|
HC AR SCREW VAL KRE 3X22
|
Facility
OP
|
$2,460.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608066
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,287.80 |
| Rate for Payer: Aetna Commercial |
$2,076.24
|
| Rate for Payer: Aetna Medicare |
$811.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$811.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,412.78
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,537.75
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$933.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$892.98
|
| Rate for Payer: Cash Price |
$1,525.20
|
| Rate for Payer: Cash Price |
$1,525.20
|
| Rate for Payer: Centivo All Commercial |
$1,254.60
|
| Rate for Payer: Cigna All Commercial |
$2,122.98
|
| Rate for Payer: CORVEL All Commercial |
$2,287.80
|
| Rate for Payer: Coventry All Commercial |
$2,164.80
|
| Rate for Payer: Encore All Commercial |
$2,264.43
|
| Rate for Payer: Frontpath All Commercial |
$2,263.20
|
| Rate for Payer: Humana ChoiceCare |
$2,124.70
|
| Rate for Payer: Humana Medicare |
$1,254.60
|
| Rate for Payer: Lucent All Commercial |
$1,254.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,214.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,845.00
|
| Rate for Payer: PHP All Commercial |
$1,865.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$959.40
|
| Rate for Payer: Sagamore Health Network All Products |
$1,899.12
|
| Rate for Payer: Signature Care EPO |
$2,041.80
|
| Rate for Payer: Signature Care PPO |
$2,164.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,091.00
|
| Rate for Payer: United Healthcare Commercial |
$1,938.48
|
| Rate for Payer: United Healthcare Medicare |
$811.80
|
|
|
HC ARSENIC
|
Facility
IP
|
$173.91
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
63001469
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$130.43 |
| Max. Negotiated Rate |
$161.74 |
| Rate for Payer: Aetna Commercial |
$150.26
|
| Rate for Payer: Cash Price |
$107.82
|
| Rate for Payer: Cigna All Commercial |
$150.08
|
| Rate for Payer: CORVEL All Commercial |
$161.74
|
| Rate for Payer: Coventry All Commercial |
$153.04
|
| Rate for Payer: Encore All Commercial |
$160.08
|
| Rate for Payer: Frontpath All Commercial |
$160.00
|
| Rate for Payer: Humana ChoiceCare |
$150.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$156.52
|
| Rate for Payer: PHCS All Commercial |
$130.43
|
| Rate for Payer: PHP All Commercial |
$131.89
|
| Rate for Payer: Sagamore Health Network All Products |
$134.26
|
| Rate for Payer: Signature Care EPO |
$144.35
|
| Rate for Payer: Signature Care PPO |
$153.04
|
| Rate for Payer: United Healthcare Commercial |
$137.04
|
|
|
HC ARSENIC
|
Facility
OP
|
$173.91
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
63001469
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.97 |
| Max. Negotiated Rate |
$161.74 |
| Rate for Payer: Aetna Commercial |
$146.78
|
| Rate for Payer: Aetna Medicare |
$57.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$57.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$99.88
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$108.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$18.97
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$66.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$63.13
|
| Rate for Payer: Cash Price |
$107.82
|
| Rate for Payer: Cash Price |
$107.82
|
| Rate for Payer: Centivo All Commercial |
$88.69
|
| Rate for Payer: Cigna All Commercial |
$150.08
|
| Rate for Payer: CORVEL All Commercial |
$161.74
|
| Rate for Payer: Coventry All Commercial |
$153.04
|
| Rate for Payer: Encore All Commercial |
$160.08
|
| Rate for Payer: Frontpath All Commercial |
$160.00
|
| Rate for Payer: Humana ChoiceCare |
$150.21
|
| Rate for Payer: Humana Medicare |
$88.69
|
| Rate for Payer: Lucent All Commercial |
$88.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$156.52
|
| Rate for Payer: Managed Health Services Medicaid |
$18.97
|
| Rate for Payer: MDWise Medicaid |
$18.97
|
| Rate for Payer: PHCS All Commercial |
$130.43
|
| Rate for Payer: PHP All Commercial |
$131.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$67.82
|
| Rate for Payer: Sagamore Health Network All Products |
$134.26
|
| Rate for Payer: Signature Care EPO |
$144.35
|
| Rate for Payer: Signature Care PPO |
$153.04
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$147.82
|
| Rate for Payer: United Healthcare Commercial |
$137.04
|
| Rate for Payer: United Healthcare Medicare |
$57.39
|
|
|
HC AR SPEEDBRG IMP SWVLK
|
Facility
IP
|
$6,890.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606147
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,167.80 |
| Max. Negotiated Rate |
$6,408.07 |
| Rate for Payer: Aetna Commercial |
$5,953.31
|
| Rate for Payer: Cash Price |
$4,272.05
|
| Rate for Payer: Cigna All Commercial |
$5,946.42
|
| Rate for Payer: CORVEL All Commercial |
$6,408.07
|
| Rate for Payer: Coventry All Commercial |
$6,063.55
|
| Rate for Payer: Encore All Commercial |
$6,342.61
|
| Rate for Payer: Frontpath All Commercial |
$6,339.17
|
| Rate for Payer: Humana ChoiceCare |
$5,951.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,201.36
|
| Rate for Payer: PHCS All Commercial |
$5,167.80
|
| Rate for Payer: PHP All Commercial |
$5,225.68
|
| Rate for Payer: Sagamore Health Network All Products |
$5,319.39
|
| Rate for Payer: Signature Care EPO |
$5,719.03
|
| Rate for Payer: Signature Care PPO |
$6,063.55
|
| Rate for Payer: United Healthcare Commercial |
$5,429.64
|
|
|
HC AR SPEEDBRG IMP SWVLK
|
Facility
OP
|
$6,890.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606147
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,408.07 |
| Rate for Payer: Aetna Commercial |
$5,815.50
|
| Rate for Payer: Aetna Medicare |
$2,273.83
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,273.83
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,957.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,307.19
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,614.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,501.22
|
| Rate for Payer: Cash Price |
$4,272.05
|
| Rate for Payer: Cash Price |
$4,272.05
|
| Rate for Payer: Centivo All Commercial |
$3,514.10
|
| Rate for Payer: Cigna All Commercial |
$5,946.42
|
| Rate for Payer: CORVEL All Commercial |
$6,408.07
|
| Rate for Payer: Coventry All Commercial |
$6,063.55
|
| Rate for Payer: Encore All Commercial |
$6,342.61
|
| Rate for Payer: Frontpath All Commercial |
$6,339.17
|
| Rate for Payer: Humana ChoiceCare |
$5,951.24
|
| Rate for Payer: Humana Medicare |
$3,514.10
|
| Rate for Payer: Lucent All Commercial |
$3,514.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,201.36
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,167.80
|
| Rate for Payer: PHP All Commercial |
$5,225.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,687.26
|
| Rate for Payer: Sagamore Health Network All Products |
$5,319.39
|
| Rate for Payer: Signature Care EPO |
$5,719.03
|
| Rate for Payer: Signature Care PPO |
$6,063.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,856.84
|
| Rate for Payer: United Healthcare Commercial |
$5,429.64
|
| Rate for Payer: United Healthcare Medicare |
$2,273.83
|
|
|
HC AR SPEEDBRIDGE 4.75 X 19.1
|
Facility
IP
|
$6,890.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603440
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,167.80 |
| Max. Negotiated Rate |
$6,408.07 |
| Rate for Payer: Aetna Commercial |
$5,953.31
|
| Rate for Payer: Cash Price |
$4,272.05
|
| Rate for Payer: Cigna All Commercial |
$5,946.42
|
| Rate for Payer: CORVEL All Commercial |
$6,408.07
|
| Rate for Payer: Coventry All Commercial |
$6,063.55
|
| Rate for Payer: Encore All Commercial |
$6,342.61
|
| Rate for Payer: Frontpath All Commercial |
$6,339.17
|
| Rate for Payer: Humana ChoiceCare |
$5,951.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,201.36
|
| Rate for Payer: PHCS All Commercial |
$5,167.80
|
| Rate for Payer: PHP All Commercial |
$5,225.68
|
| Rate for Payer: Sagamore Health Network All Products |
$5,319.39
|
| Rate for Payer: Signature Care EPO |
$5,719.03
|
| Rate for Payer: Signature Care PPO |
$6,063.55
|
| Rate for Payer: United Healthcare Commercial |
$5,429.64
|
|
|
HC AR SPEEDBRIDGE 4.75 X 19.1
|
Facility
OP
|
$6,890.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603440
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,408.07 |
| Rate for Payer: Aetna Commercial |
$5,815.50
|
| Rate for Payer: Aetna Medicare |
$2,273.83
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,273.83
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,957.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,307.19
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,614.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,501.22
|
| Rate for Payer: Cash Price |
$4,272.05
|
| Rate for Payer: Cash Price |
$4,272.05
|
| Rate for Payer: Centivo All Commercial |
$3,514.10
|
| Rate for Payer: Cigna All Commercial |
$5,946.42
|
| Rate for Payer: CORVEL All Commercial |
$6,408.07
|
| Rate for Payer: Coventry All Commercial |
$6,063.55
|
| Rate for Payer: Encore All Commercial |
$6,342.61
|
| Rate for Payer: Frontpath All Commercial |
$6,339.17
|
| Rate for Payer: Humana ChoiceCare |
$5,951.24
|
| Rate for Payer: Humana Medicare |
$3,514.10
|
| Rate for Payer: Lucent All Commercial |
$3,514.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,201.36
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,167.80
|
| Rate for Payer: PHP All Commercial |
$5,225.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,687.26
|
| Rate for Payer: Sagamore Health Network All Products |
$5,319.39
|
| Rate for Payer: Signature Care EPO |
$5,719.03
|
| Rate for Payer: Signature Care PPO |
$6,063.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,856.84
|
| Rate for Payer: United Healthcare Commercial |
$5,429.64
|
| Rate for Payer: United Healthcare Medicare |
$2,273.83
|
|
|
HC AR SPEEDBRIDGE ACHILLES
|
Facility
OP
|
$6,890.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607381
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,408.07 |
| Rate for Payer: Aetna Commercial |
$5,815.50
|
| Rate for Payer: Aetna Medicare |
$2,273.83
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,273.83
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,957.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,307.19
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,614.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,501.22
|
| Rate for Payer: Cash Price |
$4,272.05
|
| Rate for Payer: Cash Price |
$4,272.05
|
| Rate for Payer: Centivo All Commercial |
$3,514.10
|
| Rate for Payer: Cigna All Commercial |
$5,946.42
|
| Rate for Payer: CORVEL All Commercial |
$6,408.07
|
| Rate for Payer: Coventry All Commercial |
$6,063.55
|
| Rate for Payer: Encore All Commercial |
$6,342.61
|
| Rate for Payer: Frontpath All Commercial |
$6,339.17
|
| Rate for Payer: Humana ChoiceCare |
$5,951.24
|
| Rate for Payer: Humana Medicare |
$3,514.10
|
| Rate for Payer: Lucent All Commercial |
$3,514.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,201.36
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,167.80
|
| Rate for Payer: PHP All Commercial |
$5,225.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,687.26
|
| Rate for Payer: Sagamore Health Network All Products |
$5,319.39
|
| Rate for Payer: Signature Care EPO |
$5,719.03
|
| Rate for Payer: Signature Care PPO |
$6,063.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,856.84
|
| Rate for Payer: United Healthcare Commercial |
$5,429.64
|
| Rate for Payer: United Healthcare Medicare |
$2,273.83
|
|
|
HC AR SPEEDBRIDGE ACHILLES
|
Facility
IP
|
$6,890.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607381
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,167.80 |
| Max. Negotiated Rate |
$6,408.07 |
| Rate for Payer: Aetna Commercial |
$5,953.31
|
| Rate for Payer: Cash Price |
$4,272.05
|
| Rate for Payer: Cigna All Commercial |
$5,946.42
|
| Rate for Payer: CORVEL All Commercial |
$6,408.07
|
| Rate for Payer: Coventry All Commercial |
$6,063.55
|
| Rate for Payer: Encore All Commercial |
$6,342.61
|
| Rate for Payer: Frontpath All Commercial |
$6,339.17
|
| Rate for Payer: Humana ChoiceCare |
$5,951.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,201.36
|
| Rate for Payer: PHCS All Commercial |
$5,167.80
|
| Rate for Payer: PHP All Commercial |
$5,225.68
|
| Rate for Payer: Sagamore Health Network All Products |
$5,319.39
|
| Rate for Payer: Signature Care EPO |
$5,719.03
|
| Rate for Payer: Signature Care PPO |
$6,063.55
|
| Rate for Payer: United Healthcare Commercial |
$5,429.64
|
|
|
HC AR SPEEDBRIDGE ACHILLES 3.9
|
Facility
IP
|
$16,502.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608304
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,376.80 |
| Max. Negotiated Rate |
$15,347.23 |
| Rate for Payer: Aetna Commercial |
$14,258.07
|
| Rate for Payer: Cash Price |
$10,231.49
|
| Rate for Payer: Cigna All Commercial |
$14,241.57
|
| Rate for Payer: CORVEL All Commercial |
$15,347.23
|
| Rate for Payer: Coventry All Commercial |
$14,522.11
|
| Rate for Payer: Encore All Commercial |
$15,190.46
|
| Rate for Payer: Frontpath All Commercial |
$15,182.21
|
| Rate for Payer: Humana ChoiceCare |
$14,253.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14,852.16
|
| Rate for Payer: PHCS All Commercial |
$12,376.80
|
| Rate for Payer: PHP All Commercial |
$12,515.42
|
| Rate for Payer: Sagamore Health Network All Products |
$12,739.85
|
| Rate for Payer: Signature Care EPO |
$13,696.99
|
| Rate for Payer: Signature Care PPO |
$14,522.11
|
| Rate for Payer: United Healthcare Commercial |
$13,003.89
|
|
|
HC AR SPEEDBRIDGE ACHILLES 3.9
|
Facility
OP
|
$16,502.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608304
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$15,347.23 |
| Rate for Payer: Aetna Commercial |
$13,928.03
|
| Rate for Payer: Aetna Medicare |
$5,445.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5,445.79
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$9,477.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$10,315.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6,262.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,990.37
|
| Rate for Payer: Cash Price |
$10,231.49
|
| Rate for Payer: Cash Price |
$10,231.49
|
| Rate for Payer: Centivo All Commercial |
$8,416.22
|
| Rate for Payer: Cigna All Commercial |
$14,241.57
|
| Rate for Payer: CORVEL All Commercial |
$15,347.23
|
| Rate for Payer: Coventry All Commercial |
$14,522.11
|
| Rate for Payer: Encore All Commercial |
$15,190.46
|
| Rate for Payer: Frontpath All Commercial |
$15,182.21
|
| Rate for Payer: Humana ChoiceCare |
$14,253.12
|
| Rate for Payer: Humana Medicare |
$8,416.22
|
| Rate for Payer: Lucent All Commercial |
$8,416.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14,852.16
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$12,376.80
|
| Rate for Payer: PHP All Commercial |
$12,515.42
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$6,435.94
|
| Rate for Payer: Sagamore Health Network All Products |
$12,739.85
|
| Rate for Payer: Signature Care EPO |
$13,696.99
|
| Rate for Payer: Signature Care PPO |
$14,522.11
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,027.04
|
| Rate for Payer: United Healthcare Commercial |
$13,003.89
|
| Rate for Payer: United Healthcare Medicare |
$5,445.79
|
|
|
HC AR SPEED BRIDGE SWVL LOCK
|
Facility
OP
|
$6,336.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606632
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,892.48 |
| Rate for Payer: Aetna Commercial |
$5,347.58
|
| Rate for Payer: Aetna Medicare |
$2,090.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,090.88
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,638.76
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,960.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,404.51
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,299.97
|
| Rate for Payer: Cash Price |
$3,928.32
|
| Rate for Payer: Cash Price |
$3,928.32
|
| Rate for Payer: Centivo All Commercial |
$3,231.36
|
| Rate for Payer: Cigna All Commercial |
$5,467.97
|
| Rate for Payer: CORVEL All Commercial |
$5,892.48
|
| Rate for Payer: Coventry All Commercial |
$5,575.68
|
| Rate for Payer: Encore All Commercial |
$5,832.29
|
| Rate for Payer: Frontpath All Commercial |
$5,829.12
|
| Rate for Payer: Humana ChoiceCare |
$5,472.40
|
| Rate for Payer: Humana Medicare |
$3,231.36
|
| Rate for Payer: Lucent All Commercial |
$3,231.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,702.40
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,752.00
|
| Rate for Payer: PHP All Commercial |
$4,805.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,471.04
|
| Rate for Payer: Sagamore Health Network All Products |
$4,891.39
|
| Rate for Payer: Signature Care EPO |
$5,258.88
|
| Rate for Payer: Signature Care PPO |
$5,575.68
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,385.60
|
| Rate for Payer: United Healthcare Commercial |
$4,992.77
|
| Rate for Payer: United Healthcare Medicare |
$2,090.88
|
|
|
HC AR SPEED BRIDGE SWVL LOCK
|
Facility
IP
|
$6,336.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606632
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,752.00 |
| Max. Negotiated Rate |
$5,892.48 |
| Rate for Payer: Aetna Commercial |
$5,474.30
|
| Rate for Payer: Cash Price |
$3,928.32
|
| Rate for Payer: Cigna All Commercial |
$5,467.97
|
| Rate for Payer: CORVEL All Commercial |
$5,892.48
|
| Rate for Payer: Coventry All Commercial |
$5,575.68
|
| Rate for Payer: Encore All Commercial |
$5,832.29
|
| Rate for Payer: Frontpath All Commercial |
$5,829.12
|
| Rate for Payer: Humana ChoiceCare |
$5,472.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,702.40
|
| Rate for Payer: PHCS All Commercial |
$4,752.00
|
| Rate for Payer: PHP All Commercial |
$4,805.22
|
| Rate for Payer: Sagamore Health Network All Products |
$4,891.39
|
| Rate for Payer: Signature Care EPO |
$5,258.88
|
| Rate for Payer: Signature Care PPO |
$5,575.68
|
| Rate for Payer: United Healthcare Commercial |
$4,992.77
|
|
|
HC AR STAPLE NITINOL 9X10
|
Facility
OP
|
$5,920.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603875
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,505.79 |
| Rate for Payer: Aetna Commercial |
$4,996.65
|
| Rate for Payer: Aetna Medicare |
$1,953.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,953.67
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,399.97
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,700.72
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,246.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,149.03
|
| Rate for Payer: Cash Price |
$3,670.52
|
| Rate for Payer: Cash Price |
$3,670.52
|
| Rate for Payer: Centivo All Commercial |
$3,019.30
|
| Rate for Payer: Cigna All Commercial |
$5,109.13
|
| Rate for Payer: CORVEL All Commercial |
$5,505.79
|
| Rate for Payer: Coventry All Commercial |
$5,209.78
|
| Rate for Payer: Encore All Commercial |
$5,449.54
|
| Rate for Payer: Frontpath All Commercial |
$5,446.58
|
| Rate for Payer: Humana ChoiceCare |
$5,113.28
|
| Rate for Payer: Humana Medicare |
$3,019.30
|
| Rate for Payer: Lucent All Commercial |
$3,019.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,328.18
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,440.15
|
| Rate for Payer: PHP All Commercial |
$4,489.88
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,308.88
|
| Rate for Payer: Sagamore Health Network All Products |
$4,570.39
|
| Rate for Payer: Signature Care EPO |
$4,913.77
|
| Rate for Payer: Signature Care PPO |
$5,209.78
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,032.17
|
| Rate for Payer: United Healthcare Commercial |
$4,665.12
|
| Rate for Payer: United Healthcare Medicare |
$1,953.67
|
|
|
HC AR STAPLE NITINOL 9X10
|
Facility
IP
|
$5,920.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603875
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,440.15 |
| Max. Negotiated Rate |
$5,505.79 |
| Rate for Payer: Aetna Commercial |
$5,115.05
|
| Rate for Payer: Cash Price |
$3,670.52
|
| Rate for Payer: Cigna All Commercial |
$5,109.13
|
| Rate for Payer: CORVEL All Commercial |
$5,505.79
|
| Rate for Payer: Coventry All Commercial |
$5,209.78
|
| Rate for Payer: Encore All Commercial |
$5,449.54
|
| Rate for Payer: Frontpath All Commercial |
$5,446.58
|
| Rate for Payer: Humana ChoiceCare |
$5,113.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,328.18
|
| Rate for Payer: PHCS All Commercial |
$4,440.15
|
| Rate for Payer: PHP All Commercial |
$4,489.88
|
| Rate for Payer: Sagamore Health Network All Products |
$4,570.39
|
| Rate for Payer: Signature Care EPO |
$4,913.77
|
| Rate for Payer: Signature Care PPO |
$5,209.78
|
| Rate for Payer: United Healthcare Commercial |
$4,665.12
|
|
|
HC AR STAPLE NITINOL 9X7
|
Facility
OP
|
$5,920.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603893
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,505.79 |
| Rate for Payer: Aetna Commercial |
$4,996.65
|
| Rate for Payer: Aetna Medicare |
$1,953.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,953.67
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,399.97
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,700.72
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,246.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,149.03
|
| Rate for Payer: Cash Price |
$3,670.52
|
| Rate for Payer: Cash Price |
$3,670.52
|
| Rate for Payer: Centivo All Commercial |
$3,019.30
|
| Rate for Payer: Cigna All Commercial |
$5,109.13
|
| Rate for Payer: CORVEL All Commercial |
$5,505.79
|
| Rate for Payer: Coventry All Commercial |
$5,209.78
|
| Rate for Payer: Encore All Commercial |
$5,449.54
|
| Rate for Payer: Frontpath All Commercial |
$5,446.58
|
| Rate for Payer: Humana ChoiceCare |
$5,113.28
|
| Rate for Payer: Humana Medicare |
$3,019.30
|
| Rate for Payer: Lucent All Commercial |
$3,019.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,328.18
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,440.15
|
| Rate for Payer: PHP All Commercial |
$4,489.88
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,308.88
|
| Rate for Payer: Sagamore Health Network All Products |
$4,570.39
|
| Rate for Payer: Signature Care EPO |
$4,913.77
|
| Rate for Payer: Signature Care PPO |
$5,209.78
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,032.17
|
| Rate for Payer: United Healthcare Commercial |
$4,665.12
|
| Rate for Payer: United Healthcare Medicare |
$1,953.67
|
|
|
HC AR STAPLE NITINOL 9X7
|
Facility
IP
|
$5,920.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41603893
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,440.15 |
| Max. Negotiated Rate |
$5,505.79 |
| Rate for Payer: Aetna Commercial |
$5,115.05
|
| Rate for Payer: Cash Price |
$3,670.52
|
| Rate for Payer: Cigna All Commercial |
$5,109.13
|
| Rate for Payer: CORVEL All Commercial |
$5,505.79
|
| Rate for Payer: Coventry All Commercial |
$5,209.78
|
| Rate for Payer: Encore All Commercial |
$5,449.54
|
| Rate for Payer: Frontpath All Commercial |
$5,446.58
|
| Rate for Payer: Humana ChoiceCare |
$5,113.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,328.18
|
| Rate for Payer: PHCS All Commercial |
$4,440.15
|
| Rate for Payer: PHP All Commercial |
$4,489.88
|
| Rate for Payer: Sagamore Health Network All Products |
$4,570.39
|
| Rate for Payer: Signature Care EPO |
$4,913.77
|
| Rate for Payer: Signature Care PPO |
$5,209.78
|
| Rate for Payer: United Healthcare Commercial |
$4,665.12
|
|
|
HC AR SUT ANCHOR 2.9X12.5
|
Facility
IP
|
$2,200.00
|
|
| Hospital Charge Code |
41606212
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,650.00 |
| Max. Negotiated Rate |
$2,046.00 |
| Rate for Payer: Aetna Commercial |
$1,900.80
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Cigna All Commercial |
$1,898.60
|
| Rate for Payer: CORVEL All Commercial |
$2,046.00
|
| Rate for Payer: Coventry All Commercial |
$1,936.00
|
| Rate for Payer: Encore All Commercial |
$2,025.10
|
| Rate for Payer: Frontpath All Commercial |
$2,024.00
|
| Rate for Payer: Humana ChoiceCare |
$1,900.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,980.00
|
| Rate for Payer: PHCS All Commercial |
$1,650.00
|
| Rate for Payer: PHP All Commercial |
$1,668.48
|
| Rate for Payer: Sagamore Health Network All Products |
$1,698.40
|
| Rate for Payer: Signature Care EPO |
$1,826.00
|
| Rate for Payer: Signature Care PPO |
$1,936.00
|
| Rate for Payer: United Healthcare Commercial |
$1,733.60
|
|
|
HC AR SUT ANCHOR 2.9X12.5
|
Facility
OP
|
$2,200.00
|
|
| Hospital Charge Code |
41606212
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$2,046.00 |
| Rate for Payer: Aetna Commercial |
$1,856.80
|
| Rate for Payer: Aetna Medicare |
$726.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$726.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,263.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,375.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$834.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$798.60
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Cash Price |
$1,364.00
|
| Rate for Payer: Centivo All Commercial |
$1,122.00
|
| Rate for Payer: Cigna All Commercial |
$1,898.60
|
| Rate for Payer: CORVEL All Commercial |
$2,046.00
|
| Rate for Payer: Coventry All Commercial |
$1,936.00
|
| Rate for Payer: Encore All Commercial |
$2,025.10
|
| Rate for Payer: Frontpath All Commercial |
$2,024.00
|
| Rate for Payer: Humana ChoiceCare |
$1,900.14
|
| Rate for Payer: Humana Medicare |
$1,122.00
|
| Rate for Payer: Lucent All Commercial |
$1,122.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,980.00
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,650.00
|
| Rate for Payer: PHP All Commercial |
$1,668.48
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$858.00
|
| Rate for Payer: Sagamore Health Network All Products |
$1,698.40
|
| Rate for Payer: Signature Care EPO |
$1,826.00
|
| Rate for Payer: Signature Care PPO |
$1,936.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,870.00
|
| Rate for Payer: United Healthcare Commercial |
$1,733.60
|
| Rate for Payer: United Healthcare Medicare |
$726.00
|
|
|
HC AR SUT ANCHOR 3X12.7
|
Facility
IP
|
$2,117.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607799
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,588.12 |
| Max. Negotiated Rate |
$1,969.28 |
| Rate for Payer: Aetna Commercial |
$1,829.52
|
| Rate for Payer: Cash Price |
$1,312.85
|
| Rate for Payer: Cigna All Commercial |
$1,827.40
|
| Rate for Payer: CORVEL All Commercial |
$1,969.28
|
| Rate for Payer: Coventry All Commercial |
$1,863.40
|
| Rate for Payer: Encore All Commercial |
$1,949.16
|
| Rate for Payer: Frontpath All Commercial |
$1,948.10
|
| Rate for Payer: Humana ChoiceCare |
$1,828.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,905.75
|
| Rate for Payer: PHCS All Commercial |
$1,588.12
|
| Rate for Payer: PHP All Commercial |
$1,605.91
|
| Rate for Payer: Sagamore Health Network All Products |
$1,634.71
|
| Rate for Payer: Signature Care EPO |
$1,757.52
|
| Rate for Payer: Signature Care PPO |
$1,863.40
|
| Rate for Payer: United Healthcare Commercial |
$1,668.59
|
|
|
HC AR SUT ANCHOR 3X12.7
|
Facility
OP
|
$2,117.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607799
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,969.28 |
| Rate for Payer: Aetna Commercial |
$1,787.17
|
| Rate for Payer: Aetna Medicare |
$698.78
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$698.78
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,216.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,323.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$803.59
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$768.65
|
| Rate for Payer: Cash Price |
$1,312.85
|
| Rate for Payer: Cash Price |
$1,312.85
|
| Rate for Payer: Centivo All Commercial |
$1,079.92
|
| Rate for Payer: Cigna All Commercial |
$1,827.40
|
| Rate for Payer: CORVEL All Commercial |
$1,969.28
|
| Rate for Payer: Coventry All Commercial |
$1,863.40
|
| Rate for Payer: Encore All Commercial |
$1,949.16
|
| Rate for Payer: Frontpath All Commercial |
$1,948.10
|
| Rate for Payer: Humana ChoiceCare |
$1,828.88
|
| Rate for Payer: Humana Medicare |
$1,079.92
|
| Rate for Payer: Lucent All Commercial |
$1,079.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,905.75
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,588.12
|
| Rate for Payer: PHP All Commercial |
$1,605.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$825.82
|
| Rate for Payer: Sagamore Health Network All Products |
$1,634.71
|
| Rate for Payer: Signature Care EPO |
$1,757.52
|
| Rate for Payer: Signature Care PPO |
$1,863.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,799.88
|
| Rate for Payer: United Healthcare Commercial |
$1,668.59
|
| Rate for Payer: United Healthcare Medicare |
$698.78
|
|
|
HC AR SUT ANCHOR 4.75X19.1
|
Facility
IP
|
$2,062.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606527
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,546.88 |
| Max. Negotiated Rate |
$1,918.12 |
| Rate for Payer: Aetna Commercial |
$1,782.00
|
| Rate for Payer: Cash Price |
$1,278.75
|
| Rate for Payer: Cigna All Commercial |
$1,779.94
|
| Rate for Payer: CORVEL All Commercial |
$1,918.12
|
| Rate for Payer: Coventry All Commercial |
$1,815.00
|
| Rate for Payer: Encore All Commercial |
$1,898.53
|
| Rate for Payer: Frontpath All Commercial |
$1,897.50
|
| Rate for Payer: Humana ChoiceCare |
$1,781.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,856.25
|
| Rate for Payer: PHCS All Commercial |
$1,546.88
|
| Rate for Payer: PHP All Commercial |
$1,564.20
|
| Rate for Payer: Sagamore Health Network All Products |
$1,592.25
|
| Rate for Payer: Signature Care EPO |
$1,711.88
|
| Rate for Payer: Signature Care PPO |
$1,815.00
|
| Rate for Payer: United Healthcare Commercial |
$1,625.25
|
|
|
HC AR SUT ANCHOR 4.75X19.1
|
Facility
OP
|
$2,062.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606527
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,918.12 |
| Rate for Payer: Aetna Commercial |
$1,740.75
|
| Rate for Payer: Aetna Medicare |
$680.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$680.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,184.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,289.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$782.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$748.69
|
| Rate for Payer: Cash Price |
$1,278.75
|
| Rate for Payer: Cash Price |
$1,278.75
|
| Rate for Payer: Centivo All Commercial |
$1,051.88
|
| Rate for Payer: Cigna All Commercial |
$1,779.94
|
| Rate for Payer: CORVEL All Commercial |
$1,918.12
|
| Rate for Payer: Coventry All Commercial |
$1,815.00
|
| Rate for Payer: Encore All Commercial |
$1,898.53
|
| Rate for Payer: Frontpath All Commercial |
$1,897.50
|
| Rate for Payer: Humana ChoiceCare |
$1,781.38
|
| Rate for Payer: Humana Medicare |
$1,051.88
|
| Rate for Payer: Lucent All Commercial |
$1,051.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,856.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,546.88
|
| Rate for Payer: PHP All Commercial |
$1,564.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$804.38
|
| Rate for Payer: Sagamore Health Network All Products |
$1,592.25
|
| Rate for Payer: Signature Care EPO |
$1,711.88
|
| Rate for Payer: Signature Care PPO |
$1,815.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,753.12
|
| Rate for Payer: United Healthcare Commercial |
$1,625.25
|
| Rate for Payer: United Healthcare Medicare |
$680.62
|
|
|
HC AR SUT ANCHOR 5.5X19.1
|
Facility
IP
|
$1,821.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607862
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,366.20 |
| Max. Negotiated Rate |
$1,694.09 |
| Rate for Payer: Aetna Commercial |
$1,573.86
|
| Rate for Payer: Cash Price |
$1,129.39
|
| Rate for Payer: Cigna All Commercial |
$1,572.04
|
| Rate for Payer: CORVEL All Commercial |
$1,694.09
|
| Rate for Payer: Coventry All Commercial |
$1,603.01
|
| Rate for Payer: Encore All Commercial |
$1,676.78
|
| Rate for Payer: Frontpath All Commercial |
$1,675.87
|
| Rate for Payer: Humana ChoiceCare |
$1,573.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,639.44
|
| Rate for Payer: PHCS All Commercial |
$1,366.20
|
| Rate for Payer: PHP All Commercial |
$1,381.50
|
| Rate for Payer: Sagamore Health Network All Products |
$1,406.28
|
| Rate for Payer: Signature Care EPO |
$1,511.93
|
| Rate for Payer: Signature Care PPO |
$1,603.01
|
| Rate for Payer: United Healthcare Commercial |
$1,435.42
|
|
|
HC AR SUT ANCHOR 5.5X19.1
|
Facility
OP
|
$1,821.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607862
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,694.09 |
| Rate for Payer: Aetna Commercial |
$1,537.43
|
| Rate for Payer: Aetna Medicare |
$601.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$601.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,046.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,138.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$691.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$661.24
|
| Rate for Payer: Cash Price |
$1,129.39
|
| Rate for Payer: Cash Price |
$1,129.39
|
| Rate for Payer: Centivo All Commercial |
$929.02
|
| Rate for Payer: Cigna All Commercial |
$1,572.04
|
| Rate for Payer: CORVEL All Commercial |
$1,694.09
|
| Rate for Payer: Coventry All Commercial |
$1,603.01
|
| Rate for Payer: Encore All Commercial |
$1,676.78
|
| Rate for Payer: Frontpath All Commercial |
$1,675.87
|
| Rate for Payer: Humana ChoiceCare |
$1,573.32
|
| Rate for Payer: Humana Medicare |
$929.02
|
| Rate for Payer: Lucent All Commercial |
$929.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,639.44
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,366.20
|
| Rate for Payer: PHP All Commercial |
$1,381.50
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$710.42
|
| Rate for Payer: Sagamore Health Network All Products |
$1,406.28
|
| Rate for Payer: Signature Care EPO |
$1,511.93
|
| Rate for Payer: Signature Care PPO |
$1,603.01
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,548.36
|
| Rate for Payer: United Healthcare Commercial |
$1,435.42
|
| Rate for Payer: United Healthcare Medicare |
$601.13
|
|
