|
HC 17 HYDROXYPROGESTRERONE-16 & YOUNGER
|
Facility
|
OP
|
$175.99
|
|
|
Service Code
|
CPT 83498
|
| Hospital Charge Code |
63001574
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.17 |
| Max. Negotiated Rate |
$163.67 |
| Rate for Payer: Aetna Commercial |
$148.54
|
| Rate for Payer: Aetna Medicare |
$56.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$27.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$54.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$80.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$80.89
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$27.17
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$64.76
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$61.95
|
| Rate for Payer: Cash Price |
$105.59
|
| Rate for Payer: Cash Price |
$105.59
|
| Rate for Payer: Centivo All Commercial |
$95.74
|
| Rate for Payer: Cigna All Commercial |
$151.88
|
| Rate for Payer: CORVEL All Commercial |
$163.67
|
| Rate for Payer: Coventry All Commercial |
$154.87
|
| Rate for Payer: Encore All Commercial |
$162.00
|
| Rate for Payer: Frontpath All Commercial |
$161.91
|
| Rate for Payer: Humana ChoiceCare |
$152.00
|
| Rate for Payer: Humana Medicare |
$56.32
|
| Rate for Payer: Lucent All Commercial |
$95.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$158.39
|
| Rate for Payer: Managed Health Services Medicaid |
$27.17
|
| Rate for Payer: MDWise Medicaid |
$27.17
|
| Rate for Payer: PHCS All Commercial |
$131.99
|
| Rate for Payer: PHP All Commercial |
$133.47
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$68.64
|
| Rate for Payer: Sagamore Health Network All Products |
$135.86
|
| Rate for Payer: Signature Care EPO |
$146.07
|
| Rate for Payer: Signature Care PPO |
$154.87
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$149.59
|
| Rate for Payer: United Healthcare Commercial |
$138.68
|
| Rate for Payer: United Healthcare Medicare |
$56.32
|
|
|
HC 17 HYDROXYPROGESTRERONE-ADULTS
|
Facility
|
IP
|
$235.62
|
|
|
Service Code
|
CPT 83498
|
| Hospital Charge Code |
63001575
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$176.72 |
| Max. Negotiated Rate |
$219.13 |
| Rate for Payer: Aetna Commercial |
$203.58
|
| Rate for Payer: Cash Price |
$141.37
|
| Rate for Payer: Cigna All Commercial |
$203.34
|
| Rate for Payer: CORVEL All Commercial |
$219.13
|
| Rate for Payer: Coventry All Commercial |
$207.35
|
| Rate for Payer: Encore All Commercial |
$216.89
|
| Rate for Payer: Frontpath All Commercial |
$216.77
|
| Rate for Payer: Humana ChoiceCare |
$203.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$212.06
|
| Rate for Payer: PHCS All Commercial |
$176.72
|
| Rate for Payer: PHP All Commercial |
$178.69
|
| Rate for Payer: Sagamore Health Network All Products |
$181.90
|
| Rate for Payer: Signature Care EPO |
$195.56
|
| Rate for Payer: Signature Care PPO |
$207.35
|
| Rate for Payer: United Healthcare Commercial |
$185.67
|
|
|
HC 17 HYDROXYPROGESTRERONE-ADULTS
|
Facility
|
OP
|
$235.62
|
|
|
Service Code
|
CPT 83498
|
| Hospital Charge Code |
63001575
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.17 |
| Max. Negotiated Rate |
$219.13 |
| Rate for Payer: Aetna Commercial |
$198.86
|
| Rate for Payer: Aetna Medicare |
$75.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$27.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$73.04
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$108.29
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$108.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$27.17
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$86.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$82.94
|
| Rate for Payer: Cash Price |
$141.37
|
| Rate for Payer: Cash Price |
$141.37
|
| Rate for Payer: Centivo All Commercial |
$128.18
|
| Rate for Payer: Cigna All Commercial |
$203.34
|
| Rate for Payer: CORVEL All Commercial |
$219.13
|
| Rate for Payer: Coventry All Commercial |
$207.35
|
| Rate for Payer: Encore All Commercial |
$216.89
|
| Rate for Payer: Frontpath All Commercial |
$216.77
|
| Rate for Payer: Humana ChoiceCare |
$203.50
|
| Rate for Payer: Humana Medicare |
$75.40
|
| Rate for Payer: Lucent All Commercial |
$128.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$212.06
|
| Rate for Payer: Managed Health Services Medicaid |
$27.17
|
| Rate for Payer: MDWise Medicaid |
$27.17
|
| Rate for Payer: PHCS All Commercial |
$176.72
|
| Rate for Payer: PHP All Commercial |
$178.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$91.89
|
| Rate for Payer: Sagamore Health Network All Products |
$181.90
|
| Rate for Payer: Signature Care EPO |
$195.56
|
| Rate for Payer: Signature Care PPO |
$207.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$200.28
|
| Rate for Payer: United Healthcare Commercial |
$185.67
|
| Rate for Payer: United Healthcare Medicare |
$75.40
|
|
|
HC 1 ADMN RSV MONOC ANTB IM NJX
|
Facility
|
OP
|
$111.00
|
|
|
Service Code
|
CPT 96381
|
| Hospital Charge Code |
526381
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$34.41 |
| Max. Negotiated Rate |
$103.23 |
| Rate for Payer: Aetna Commercial |
$93.68
|
| Rate for Payer: Aetna Medicare |
$35.52
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$34.41
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$63.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$69.39
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$40.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$39.07
|
| Rate for Payer: Cash Price |
$66.60
|
| Rate for Payer: Centivo All Commercial |
$60.38
|
| Rate for Payer: Cigna All Commercial |
$95.79
|
| Rate for Payer: CORVEL All Commercial |
$103.23
|
| Rate for Payer: Coventry All Commercial |
$97.68
|
| Rate for Payer: Encore All Commercial |
$102.18
|
| Rate for Payer: Frontpath All Commercial |
$102.12
|
| Rate for Payer: Humana ChoiceCare |
$95.87
|
| Rate for Payer: Humana Medicare |
$35.52
|
| Rate for Payer: Lucent All Commercial |
$60.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$99.90
|
| Rate for Payer: PHCS All Commercial |
$83.25
|
| Rate for Payer: PHP All Commercial |
$84.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$43.29
|
| Rate for Payer: Sagamore Health Network All Products |
$85.69
|
| Rate for Payer: Signature Care EPO |
$92.13
|
| Rate for Payer: Signature Care PPO |
$97.68
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$94.35
|
| Rate for Payer: United Healthcare Commercial |
$87.47
|
| Rate for Payer: United Healthcare Medicare |
$35.52
|
|
|
HC 1 ADMN RSV MONOC ANTB IM NJX
|
Facility
|
IP
|
$111.00
|
|
|
Service Code
|
CPT 96381
|
| Hospital Charge Code |
526381
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$83.25 |
| Max. Negotiated Rate |
$103.23 |
| Rate for Payer: Aetna Commercial |
$95.90
|
| Rate for Payer: Cash Price |
$66.60
|
| Rate for Payer: Cigna All Commercial |
$95.79
|
| Rate for Payer: CORVEL All Commercial |
$103.23
|
| Rate for Payer: Coventry All Commercial |
$97.68
|
| Rate for Payer: Encore All Commercial |
$102.18
|
| Rate for Payer: Frontpath All Commercial |
$102.12
|
| Rate for Payer: Humana ChoiceCare |
$95.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$99.90
|
| Rate for Payer: PHCS All Commercial |
$83.25
|
| Rate for Payer: PHP All Commercial |
$84.18
|
| Rate for Payer: Sagamore Health Network All Products |
$85.69
|
| Rate for Payer: Signature Care EPO |
$92.13
|
| Rate for Payer: Signature Care PPO |
$97.68
|
| Rate for Payer: United Healthcare Commercial |
$87.47
|
|
|
HC 24 HR CREATININE
|
Facility
|
OP
|
$106.52
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
63001523
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.18 |
| Max. Negotiated Rate |
$99.06 |
| Rate for Payer: Aetna Commercial |
$89.90
|
| Rate for Payer: Aetna Medicare |
$34.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$5.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$33.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$48.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$48.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$5.18
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$39.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$37.50
|
| Rate for Payer: Cash Price |
$63.91
|
| Rate for Payer: Cash Price |
$63.91
|
| Rate for Payer: Centivo All Commercial |
$57.95
|
| Rate for Payer: Cigna All Commercial |
$91.93
|
| Rate for Payer: CORVEL All Commercial |
$99.06
|
| Rate for Payer: Coventry All Commercial |
$93.74
|
| Rate for Payer: Encore All Commercial |
$98.05
|
| Rate for Payer: Frontpath All Commercial |
$98.00
|
| Rate for Payer: Humana ChoiceCare |
$92.00
|
| Rate for Payer: Humana Medicare |
$34.09
|
| Rate for Payer: Lucent All Commercial |
$57.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$95.87
|
| Rate for Payer: Managed Health Services Medicaid |
$5.18
|
| Rate for Payer: MDWise Medicaid |
$5.18
|
| Rate for Payer: PHCS All Commercial |
$79.89
|
| Rate for Payer: PHP All Commercial |
$80.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$41.54
|
| Rate for Payer: Sagamore Health Network All Products |
$82.23
|
| Rate for Payer: Signature Care EPO |
$88.41
|
| Rate for Payer: Signature Care PPO |
$93.74
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$90.54
|
| Rate for Payer: United Healthcare Commercial |
$83.94
|
| Rate for Payer: United Healthcare Medicare |
$34.09
|
|
|
HC 24 HR CREATININE
|
Facility
|
IP
|
$106.52
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
63001523
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$79.89 |
| Max. Negotiated Rate |
$99.06 |
| Rate for Payer: Aetna Commercial |
$92.03
|
| Rate for Payer: Cash Price |
$63.91
|
| Rate for Payer: Cigna All Commercial |
$91.93
|
| Rate for Payer: CORVEL All Commercial |
$99.06
|
| Rate for Payer: Coventry All Commercial |
$93.74
|
| Rate for Payer: Encore All Commercial |
$98.05
|
| Rate for Payer: Frontpath All Commercial |
$98.00
|
| Rate for Payer: Humana ChoiceCare |
$92.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$95.87
|
| Rate for Payer: PHCS All Commercial |
$79.89
|
| Rate for Payer: PHP All Commercial |
$80.78
|
| Rate for Payer: Sagamore Health Network All Products |
$82.23
|
| Rate for Payer: Signature Care EPO |
$88.41
|
| Rate for Payer: Signature Care PPO |
$93.74
|
| Rate for Payer: United Healthcare Commercial |
$83.94
|
|
|
HC 24 HR POTASSIUM
|
Facility
|
OP
|
$100.42
|
|
|
Service Code
|
CPT 84133
|
| Hospital Charge Code |
63001662
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.73 |
| Max. Negotiated Rate |
$93.39 |
| Rate for Payer: Aetna Commercial |
$84.75
|
| Rate for Payer: Aetna Medicare |
$32.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$4.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$31.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$46.15
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$46.15
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$4.73
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$36.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$35.35
|
| Rate for Payer: Cash Price |
$60.25
|
| Rate for Payer: Cash Price |
$60.25
|
| Rate for Payer: Centivo All Commercial |
$54.63
|
| Rate for Payer: Cigna All Commercial |
$86.66
|
| Rate for Payer: CORVEL All Commercial |
$93.39
|
| Rate for Payer: Coventry All Commercial |
$88.37
|
| Rate for Payer: Encore All Commercial |
$92.44
|
| Rate for Payer: Frontpath All Commercial |
$92.39
|
| Rate for Payer: Humana ChoiceCare |
$86.73
|
| Rate for Payer: Humana Medicare |
$32.13
|
| Rate for Payer: Lucent All Commercial |
$54.63
|
| Rate for Payer: Lutheran Preferred All Commercial |
$90.38
|
| Rate for Payer: Managed Health Services Medicaid |
$4.73
|
| Rate for Payer: MDWise Medicaid |
$4.73
|
| Rate for Payer: PHCS All Commercial |
$75.31
|
| Rate for Payer: PHP All Commercial |
$76.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$39.16
|
| Rate for Payer: Sagamore Health Network All Products |
$77.52
|
| Rate for Payer: Signature Care EPO |
$83.35
|
| Rate for Payer: Signature Care PPO |
$88.37
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$85.36
|
| Rate for Payer: United Healthcare Commercial |
$79.13
|
| Rate for Payer: United Healthcare Medicare |
$32.13
|
|
|
HC 24 HR POTASSIUM
|
Facility
|
IP
|
$100.42
|
|
|
Service Code
|
CPT 84133
|
| Hospital Charge Code |
63001662
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$75.31 |
| Max. Negotiated Rate |
$93.39 |
| Rate for Payer: Aetna Commercial |
$86.76
|
| Rate for Payer: Cash Price |
$60.25
|
| Rate for Payer: Cigna All Commercial |
$86.66
|
| Rate for Payer: CORVEL All Commercial |
$93.39
|
| Rate for Payer: Coventry All Commercial |
$88.37
|
| Rate for Payer: Encore All Commercial |
$92.44
|
| Rate for Payer: Frontpath All Commercial |
$92.39
|
| Rate for Payer: Humana ChoiceCare |
$86.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$90.38
|
| Rate for Payer: PHCS All Commercial |
$75.31
|
| Rate for Payer: PHP All Commercial |
$76.16
|
| Rate for Payer: Sagamore Health Network All Products |
$77.52
|
| Rate for Payer: Signature Care EPO |
$83.35
|
| Rate for Payer: Signature Care PPO |
$88.37
|
| Rate for Payer: United Healthcare Commercial |
$79.13
|
|
|
HC 24 HR SODIUM
|
Facility
|
OP
|
$99.86
|
|
|
Service Code
|
CPT 84300
|
| Hospital Charge Code |
63001678
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.06 |
| Max. Negotiated Rate |
$92.87 |
| Rate for Payer: Aetna Commercial |
$84.28
|
| Rate for Payer: Aetna Medicare |
$31.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$5.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$30.96
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$45.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$45.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$5.06
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$36.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$35.15
|
| Rate for Payer: Cash Price |
$59.92
|
| Rate for Payer: Cash Price |
$59.92
|
| Rate for Payer: Centivo All Commercial |
$54.32
|
| Rate for Payer: Cigna All Commercial |
$86.18
|
| Rate for Payer: CORVEL All Commercial |
$92.87
|
| Rate for Payer: Coventry All Commercial |
$87.88
|
| Rate for Payer: Encore All Commercial |
$91.92
|
| Rate for Payer: Frontpath All Commercial |
$91.87
|
| Rate for Payer: Humana ChoiceCare |
$86.25
|
| Rate for Payer: Humana Medicare |
$31.96
|
| Rate for Payer: Lucent All Commercial |
$54.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$89.87
|
| Rate for Payer: Managed Health Services Medicaid |
$5.06
|
| Rate for Payer: MDWise Medicaid |
$5.06
|
| Rate for Payer: PHCS All Commercial |
$74.89
|
| Rate for Payer: PHP All Commercial |
$75.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$38.95
|
| Rate for Payer: Sagamore Health Network All Products |
$77.09
|
| Rate for Payer: Signature Care EPO |
$82.88
|
| Rate for Payer: Signature Care PPO |
$87.88
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$84.88
|
| Rate for Payer: United Healthcare Commercial |
$78.69
|
| Rate for Payer: United Healthcare Medicare |
$31.96
|
|
|
HC 24 HR SODIUM
|
Facility
|
IP
|
$99.86
|
|
|
Service Code
|
CPT 84300
|
| Hospital Charge Code |
63001678
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$74.89 |
| Max. Negotiated Rate |
$92.87 |
| Rate for Payer: Aetna Commercial |
$86.28
|
| Rate for Payer: Cash Price |
$59.92
|
| Rate for Payer: Cigna All Commercial |
$86.18
|
| Rate for Payer: CORVEL All Commercial |
$92.87
|
| Rate for Payer: Coventry All Commercial |
$87.88
|
| Rate for Payer: Encore All Commercial |
$91.92
|
| Rate for Payer: Frontpath All Commercial |
$91.87
|
| Rate for Payer: Humana ChoiceCare |
$86.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$89.87
|
| Rate for Payer: PHCS All Commercial |
$74.89
|
| Rate for Payer: PHP All Commercial |
$75.73
|
| Rate for Payer: Sagamore Health Network All Products |
$77.09
|
| Rate for Payer: Signature Care EPO |
$82.88
|
| Rate for Payer: Signature Care PPO |
$87.88
|
| Rate for Payer: United Healthcare Commercial |
$78.69
|
|
|
HC 2D&M-MODE W/SPCTRL & CF DPLR
|
Facility
|
OP
|
$3,326.64
|
|
|
Service Code
|
CPT 93306
|
| Hospital Charge Code |
863306
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$202.23 |
| Max. Negotiated Rate |
$3,093.78 |
| Rate for Payer: Aetna Commercial |
$2,807.68
|
| Rate for Payer: Aetna Medicare |
$1,064.52
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$202.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,031.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,910.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,079.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$202.23
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,224.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,170.98
|
| Rate for Payer: Cash Price |
$1,995.98
|
| Rate for Payer: Cash Price |
$1,995.98
|
| Rate for Payer: Centivo All Commercial |
$1,809.69
|
| Rate for Payer: Cigna All Commercial |
$2,870.89
|
| Rate for Payer: CORVEL All Commercial |
$3,093.78
|
| Rate for Payer: Coventry All Commercial |
$2,927.44
|
| Rate for Payer: Encore All Commercial |
$3,062.17
|
| Rate for Payer: Frontpath All Commercial |
$3,060.51
|
| Rate for Payer: Humana ChoiceCare |
$2,873.22
|
| Rate for Payer: Humana Medicare |
$1,064.52
|
| Rate for Payer: Lucent All Commercial |
$1,809.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,993.98
|
| Rate for Payer: Managed Health Services Medicaid |
$202.23
|
| Rate for Payer: MDWise Medicaid |
$202.23
|
| Rate for Payer: PHCS All Commercial |
$2,494.98
|
| Rate for Payer: PHP All Commercial |
$2,522.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,297.39
|
| Rate for Payer: Sagamore Health Network All Products |
$2,568.17
|
| Rate for Payer: Signature Care EPO |
$2,761.11
|
| Rate for Payer: Signature Care PPO |
$2,927.44
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,827.64
|
| Rate for Payer: United Healthcare Commercial |
$2,621.39
|
| Rate for Payer: United Healthcare Medicare |
$1,064.52
|
|
|
HC 2D&M-MODE W/SPCTRL & CF DPLR
|
Facility
|
IP
|
$3,326.64
|
|
|
Service Code
|
CPT 93306
|
| Hospital Charge Code |
863306
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$2,494.98 |
| Max. Negotiated Rate |
$3,093.78 |
| Rate for Payer: Aetna Commercial |
$2,874.22
|
| Rate for Payer: Cash Price |
$1,995.98
|
| Rate for Payer: Cigna All Commercial |
$2,870.89
|
| Rate for Payer: CORVEL All Commercial |
$3,093.78
|
| Rate for Payer: Coventry All Commercial |
$2,927.44
|
| Rate for Payer: Encore All Commercial |
$3,062.17
|
| Rate for Payer: Frontpath All Commercial |
$3,060.51
|
| Rate for Payer: Humana ChoiceCare |
$2,873.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,993.98
|
| Rate for Payer: PHCS All Commercial |
$2,494.98
|
| Rate for Payer: PHP All Commercial |
$2,522.92
|
| Rate for Payer: Sagamore Health Network All Products |
$2,568.17
|
| Rate for Payer: Signature Care EPO |
$2,761.11
|
| Rate for Payer: Signature Care PPO |
$2,927.44
|
| Rate for Payer: United Healthcare Commercial |
$2,621.39
|
|
|
HC 3D RENDER W/INTRP POSTPROCES ECHOCARDIOGRAPHY
|
Facility
|
IP
|
$774.54
|
|
|
Service Code
|
CPT 76376
|
| Hospital Charge Code |
866376
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$580.90 |
| Max. Negotiated Rate |
$720.32 |
| Rate for Payer: Aetna Commercial |
$669.20
|
| Rate for Payer: Cash Price |
$464.72
|
| Rate for Payer: Cigna All Commercial |
$668.43
|
| Rate for Payer: CORVEL All Commercial |
$720.32
|
| Rate for Payer: Coventry All Commercial |
$681.60
|
| Rate for Payer: Encore All Commercial |
$712.96
|
| Rate for Payer: Frontpath All Commercial |
$712.58
|
| Rate for Payer: Humana ChoiceCare |
$668.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$697.09
|
| Rate for Payer: PHCS All Commercial |
$580.90
|
| Rate for Payer: PHP All Commercial |
$587.41
|
| Rate for Payer: Sagamore Health Network All Products |
$597.94
|
| Rate for Payer: Signature Care EPO |
$642.87
|
| Rate for Payer: Signature Care PPO |
$681.60
|
| Rate for Payer: United Healthcare Commercial |
$610.34
|
|
|
HC 3D RENDER W/INTRP POSTPROCES ECHOCARDIOGRAPHY
|
Facility
|
OP
|
$774.54
|
|
|
Service Code
|
CPT 76376
|
| Hospital Charge Code |
866376
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$13.05 |
| Max. Negotiated Rate |
$720.32 |
| Rate for Payer: Aetna Commercial |
$653.71
|
| Rate for Payer: Aetna Medicare |
$247.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$13.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$240.11
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$444.82
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$484.16
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$13.05
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$285.03
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$272.64
|
| Rate for Payer: Cash Price |
$464.72
|
| Rate for Payer: Cash Price |
$464.72
|
| Rate for Payer: Centivo All Commercial |
$421.35
|
| Rate for Payer: Cigna All Commercial |
$668.43
|
| Rate for Payer: CORVEL All Commercial |
$720.32
|
| Rate for Payer: Coventry All Commercial |
$681.60
|
| Rate for Payer: Encore All Commercial |
$712.96
|
| Rate for Payer: Frontpath All Commercial |
$712.58
|
| Rate for Payer: Humana ChoiceCare |
$668.97
|
| Rate for Payer: Humana Medicare |
$247.85
|
| Rate for Payer: Lucent All Commercial |
$421.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$697.09
|
| Rate for Payer: Managed Health Services Medicaid |
$13.05
|
| Rate for Payer: MDWise Medicaid |
$13.05
|
| Rate for Payer: PHCS All Commercial |
$580.90
|
| Rate for Payer: PHP All Commercial |
$587.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$302.07
|
| Rate for Payer: Sagamore Health Network All Products |
$597.94
|
| Rate for Payer: Signature Care EPO |
$642.87
|
| Rate for Payer: Signature Care PPO |
$681.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$658.36
|
| Rate for Payer: United Healthcare Commercial |
$610.34
|
| Rate for Payer: United Healthcare Medicare |
$247.85
|
|
|
HC 5 A DIHYDROTESTOSTERONE
|
Facility
|
OP
|
$290.24
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
63001509
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.09 |
| Max. Negotiated Rate |
$269.92 |
| Rate for Payer: Aetna Commercial |
$244.96
|
| Rate for Payer: Aetna Medicare |
$92.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$24.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$89.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$133.39
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$133.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$24.09
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$106.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$102.16
|
| Rate for Payer: Cash Price |
$174.14
|
| Rate for Payer: Cash Price |
$174.14
|
| Rate for Payer: Centivo All Commercial |
$157.89
|
| Rate for Payer: Cigna All Commercial |
$250.48
|
| Rate for Payer: CORVEL All Commercial |
$269.92
|
| Rate for Payer: Coventry All Commercial |
$255.41
|
| Rate for Payer: Encore All Commercial |
$267.17
|
| Rate for Payer: Frontpath All Commercial |
$267.02
|
| Rate for Payer: Humana ChoiceCare |
$250.68
|
| Rate for Payer: Humana Medicare |
$92.88
|
| Rate for Payer: Lucent All Commercial |
$157.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$261.22
|
| Rate for Payer: Managed Health Services Medicaid |
$24.09
|
| Rate for Payer: MDWise Medicaid |
$24.09
|
| Rate for Payer: PHCS All Commercial |
$217.68
|
| Rate for Payer: PHP All Commercial |
$220.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$113.19
|
| Rate for Payer: Sagamore Health Network All Products |
$224.07
|
| Rate for Payer: Signature Care EPO |
$240.90
|
| Rate for Payer: Signature Care PPO |
$255.41
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$246.70
|
| Rate for Payer: United Healthcare Commercial |
$228.71
|
| Rate for Payer: United Healthcare Medicare |
$92.88
|
|
|
HC 5 A DIHYDROTESTOSTERONE
|
Facility
|
IP
|
$290.24
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
63001509
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$217.68 |
| Max. Negotiated Rate |
$269.92 |
| Rate for Payer: Aetna Commercial |
$250.77
|
| Rate for Payer: Cash Price |
$174.14
|
| Rate for Payer: Cigna All Commercial |
$250.48
|
| Rate for Payer: CORVEL All Commercial |
$269.92
|
| Rate for Payer: Coventry All Commercial |
$255.41
|
| Rate for Payer: Encore All Commercial |
$267.17
|
| Rate for Payer: Frontpath All Commercial |
$267.02
|
| Rate for Payer: Humana ChoiceCare |
$250.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$261.22
|
| Rate for Payer: PHCS All Commercial |
$217.68
|
| Rate for Payer: PHP All Commercial |
$220.12
|
| Rate for Payer: Sagamore Health Network All Products |
$224.07
|
| Rate for Payer: Signature Care EPO |
$240.90
|
| Rate for Payer: Signature Care PPO |
$255.41
|
| Rate for Payer: United Healthcare Commercial |
$228.71
|
|
|
HC 5-HIAA QT UR
|
Facility
|
OP
|
$184.01
|
|
|
Service Code
|
CPT 83497
|
| Hospital Charge Code |
63001573
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.90 |
| Max. Negotiated Rate |
$171.13 |
| Rate for Payer: Aetna Commercial |
$155.30
|
| Rate for Payer: Aetna Medicare |
$58.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$12.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$57.04
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$84.57
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$84.57
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$12.90
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$67.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$64.77
|
| Rate for Payer: Cash Price |
$110.41
|
| Rate for Payer: Cash Price |
$110.41
|
| Rate for Payer: Centivo All Commercial |
$100.10
|
| Rate for Payer: Cigna All Commercial |
$158.80
|
| Rate for Payer: CORVEL All Commercial |
$171.13
|
| Rate for Payer: Coventry All Commercial |
$161.93
|
| Rate for Payer: Encore All Commercial |
$169.38
|
| Rate for Payer: Frontpath All Commercial |
$169.29
|
| Rate for Payer: Humana ChoiceCare |
$158.93
|
| Rate for Payer: Humana Medicare |
$58.88
|
| Rate for Payer: Lucent All Commercial |
$100.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$165.61
|
| Rate for Payer: Managed Health Services Medicaid |
$12.90
|
| Rate for Payer: MDWise Medicaid |
$12.90
|
| Rate for Payer: PHCS All Commercial |
$138.01
|
| Rate for Payer: PHP All Commercial |
$139.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$71.76
|
| Rate for Payer: Sagamore Health Network All Products |
$142.06
|
| Rate for Payer: Signature Care EPO |
$152.73
|
| Rate for Payer: Signature Care PPO |
$161.93
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$156.41
|
| Rate for Payer: United Healthcare Commercial |
$145.00
|
| Rate for Payer: United Healthcare Medicare |
$58.88
|
|
|
HC 5-HIAA QT UR
|
Facility
|
IP
|
$184.01
|
|
|
Service Code
|
CPT 83497
|
| Hospital Charge Code |
63001573
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$138.01 |
| Max. Negotiated Rate |
$171.13 |
| Rate for Payer: Aetna Commercial |
$158.98
|
| Rate for Payer: Cash Price |
$110.41
|
| Rate for Payer: Cigna All Commercial |
$158.80
|
| Rate for Payer: CORVEL All Commercial |
$171.13
|
| Rate for Payer: Coventry All Commercial |
$161.93
|
| Rate for Payer: Encore All Commercial |
$169.38
|
| Rate for Payer: Frontpath All Commercial |
$169.29
|
| Rate for Payer: Humana ChoiceCare |
$158.93
|
| Rate for Payer: Lutheran Preferred All Commercial |
$165.61
|
| Rate for Payer: PHCS All Commercial |
$138.01
|
| Rate for Payer: PHP All Commercial |
$139.55
|
| Rate for Payer: Sagamore Health Network All Products |
$142.06
|
| Rate for Payer: Signature Care EPO |
$152.73
|
| Rate for Payer: Signature Care PPO |
$161.93
|
| Rate for Payer: United Healthcare Commercial |
$145.00
|
|
|
HC ABD PARACENTESIS W/IMAGING
|
Facility
|
OP
|
$1,562.05
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
1599083
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$329.12 |
| Max. Negotiated Rate |
$1,452.71 |
| Rate for Payer: Aetna Commercial |
$1,318.37
|
| Rate for Payer: Aetna Medicare |
$499.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$329.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$484.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$897.09
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$976.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$329.12
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$574.83
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$549.84
|
| Rate for Payer: Cash Price |
$937.23
|
| Rate for Payer: Cash Price |
$937.23
|
| Rate for Payer: Centivo All Commercial |
$849.76
|
| Rate for Payer: Cigna All Commercial |
$1,348.05
|
| Rate for Payer: CORVEL All Commercial |
$1,452.71
|
| Rate for Payer: Coventry All Commercial |
$1,374.60
|
| Rate for Payer: Encore All Commercial |
$1,437.87
|
| Rate for Payer: Frontpath All Commercial |
$1,437.09
|
| Rate for Payer: Humana ChoiceCare |
$1,349.14
|
| Rate for Payer: Humana Medicare |
$499.86
|
| Rate for Payer: Lucent All Commercial |
$849.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,405.85
|
| Rate for Payer: Managed Health Services Medicaid |
$329.12
|
| Rate for Payer: MDWise Medicaid |
$329.12
|
| Rate for Payer: PHCS All Commercial |
$1,171.54
|
| Rate for Payer: PHP All Commercial |
$1,184.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$609.20
|
| Rate for Payer: Sagamore Health Network All Products |
$1,205.90
|
| Rate for Payer: Signature Care EPO |
$1,296.50
|
| Rate for Payer: Signature Care PPO |
$1,374.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,327.74
|
| Rate for Payer: United Healthcare Commercial |
$1,230.90
|
| Rate for Payer: United Healthcare Medicare |
$499.86
|
|
|
HC ABD PARACENTESIS W/IMAGING
|
Facility
|
IP
|
$1,562.05
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
1599083
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,171.54 |
| Max. Negotiated Rate |
$1,452.71 |
| Rate for Payer: Aetna Commercial |
$1,349.61
|
| Rate for Payer: Cash Price |
$937.23
|
| Rate for Payer: Cigna All Commercial |
$1,348.05
|
| Rate for Payer: CORVEL All Commercial |
$1,452.71
|
| Rate for Payer: Coventry All Commercial |
$1,374.60
|
| Rate for Payer: Encore All Commercial |
$1,437.87
|
| Rate for Payer: Frontpath All Commercial |
$1,437.09
|
| Rate for Payer: Humana ChoiceCare |
$1,349.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,405.85
|
| Rate for Payer: PHCS All Commercial |
$1,171.54
|
| Rate for Payer: PHP All Commercial |
$1,184.66
|
| Rate for Payer: Sagamore Health Network All Products |
$1,205.90
|
| Rate for Payer: Signature Care EPO |
$1,296.50
|
| Rate for Payer: Signature Care PPO |
$1,374.60
|
| Rate for Payer: United Healthcare Commercial |
$1,230.90
|
|
|
HC ABD PARACENTESIS W/IMAGING
|
Facility
|
IP
|
$1,562.05
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
1649083
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,171.54 |
| Max. Negotiated Rate |
$1,452.71 |
| Rate for Payer: Aetna Commercial |
$1,349.61
|
| Rate for Payer: Cash Price |
$937.23
|
| Rate for Payer: Cigna All Commercial |
$1,348.05
|
| Rate for Payer: CORVEL All Commercial |
$1,452.71
|
| Rate for Payer: Coventry All Commercial |
$1,374.60
|
| Rate for Payer: Encore All Commercial |
$1,437.87
|
| Rate for Payer: Frontpath All Commercial |
$1,437.09
|
| Rate for Payer: Humana ChoiceCare |
$1,349.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,405.85
|
| Rate for Payer: PHCS All Commercial |
$1,171.54
|
| Rate for Payer: PHP All Commercial |
$1,184.66
|
| Rate for Payer: Sagamore Health Network All Products |
$1,205.90
|
| Rate for Payer: Signature Care EPO |
$1,296.50
|
| Rate for Payer: Signature Care PPO |
$1,374.60
|
| Rate for Payer: United Healthcare Commercial |
$1,230.90
|
|
|
HC ABD PARACENTESIS W/IMAGING
|
Facility
|
OP
|
$1,562.05
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
1649083
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$329.12 |
| Max. Negotiated Rate |
$1,452.71 |
| Rate for Payer: Aetna Commercial |
$1,318.37
|
| Rate for Payer: Aetna Medicare |
$499.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$329.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$484.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$897.09
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$976.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$329.12
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$574.83
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$549.84
|
| Rate for Payer: Cash Price |
$937.23
|
| Rate for Payer: Cash Price |
$937.23
|
| Rate for Payer: Centivo All Commercial |
$849.76
|
| Rate for Payer: Cigna All Commercial |
$1,348.05
|
| Rate for Payer: CORVEL All Commercial |
$1,452.71
|
| Rate for Payer: Coventry All Commercial |
$1,374.60
|
| Rate for Payer: Encore All Commercial |
$1,437.87
|
| Rate for Payer: Frontpath All Commercial |
$1,437.09
|
| Rate for Payer: Humana ChoiceCare |
$1,349.14
|
| Rate for Payer: Humana Medicare |
$499.86
|
| Rate for Payer: Lucent All Commercial |
$849.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,405.85
|
| Rate for Payer: Managed Health Services Medicaid |
$329.12
|
| Rate for Payer: MDWise Medicaid |
$329.12
|
| Rate for Payer: PHCS All Commercial |
$1,171.54
|
| Rate for Payer: PHP All Commercial |
$1,184.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$609.20
|
| Rate for Payer: Sagamore Health Network All Products |
$1,205.90
|
| Rate for Payer: Signature Care EPO |
$1,296.50
|
| Rate for Payer: Signature Care PPO |
$1,374.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,327.74
|
| Rate for Payer: United Healthcare Commercial |
$1,230.90
|
| Rate for Payer: United Healthcare Medicare |
$499.86
|
|
|
HC ABG DRAW
|
Facility
|
OP
|
$98.47
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
1706485
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.53 |
| Max. Negotiated Rate |
$91.58 |
| Rate for Payer: Aetna Commercial |
$83.11
|
| Rate for Payer: Aetna Medicare |
$31.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$30.53
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$45.26
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$45.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$36.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$34.66
|
| Rate for Payer: Cash Price |
$59.08
|
| Rate for Payer: Centivo All Commercial |
$53.57
|
| Rate for Payer: Cigna All Commercial |
$84.98
|
| Rate for Payer: CORVEL All Commercial |
$91.58
|
| Rate for Payer: Coventry All Commercial |
$86.65
|
| Rate for Payer: Encore All Commercial |
$90.64
|
| Rate for Payer: Frontpath All Commercial |
$90.59
|
| Rate for Payer: Humana ChoiceCare |
$85.05
|
| Rate for Payer: Humana Medicare |
$31.51
|
| Rate for Payer: Lucent All Commercial |
$53.57
|
| Rate for Payer: Lutheran Preferred All Commercial |
$88.62
|
| Rate for Payer: PHCS All Commercial |
$73.85
|
| Rate for Payer: PHP All Commercial |
$74.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$38.40
|
| Rate for Payer: Sagamore Health Network All Products |
$76.02
|
| Rate for Payer: Signature Care EPO |
$81.73
|
| Rate for Payer: Signature Care PPO |
$86.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$83.70
|
| Rate for Payer: United Healthcare Commercial |
$77.59
|
| Rate for Payer: United Healthcare Medicare |
$31.51
|
|
|
HC ABG DRAW
|
Facility
|
IP
|
$98.47
|
|
|
Service Code
|
CPT 36600
|
| Hospital Charge Code |
1706485
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$73.85 |
| Max. Negotiated Rate |
$91.58 |
| Rate for Payer: Aetna Commercial |
$85.08
|
| Rate for Payer: Cash Price |
$59.08
|
| Rate for Payer: Cigna All Commercial |
$84.98
|
| Rate for Payer: CORVEL All Commercial |
$91.58
|
| Rate for Payer: Coventry All Commercial |
$86.65
|
| Rate for Payer: Encore All Commercial |
$90.64
|
| Rate for Payer: Frontpath All Commercial |
$90.59
|
| Rate for Payer: Humana ChoiceCare |
$85.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$88.62
|
| Rate for Payer: PHCS All Commercial |
$73.85
|
| Rate for Payer: PHP All Commercial |
$74.68
|
| Rate for Payer: Sagamore Health Network All Products |
$76.02
|
| Rate for Payer: Signature Care EPO |
$81.73
|
| Rate for Payer: Signature Care PPO |
$86.65
|
| Rate for Payer: United Healthcare Commercial |
$77.59
|
|
