|
HC BIV ICD DYNAGEN LV1
|
Facility
OP
|
$60,637.50
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607256
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$56,392.88 |
| Rate for Payer: Aetna Commercial |
$51,178.05
|
| Rate for Payer: Aetna Medicare |
$20,010.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$20,010.38
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$34,824.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$37,904.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$23,011.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$22,011.41
|
| Rate for Payer: Cash Price |
$37,595.25
|
| Rate for Payer: Cash Price |
$37,595.25
|
| Rate for Payer: Centivo All Commercial |
$30,925.12
|
| Rate for Payer: Cigna All Commercial |
$52,330.16
|
| Rate for Payer: CORVEL All Commercial |
$56,392.88
|
| Rate for Payer: Coventry All Commercial |
$53,361.00
|
| Rate for Payer: Encore All Commercial |
$55,816.82
|
| Rate for Payer: Frontpath All Commercial |
$55,786.50
|
| Rate for Payer: Humana ChoiceCare |
$52,372.61
|
| Rate for Payer: Humana Medicare |
$30,925.12
|
| Rate for Payer: Lucent All Commercial |
$30,925.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$54,573.75
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$45,478.12
|
| Rate for Payer: PHP All Commercial |
$45,987.48
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$23,648.62
|
| Rate for Payer: Sagamore Health Network All Products |
$46,812.15
|
| Rate for Payer: Signature Care EPO |
$50,329.12
|
| Rate for Payer: Signature Care PPO |
$53,361.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$51,541.88
|
| Rate for Payer: United Healthcare Commercial |
$47,782.35
|
| Rate for Payer: United Healthcare Medicare |
$20,010.38
|
|
|
HC BIV ICD DYNAGEN LV1
|
Facility
IP
|
$60,637.50
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607256
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$45,478.12 |
| Max. Negotiated Rate |
$56,392.88 |
| Rate for Payer: Aetna Commercial |
$52,390.80
|
| Rate for Payer: Cash Price |
$37,595.25
|
| Rate for Payer: Cigna All Commercial |
$52,330.16
|
| Rate for Payer: CORVEL All Commercial |
$56,392.88
|
| Rate for Payer: Coventry All Commercial |
$53,361.00
|
| Rate for Payer: Encore All Commercial |
$55,816.82
|
| Rate for Payer: Frontpath All Commercial |
$55,786.50
|
| Rate for Payer: Humana ChoiceCare |
$52,372.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$54,573.75
|
| Rate for Payer: PHCS All Commercial |
$45,478.12
|
| Rate for Payer: PHP All Commercial |
$45,987.48
|
| Rate for Payer: Sagamore Health Network All Products |
$46,812.15
|
| Rate for Payer: Signature Care EPO |
$50,329.12
|
| Rate for Payer: Signature Care PPO |
$53,361.00
|
| Rate for Payer: United Healthcare Commercial |
$47,782.35
|
|
|
HC BIV ICD DYNAGEN X4
|
Facility
IP
|
$60,637.50
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607253
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$45,478.12 |
| Max. Negotiated Rate |
$56,392.88 |
| Rate for Payer: Aetna Commercial |
$52,390.80
|
| Rate for Payer: Cash Price |
$37,595.25
|
| Rate for Payer: Cigna All Commercial |
$52,330.16
|
| Rate for Payer: CORVEL All Commercial |
$56,392.88
|
| Rate for Payer: Coventry All Commercial |
$53,361.00
|
| Rate for Payer: Encore All Commercial |
$55,816.82
|
| Rate for Payer: Frontpath All Commercial |
$55,786.50
|
| Rate for Payer: Humana ChoiceCare |
$52,372.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$54,573.75
|
| Rate for Payer: PHCS All Commercial |
$45,478.12
|
| Rate for Payer: PHP All Commercial |
$45,987.48
|
| Rate for Payer: Sagamore Health Network All Products |
$46,812.15
|
| Rate for Payer: Signature Care EPO |
$50,329.12
|
| Rate for Payer: Signature Care PPO |
$53,361.00
|
| Rate for Payer: United Healthcare Commercial |
$47,782.35
|
|
|
HC BIV ICD DYNAGEN X4
|
Facility
OP
|
$60,637.50
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607253
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$56,392.88 |
| Rate for Payer: Aetna Commercial |
$51,178.05
|
| Rate for Payer: Aetna Medicare |
$20,010.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$20,010.38
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$34,824.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$37,904.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$23,011.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$22,011.41
|
| Rate for Payer: Cash Price |
$37,595.25
|
| Rate for Payer: Cash Price |
$37,595.25
|
| Rate for Payer: Centivo All Commercial |
$30,925.12
|
| Rate for Payer: Cigna All Commercial |
$52,330.16
|
| Rate for Payer: CORVEL All Commercial |
$56,392.88
|
| Rate for Payer: Coventry All Commercial |
$53,361.00
|
| Rate for Payer: Encore All Commercial |
$55,816.82
|
| Rate for Payer: Frontpath All Commercial |
$55,786.50
|
| Rate for Payer: Humana ChoiceCare |
$52,372.61
|
| Rate for Payer: Humana Medicare |
$30,925.12
|
| Rate for Payer: Lucent All Commercial |
$30,925.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$54,573.75
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$45,478.12
|
| Rate for Payer: PHP All Commercial |
$45,987.48
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$23,648.62
|
| Rate for Payer: Sagamore Health Network All Products |
$46,812.15
|
| Rate for Payer: Signature Care EPO |
$50,329.12
|
| Rate for Payer: Signature Care PPO |
$53,361.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$51,541.88
|
| Rate for Payer: United Healthcare Commercial |
$47,782.35
|
| Rate for Payer: United Healthcare Medicare |
$20,010.38
|
|
|
HC BIV ICD DYNAGEN X4 DF4
|
Facility
IP
|
$60,637.50
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607252
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$45,478.12 |
| Max. Negotiated Rate |
$56,392.88 |
| Rate for Payer: Aetna Commercial |
$52,390.80
|
| Rate for Payer: Cash Price |
$37,595.25
|
| Rate for Payer: Cigna All Commercial |
$52,330.16
|
| Rate for Payer: CORVEL All Commercial |
$56,392.88
|
| Rate for Payer: Coventry All Commercial |
$53,361.00
|
| Rate for Payer: Encore All Commercial |
$55,816.82
|
| Rate for Payer: Frontpath All Commercial |
$55,786.50
|
| Rate for Payer: Humana ChoiceCare |
$52,372.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$54,573.75
|
| Rate for Payer: PHCS All Commercial |
$45,478.12
|
| Rate for Payer: PHP All Commercial |
$45,987.48
|
| Rate for Payer: Sagamore Health Network All Products |
$46,812.15
|
| Rate for Payer: Signature Care EPO |
$50,329.12
|
| Rate for Payer: Signature Care PPO |
$53,361.00
|
| Rate for Payer: United Healthcare Commercial |
$47,782.35
|
|
|
HC BIV ICD DYNAGEN X4 DF4
|
Facility
OP
|
$60,637.50
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607252
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$56,392.88 |
| Rate for Payer: Aetna Commercial |
$51,178.05
|
| Rate for Payer: Aetna Medicare |
$20,010.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$20,010.38
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$34,824.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$37,904.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$23,011.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$22,011.41
|
| Rate for Payer: Cash Price |
$37,595.25
|
| Rate for Payer: Cash Price |
$37,595.25
|
| Rate for Payer: Centivo All Commercial |
$30,925.12
|
| Rate for Payer: Cigna All Commercial |
$52,330.16
|
| Rate for Payer: CORVEL All Commercial |
$56,392.88
|
| Rate for Payer: Coventry All Commercial |
$53,361.00
|
| Rate for Payer: Encore All Commercial |
$55,816.82
|
| Rate for Payer: Frontpath All Commercial |
$55,786.50
|
| Rate for Payer: Humana ChoiceCare |
$52,372.61
|
| Rate for Payer: Humana Medicare |
$30,925.12
|
| Rate for Payer: Lucent All Commercial |
$30,925.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$54,573.75
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$45,478.12
|
| Rate for Payer: PHP All Commercial |
$45,987.48
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$23,648.62
|
| Rate for Payer: Sagamore Health Network All Products |
$46,812.15
|
| Rate for Payer: Signature Care EPO |
$50,329.12
|
| Rate for Payer: Signature Care PPO |
$53,361.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$51,541.88
|
| Rate for Payer: United Healthcare Commercial |
$47,782.35
|
| Rate for Payer: United Healthcare Medicare |
$20,010.38
|
|
|
HC BIV ICD ENTRANT HF CRT-D
|
Facility
OP
|
$64,260.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607563
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$59,761.80 |
| Rate for Payer: Aetna Commercial |
$54,235.44
|
| Rate for Payer: Aetna Medicare |
$21,205.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$21,205.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$36,904.52
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$40,168.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$24,386.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$23,326.38
|
| Rate for Payer: Cash Price |
$39,841.20
|
| Rate for Payer: Cash Price |
$39,841.20
|
| Rate for Payer: Centivo All Commercial |
$32,772.60
|
| Rate for Payer: Cigna All Commercial |
$55,456.38
|
| Rate for Payer: CORVEL All Commercial |
$59,761.80
|
| Rate for Payer: Coventry All Commercial |
$56,548.80
|
| Rate for Payer: Encore All Commercial |
$59,151.33
|
| Rate for Payer: Frontpath All Commercial |
$59,119.20
|
| Rate for Payer: Humana ChoiceCare |
$55,501.36
|
| Rate for Payer: Humana Medicare |
$32,772.60
|
| Rate for Payer: Lucent All Commercial |
$32,772.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$57,834.00
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$48,195.00
|
| Rate for Payer: PHP All Commercial |
$48,734.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$25,061.40
|
| Rate for Payer: Sagamore Health Network All Products |
$49,608.72
|
| Rate for Payer: Signature Care EPO |
$53,335.80
|
| Rate for Payer: Signature Care PPO |
$56,548.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$54,621.00
|
| Rate for Payer: United Healthcare Commercial |
$50,636.88
|
| Rate for Payer: United Healthcare Medicare |
$21,205.80
|
|
|
HC BIV ICD ENTRANT HF CRT-D
|
Facility
IP
|
$64,260.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607563
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$48,195.00 |
| Max. Negotiated Rate |
$59,761.80 |
| Rate for Payer: Aetna Commercial |
$55,520.64
|
| Rate for Payer: Cash Price |
$39,841.20
|
| Rate for Payer: Cigna All Commercial |
$55,456.38
|
| Rate for Payer: CORVEL All Commercial |
$59,761.80
|
| Rate for Payer: Coventry All Commercial |
$56,548.80
|
| Rate for Payer: Encore All Commercial |
$59,151.33
|
| Rate for Payer: Frontpath All Commercial |
$59,119.20
|
| Rate for Payer: Humana ChoiceCare |
$55,501.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$57,834.00
|
| Rate for Payer: PHCS All Commercial |
$48,195.00
|
| Rate for Payer: PHP All Commercial |
$48,734.78
|
| Rate for Payer: Sagamore Health Network All Products |
$49,608.72
|
| Rate for Payer: Signature Care EPO |
$53,335.80
|
| Rate for Payer: Signature Care PPO |
$56,548.80
|
| Rate for Payer: United Healthcare Commercial |
$50,636.88
|
|
|
HC BIV ICD GALLANT HF CRT-D
|
Facility
OP
|
$65,205.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607564
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$60,640.65 |
| Rate for Payer: Aetna Commercial |
$55,033.02
|
| Rate for Payer: Aetna Medicare |
$21,517.65
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$21,517.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$37,447.23
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$40,759.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$24,745.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$23,669.42
|
| Rate for Payer: Cash Price |
$40,427.10
|
| Rate for Payer: Cash Price |
$40,427.10
|
| Rate for Payer: Centivo All Commercial |
$33,254.55
|
| Rate for Payer: Cigna All Commercial |
$56,271.92
|
| Rate for Payer: CORVEL All Commercial |
$60,640.65
|
| Rate for Payer: Coventry All Commercial |
$57,380.40
|
| Rate for Payer: Encore All Commercial |
$60,021.20
|
| Rate for Payer: Frontpath All Commercial |
$59,988.60
|
| Rate for Payer: Humana ChoiceCare |
$56,317.56
|
| Rate for Payer: Humana Medicare |
$33,254.55
|
| Rate for Payer: Lucent All Commercial |
$33,254.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$58,684.50
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$48,903.75
|
| Rate for Payer: PHP All Commercial |
$49,451.47
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$25,429.95
|
| Rate for Payer: Sagamore Health Network All Products |
$50,338.26
|
| Rate for Payer: Signature Care EPO |
$54,120.15
|
| Rate for Payer: Signature Care PPO |
$57,380.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$55,424.25
|
| Rate for Payer: United Healthcare Commercial |
$51,381.54
|
| Rate for Payer: United Healthcare Medicare |
$21,517.65
|
|
|
HC BIV ICD GALLANT HF CRT-D
|
Facility
IP
|
$65,205.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607564
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$48,903.75 |
| Max. Negotiated Rate |
$60,640.65 |
| Rate for Payer: Aetna Commercial |
$56,337.12
|
| Rate for Payer: Cash Price |
$40,427.10
|
| Rate for Payer: Cigna All Commercial |
$56,271.92
|
| Rate for Payer: CORVEL All Commercial |
$60,640.65
|
| Rate for Payer: Coventry All Commercial |
$57,380.40
|
| Rate for Payer: Encore All Commercial |
$60,021.20
|
| Rate for Payer: Frontpath All Commercial |
$59,988.60
|
| Rate for Payer: Humana ChoiceCare |
$56,317.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$58,684.50
|
| Rate for Payer: PHCS All Commercial |
$48,903.75
|
| Rate for Payer: PHP All Commercial |
$49,451.47
|
| Rate for Payer: Sagamore Health Network All Products |
$50,338.26
|
| Rate for Payer: Signature Care EPO |
$54,120.15
|
| Rate for Payer: Signature Care PPO |
$57,380.40
|
| Rate for Payer: United Healthcare Commercial |
$51,381.54
|
|
|
HC BIV ICD MOMENTUM IS1 DF1
|
Facility
IP
|
$65,782.50
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607250
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$49,336.88 |
| Max. Negotiated Rate |
$61,177.72 |
| Rate for Payer: Aetna Commercial |
$56,836.08
|
| Rate for Payer: Cash Price |
$40,785.15
|
| Rate for Payer: Cigna All Commercial |
$56,770.30
|
| Rate for Payer: CORVEL All Commercial |
$61,177.72
|
| Rate for Payer: Coventry All Commercial |
$57,888.60
|
| Rate for Payer: Encore All Commercial |
$60,552.79
|
| Rate for Payer: Frontpath All Commercial |
$60,519.90
|
| Rate for Payer: Humana ChoiceCare |
$56,816.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$59,204.25
|
| Rate for Payer: PHCS All Commercial |
$49,336.88
|
| Rate for Payer: PHP All Commercial |
$49,889.45
|
| Rate for Payer: Sagamore Health Network All Products |
$50,784.09
|
| Rate for Payer: Signature Care EPO |
$54,599.48
|
| Rate for Payer: Signature Care PPO |
$57,888.60
|
| Rate for Payer: United Healthcare Commercial |
$51,836.61
|
|
|
HC BIV ICD MOMENTUM IS1 DF1
|
Facility
OP
|
$65,782.50
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607250
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$61,177.72 |
| Rate for Payer: Aetna Commercial |
$55,520.43
|
| Rate for Payer: Aetna Medicare |
$21,708.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$21,708.22
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$37,778.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$41,120.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$24,964.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$23,879.05
|
| Rate for Payer: Cash Price |
$40,785.15
|
| Rate for Payer: Cash Price |
$40,785.15
|
| Rate for Payer: Centivo All Commercial |
$33,549.08
|
| Rate for Payer: Cigna All Commercial |
$56,770.30
|
| Rate for Payer: CORVEL All Commercial |
$61,177.72
|
| Rate for Payer: Coventry All Commercial |
$57,888.60
|
| Rate for Payer: Encore All Commercial |
$60,552.79
|
| Rate for Payer: Frontpath All Commercial |
$60,519.90
|
| Rate for Payer: Humana ChoiceCare |
$56,816.35
|
| Rate for Payer: Humana Medicare |
$33,549.08
|
| Rate for Payer: Lucent All Commercial |
$33,549.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$59,204.25
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$49,336.88
|
| Rate for Payer: PHP All Commercial |
$49,889.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$25,655.18
|
| Rate for Payer: Sagamore Health Network All Products |
$50,784.09
|
| Rate for Payer: Signature Care EPO |
$54,599.48
|
| Rate for Payer: Signature Care PPO |
$57,888.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$55,915.12
|
| Rate for Payer: United Healthcare Commercial |
$51,836.61
|
| Rate for Payer: United Healthcare Medicare |
$21,708.22
|
|
|
HC BIV ICD MOMENTUM IS1 DF4
|
Facility
IP
|
$65,782.50
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607249
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$49,336.88 |
| Max. Negotiated Rate |
$61,177.72 |
| Rate for Payer: Aetna Commercial |
$56,836.08
|
| Rate for Payer: Cash Price |
$40,785.15
|
| Rate for Payer: Cigna All Commercial |
$56,770.30
|
| Rate for Payer: CORVEL All Commercial |
$61,177.72
|
| Rate for Payer: Coventry All Commercial |
$57,888.60
|
| Rate for Payer: Encore All Commercial |
$60,552.79
|
| Rate for Payer: Frontpath All Commercial |
$60,519.90
|
| Rate for Payer: Humana ChoiceCare |
$56,816.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$59,204.25
|
| Rate for Payer: PHCS All Commercial |
$49,336.88
|
| Rate for Payer: PHP All Commercial |
$49,889.45
|
| Rate for Payer: Sagamore Health Network All Products |
$50,784.09
|
| Rate for Payer: Signature Care EPO |
$54,599.48
|
| Rate for Payer: Signature Care PPO |
$57,888.60
|
| Rate for Payer: United Healthcare Commercial |
$51,836.61
|
|
|
HC BIV ICD MOMENTUM IS1 DF4
|
Facility
OP
|
$65,782.50
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607249
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$61,177.72 |
| Rate for Payer: Aetna Commercial |
$55,520.43
|
| Rate for Payer: Aetna Medicare |
$21,708.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$21,708.22
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$37,778.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$41,120.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$24,964.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$23,879.05
|
| Rate for Payer: Cash Price |
$40,785.15
|
| Rate for Payer: Cash Price |
$40,785.15
|
| Rate for Payer: Centivo All Commercial |
$33,549.08
|
| Rate for Payer: Cigna All Commercial |
$56,770.30
|
| Rate for Payer: CORVEL All Commercial |
$61,177.72
|
| Rate for Payer: Coventry All Commercial |
$57,888.60
|
| Rate for Payer: Encore All Commercial |
$60,552.79
|
| Rate for Payer: Frontpath All Commercial |
$60,519.90
|
| Rate for Payer: Humana ChoiceCare |
$56,816.35
|
| Rate for Payer: Humana Medicare |
$33,549.08
|
| Rate for Payer: Lucent All Commercial |
$33,549.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$59,204.25
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$49,336.88
|
| Rate for Payer: PHP All Commercial |
$49,889.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$25,655.18
|
| Rate for Payer: Sagamore Health Network All Products |
$50,784.09
|
| Rate for Payer: Signature Care EPO |
$54,599.48
|
| Rate for Payer: Signature Care PPO |
$57,888.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$55,915.12
|
| Rate for Payer: United Healthcare Commercial |
$51,836.61
|
| Rate for Payer: United Healthcare Medicare |
$21,708.22
|
|
|
HC BIV ICD MOMENTUM LV1
|
Facility
IP
|
$65,782.50
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607251
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$49,336.88 |
| Max. Negotiated Rate |
$61,177.72 |
| Rate for Payer: Aetna Commercial |
$56,836.08
|
| Rate for Payer: Cash Price |
$40,785.15
|
| Rate for Payer: Cigna All Commercial |
$56,770.30
|
| Rate for Payer: CORVEL All Commercial |
$61,177.72
|
| Rate for Payer: Coventry All Commercial |
$57,888.60
|
| Rate for Payer: Encore All Commercial |
$60,552.79
|
| Rate for Payer: Frontpath All Commercial |
$60,519.90
|
| Rate for Payer: Humana ChoiceCare |
$56,816.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$59,204.25
|
| Rate for Payer: PHCS All Commercial |
$49,336.88
|
| Rate for Payer: PHP All Commercial |
$49,889.45
|
| Rate for Payer: Sagamore Health Network All Products |
$50,784.09
|
| Rate for Payer: Signature Care EPO |
$54,599.48
|
| Rate for Payer: Signature Care PPO |
$57,888.60
|
| Rate for Payer: United Healthcare Commercial |
$51,836.61
|
|
|
HC BIV ICD MOMENTUM LV1
|
Facility
OP
|
$65,782.50
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607251
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$61,177.72 |
| Rate for Payer: Aetna Commercial |
$55,520.43
|
| Rate for Payer: Aetna Medicare |
$21,708.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$21,708.22
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$37,778.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$41,120.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$24,964.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$23,879.05
|
| Rate for Payer: Cash Price |
$40,785.15
|
| Rate for Payer: Cash Price |
$40,785.15
|
| Rate for Payer: Centivo All Commercial |
$33,549.08
|
| Rate for Payer: Cigna All Commercial |
$56,770.30
|
| Rate for Payer: CORVEL All Commercial |
$61,177.72
|
| Rate for Payer: Coventry All Commercial |
$57,888.60
|
| Rate for Payer: Encore All Commercial |
$60,552.79
|
| Rate for Payer: Frontpath All Commercial |
$60,519.90
|
| Rate for Payer: Humana ChoiceCare |
$56,816.35
|
| Rate for Payer: Humana Medicare |
$33,549.08
|
| Rate for Payer: Lucent All Commercial |
$33,549.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$59,204.25
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$49,336.88
|
| Rate for Payer: PHP All Commercial |
$49,889.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$25,655.18
|
| Rate for Payer: Sagamore Health Network All Products |
$50,784.09
|
| Rate for Payer: Signature Care EPO |
$54,599.48
|
| Rate for Payer: Signature Care PPO |
$57,888.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$55,915.12
|
| Rate for Payer: United Healthcare Commercial |
$51,836.61
|
| Rate for Payer: United Healthcare Medicare |
$21,708.22
|
|
|
HC BIV ICD MOMENTUM X4 IS4 DF1
|
Facility
IP
|
$65,782.50
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607248
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$49,336.88 |
| Max. Negotiated Rate |
$61,177.72 |
| Rate for Payer: Aetna Commercial |
$56,836.08
|
| Rate for Payer: Cash Price |
$40,785.15
|
| Rate for Payer: Cigna All Commercial |
$56,770.30
|
| Rate for Payer: CORVEL All Commercial |
$61,177.72
|
| Rate for Payer: Coventry All Commercial |
$57,888.60
|
| Rate for Payer: Encore All Commercial |
$60,552.79
|
| Rate for Payer: Frontpath All Commercial |
$60,519.90
|
| Rate for Payer: Humana ChoiceCare |
$56,816.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$59,204.25
|
| Rate for Payer: PHCS All Commercial |
$49,336.88
|
| Rate for Payer: PHP All Commercial |
$49,889.45
|
| Rate for Payer: Sagamore Health Network All Products |
$50,784.09
|
| Rate for Payer: Signature Care EPO |
$54,599.48
|
| Rate for Payer: Signature Care PPO |
$57,888.60
|
| Rate for Payer: United Healthcare Commercial |
$51,836.61
|
|
|
HC BIV ICD MOMENTUM X4 IS4 DF1
|
Facility
OP
|
$65,782.50
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607248
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$61,177.72 |
| Rate for Payer: Aetna Commercial |
$55,520.43
|
| Rate for Payer: Aetna Medicare |
$21,708.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$21,708.22
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$37,778.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$41,120.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$24,964.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$23,879.05
|
| Rate for Payer: Cash Price |
$40,785.15
|
| Rate for Payer: Cash Price |
$40,785.15
|
| Rate for Payer: Centivo All Commercial |
$33,549.08
|
| Rate for Payer: Cigna All Commercial |
$56,770.30
|
| Rate for Payer: CORVEL All Commercial |
$61,177.72
|
| Rate for Payer: Coventry All Commercial |
$57,888.60
|
| Rate for Payer: Encore All Commercial |
$60,552.79
|
| Rate for Payer: Frontpath All Commercial |
$60,519.90
|
| Rate for Payer: Humana ChoiceCare |
$56,816.35
|
| Rate for Payer: Humana Medicare |
$33,549.08
|
| Rate for Payer: Lucent All Commercial |
$33,549.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$59,204.25
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$49,336.88
|
| Rate for Payer: PHP All Commercial |
$49,889.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$25,655.18
|
| Rate for Payer: Sagamore Health Network All Products |
$50,784.09
|
| Rate for Payer: Signature Care EPO |
$54,599.48
|
| Rate for Payer: Signature Care PPO |
$57,888.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$55,915.12
|
| Rate for Payer: United Healthcare Commercial |
$51,836.61
|
| Rate for Payer: United Healthcare Medicare |
$21,708.22
|
|
|
HC BIV ICD QUAD ASS CRT-D 40
|
Facility
IP
|
$58,401.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607567
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$43,800.75 |
| Max. Negotiated Rate |
$54,312.93 |
| Rate for Payer: Aetna Commercial |
$50,458.46
|
| Rate for Payer: Cash Price |
$36,208.62
|
| Rate for Payer: Cigna All Commercial |
$50,400.06
|
| Rate for Payer: CORVEL All Commercial |
$54,312.93
|
| Rate for Payer: Coventry All Commercial |
$51,392.88
|
| Rate for Payer: Encore All Commercial |
$53,758.12
|
| Rate for Payer: Frontpath All Commercial |
$53,728.92
|
| Rate for Payer: Humana ChoiceCare |
$50,440.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$52,560.90
|
| Rate for Payer: PHCS All Commercial |
$43,800.75
|
| Rate for Payer: PHP All Commercial |
$44,291.32
|
| Rate for Payer: Sagamore Health Network All Products |
$45,085.57
|
| Rate for Payer: Signature Care EPO |
$48,472.83
|
| Rate for Payer: Signature Care PPO |
$51,392.88
|
| Rate for Payer: United Healthcare Commercial |
$46,019.99
|
|
|
HC BIV ICD QUAD ASS CRT-D 40
|
Facility
OP
|
$58,401.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607567
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$54,312.93 |
| Rate for Payer: Aetna Commercial |
$49,290.44
|
| Rate for Payer: Aetna Medicare |
$19,272.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$19,272.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$33,539.69
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$36,506.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$22,163.18
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$21,199.56
|
| Rate for Payer: Cash Price |
$36,208.62
|
| Rate for Payer: Cash Price |
$36,208.62
|
| Rate for Payer: Centivo All Commercial |
$29,784.51
|
| Rate for Payer: Cigna All Commercial |
$50,400.06
|
| Rate for Payer: CORVEL All Commercial |
$54,312.93
|
| Rate for Payer: Coventry All Commercial |
$51,392.88
|
| Rate for Payer: Encore All Commercial |
$53,758.12
|
| Rate for Payer: Frontpath All Commercial |
$53,728.92
|
| Rate for Payer: Humana ChoiceCare |
$50,440.94
|
| Rate for Payer: Humana Medicare |
$29,784.51
|
| Rate for Payer: Lucent All Commercial |
$29,784.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$52,560.90
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$43,800.75
|
| Rate for Payer: PHP All Commercial |
$44,291.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$22,776.39
|
| Rate for Payer: Sagamore Health Network All Products |
$45,085.57
|
| Rate for Payer: Signature Care EPO |
$48,472.83
|
| Rate for Payer: Signature Care PPO |
$51,392.88
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$49,640.85
|
| Rate for Payer: United Healthcare Commercial |
$46,019.99
|
| Rate for Payer: United Healthcare Medicare |
$19,272.33
|
|
|
HC BIVICDQUADASSCRT-D40DF4CONNMRI
|
Facility
OP
|
$58,401.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607568
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$54,312.93 |
| Rate for Payer: Aetna Commercial |
$49,290.44
|
| Rate for Payer: Aetna Medicare |
$19,272.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$19,272.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$33,539.69
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$36,506.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$22,163.18
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$21,199.56
|
| Rate for Payer: Cash Price |
$36,208.62
|
| Rate for Payer: Cash Price |
$36,208.62
|
| Rate for Payer: Centivo All Commercial |
$29,784.51
|
| Rate for Payer: Cigna All Commercial |
$50,400.06
|
| Rate for Payer: CORVEL All Commercial |
$54,312.93
|
| Rate for Payer: Coventry All Commercial |
$51,392.88
|
| Rate for Payer: Encore All Commercial |
$53,758.12
|
| Rate for Payer: Frontpath All Commercial |
$53,728.92
|
| Rate for Payer: Humana ChoiceCare |
$50,440.94
|
| Rate for Payer: Humana Medicare |
$29,784.51
|
| Rate for Payer: Lucent All Commercial |
$29,784.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$52,560.90
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$43,800.75
|
| Rate for Payer: PHP All Commercial |
$44,291.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$22,776.39
|
| Rate for Payer: Sagamore Health Network All Products |
$45,085.57
|
| Rate for Payer: Signature Care EPO |
$48,472.83
|
| Rate for Payer: Signature Care PPO |
$51,392.88
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$49,640.85
|
| Rate for Payer: United Healthcare Commercial |
$46,019.99
|
| Rate for Payer: United Healthcare Medicare |
$19,272.33
|
|
|
HC BIVICDQUADASSCRT-D40DF4CONNMRI
|
Facility
IP
|
$58,401.00
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607568
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$43,800.75 |
| Max. Negotiated Rate |
$54,312.93 |
| Rate for Payer: Aetna Commercial |
$50,458.46
|
| Rate for Payer: Cash Price |
$36,208.62
|
| Rate for Payer: Cigna All Commercial |
$50,400.06
|
| Rate for Payer: CORVEL All Commercial |
$54,312.93
|
| Rate for Payer: Coventry All Commercial |
$51,392.88
|
| Rate for Payer: Encore All Commercial |
$53,758.12
|
| Rate for Payer: Frontpath All Commercial |
$53,728.92
|
| Rate for Payer: Humana ChoiceCare |
$50,440.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$52,560.90
|
| Rate for Payer: PHCS All Commercial |
$43,800.75
|
| Rate for Payer: PHP All Commercial |
$44,291.32
|
| Rate for Payer: Sagamore Health Network All Products |
$45,085.57
|
| Rate for Payer: Signature Care EPO |
$48,472.83
|
| Rate for Payer: Signature Care PPO |
$51,392.88
|
| Rate for Payer: United Healthcare Commercial |
$46,019.99
|
|
|
HC BIV ICD QUAD ASS MP CRT-D
|
Facility
IP
|
$60,007.50
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607565
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$45,005.62 |
| Max. Negotiated Rate |
$55,806.98 |
| Rate for Payer: Aetna Commercial |
$51,846.48
|
| Rate for Payer: Cash Price |
$37,204.65
|
| Rate for Payer: Cigna All Commercial |
$51,786.47
|
| Rate for Payer: CORVEL All Commercial |
$55,806.98
|
| Rate for Payer: Coventry All Commercial |
$52,806.60
|
| Rate for Payer: Encore All Commercial |
$55,236.90
|
| Rate for Payer: Frontpath All Commercial |
$55,206.90
|
| Rate for Payer: Humana ChoiceCare |
$51,828.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$54,006.75
|
| Rate for Payer: PHCS All Commercial |
$45,005.62
|
| Rate for Payer: PHP All Commercial |
$45,509.69
|
| Rate for Payer: Sagamore Health Network All Products |
$46,325.79
|
| Rate for Payer: Signature Care EPO |
$49,806.22
|
| Rate for Payer: Signature Care PPO |
$52,806.60
|
| Rate for Payer: United Healthcare Commercial |
$47,285.91
|
|
|
HC BIV ICD QUAD ASS MP CRT-D
|
Facility
OP
|
$60,007.50
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607565
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$55,806.98 |
| Rate for Payer: Aetna Commercial |
$50,646.33
|
| Rate for Payer: Aetna Medicare |
$19,802.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$19,802.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$34,462.31
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$37,510.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$22,772.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$21,782.72
|
| Rate for Payer: Cash Price |
$37,204.65
|
| Rate for Payer: Cash Price |
$37,204.65
|
| Rate for Payer: Centivo All Commercial |
$30,603.82
|
| Rate for Payer: Cigna All Commercial |
$51,786.47
|
| Rate for Payer: CORVEL All Commercial |
$55,806.98
|
| Rate for Payer: Coventry All Commercial |
$52,806.60
|
| Rate for Payer: Encore All Commercial |
$55,236.90
|
| Rate for Payer: Frontpath All Commercial |
$55,206.90
|
| Rate for Payer: Humana ChoiceCare |
$51,828.48
|
| Rate for Payer: Humana Medicare |
$30,603.82
|
| Rate for Payer: Lucent All Commercial |
$30,603.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$54,006.75
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$45,005.62
|
| Rate for Payer: PHP All Commercial |
$45,509.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$23,402.92
|
| Rate for Payer: Sagamore Health Network All Products |
$46,325.79
|
| Rate for Payer: Signature Care EPO |
$49,806.22
|
| Rate for Payer: Signature Care PPO |
$52,806.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$51,006.38
|
| Rate for Payer: United Healthcare Commercial |
$47,285.91
|
| Rate for Payer: United Healthcare Medicare |
$19,802.48
|
|
|
HC BIVICDQUADASSMPCRT-DDF4CONNMRI
|
Facility
IP
|
$60,007.50
|
|
|
Service Code
|
CPT C1882
|
| Hospital Charge Code |
41607566
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$45,005.62 |
| Max. Negotiated Rate |
$55,806.98 |
| Rate for Payer: Aetna Commercial |
$51,846.48
|
| Rate for Payer: Cash Price |
$37,204.65
|
| Rate for Payer: Cigna All Commercial |
$51,786.47
|
| Rate for Payer: CORVEL All Commercial |
$55,806.98
|
| Rate for Payer: Coventry All Commercial |
$52,806.60
|
| Rate for Payer: Encore All Commercial |
$55,236.90
|
| Rate for Payer: Frontpath All Commercial |
$55,206.90
|
| Rate for Payer: Humana ChoiceCare |
$51,828.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$54,006.75
|
| Rate for Payer: PHCS All Commercial |
$45,005.62
|
| Rate for Payer: PHP All Commercial |
$45,509.69
|
| Rate for Payer: Sagamore Health Network All Products |
$46,325.79
|
| Rate for Payer: Signature Care EPO |
$49,806.22
|
| Rate for Payer: Signature Care PPO |
$52,806.60
|
| Rate for Payer: United Healthcare Commercial |
$47,285.91
|
|
