|
HC AR SUT ANCHOR 5.5X22
|
Facility
IP
|
$2,337.50
|
|
| Hospital Charge Code |
41606211
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,753.12 |
| Max. Negotiated Rate |
$2,173.88 |
| Rate for Payer: Aetna Commercial |
$2,019.60
|
| Rate for Payer: Cash Price |
$1,449.25
|
| Rate for Payer: Cigna All Commercial |
$2,017.26
|
| Rate for Payer: CORVEL All Commercial |
$2,173.88
|
| Rate for Payer: Coventry All Commercial |
$2,057.00
|
| Rate for Payer: Encore All Commercial |
$2,151.67
|
| Rate for Payer: Frontpath All Commercial |
$2,150.50
|
| Rate for Payer: Humana ChoiceCare |
$2,018.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,103.75
|
| Rate for Payer: PHCS All Commercial |
$1,753.12
|
| Rate for Payer: PHP All Commercial |
$1,772.76
|
| Rate for Payer: Sagamore Health Network All Products |
$1,804.55
|
| Rate for Payer: Signature Care EPO |
$1,940.12
|
| Rate for Payer: Signature Care PPO |
$2,057.00
|
| Rate for Payer: United Healthcare Commercial |
$1,841.95
|
|
|
HC AR SUT ANCHOR 5.5X22
|
Facility
OP
|
$2,337.50
|
|
| Hospital Charge Code |
41606211
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$2,173.88 |
| Rate for Payer: Aetna Commercial |
$1,972.85
|
| Rate for Payer: Aetna Medicare |
$771.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$771.38
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,342.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,461.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$887.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$848.51
|
| Rate for Payer: Cash Price |
$1,449.25
|
| Rate for Payer: Cash Price |
$1,449.25
|
| Rate for Payer: Centivo All Commercial |
$1,192.12
|
| Rate for Payer: Cigna All Commercial |
$2,017.26
|
| Rate for Payer: CORVEL All Commercial |
$2,173.88
|
| Rate for Payer: Coventry All Commercial |
$2,057.00
|
| Rate for Payer: Encore All Commercial |
$2,151.67
|
| Rate for Payer: Frontpath All Commercial |
$2,150.50
|
| Rate for Payer: Humana ChoiceCare |
$2,018.90
|
| Rate for Payer: Humana Medicare |
$1,192.12
|
| Rate for Payer: Lucent All Commercial |
$1,192.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,103.75
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,753.12
|
| Rate for Payer: PHP All Commercial |
$1,772.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$911.62
|
| Rate for Payer: Sagamore Health Network All Products |
$1,804.55
|
| Rate for Payer: Signature Care EPO |
$1,940.12
|
| Rate for Payer: Signature Care PPO |
$2,057.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,986.88
|
| Rate for Payer: United Healthcare Commercial |
$1,841.95
|
| Rate for Payer: United Healthcare Medicare |
$771.38
|
|
|
HC AR SUT ANCHOR CORK 3.9X11.2
|
Facility
OP
|
$2,117.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607408
|
|
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 CORK 3.9X11.2
|
Facility
IP
|
$2,117.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607408
|
|
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 CORK 4.75X14
|
Facility
OP
|
$1,732.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606524
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,611.22 |
| Rate for Payer: Aetna Commercial |
$1,462.23
|
| Rate for Payer: Aetna Medicare |
$571.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$571.72
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$994.97
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,082.99
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$657.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$628.90
|
| Rate for Payer: Cash Price |
$1,074.15
|
| Rate for Payer: Cash Price |
$1,074.15
|
| Rate for Payer: Centivo All Commercial |
$883.58
|
| Rate for Payer: Cigna All Commercial |
$1,495.15
|
| Rate for Payer: CORVEL All Commercial |
$1,611.22
|
| Rate for Payer: Coventry All Commercial |
$1,524.60
|
| Rate for Payer: Encore All Commercial |
$1,594.77
|
| Rate for Payer: Frontpath All Commercial |
$1,593.90
|
| Rate for Payer: Humana ChoiceCare |
$1,496.36
|
| Rate for Payer: Humana Medicare |
$883.58
|
| Rate for Payer: Lucent All Commercial |
$883.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,559.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,299.38
|
| Rate for Payer: PHP All Commercial |
$1,313.93
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$675.68
|
| Rate for Payer: Sagamore Health Network All Products |
$1,337.49
|
| Rate for Payer: Signature Care EPO |
$1,437.98
|
| Rate for Payer: Signature Care PPO |
$1,524.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,472.62
|
| Rate for Payer: United Healthcare Commercial |
$1,365.21
|
| Rate for Payer: United Healthcare Medicare |
$571.72
|
|
|
HC AR SUT ANCHOR CORK 4.75X14
|
Facility
IP
|
$1,732.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606524
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,299.38 |
| Max. Negotiated Rate |
$1,611.22 |
| Rate for Payer: Aetna Commercial |
$1,496.88
|
| Rate for Payer: Cash Price |
$1,074.15
|
| Rate for Payer: Cigna All Commercial |
$1,495.15
|
| Rate for Payer: CORVEL All Commercial |
$1,611.22
|
| Rate for Payer: Coventry All Commercial |
$1,524.60
|
| Rate for Payer: Encore All Commercial |
$1,594.77
|
| Rate for Payer: Frontpath All Commercial |
$1,593.90
|
| Rate for Payer: Humana ChoiceCare |
$1,496.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,559.25
|
| Rate for Payer: PHCS All Commercial |
$1,299.38
|
| Rate for Payer: PHP All Commercial |
$1,313.93
|
| Rate for Payer: Sagamore Health Network All Products |
$1,337.49
|
| Rate for Payer: Signature Care EPO |
$1,437.98
|
| Rate for Payer: Signature Care PPO |
$1,524.60
|
| Rate for Payer: United Healthcare Commercial |
$1,365.21
|
|
|
HC AR SUT ANCHOR DL 4.75X22
|
Facility
IP
|
$2,034.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606199
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,525.50 |
| Max. Negotiated Rate |
$1,891.62 |
| Rate for Payer: Aetna Commercial |
$1,757.38
|
| Rate for Payer: Cash Price |
$1,261.08
|
| Rate for Payer: Cigna All Commercial |
$1,755.34
|
| Rate for Payer: CORVEL All Commercial |
$1,891.62
|
| Rate for Payer: Coventry All Commercial |
$1,789.92
|
| Rate for Payer: Encore All Commercial |
$1,872.30
|
| Rate for Payer: Frontpath All Commercial |
$1,871.28
|
| Rate for Payer: Humana ChoiceCare |
$1,756.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,830.60
|
| Rate for Payer: PHCS All Commercial |
$1,525.50
|
| Rate for Payer: PHP All Commercial |
$1,542.59
|
| Rate for Payer: Sagamore Health Network All Products |
$1,570.25
|
| Rate for Payer: Signature Care EPO |
$1,688.22
|
| Rate for Payer: Signature Care PPO |
$1,789.92
|
| Rate for Payer: United Healthcare Commercial |
$1,602.79
|
|
|
HC AR SUT ANCHOR DL 4.75X22
|
Facility
OP
|
$2,034.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606199
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,891.62 |
| Rate for Payer: Aetna Commercial |
$1,716.70
|
| Rate for Payer: Aetna Medicare |
$671.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$671.22
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,168.13
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,271.45
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$771.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$738.34
|
| Rate for Payer: Cash Price |
$1,261.08
|
| Rate for Payer: Cash Price |
$1,261.08
|
| Rate for Payer: Centivo All Commercial |
$1,037.34
|
| Rate for Payer: Cigna All Commercial |
$1,755.34
|
| Rate for Payer: CORVEL All Commercial |
$1,891.62
|
| Rate for Payer: Coventry All Commercial |
$1,789.92
|
| Rate for Payer: Encore All Commercial |
$1,872.30
|
| Rate for Payer: Frontpath All Commercial |
$1,871.28
|
| Rate for Payer: Humana ChoiceCare |
$1,756.77
|
| Rate for Payer: Humana Medicare |
$1,037.34
|
| Rate for Payer: Lucent All Commercial |
$1,037.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,830.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,525.50
|
| Rate for Payer: PHP All Commercial |
$1,542.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$793.26
|
| Rate for Payer: Sagamore Health Network All Products |
$1,570.25
|
| Rate for Payer: Signature Care EPO |
$1,688.22
|
| Rate for Payer: Signature Care PPO |
$1,789.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,728.90
|
| Rate for Payer: United Healthcare Commercial |
$1,602.79
|
| Rate for Payer: United Healthcare Medicare |
$671.22
|
|
|
HC AR SUT ANCHOR FIBERTAK 1.8
|
Facility
OP
|
$2,420.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607927
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,250.60 |
| Rate for Payer: Aetna Commercial |
$2,042.48
|
| Rate for Payer: Aetna Medicare |
$798.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$798.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,389.81
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,512.74
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$918.39
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$878.46
|
| Rate for Payer: Cash Price |
$1,500.40
|
| Rate for Payer: Cash Price |
$1,500.40
|
| Rate for Payer: Centivo All Commercial |
$1,234.20
|
| Rate for Payer: Cigna All Commercial |
$2,088.46
|
| Rate for Payer: CORVEL All Commercial |
$2,250.60
|
| Rate for Payer: Coventry All Commercial |
$2,129.60
|
| Rate for Payer: Encore All Commercial |
$2,227.61
|
| Rate for Payer: Frontpath All Commercial |
$2,226.40
|
| Rate for Payer: Humana ChoiceCare |
$2,090.15
|
| Rate for Payer: Humana Medicare |
$1,234.20
|
| Rate for Payer: Lucent All Commercial |
$1,234.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,178.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,815.00
|
| Rate for Payer: PHP All Commercial |
$1,835.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$943.80
|
| Rate for Payer: Sagamore Health Network All Products |
$1,868.24
|
| Rate for Payer: Signature Care EPO |
$2,008.60
|
| Rate for Payer: Signature Care PPO |
$2,129.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,057.00
|
| Rate for Payer: United Healthcare Commercial |
$1,906.96
|
| Rate for Payer: United Healthcare Medicare |
$798.60
|
|
|
HC AR SUT ANCHOR FIBERTAK 1.8
|
Facility
IP
|
$2,420.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607927
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,815.00 |
| Max. Negotiated Rate |
$2,250.60 |
| Rate for Payer: Aetna Commercial |
$2,090.88
|
| Rate for Payer: Cash Price |
$1,500.40
|
| Rate for Payer: Cigna All Commercial |
$2,088.46
|
| Rate for Payer: CORVEL All Commercial |
$2,250.60
|
| Rate for Payer: Coventry All Commercial |
$2,129.60
|
| Rate for Payer: Encore All Commercial |
$2,227.61
|
| Rate for Payer: Frontpath All Commercial |
$2,226.40
|
| Rate for Payer: Humana ChoiceCare |
$2,090.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,178.00
|
| Rate for Payer: PHCS All Commercial |
$1,815.00
|
| Rate for Payer: PHP All Commercial |
$1,835.33
|
| Rate for Payer: Sagamore Health Network All Products |
$1,868.24
|
| Rate for Payer: Signature Care EPO |
$2,008.60
|
| Rate for Payer: Signature Care PPO |
$2,129.60
|
| Rate for Payer: United Healthcare Commercial |
$1,906.96
|
|
|
HC AR SUT ANCHOR FIBERTAK 2.6 DBL
|
Facility
IP
|
$2,172.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607460
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,629.38 |
| Max. Negotiated Rate |
$2,020.42 |
| Rate for Payer: Aetna Commercial |
$1,877.04
|
| Rate for Payer: Cash Price |
$1,346.95
|
| Rate for Payer: Cigna All Commercial |
$1,874.87
|
| Rate for Payer: CORVEL All Commercial |
$2,020.42
|
| Rate for Payer: Coventry All Commercial |
$1,911.80
|
| Rate for Payer: Encore All Commercial |
$1,999.79
|
| Rate for Payer: Frontpath All Commercial |
$1,998.70
|
| Rate for Payer: Humana ChoiceCare |
$1,876.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,955.25
|
| Rate for Payer: PHCS All Commercial |
$1,629.38
|
| Rate for Payer: PHP All Commercial |
$1,647.62
|
| Rate for Payer: Sagamore Health Network All Products |
$1,677.17
|
| Rate for Payer: Signature Care EPO |
$1,803.18
|
| Rate for Payer: Signature Care PPO |
$1,911.80
|
| Rate for Payer: United Healthcare Commercial |
$1,711.93
|
|
|
HC AR SUT ANCHOR FIBERTAK 2.6 DBL
|
Facility
OP
|
$2,172.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607460
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,020.42 |
| Rate for Payer: Aetna Commercial |
$1,833.59
|
| Rate for Payer: Aetna Medicare |
$716.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$716.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,247.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,358.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$824.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$788.62
|
| Rate for Payer: Cash Price |
$1,346.95
|
| Rate for Payer: Cash Price |
$1,346.95
|
| Rate for Payer: Centivo All Commercial |
$1,107.98
|
| Rate for Payer: Cigna All Commercial |
$1,874.87
|
| Rate for Payer: CORVEL All Commercial |
$2,020.42
|
| Rate for Payer: Coventry All Commercial |
$1,911.80
|
| Rate for Payer: Encore All Commercial |
$1,999.79
|
| Rate for Payer: Frontpath All Commercial |
$1,998.70
|
| Rate for Payer: Humana ChoiceCare |
$1,876.39
|
| Rate for Payer: Humana Medicare |
$1,107.98
|
| Rate for Payer: Lucent All Commercial |
$1,107.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,955.25
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,629.38
|
| Rate for Payer: PHP All Commercial |
$1,647.62
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$847.28
|
| Rate for Payer: Sagamore Health Network All Products |
$1,677.17
|
| Rate for Payer: Signature Care EPO |
$1,803.18
|
| Rate for Payer: Signature Care PPO |
$1,911.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,846.62
|
| Rate for Payer: United Healthcare Commercial |
$1,711.93
|
| Rate for Payer: United Healthcare Medicare |
$716.92
|
|
|
HC AR SUT ANCHOR FIBERTAK 2.6 SP
|
Facility
OP
|
$2,475.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607461
|
|
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
|
|
|
HC AR SUT ANCHOR FIBERTAK 2.6 SP
|
Facility
IP
|
$2,475.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607461
|
|
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 SUT ANCHOR STR TAK 3X14.5
|
Facility
OP
|
$1,787.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605566
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,662.38 |
| Rate for Payer: Aetna Commercial |
$1,508.65
|
| Rate for Payer: Aetna Medicare |
$589.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$589.88
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,026.56
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,117.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$678.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$648.86
|
| Rate for Payer: Cash Price |
$1,108.25
|
| Rate for Payer: Cash Price |
$1,108.25
|
| Rate for Payer: Centivo All Commercial |
$911.62
|
| Rate for Payer: Cigna All Commercial |
$1,542.61
|
| Rate for Payer: CORVEL All Commercial |
$1,662.38
|
| Rate for Payer: Coventry All Commercial |
$1,573.00
|
| Rate for Payer: Encore All Commercial |
$1,645.39
|
| Rate for Payer: Frontpath All Commercial |
$1,644.50
|
| Rate for Payer: Humana ChoiceCare |
$1,543.86
|
| Rate for Payer: Humana Medicare |
$911.62
|
| Rate for Payer: Lucent All Commercial |
$911.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,608.75
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,340.62
|
| Rate for Payer: PHP All Commercial |
$1,355.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$697.12
|
| Rate for Payer: Sagamore Health Network All Products |
$1,379.95
|
| Rate for Payer: Signature Care EPO |
$1,483.62
|
| Rate for Payer: Signature Care PPO |
$1,573.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,519.38
|
| Rate for Payer: United Healthcare Commercial |
$1,408.55
|
| Rate for Payer: United Healthcare Medicare |
$589.88
|
|
|
HC AR SUT ANCHOR STR TAK 3X14.5
|
Facility
IP
|
$1,787.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41605566
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,340.62 |
| Max. Negotiated Rate |
$1,662.38 |
| Rate for Payer: Aetna Commercial |
$1,544.40
|
| Rate for Payer: Cash Price |
$1,108.25
|
| Rate for Payer: Cigna All Commercial |
$1,542.61
|
| Rate for Payer: CORVEL All Commercial |
$1,662.38
|
| Rate for Payer: Coventry All Commercial |
$1,573.00
|
| Rate for Payer: Encore All Commercial |
$1,645.39
|
| Rate for Payer: Frontpath All Commercial |
$1,644.50
|
| Rate for Payer: Humana ChoiceCare |
$1,543.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,608.75
|
| Rate for Payer: PHCS All Commercial |
$1,340.62
|
| Rate for Payer: PHP All Commercial |
$1,355.64
|
| Rate for Payer: Sagamore Health Network All Products |
$1,379.95
|
| Rate for Payer: Signature Care EPO |
$1,483.62
|
| Rate for Payer: Signature Care PPO |
$1,573.00
|
| Rate for Payer: United Healthcare Commercial |
$1,408.55
|
|
|
HC AR SUT ANCHOR SWVLCK 4.7X19.1
|
Facility
OP
|
$1,861.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,730.92 |
| Rate for Payer: Aetna Commercial |
$1,570.85
|
| Rate for Payer: Aetna Medicare |
$614.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$614.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,068.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,163.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$706.33
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$675.62
|
| Rate for Payer: Cash Price |
$1,153.94
|
| Rate for Payer: Cash Price |
$1,153.94
|
| Rate for Payer: Centivo All Commercial |
$949.21
|
| Rate for Payer: Cigna All Commercial |
$1,606.22
|
| Rate for Payer: CORVEL All Commercial |
$1,730.92
|
| Rate for Payer: Coventry All Commercial |
$1,637.86
|
| Rate for Payer: Encore All Commercial |
$1,713.23
|
| Rate for Payer: Frontpath All Commercial |
$1,712.30
|
| Rate for Payer: Humana ChoiceCare |
$1,607.52
|
| Rate for Payer: Humana Medicare |
$949.21
|
| Rate for Payer: Lucent All Commercial |
$949.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,675.08
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,395.90
|
| Rate for Payer: PHP All Commercial |
$1,411.53
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$725.87
|
| Rate for Payer: Sagamore Health Network All Products |
$1,436.85
|
| Rate for Payer: Signature Care EPO |
$1,544.80
|
| Rate for Payer: Signature Care PPO |
$1,637.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,582.02
|
| Rate for Payer: United Healthcare Commercial |
$1,466.63
|
| Rate for Payer: United Healthcare Medicare |
$614.20
|
|
|
HC AR SUT ANCHOR SWVLCK 4.7X19.1
|
Facility
IP
|
$1,861.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,395.90 |
| Max. Negotiated Rate |
$1,730.92 |
| Rate for Payer: Aetna Commercial |
$1,608.08
|
| Rate for Payer: Cash Price |
$1,153.94
|
| Rate for Payer: Cigna All Commercial |
$1,606.22
|
| Rate for Payer: CORVEL All Commercial |
$1,730.92
|
| Rate for Payer: Coventry All Commercial |
$1,637.86
|
| Rate for Payer: Encore All Commercial |
$1,713.23
|
| Rate for Payer: Frontpath All Commercial |
$1,712.30
|
| Rate for Payer: Humana ChoiceCare |
$1,607.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,675.08
|
| Rate for Payer: PHCS All Commercial |
$1,395.90
|
| Rate for Payer: PHP All Commercial |
$1,411.53
|
| Rate for Payer: Sagamore Health Network All Products |
$1,436.85
|
| Rate for Payer: Signature Care EPO |
$1,544.80
|
| Rate for Payer: Signature Care PPO |
$1,637.86
|
| Rate for Payer: United Healthcare Commercial |
$1,466.63
|
|
|
HC AR SUT ANCHOR SWVLCK 6.25X19.1
|
Facility
OP
|
$2,255.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607487
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,097.15 |
| Rate for Payer: Aetna Commercial |
$1,903.22
|
| Rate for Payer: Aetna Medicare |
$744.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$744.15
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,295.05
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,409.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$855.77
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$818.56
|
| Rate for Payer: Cash Price |
$1,398.10
|
| Rate for Payer: Cash Price |
$1,398.10
|
| Rate for Payer: Centivo All Commercial |
$1,150.05
|
| Rate for Payer: Cigna All Commercial |
$1,946.06
|
| Rate for Payer: CORVEL All Commercial |
$2,097.15
|
| Rate for Payer: Coventry All Commercial |
$1,984.40
|
| Rate for Payer: Encore All Commercial |
$2,075.73
|
| Rate for Payer: Frontpath All Commercial |
$2,074.60
|
| Rate for Payer: Humana ChoiceCare |
$1,947.64
|
| Rate for Payer: Humana Medicare |
$1,150.05
|
| Rate for Payer: Lucent All Commercial |
$1,150.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,029.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,691.25
|
| Rate for Payer: PHP All Commercial |
$1,710.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$879.45
|
| Rate for Payer: Sagamore Health Network All Products |
$1,740.86
|
| Rate for Payer: Signature Care EPO |
$1,871.65
|
| Rate for Payer: Signature Care PPO |
$1,984.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,916.75
|
| Rate for Payer: United Healthcare Commercial |
$1,776.94
|
| Rate for Payer: United Healthcare Medicare |
$744.15
|
|
|
HC AR SUT ANCHOR SWVLCK 6.25X19.1
|
Facility
IP
|
$2,255.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607487
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,691.25 |
| Max. Negotiated Rate |
$2,097.15 |
| Rate for Payer: Aetna Commercial |
$1,948.32
|
| Rate for Payer: Cash Price |
$1,398.10
|
| Rate for Payer: Cigna All Commercial |
$1,946.06
|
| Rate for Payer: CORVEL All Commercial |
$2,097.15
|
| Rate for Payer: Coventry All Commercial |
$1,984.40
|
| Rate for Payer: Encore All Commercial |
$2,075.73
|
| Rate for Payer: Frontpath All Commercial |
$2,074.60
|
| Rate for Payer: Humana ChoiceCare |
$1,947.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,029.50
|
| Rate for Payer: PHCS All Commercial |
$1,691.25
|
| Rate for Payer: PHP All Commercial |
$1,710.19
|
| Rate for Payer: Sagamore Health Network All Products |
$1,740.86
|
| Rate for Payer: Signature Care EPO |
$1,871.65
|
| Rate for Payer: Signature Care PPO |
$1,984.40
|
| Rate for Payer: United Healthcare Commercial |
$1,776.94
|
|
|
HC AR SUT ANCHOR TAK
|
Facility
IP
|
$2,337.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607029
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,753.12 |
| Max. Negotiated Rate |
$2,173.88 |
| Rate for Payer: Aetna Commercial |
$2,019.60
|
| Rate for Payer: Cash Price |
$1,449.25
|
| Rate for Payer: Cigna All Commercial |
$2,017.26
|
| Rate for Payer: CORVEL All Commercial |
$2,173.88
|
| Rate for Payer: Coventry All Commercial |
$2,057.00
|
| Rate for Payer: Encore All Commercial |
$2,151.67
|
| Rate for Payer: Frontpath All Commercial |
$2,150.50
|
| Rate for Payer: Humana ChoiceCare |
$2,018.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,103.75
|
| Rate for Payer: PHCS All Commercial |
$1,753.12
|
| Rate for Payer: PHP All Commercial |
$1,772.76
|
| Rate for Payer: Sagamore Health Network All Products |
$1,804.55
|
| Rate for Payer: Signature Care EPO |
$1,940.12
|
| Rate for Payer: Signature Care PPO |
$2,057.00
|
| Rate for Payer: United Healthcare Commercial |
$1,841.95
|
|
|
HC AR SUT ANCHOR TAK
|
Facility
OP
|
$2,337.50
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607029
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,173.88 |
| Rate for Payer: Aetna Commercial |
$1,972.85
|
| Rate for Payer: Aetna Medicare |
$771.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$771.38
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,342.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,461.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$887.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$848.51
|
| Rate for Payer: Cash Price |
$1,449.25
|
| Rate for Payer: Cash Price |
$1,449.25
|
| Rate for Payer: Centivo All Commercial |
$1,192.12
|
| Rate for Payer: Cigna All Commercial |
$2,017.26
|
| Rate for Payer: CORVEL All Commercial |
$2,173.88
|
| Rate for Payer: Coventry All Commercial |
$2,057.00
|
| Rate for Payer: Encore All Commercial |
$2,151.67
|
| Rate for Payer: Frontpath All Commercial |
$2,150.50
|
| Rate for Payer: Humana ChoiceCare |
$2,018.90
|
| Rate for Payer: Humana Medicare |
$1,192.12
|
| Rate for Payer: Lucent All Commercial |
$1,192.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,103.75
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,753.12
|
| Rate for Payer: PHP All Commercial |
$1,772.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$911.62
|
| Rate for Payer: Sagamore Health Network All Products |
$1,804.55
|
| Rate for Payer: Signature Care EPO |
$1,940.12
|
| Rate for Payer: Signature Care PPO |
$2,057.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,986.88
|
| Rate for Payer: United Healthcare Commercial |
$1,841.95
|
| Rate for Payer: United Healthcare Medicare |
$771.38
|
|
|
HC AR SUT LASSO 45-CURVE FP R
|
Facility
IP
|
$880.00
|
|
| Hospital Charge Code |
41607715
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$660.00 |
| Max. Negotiated Rate |
$818.40 |
| Rate for Payer: Aetna Commercial |
$760.32
|
| Rate for Payer: Cash Price |
$545.60
|
| Rate for Payer: Cigna All Commercial |
$759.44
|
| Rate for Payer: CORVEL All Commercial |
$818.40
|
| Rate for Payer: Coventry All Commercial |
$774.40
|
| Rate for Payer: Encore All Commercial |
$810.04
|
| Rate for Payer: Frontpath All Commercial |
$809.60
|
| Rate for Payer: Humana ChoiceCare |
$760.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$792.00
|
| Rate for Payer: PHCS All Commercial |
$660.00
|
| Rate for Payer: PHP All Commercial |
$667.39
|
| Rate for Payer: Sagamore Health Network All Products |
$679.36
|
| Rate for Payer: Signature Care EPO |
$730.40
|
| Rate for Payer: Signature Care PPO |
$774.40
|
| Rate for Payer: United Healthcare Commercial |
$693.44
|
|
|
HC AR SUT LASSO 45-CURVE FP R
|
Facility
OP
|
$880.00
|
|
| Hospital Charge Code |
41607715
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$818.40 |
| Rate for Payer: Aetna Commercial |
$742.72
|
| Rate for Payer: Aetna Medicare |
$290.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$290.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$505.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$550.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$333.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$319.44
|
| Rate for Payer: Cash Price |
$545.60
|
| Rate for Payer: Cash Price |
$545.60
|
| Rate for Payer: Centivo All Commercial |
$448.80
|
| Rate for Payer: Cigna All Commercial |
$759.44
|
| Rate for Payer: CORVEL All Commercial |
$818.40
|
| Rate for Payer: Coventry All Commercial |
$774.40
|
| Rate for Payer: Encore All Commercial |
$810.04
|
| Rate for Payer: Frontpath All Commercial |
$809.60
|
| Rate for Payer: Humana ChoiceCare |
$760.06
|
| Rate for Payer: Humana Medicare |
$448.80
|
| Rate for Payer: Lucent All Commercial |
$448.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$792.00
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$660.00
|
| Rate for Payer: PHP All Commercial |
$667.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$343.20
|
| Rate for Payer: Sagamore Health Network All Products |
$679.36
|
| Rate for Payer: Signature Care EPO |
$730.40
|
| Rate for Payer: Signature Care PPO |
$774.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$748.00
|
| Rate for Payer: United Healthcare Commercial |
$693.44
|
| Rate for Payer: United Healthcare Medicare |
$290.40
|
|
|
HC AR SUT LASSO 45-CURVE QP L
|
Facility
IP
|
$880.00
|
|
| Hospital Charge Code |
41607714
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$660.00 |
| Max. Negotiated Rate |
$818.40 |
| Rate for Payer: Aetna Commercial |
$760.32
|
| Rate for Payer: Cash Price |
$545.60
|
| Rate for Payer: Cigna All Commercial |
$759.44
|
| Rate for Payer: CORVEL All Commercial |
$818.40
|
| Rate for Payer: Coventry All Commercial |
$774.40
|
| Rate for Payer: Encore All Commercial |
$810.04
|
| Rate for Payer: Frontpath All Commercial |
$809.60
|
| Rate for Payer: Humana ChoiceCare |
$760.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$792.00
|
| Rate for Payer: PHCS All Commercial |
$660.00
|
| Rate for Payer: PHP All Commercial |
$667.39
|
| Rate for Payer: Sagamore Health Network All Products |
$679.36
|
| Rate for Payer: Signature Care EPO |
$730.40
|
| Rate for Payer: Signature Care PPO |
$774.40
|
| Rate for Payer: United Healthcare Commercial |
$693.44
|
|
