rate for Payer: Frontpath All Commercial |
$2,300.00
|
| Rate for Payer: Humana ChoiceCare |
$2,159.25
|
| Rate for Payer: Humana Medicare |
$1,275.00
|
| Rate for Payer: Lucent All Commercial |
$1,275.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,250.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,875.00
|
| Rate for Payer: PHP All Commercial |
$1,896.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$975.00
|
| Rate for Payer: Sagamore Health Network All Products |
$1,930.00
|
| Rate for Payer: Signature Care EPO |
$2,075.00
|
| Rate for Payer: Signature Care PPO |
$2,200.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,125.00
|
| Rate for Payer: United Healthcare Commercial |
$1,970.00
|
| Rate for Payer: United Healthcare Medicare |
$825.00
|
|
|
HC AR PLATE TUB 4H LOCK
|
Facility
OP
|
$1,875.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608172
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,743.75 |
| Rate for Payer: Aetna Commercial |
$1,582.50
|
| Rate for Payer: Aetna Medicare |
$618.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$618.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,076.81
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,172.06
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$711.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$680.62
|
| Rate for Payer: Cash Price |
$1,162.50
|
| Rate for Payer: Cash Price |
$1,162.50
|
| Rate for Payer: Centivo All Commercial |
$956.25
|
| Rate for Payer: Cigna All Commercial |
$1,618.12
|
| Rate for Payer: CORVEL All Commercial |
$1,743.75
|
| Rate for Payer: Coventry All Commercial |
$1,650.00
|
| Rate for Payer: Encore All Commercial |
$1,725.94
|
| Rate for Payer: Frontpath All Commercial |
$1,725.00
|
| Rate for Payer: Humana ChoiceCare |
$1,619.44
|
| Rate for Payer: Humana Medicare |
$956.25
|
| Rate for Payer: Lucent All Commercial |
$956.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,687.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,406.25
|
| Rate for Payer: PHP All Commercial |
$1,422.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$731.25
|
| Rate for Payer: Sagamore Health Network All Products |
$1,447.50
|
| Rate for Payer: Signature Care EPO |
$1,556.25
|
| Rate for Payer: Signature Care PPO |
$1,650.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,593.75
|
| Rate for Payer: United Healthcare Commercial |
$1,477.50
|
| Rate for Payer: United Healthcare Medicare |
$618.75
|
|
|
HC AR PLATE TUB 4H LOCK
|
Facility
IP
|
$1,875.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608172
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,406.25 |
| Max. Negotiated Rate |
$1,743.75 |
| Rate for Payer: Aetna Commercial |
$1,620.00
|
| Rate for Payer: Cash Price |
$1,162.50
|
| Rate for Payer: Cigna All Commercial |
$1,618.12
|
| Rate for Payer: CORVEL All Commercial |
$1,743.75
|
| Rate for Payer: Coventry All Commercial |
$1,650.00
|
| Rate for Payer: Encore All Commercial |
$1,725.94
|
| Rate for Payer: Frontpath All Commercial |
$1,725.00
|
| Rate for Payer: Humana ChoiceCare |
$1,619.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,687.50
|
| Rate for Payer: PHCS All Commercial |
$1,406.25
|
| Rate for Payer: PHP All Commercial |
$1,422.00
|
| Rate for Payer: Sagamore Health Network All Products |
$1,447.50
|
| Rate for Payer: Signature Care EPO |
$1,556.25
|
| Rate for Payer: Signature Care PPO |
$1,650.00
|
| Rate for Payer: United Healthcare Commercial |
$1,477.50
|
|
|
HC AR PORTAL SKID
|
Facility
OP
|
$346.50
|
|
| Hospital Charge Code |
41606980
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$114.34 |
| Max. Negotiated Rate |
$322.24 |
| Rate for Payer: Aetna Commercial |
$292.45
|
| Rate for Payer: Aetna Medicare |
$114.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$114.34
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$198.99
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$216.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$131.50
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$125.78
|
| Rate for Payer: Cash Price |
$214.83
|
| Rate for Payer: Cash Price |
$214.83
|
| Rate for Payer: Centivo All Commercial |
$176.72
|
| Rate for Payer: Cigna All Commercial |
$299.03
|
| Rate for Payer: CORVEL All Commercial |
$322.24
|
| Rate for Payer: Coventry All Commercial |
$304.92
|
| Rate for Payer: Encore All Commercial |
$318.95
|
| Rate for Payer: Frontpath All Commercial |
$318.78
|
| Rate for Payer: Humana ChoiceCare |
$299.27
|
| Rate for Payer: Humana Medicare |
$176.72
|
| Rate for Payer: Lucent All Commercial |
$176.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.85
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$259.88
|
| Rate for Payer: PHP All Commercial |
$262.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$135.14
|
| Rate for Payer: Sagamore Health Network All Products |
$267.50
|
| Rate for Payer: Signature Care EPO |
$287.60
|
| Rate for Payer: Signature Care PPO |
$304.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$294.52
|
| Rate for Payer: United Healthcare Commercial |
$273.04
|
| Rate for Payer: United Healthcare Medicare |
$114.34
|
|
|
HC AR PORTAL SKID
|
Facility
IP
|
$346.50
|
|
| Hospital Charge Code |
41606980
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$259.88 |
| Max. Negotiated Rate |
$322.24 |
| Rate for Payer: Aetna Commercial |
$299.38
|
| Rate for Payer: Cash Price |
$214.83
|
| Rate for Payer: Cigna All Commercial |
$299.03
|
| Rate for Payer: CORVEL All Commercial |
$322.24
|
| Rate for Payer: Coventry All Commercial |
$304.92
|
| Rate for Payer: Encore All Commercial |
$318.95
|
| Rate for Payer: Frontpath All Commercial |
$318.78
|
| Rate for Payer: Humana ChoiceCare |
$299.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.85
|
| Rate for Payer: PHCS All Commercial |
$259.88
|
| Rate for Payer: PHP All Commercial |
$262.79
|
| Rate for Payer: Sagamore Health Network All Products |
$267.50
|
| Rate for Payer: Signature Care EPO |
$287.60
|
| Rate for Payer: Signature Care PPO |
$304.92
|
| Rate for Payer: United Healthcare Commercial |
$273.04
|
|
|
HC AR PROFILE DRILL MINI CMP FT
|
Facility
IP
|
$825.00
|
|
| Hospital Charge Code |
41602615
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$618.75 |
| Max. Negotiated Rate |
$767.25 |
| Rate for Payer: Aetna Commercial |
$712.80
|
| Rate for Payer: Cash Price |
$511.50
|
| Rate for Payer: Cigna All Commercial |
$711.98
|
| Rate for Payer: CORVEL All Commercial |
$767.25
|
| Rate for Payer: Coventry All Commercial |
$726.00
|
| Rate for Payer: Encore All Commercial |
$759.41
|
| Rate for Payer: Frontpath All Commercial |
$759.00
|
| Rate for Payer: Humana ChoiceCare |
$712.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$742.50
|
| Rate for Payer: PHCS All Commercial |
$618.75
|
| Rate for Payer: PHP All Commercial |
$625.68
|
| Rate for Payer: Sagamore Health Network All Products |
$636.90
|
| Rate for Payer: Signature Care EPO |
$684.75
|
| Rate for Payer: Signature Care PPO |
$726.00
|
| Rate for Payer: United Healthcare Commercial |
$650.10
|
|
|
HC AR PROFILE DRILL MINI CMP FT
|
Facility
OP
|
$825.00
|
|
| Hospital Charge Code |
41602615
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$767.25 |
| Rate for Payer: Aetna Commercial |
$696.30
|
| Rate for Payer: Aetna Medicare |
$272.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$272.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$473.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$515.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$313.09
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$299.48
|
| Rate for Payer: Cash Price |
$511.50
|
| Rate for Payer: Cash Price |
$511.50
|
| Rate for Payer: Centivo All Commercial |
$420.75
|
| Rate for Payer: Cigna All Commercial |
$711.98
|
| Rate for Payer: CORVEL All Commercial |
$767.25
|
| Rate for Payer: Coventry All Commercial |
$726.00
|
| Rate for Payer: Encore All Commercial |
$759.41
|
| Rate for Payer: Frontpath All Commercial |
$759.00
|
| Rate for Payer: Humana ChoiceCare |
$712.55
|
| Rate for Payer: Humana Medicare |
$420.75
|
| Rate for Payer: Lucent All Commercial |
$420.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$742.50
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$618.75
|
| Rate for Payer: PHP All Commercial |
$625.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$321.75
|
| Rate for Payer: Sagamore Health Network All Products |
$636.90
|
| Rate for Payer: Signature Care EPO |
$684.75
|
| Rate for Payer: Signature Care PPO |
$726.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$701.25
|
| Rate for Payer: United Healthcare Commercial |
$650.10
|
| Rate for Payer: United Healthcare Medicare |
$272.25
|
|
|
HC AR PROFILE DRILL STND CMP FT
|
Facility
IP
|
$825.00
|
|
| Hospital Charge Code |
41602604
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$618.75 |
| Max. Negotiated Rate |
$767.25 |
| Rate for Payer: Aetna Commercial |
$712.80
|
| Rate for Payer: Cash Price |
$511.50
|
| Rate for Payer: Cigna All Commercial |
$711.98
|
| Rate for Payer: CORVEL All Commercial |
$767.25
|
| Rate for Payer: Coventry All Commercial |
$726.00
|
| Rate for Payer: Encore All Commercial |
$759.41
|
| Rate for Payer: Frontpath All Commercial |
$759.00
|
| Rate for Payer: Humana ChoiceCare |
$712.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$742.50
|
| Rate for Payer: PHCS All Commercial |
$618.75
|
| Rate for Payer: PHP All Commercial |
$625.68
|
| Rate for Payer: Sagamore Health Network All Products |
$636.90
|
| Rate for Payer: Signature Care EPO |
$684.75
|
| Rate for Payer: Signature Care PPO |
$726.00
|
| Rate for Payer: United Healthcare Commercial |
$650.10
|
|
|
HC AR PROFILE DRILL STND CMP FT
|
Facility
OP
|
$825.00
|
|
| Hospital Charge Code |
41602604
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$767.25 |
| Rate for Payer: Aetna Commercial |
$696.30
|
| Rate for Payer: Aetna Medicare |
$272.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$272.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$473.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$515.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$313.09
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$299.48
|
| Rate for Payer: Cash Price |
$511.50
|
| Rate for Payer: Cash Price |
$511.50
|
| Rate for Payer: Centivo All Commercial |
$420.75
|
| Rate for Payer: Cigna All Commercial |
$711.98
|
| Rate for Payer: CORVEL All Commercial |
$767.25
|
| Rate for Payer: Coventry All Commercial |
$726.00
|
| Rate for Payer: Encore All Commercial |
$759.41
|
| Rate for Payer: Frontpath All Commercial |
$759.00
|
| Rate for Payer: Humana ChoiceCare |
$712.55
|
| Rate for Payer: Humana Medicare |
$420.75
|
| Rate for Payer: Lucent All Commercial |
$420.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$742.50
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$618.75
|
| Rate for Payer: PHP All Commercial |
$625.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$321.75
|
| Rate for Payer: Sagamore Health Network All Products |
$636.90
|
| Rate for Payer: Signature Care EPO |
$684.75
|
| Rate for Payer: Signature Care PPO |
$726.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$701.25
|
| Rate for Payer: United Healthcare Commercial |
$650.10
|
| Rate for Payer: United Healthcare Medicare |
$272.25
|
|
|
HC AR PUNCH 4.75 SWIVELOCK
|
Facility
IP
|
$1,960.20
|
|
| Hospital Charge Code |
41607082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,470.15 |
| Max. Negotiated Rate |
$1,822.99 |
| Rate for Payer: Aetna Commercial |
$1,693.61
|
| Rate for Payer: Cash Price |
$1,215.32
|
| Rate for Payer: Cigna All Commercial |
$1,691.65
|
| Rate for Payer: CORVEL All Commercial |
$1,822.99
|
| Rate for Payer: Coventry All Commercial |
$1,724.98
|
| Rate for Payer: Encore All Commercial |
$1,804.36
|
| Rate for Payer: Frontpath All Commercial |
$1,803.38
|
| Rate for Payer: Humana ChoiceCare |
$1,693.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,764.18
|
| Rate for Payer: PHCS All Commercial |
$1,470.15
|
| Rate for Payer: PHP All Commercial |
$1,486.62
|
| Rate for Payer: Sagamore Health Network All Products |
$1,513.27
|
| Rate for Payer: Signature Care EPO |
$1,626.97
|
| Rate for Payer: Signature Care PPO |
$1,724.98
|
| Rate for Payer: United Healthcare Commercial |
$1,544.64
|
|
|
HC AR PUNCH 4.75 SWIVELOCK
|
Facility
OP
|
$1,960.20
|
|
| Hospital Charge Code |
41607082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,822.99 |
| Rate for Payer: Aetna Commercial |
$1,654.41
|
| Rate for Payer: Aetna Medicare |
$646.87
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$646.87
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,125.74
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,225.32
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$743.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$711.55
|
| Rate for Payer: Cash Price |
$1,215.32
|
| Rate for Payer: Cash Price |
$1,215.32
|
| Rate for Payer: Centivo All Commercial |
$999.70
|
| Rate for Payer: Cigna All Commercial |
$1,691.65
|
| Rate for Payer: CORVEL All Commercial |
$1,822.99
|
| Rate for Payer: Coventry All Commercial |
$1,724.98
|
| Rate for Payer: Encore All Commercial |
$1,804.36
|
| Rate for Payer: Frontpath All Commercial |
$1,803.38
|
| Rate for Payer: Humana ChoiceCare |
$1,693.02
|
| Rate for Payer: Humana Medicare |
$999.70
|
| Rate for Payer: Lucent All Commercial |
$999.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,764.18
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,470.15
|
| Rate for Payer: PHP All Commercial |
$1,486.62
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$764.48
|
| Rate for Payer: Sagamore Health Network All Products |
$1,513.27
|
| Rate for Payer: Signature Care EPO |
$1,626.97
|
| Rate for Payer: Signature Care PPO |
$1,724.98
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,666.17
|
| Rate for Payer: United Healthcare Commercial |
$1,544.64
|
| Rate for Payer: United Healthcare Medicare |
$646.87
|
|
