|
HC CMCH NEW SUPPLY
|
Facility
IP
|
$1,841.40
|
|
| Hospital Charge Code |
41607814
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,381.05 |
| Max. Negotiated Rate |
$1,712.50 |
| Rate for Payer: Aetna Commercial |
$1,590.97
|
| Rate for Payer: Cash Price |
$1,141.67
|
| Rate for Payer: Cigna All Commercial |
$1,589.13
|
| Rate for Payer: CORVEL All Commercial |
$1,712.50
|
| Rate for Payer: Coventry All Commercial |
$1,620.43
|
| Rate for Payer: Encore All Commercial |
$1,695.01
|
| Rate for Payer: Frontpath All Commercial |
$1,694.09
|
| Rate for Payer: Humana ChoiceCare |
$1,590.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,657.26
|
| Rate for Payer: PHCS All Commercial |
$1,381.05
|
| Rate for Payer: PHP All Commercial |
$1,396.52
|
| Rate for Payer: Sagamore Health Network All Products |
$1,421.56
|
| Rate for Payer: Signature Care EPO |
$1,528.36
|
| Rate for Payer: Signature Care PPO |
$1,620.43
|
| Rate for Payer: United Healthcare Commercial |
$1,451.02
|
|
|
HC CMCH NEW SUPPLY
|
Facility
OP
|
$121.68
|
|
| Hospital Charge Code |
41608386
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$121.68 |
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
|
|
HC CMCH NEW SUPPLY
|
Facility
IP
|
$5,920.20
|
|
| Hospital Charge Code |
41607813
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,440.15 |
| Max. Negotiated Rate |
$5,505.79 |
| Rate for Payer: Aetna Commercial |
$5,115.05
|
| Rate for Payer: Cash Price |
$3,670.52
|
| Rate for Payer: Cigna All Commercial |
$5,109.13
|
| Rate for Payer: CORVEL All Commercial |
$5,505.79
|
| Rate for Payer: Coventry All Commercial |
$5,209.78
|
| Rate for Payer: Encore All Commercial |
$5,449.54
|
| Rate for Payer: Frontpath All Commercial |
$5,446.58
|
| Rate for Payer: Humana ChoiceCare |
$5,113.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,328.18
|
| Rate for Payer: PHCS All Commercial |
$4,440.15
|
| Rate for Payer: PHP All Commercial |
$4,489.88
|
| Rate for Payer: Sagamore Health Network All Products |
$4,570.39
|
| Rate for Payer: Signature Care EPO |
$4,913.77
|
| Rate for Payer: Signature Care PPO |
$5,209.78
|
| Rate for Payer: United Healthcare Commercial |
$4,665.12
|
|
|
HC CMCH NEW SUPPLY
|
Facility
OP
|
$1,341.50
|
|
| Hospital Charge Code |
41607811
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,247.60 |
| Rate for Payer: Aetna Commercial |
$1,132.23
|
| Rate for Payer: Aetna Medicare |
$442.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$442.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$770.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$838.57
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$509.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$486.96
|
| Rate for Payer: Cash Price |
$831.73
|
| Rate for Payer: Cash Price |
$831.73
|
| Rate for Payer: Centivo All Commercial |
$684.16
|
| Rate for Payer: Cigna All Commercial |
$1,157.71
|
| Rate for Payer: CORVEL All Commercial |
$1,247.60
|
| Rate for Payer: Coventry All Commercial |
$1,180.52
|
| Rate for Payer: Encore All Commercial |
$1,234.85
|
| Rate for Payer: Frontpath All Commercial |
$1,234.18
|
| Rate for Payer: Humana ChoiceCare |
$1,158.65
|
| Rate for Payer: Humana Medicare |
$684.16
|
| Rate for Payer: Lucent All Commercial |
$684.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,207.35
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,006.12
|
| Rate for Payer: PHP All Commercial |
$1,017.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$523.18
|
| Rate for Payer: Sagamore Health Network All Products |
$1,035.64
|
| Rate for Payer: Signature Care EPO |
$1,113.44
|
| Rate for Payer: Signature Care PPO |
$1,180.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,140.28
|
| Rate for Payer: United Healthcare Commercial |
$1,057.10
|
| Rate for Payer: United Healthcare Medicare |
$442.70
|
|
|
HC CMCH NEW SUPPLY
|
Facility
OP
|
$4,865.47
|
|
| Hospital Charge Code |
41607601
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$4,524.89 |
| Rate for Payer: Aetna Commercial |
$4,106.46
|
| Rate for Payer: Aetna Medicare |
$1,605.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,605.61
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,794.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,041.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,846.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,766.17
|
| Rate for Payer: Cash Price |
$3,016.59
|
| Rate for Payer: Cash Price |
$3,016.59
|
| Rate for Payer: Centivo All Commercial |
$2,481.39
|
| Rate for Payer: Cigna All Commercial |
$4,198.90
|
| Rate for Payer: CORVEL All Commercial |
$4,524.89
|
| Rate for Payer: Coventry All Commercial |
$4,281.61
|
| Rate for Payer: Encore All Commercial |
$4,478.67
|
| Rate for Payer: Frontpath All Commercial |
$4,476.23
|
| Rate for Payer: Humana ChoiceCare |
$4,202.31
|
| Rate for Payer: Humana Medicare |
$2,481.39
|
| Rate for Payer: Lucent All Commercial |
$2,481.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,378.92
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$3,649.10
|
| Rate for Payer: PHP All Commercial |
$3,689.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,897.53
|
| Rate for Payer: Sagamore Health Network All Products |
$3,756.14
|
| Rate for Payer: Signature Care EPO |
$4,038.34
|
| Rate for Payer: Signature Care PPO |
$4,281.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,135.65
|
| Rate for Payer: United Healthcare Commercial |
$3,833.99
|
| Rate for Payer: United Healthcare Medicare |
$1,605.61
|
|
|
HC CMCH NEW SUPPLY
|
Facility
OP
|
$121.68
|
|
| Hospital Charge Code |
41608430
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$121.68 |
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
|
|
HC CMCH NEW SUPPLY
|
Facility
IP
|
$1,232.00
|
|
| Hospital Charge Code |
41607808
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$924.00 |
| Max. Negotiated Rate |
$1,145.76 |
| Rate for Payer: Aetna Commercial |
$1,064.45
|
| Rate for Payer: Cash Price |
$763.84
|
| Rate for Payer: Cigna All Commercial |
$1,063.22
|
| Rate for Payer: CORVEL All Commercial |
$1,145.76
|
| Rate for Payer: Coventry All Commercial |
$1,084.16
|
| Rate for Payer: Encore All Commercial |
$1,134.06
|
| Rate for Payer: Frontpath All Commercial |
$1,133.44
|
| Rate for Payer: Humana ChoiceCare |
$1,064.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,108.80
|
| Rate for Payer: PHCS All Commercial |
$924.00
|
| Rate for Payer: PHP All Commercial |
$934.35
|
| Rate for Payer: Sagamore Health Network All Products |
$951.10
|
| Rate for Payer: Signature Care EPO |
$1,022.56
|
| Rate for Payer: Signature Care PPO |
$1,084.16
|
| Rate for Payer: United Healthcare Commercial |
$970.82
|
|
|
HC CMCH NEW SUPPLY
|
Facility
OP
|
$2,520.00
|
|
| Hospital Charge Code |
41607806
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$2,343.60 |
| Rate for Payer: Aetna Commercial |
$2,126.88
|
| Rate for Payer: Aetna Medicare |
$831.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$831.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,447.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,575.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$956.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$914.76
|
| Rate for Payer: Cash Price |
$1,562.40
|
| Rate for Payer: Cash Price |
$1,562.40
|
| Rate for Payer: Centivo All Commercial |
$1,285.20
|
| Rate for Payer: Cigna All Commercial |
$2,174.76
|
| Rate for Payer: CORVEL All Commercial |
$2,343.60
|
| Rate for Payer: Coventry All Commercial |
$2,217.60
|
| Rate for Payer: Encore All Commercial |
$2,319.66
|
| Rate for Payer: Frontpath All Commercial |
$2,318.40
|
| Rate for Payer: Humana ChoiceCare |
$2,176.52
|
| Rate for Payer: Humana Medicare |
$1,285.20
|
| Rate for Payer: Lucent All Commercial |
$1,285.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,268.00
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,890.00
|
| Rate for Payer: PHP All Commercial |
$1,911.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$982.80
|
| Rate for Payer: Sagamore Health Network All Products |
$1,945.44
|
| Rate for Payer: Signature Care EPO |
$2,091.60
|
| Rate for Payer: Signature Care PPO |
$2,217.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,142.00
|
| Rate for Payer: United Healthcare Commercial |
$1,985.76
|
| Rate for Payer: United Healthcare Medicare |
$831.60
|
|
|
HC CMCH NEW SUPPLY
|
Facility
OP
|
$6,624.00
|
|
| Hospital Charge Code |
41607600
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$6,160.32 |
| Rate for Payer: Aetna Commercial |
$5,590.66
|
| Rate for Payer: Aetna Medicare |
$2,185.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,185.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,804.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,140.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,513.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,404.51
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Centivo All Commercial |
$3,378.24
|
| Rate for Payer: Cigna All Commercial |
$5,716.51
|
| Rate for Payer: CORVEL All Commercial |
$6,160.32
|
| Rate for Payer: Coventry All Commercial |
$5,829.12
|
| Rate for Payer: Encore All Commercial |
$6,097.39
|
| Rate for Payer: Frontpath All Commercial |
$6,094.08
|
| Rate for Payer: Humana ChoiceCare |
$5,721.15
|
| Rate for Payer: Humana Medicare |
$3,378.24
|
| Rate for Payer: Lucent All Commercial |
$3,378.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,961.60
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$4,968.00
|
| Rate for Payer: PHP All Commercial |
$5,023.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,583.36
|
| Rate for Payer: Sagamore Health Network All Products |
$5,113.73
|
| Rate for Payer: Signature Care EPO |
$5,497.92
|
| Rate for Payer: Signature Care PPO |
$5,829.12
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,630.40
|
| Rate for Payer: United Healthcare Commercial |
$5,219.71
|
| Rate for Payer: United Healthcare Medicare |
$2,185.92
|
|
|
HC CMCH NEW SUPPLY
|
Facility
IP
|
$2,649.60
|
|
| Hospital Charge Code |
41607599
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,987.20 |
| Max. Negotiated Rate |
$2,464.13 |
| Rate for Payer: Aetna Commercial |
$2,289.25
|
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Cigna All Commercial |
$2,286.60
|
| Rate for Payer: CORVEL All Commercial |
$2,464.13
|
| Rate for Payer: Coventry All Commercial |
$2,331.65
|
| Rate for Payer: Encore All Commercial |
$2,438.96
|
| Rate for Payer: Frontpath All Commercial |
$2,437.63
|
| Rate for Payer: Humana ChoiceCare |
$2,288.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,384.64
|
| Rate for Payer: PHCS All Commercial |
$1,987.20
|
| Rate for Payer: PHP All Commercial |
$2,009.46
|
| Rate for Payer: Sagamore Health Network All Products |
$2,045.49
|
| Rate for Payer: Signature Care EPO |
$2,199.17
|
| Rate for Payer: Signature Care PPO |
$2,331.65
|
| Rate for Payer: United Healthcare Commercial |
$2,087.88
|
|
|
HC CMCH NEW SUPPLY
|
Facility
OP
|
$121.68
|
|
| Hospital Charge Code |
41608444
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$121.68 |
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
|
|
HC CMCH NEW SUPPLY
|
Facility
OP
|
$121.68
|
|
| Hospital Charge Code |
41608462
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$121.68 |
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
|
|
HC CMCH NEW SUPPLY
|
Facility
OP
|
$121.68
|
|
| Hospital Charge Code |
41608457
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$121.68 |
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
|
|
HC CMCH NEW SUPPLY
|
Facility
OP
|
$121.68
|
|
| Hospital Charge Code |
41608513
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$121.68 |
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
|
|
HC CMCH NEW SUPPLY
|
Facility
OP
|
$121.68
|
|
| Hospital Charge Code |
41608466
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$121.68 |
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
|
|
HC CMCH NEW SUPPLY
|
Facility
OP
|
$121.68
|
|
| Hospital Charge Code |
41608502
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$121.68 |
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
|
|
HC CMCH NEW SUPPLY
|
Facility
OP
|
$121.68
|
|
| Hospital Charge Code |
41608482
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$121.68 |
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
|
|
HC CMCH NEW SUPPLY
|
Facility
OP
|
$121.68
|
|
| Hospital Charge Code |
41608417
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$121.68 |
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
|
|
HC CMCH NEW SUPPLY
|
Facility
OP
|
$121.68
|
|
| Hospital Charge Code |
41608418
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$121.68 |
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
|
|
HC CMCH NEW SUPPLY
|
Facility
OP
|
$121.68
|
|
| Hospital Charge Code |
41608499
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$121.68 |
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
|
|
HC CMCH NEW SUPPLY
|
Facility
IP
|
$6,624.00
|
|
| Hospital Charge Code |
41607397
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,968.00 |
| Max. Negotiated Rate |
$6,160.32 |
| Rate for Payer: Aetna Commercial |
$5,723.14
|
| Rate for Payer: Cash Price |
$4,106.88
|
| Rate for Payer: Cigna All Commercial |
$5,716.51
|
| Rate for Payer: CORVEL All Commercial |
$6,160.32
|
| Rate for Payer: Coventry All Commercial |
$5,829.12
|
| Rate for Payer: Encore All Commercial |
$6,097.39
|
| Rate for Payer: Frontpath All Commercial |
$6,094.08
|
| Rate for Payer: Humana ChoiceCare |
$5,721.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,961.60
|
| Rate for Payer: PHCS All Commercial |
$4,968.00
|
| Rate for Payer: PHP All Commercial |
$5,023.64
|
| Rate for Payer: Sagamore Health Network All Products |
$5,113.73
|
| Rate for Payer: Signature Care EPO |
$5,497.92
|
| Rate for Payer: Signature Care PPO |
$5,829.12
|
| Rate for Payer: United Healthcare Commercial |
$5,219.71
|
|
|
HC CMCH NEW SUPPLY
|
Facility
OP
|
$99.89
|
|
| Hospital Charge Code |
41607817
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.96 |
| Max. Negotiated Rate |
$121.68 |
| Rate for Payer: Aetna Commercial |
$84.31
|
| Rate for Payer: Aetna Medicare |
$32.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$32.96
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$57.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$62.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$37.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$36.26
|
| Rate for Payer: Cash Price |
$61.93
|
| Rate for Payer: Cash Price |
$61.93
|
| Rate for Payer: Centivo All Commercial |
$50.94
|
| Rate for Payer: Cigna All Commercial |
$86.21
|
| Rate for Payer: CORVEL All Commercial |
$92.90
|
| Rate for Payer: Coventry All Commercial |
$87.90
|
| Rate for Payer: Encore All Commercial |
$91.95
|
| Rate for Payer: Frontpath All Commercial |
$91.90
|
| Rate for Payer: Humana ChoiceCare |
$86.27
|
| Rate for Payer: Humana Medicare |
$50.94
|
| Rate for Payer: Lucent All Commercial |
$50.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$89.90
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$74.92
|
| Rate for Payer: PHP All Commercial |
$75.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$38.96
|
| Rate for Payer: Sagamore Health Network All Products |
$77.12
|
| Rate for Payer: Signature Care EPO |
$82.91
|
| Rate for Payer: Signature Care PPO |
$87.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$84.91
|
| Rate for Payer: United Healthcare Commercial |
$78.71
|
| Rate for Payer: United Healthcare Medicare |
$32.96
|
|
|
HC CMCH NEW SUPPLY
|
Facility
OP
|
$1,841.40
|
|
| Hospital Charge Code |
41607814
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,712.50 |
| Rate for Payer: Aetna Commercial |
$1,554.14
|
| Rate for Payer: Aetna Medicare |
$607.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$607.66
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,057.52
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,151.06
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$698.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$668.43
|
| Rate for Payer: Cash Price |
$1,141.67
|
| Rate for Payer: Cash Price |
$1,141.67
|
| Rate for Payer: Centivo All Commercial |
$939.11
|
| Rate for Payer: Cigna All Commercial |
$1,589.13
|
| Rate for Payer: CORVEL All Commercial |
$1,712.50
|
| Rate for Payer: Coventry All Commercial |
$1,620.43
|
| Rate for Payer: Encore All Commercial |
$1,695.01
|
| Rate for Payer: Frontpath All Commercial |
$1,694.09
|
| Rate for Payer: Humana ChoiceCare |
$1,590.42
|
| Rate for Payer: Humana Medicare |
$939.11
|
| Rate for Payer: Lucent All Commercial |
$939.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,657.26
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,381.05
|
| Rate for Payer: PHP All Commercial |
$1,396.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$718.15
|
| Rate for Payer: Sagamore Health Network All Products |
$1,421.56
|
| Rate for Payer: Signature Care EPO |
$1,528.36
|
| Rate for Payer: Signature Care PPO |
$1,620.43
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,565.19
|
| Rate for Payer: United Healthcare Commercial |
$1,451.02
|
| Rate for Payer: United Healthcare Medicare |
$607.66
|
|
|
HC CMCH NEW SUPPLY
|
Facility
OP
|
$1,375.00
|
|
| Hospital Charge Code |
41607816
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,278.75 |
| Rate for Payer: Aetna Commercial |
$1,160.50
|
| Rate for Payer: Aetna Medicare |
$453.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$453.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$789.66
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$859.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$521.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$499.12
|
| Rate for Payer: Cash Price |
$852.50
|
| Rate for Payer: Cash Price |
$852.50
|
| Rate for Payer: Centivo All Commercial |
$701.25
|
| Rate for Payer: Cigna All Commercial |
$1,186.62
|
| Rate for Payer: CORVEL All Commercial |
$1,278.75
|
| Rate for Payer: Coventry All Commercial |
$1,210.00
|
| Rate for Payer: Encore All Commercial |
$1,265.69
|
| Rate for Payer: Frontpath All Commercial |
$1,265.00
|
| Rate for Payer: Humana ChoiceCare |
$1,187.59
|
| Rate for Payer: Humana Medicare |
$701.25
|
| Rate for Payer: Lucent All Commercial |
$701.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,237.50
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,031.25
|
| Rate for Payer: PHP All Commercial |
$1,042.80
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$536.25
|
| Rate for Payer: Sagamore Health Network All Products |
$1,061.50
|
| Rate for Payer: Signature Care EPO |
$1,141.25
|
| Rate for Payer: Signature Care PPO |
$1,210.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,168.75
|
| Rate for Payer: United Healthcare Commercial |
$1,083.50
|
| Rate for Payer: United Healthcare Medicare |
$453.75
|
|
|
HC CMCH NEW SUPPLY
|
Facility
IP
|
$99.89
|
|
| Hospital Charge Code |
41607817
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.92 |
| Max. Negotiated Rate |
$92.90 |
| Rate for Payer: Aetna Commercial |
$86.30
|
| Rate for Payer: Cash Price |
$61.93
|
| Rate for Payer: Cigna All Commercial |
$86.21
|
| Rate for Payer: CORVEL All Commercial |
$92.90
|
| Rate for Payer: Coventry All Commercial |
$87.90
|
| Rate for Payer: Encore All Commercial |
$91.95
|
| Rate for Payer: Frontpath All Commercial |
$91.90
|
| Rate for Payer: Humana ChoiceCare |
$86.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$89.90
|
| Rate for Payer: PHCS All Commercial |
$74.92
|
| Rate for Payer: PHP All Commercial |
$75.76
|
| Rate for Payer: Sagamore Health Network All Products |
$77.12
|
| Rate for Payer: Signature Care EPO |
$82.91
|
| Rate for Payer: Signature Care PPO |
$87.90
|
| Rate for Payer: United Healthcare Commercial |
$78.71
|
|
