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Service Code CPT C1713
Hospital Charge Code 41602892
Hospital Revenue Code 278
Min. Negotiated Rate $187.44
Max. Negotiated Rate $522.84
Rate for Payer: Signature Care PPO $499.84
Rate for Payer: Aetna Commercial $479.39
Rate for Payer: Aetna Medicare $187.44
Rate for Payer: Anthem Exchange $326.20
Rate for Payer: Anthem Medicare $187.44
Rate for Payer: Anthem PPO $326.20
Rate for Payer: Anthem Traditional $355.06
Rate for Payer: Caresource Just 4 Me $215.56
Rate for Payer: Caresource Medicare $206.18
Rate for Payer: Centivo/Paragon All Products $289.68
Rate for Payer: Cigna All Products $490.18
Rate for Payer: Coventry/First Health All Products $499.84
Rate for Payer: Encore All Products $522.84
Rate for Payer: Frontpath All Products $522.56
Rate for Payer: Humana ChoiceCare $490.58
Rate for Payer: Humana Medicare $289.68
Rate for Payer: Lucent/Coldwater Veneers $289.68
Rate for Payer: Lutheran Preferred All Products $511.20
Rate for Payer: PHCS/Multiplan All Products $426.00
Rate for Payer: PHP All Products $430.77
Rate for Payer: Plain Church Group Ministry All Products $221.52
Rate for Payer: Sagamore All Products $438.50
Rate for Payer: Self Pay/Cash Rate $352.16
Rate for Payer: Signature Care EPO $471.44
Rate for Payer: Three Rivers Preferred All Products $482.80
Rate for Payer: United Healthcare Commercial $447.58
Rate for Payer: United Healthcare Medicare $187.44
Service Code CPT C1713
Hospital Charge Code 41602847
Hospital Revenue Code 278
Min. Negotiated Rate $236.94
Max. Negotiated Rate $660.92
Rate for Payer: Aetna Commercial $605.99
Rate for Payer: Aetna Medicare $236.94
Rate for Payer: Anthem Exchange $412.35
Rate for Payer: Anthem Medicare $236.94
Rate for Payer: Anthem PPO $412.35
Rate for Payer: Anthem Traditional $448.82
Rate for Payer: Caresource Just 4 Me $272.48
Rate for Payer: Caresource Medicare $260.63
Rate for Payer: Centivo/Paragon All Products $366.18
Rate for Payer: Cigna All Products $619.63
Rate for Payer: Coventry/First Health All Products $631.84
Rate for Payer: Encore All Products $660.92
Rate for Payer: Frontpath All Products $660.56
Rate for Payer: Humana ChoiceCare $620.14
Rate for Payer: Humana Medicare $366.18
Rate for Payer: Lucent/Coldwater Veneers $366.18
Rate for Payer: Lutheran Preferred All Products $646.20
Rate for Payer: PHCS/Multiplan All Products $538.50
Rate for Payer: PHP All Products $544.53
Rate for Payer: Plain Church Group Ministry All Products $280.02
Rate for Payer: Sagamore All Products $554.30
Rate for Payer: Self Pay/Cash Rate $445.16
Rate for Payer: Signature Care EPO $595.94
Rate for Payer: Signature Care PPO $631.84
Rate for Payer: Three Rivers Preferred All Products $610.30
Rate for Payer: United Healthcare Commercial $565.78
Rate for Payer: United Healthcare Medicare $236.94
Service Code CPT C1713
Hospital Charge Code 41602847
Hospital Revenue Code 278
Min. Negotiated Rate $445.16
Max. Negotiated Rate $660.92
Rate for Payer: Aetna Commercial $620.35
Rate for Payer: Cigna All Products $619.63
Rate for Payer: Coventry/First Health All Products $631.84
Rate for Payer: Encore All Products $660.92
Rate for Payer: Frontpath All Products $660.56
Rate for Payer: Humana ChoiceCare $620.14
Rate for Payer: Lutheran Preferred All Products $646.20
Rate for Payer: PHCS/Multiplan All Products $538.50
Rate for Payer: PHP All Products $544.53
Rate for Payer: Sagamore All Products $554.30
Rate for Payer: Self Pay/Cash Rate $445.16
Rate for Payer: Signature Care EPO $595.94
Rate for Payer: Signature Care PPO $631.84
Rate for Payer: United Healthcare Commercial $565.78
Service Code CPT C1713
Hospital Charge Code 41602913
Hospital Revenue Code 278
Min. Negotiated Rate $187.44
Max. Negotiated Rate $522.84
Rate for Payer: Aetna Commercial $479.39
Rate for Payer: Aetna Medicare $187.44
Rate for Payer: Anthem Exchange $326.20
Rate for Payer: Anthem Medicare $187.44
Rate for Payer: Anthem PPO $326.20
Rate for Payer: Anthem Traditional $355.06
Rate for Payer: Caresource Just 4 Me $215.56
Rate for Payer: Caresource Medicare $206.18
Rate for Payer: Centivo/Paragon All Products $289.68
Rate for Payer: Cigna All Products $490.18
Rate for Payer: Coventry/First Health All Products $499.84
Rate for Payer: Encore All Products $522.84
Rate for Payer: Frontpath All Products $522.56
Rate for Payer: Humana ChoiceCare $490.58
Rate for Payer: Humana Medicare $289.68
Rate for Payer: Lucent/Coldwater Veneers $289.68
Rate for Payer: Lutheran Preferred All Products $511.20
Rate for Payer: PHCS/Multiplan All Products $426.00
Rate for Payer: PHP All Products $430.77
Rate for Payer: Plain Church Group Ministry All Products $221.52
Rate for Payer: Sagamore All Products $438.50
Rate for Payer: Self Pay/Cash Rate $352.16
Rate for Payer: Signature Care EPO $471.44
Rate for Payer: Signature Care PPO $499.84
Rate for Payer: Three Rivers Preferred All Products $482.80
Rate for Payer: United Healthcare Commercial $447.58
Rate for Payer: United Healthcare Medicare $187.44
Service Code CPT C1713
Hospital Charge Code 41602913
Hospital Revenue Code 278
Min. Negotiated Rate $352.16
Max. Negotiated Rate $522.84
Rate for Payer: Aetna Commercial $490.75
Rate for Payer: Cigna All Products $490.18
Rate for Payer: Coventry/First Health All Products $499.84
Rate for Payer: Encore All Products $522.84
Rate for Payer: Frontpath All Products $522.56
Rate for Payer: Humana ChoiceCare $490.58
Rate for Payer: Lutheran Preferred All Products $511.20
Rate for Payer: PHCS/Multiplan All Products $426.00
Rate for Payer: PHP All Products $430.77
Rate for Payer: Sagamore All Products $438.50
Rate for Payer: Self Pay/Cash Rate $352.16
Rate for Payer: Signature Care EPO $471.44
Rate for Payer: Signature Care PPO $499.84
Rate for Payer: United Healthcare Commercial $447.58
Service Code CPT C1713
Hospital Charge Code 41602924
Hospital Revenue Code 278
Min. Negotiated Rate $352.16
Max. Negotiated Rate $522.84
Rate for Payer: Aetna Commercial $490.75
Rate for Payer: Cigna All Products $490.18
Rate for Payer: Coventry/First Health All Products $499.84
Rate for Payer: Encore All Products $522.84
Rate for Payer: Frontpath All Products $522.56
Rate for Payer: Humana ChoiceCare $490.58
Rate for Payer: Lutheran Preferred All Products $511.20
Rate for Payer: PHCS/Multiplan All Products $426.00
Rate for Payer: PHP All Products $430.77
Rate for Payer: Sagamore All Products $438.50
Rate for Payer: Self Pay/Cash Rate $352.16
Rate for Payer: Signature Care EPO $471.44
Rate for Payer: Signature Care PPO $499.84
Rate for Payer: United Healthcare Commercial $447.58
Service Code CPT C1713
Hospital Charge Code 41602924
Hospital Revenue Code 278
Min. Negotiated Rate $187.44
Max. Negotiated Rate $522.84
Rate for Payer: Aetna Commercial $479.39
Rate for Payer: Aetna Medicare $187.44
Rate for Payer: Anthem Exchange $326.20
Rate for Payer: Anthem Medicare $187.44
Rate for Payer: Anthem PPO $326.20
Rate for Payer: Anthem Traditional $355.06
Rate for Payer: Caresource Just 4 Me $215.56
Rate for Payer: Caresource Medicare $206.18
Rate for Payer: Centivo/Paragon All Products $289.68
Rate for Payer: Cigna All Products $490.18
Rate for Payer: Coventry/First Health All Products $499.84
Rate for Payer: Encore All Products $522.84
Rate for Payer: Frontpath All Products $522.56
Rate for Payer: Humana ChoiceCare $490.58
Rate for Payer: Humana Medicare $289.68
Rate for Payer: Lucent/Coldwater Veneers $289.68
Rate for Payer: Lutheran Preferred All Products $511.20
Rate for Payer: PHCS/Multiplan All Products $426.00
Rate for Payer: PHP All Products $430.77
Rate for Payer: Plain Church Group Ministry All Products $221.52
Rate for Payer: Sagamore All Products $438.50
Rate for Payer: Self Pay/Cash Rate $352.16
Rate for Payer: Signature Care EPO $471.44
Rate for Payer: Signature Care PPO $499.84
Rate for Payer: Three Rivers Preferred All Products $482.80
Rate for Payer: United Healthcare Commercial $447.58
Rate for Payer: United Healthcare Medicare $187.44
Service Code CPT C1713
Hospital Charge Code 41602893
Hospital Revenue Code 278
Min. Negotiated Rate $187.44
Max. Negotiated Rate $522.84
Rate for Payer: Aetna Commercial $479.39
Rate for Payer: Aetna Medicare $187.44
Rate for Payer: Anthem Exchange $326.20
Rate for Payer: Anthem Medicare $187.44
Rate for Payer: Anthem PPO $326.20
Rate for Payer: Anthem Traditional $355.06
Rate for Payer: Caresource Just 4 Me $215.56
Rate for Payer: Caresource Medicare $206.18
Rate for Payer: Centivo/Paragon All Products $289.68
Rate for Payer: Cigna All Products $490.18
Rate for Payer: Coventry/First Health All Products $499.84
Rate for Payer: Encore All Products $522.84
Rate for Payer: Frontpath All Products $522.56
Rate for Payer: Humana ChoiceCare $490.58
Rate for Payer: Humana Medicare $289.68
Rate for Payer: Lucent/Coldwater Veneers $289.68
Rate for Payer: Lutheran Preferred All Products $511.20
Rate for Payer: PHCS/Multiplan All Products $426.00
Rate for Payer: PHP All Products $430.77
Rate for Payer: Plain Church Group Ministry All Products $221.52
Rate for Payer: Sagamore All Products $438.50
Rate for Payer: Self Pay/Cash Rate $352.16
Rate for Payer: Signature Care EPO $471.44
Rate for Payer: Signature Care PPO $499.84
Rate for Payer: Three Rivers Preferred All Products $482.80
Rate for Payer: United Healthcare Commercial $447.58
Rate for Payer: United Healthcare Medicare $187.44
Service Code CPT C1713
Hospital Charge Code 41602893
Hospital Revenue Code 278
Min. Negotiated Rate $352.16
Max. Negotiated Rate $522.84
Rate for Payer: Aetna Commercial $490.75
Rate for Payer: Cigna All Products $490.18
Rate for Payer: Coventry/First Health All Products $499.84
Rate for Payer: Encore All Products $522.84
Rate for Payer: Frontpath All Products $522.56
Rate for Payer: Humana ChoiceCare $490.58
Rate for Payer: Lutheran Preferred All Products $511.20
Rate for Payer: PHCS/Multiplan All Products $426.00
Rate for Payer: PHP All Products $430.77
Rate for Payer: Sagamore All Products $438.50
Rate for Payer: Self Pay/Cash Rate $352.16
Rate for Payer: Signature Care EPO $471.44
Rate for Payer: Signature Care PPO $499.84
Rate for Payer: United Healthcare Commercial $447.58
Service Code CPT C1713
Hospital Charge Code 41602925
Hospital Revenue Code 278
Min. Negotiated Rate $187.44
Max. Negotiated Rate $522.84
Rate for Payer: Aetna Commercial $479.39
Rate for Payer: Aetna Medicare $187.44
Rate for Payer: Anthem Exchange $326.20
Rate for Payer: Anthem Medicare $187.44
Rate for Payer: Anthem PPO $326.20
Rate for Payer: Anthem Traditional $355.06
Rate for Payer: Caresource Just 4 Me $215.56
Rate for Payer: Caresource Medicare $206.18
Rate for Payer: Centivo/Paragon All Products $289.68
Rate for Payer: Cigna All Products $490.18
Rate for Payer: Coventry/First Health All Products $499.84
Rate for Payer: Encore All Products $522.84
Rate for Payer: Frontpath All Products $522.56
Rate for Payer: Humana ChoiceCare $490.58
Rate for Payer: Humana Medicare $289.68
Rate for Payer: Lucent/Coldwater Veneers $289.68
Rate for Payer: Lutheran Preferred All Products $511.20
Rate for Payer: PHCS/Multiplan All Products $426.00
Rate for Payer: PHP All Products $430.77
Rate for Payer: Plain Church Group Ministry All Products $221.52
Rate for Payer: Sagamore All Products $438.50
Rate for Payer: Self Pay/Cash Rate $352.16
Rate for Payer: Signature Care EPO $471.44
Rate for Payer: Signature Care PPO $499.84
Rate for Payer: Three Rivers Preferred All Products $482.80
Rate for Payer: United Healthcare Commercial $447.58
Rate for Payer: United Healthcare Medicare $187.44
Service Code CPT C1713
Hospital Charge Code 41602925
Hospital Revenue Code 278
Min. Negotiated Rate $352.16
Max. Negotiated Rate $522.84
Rate for Payer: Aetna Commercial $490.75
Rate for Payer: Cigna All Products $490.18
Rate for Payer: Coventry/First Health All Products $499.84
Rate for Payer: Encore All Products $522.84
Rate for Payer: Frontpath All Products $522.56
Rate for Payer: Humana ChoiceCare $490.58
Rate for Payer: Lutheran Preferred All Products $511.20
Rate for Payer: PHCS/Multiplan All Products $426.00
Rate for Payer: PHP All Products $430.77
Rate for Payer: Sagamore All Products $438.50
Rate for Payer: Self Pay/Cash Rate $352.16
Rate for Payer: Signature Care EPO $471.44
Rate for Payer: Signature Care PPO $499.84
Rate for Payer: United Healthcare Commercial $447.58
Service Code CPT C1713
Hospital Charge Code 41602894
Hospital Revenue Code 278
Min. Negotiated Rate $352.16
Max. Negotiated Rate $522.84
Rate for Payer: Aetna Commercial $490.75
Rate for Payer: Cigna All Products $490.18
Rate for Payer: Coventry/First Health All Products $499.84
Rate for Payer: Encore All Products $522.84
Rate for Payer: Frontpath All Products $522.56
Rate for Payer: Humana ChoiceCare $490.58
Rate for Payer: Lutheran Preferred All Products $511.20
Rate for Payer: PHCS/Multiplan All Products $426.00
Rate for Payer: PHP All Products $430.77
Rate for Payer: Sagamore All Products $438.50
Rate for Payer: Self Pay/Cash Rate $352.16
Rate for Payer: Signature Care EPO $471.44
Rate for Payer: Signature Care PPO $499.84
Rate for Payer: United Healthcare Commercial $447.58
Service Code CPT C1713
Hospital Charge Code 41602894
Hospital Revenue Code 278
Min. Negotiated Rate $187.44
Max. Negotiated Rate $522.84
Rate for Payer: Aetna Commercial $479.39
Rate for Payer: Aetna Medicare $187.44
Rate for Payer: Anthem Exchange $326.20
Rate for Payer: Anthem Medicare $187.44
Rate for Payer: Anthem PPO $326.20
Rate for Payer: Anthem Traditional $355.06
Rate for Payer: Caresource Just 4 Me $215.56
Rate for Payer: Caresource Medicare $206.18
Rate for Payer: Centivo/Paragon All Products $289.68
Rate for Payer: Cigna All Products $490.18
Rate for Payer: Coventry/First Health All Products $499.84
Rate for Payer: Encore All Products $522.84
Rate for Payer: Frontpath All Products $522.56
Rate for Payer: Humana ChoiceCare $490.58
Rate for Payer: Humana Medicare $289.68
Rate for Payer: Lucent/Coldwater Veneers $289.68
Rate for Payer: Lutheran Preferred All Products $511.20
Rate for Payer: PHCS/Multiplan All Products $426.00
Rate for Payer: PHP All Products $430.77
Rate for Payer: Plain Church Group Ministry All Products $221.52
Rate for Payer: Sagamore All Products $438.50
Rate for Payer: Self Pay/Cash Rate $352.16
Rate for Payer: Signature Care EPO $471.44
Rate for Payer: Signature Care PPO $499.84
Rate for Payer: Three Rivers Preferred All Products $482.80
Rate for Payer: United Healthcare Commercial $447.58
Rate for Payer: United Healthcare Medicare $187.44
Service Code CPT C1713
Hospital Charge Code 41602926
Hospital Revenue Code 278
Min. Negotiated Rate $187.44
Max. Negotiated Rate $522.84
Rate for Payer: Aetna Commercial $479.39
Rate for Payer: Aetna Medicare $187.44
Rate for Payer: Anthem Exchange $326.20
Rate for Payer: Anthem Medicare $187.44
Rate for Payer: Anthem PPO $326.20
Rate for Payer: Anthem Traditional $355.06
Rate for Payer: Caresource Just 4 Me $215.56
Rate for Payer: Caresource Medicare $206.18
Rate for Payer: Centivo/Paragon All Products $289.68
Rate for Payer: Cigna All Products $490.18
Rate for Payer: Coventry/First Health All Products $499.84
Rate for Payer: Encore All Products $522.84
Rate for Payer: Frontpath All Products $522.56
Rate for Payer: Humana ChoiceCare $490.58
Rate for Payer: Humana Medicare $289.68
Rate for Payer: Lucent/Coldwater Veneers $289.68
Rate for Payer: Lutheran Preferred All Products $511.20
Rate for Payer: PHCS/Multiplan All Products $426.00
Rate for Payer: PHP All Products $430.77
Rate for Payer: Plain Church Group Ministry All Products $221.52
Rate for Payer: Sagamore All Products $438.50
Rate for Payer: Self Pay/Cash Rate $352.16
Rate for Payer: Signature Care EPO $471.44
Rate for Payer: Signature Care PPO $499.84
Rate for Payer: Three Rivers Preferred All Products $482.80
Rate for Payer: United Healthcare Commercial $447.58
Rate for Payer: United Healthcare Medicare $187.44
Service Code CPT C1713
Hospital Charge Code 41602926
Hospital Revenue Code 278
Min. Negotiated Rate $352.16
Max. Negotiated Rate $522.84
Rate for Payer: Aetna Commercial $490.75
Rate for Payer: Cigna All Products $490.18
Rate for Payer: Coventry/First Health All Products $499.84
Rate for Payer: Encore All Products $522.84
Rate for Payer: Frontpath All Products $522.56
Rate for Payer: Humana ChoiceCare $490.58
Rate for Payer: Lutheran Preferred All Products $511.20
Rate for Payer: PHCS/Multiplan All Products $426.00
Rate for Payer: PHP All Products $430.77
Rate for Payer: Sagamore All Products $438.50
Rate for Payer: Self Pay/Cash Rate $352.16
Rate for Payer: Signature Care EPO $471.44
Rate for Payer: Signature Care PPO $499.84
Rate for Payer: United Healthcare Commercial $447.58
Service Code CPT C1713
Hospital Charge Code 41602895
Hospital Revenue Code 278
Min. Negotiated Rate $187.44
Max. Negotiated Rate $522.84
Rate for Payer: Aetna Commercial $479.39
Rate for Payer: Aetna Medicare $187.44
Rate for Payer: Anthem Exchange $326.20
Rate for Payer: Anthem Medicare $187.44
Rate for Payer: Anthem PPO $326.20
Rate for Payer: Anthem Traditional $355.06
Rate for Payer: Caresource Just 4 Me $215.56
Rate for Payer: Caresource Medicare $206.18
Rate for Payer: Centivo/Paragon All Products $289.68
Rate for Payer: Cigna All Products $490.18
Rate for Payer: Coventry/First Health All Products $499.84
Rate for Payer: Encore All Products $522.84
Rate for Payer: Frontpath All Products $522.56
Rate for Payer: Humana ChoiceCare $490.58
Rate for Payer: Humana Medicare $289.68
Rate for Payer: Lucent/Coldwater Veneers $289.68
Rate for Payer: Lutheran Preferred All Products $511.20
Rate for Payer: PHCS/Multiplan All Products $426.00
Rate for Payer: PHP All Products $430.77
Rate for Payer: Plain Church Group Ministry All Products $221.52
Rate for Payer: Sagamore All Products $438.50
Rate for Payer: Self Pay/Cash Rate $352.16
Rate for Payer: Signature Care EPO $471.44
Rate for Payer: Signature Care PPO $499.84
Rate for Payer: Three Rivers Preferred All Products $482.80
Rate for Payer: United Healthcare Commercial $447.58
Rate for Payer: United Healthcare Medicare $187.44
Service Code CPT C1713
Hospital Charge Code 41602895
Hospital Revenue Code 278
Min. Negotiated Rate $352.16
Max. Negotiated Rate $522.84
Rate for Payer: Aetna Commercial $490.75
Rate for Payer: Cigna All Products $490.18
Rate for Payer: Coventry/First Health All Products $499.84
Rate for Payer: Encore All Products $522.84
Rate for Payer: Frontpath All Products $522.56
Rate for Payer: Humana ChoiceCare $490.58
Rate for Payer: Lutheran Preferred All Products $511.20
Rate for Payer: PHCS/Multiplan All Products $426.00
Rate for Payer: PHP All Products $430.77
Rate for Payer: Sagamore All Products $438.50
Rate for Payer: Self Pay/Cash Rate $352.16
Rate for Payer: Signature Care EPO $471.44
Rate for Payer: Signature Care PPO $499.84
Rate for Payer: United Healthcare Commercial $447.58
Service Code CPT C1713
Hospital Charge Code 41602927
Hospital Revenue Code 278
Min. Negotiated Rate $187.44
Max. Negotiated Rate $522.84
Rate for Payer: Aetna Commercial $479.39
Rate for Payer: Aetna Medicare $187.44
Rate for Payer: Anthem Exchange $326.20
Rate for Payer: Anthem Medicare $187.44
Rate for Payer: Anthem PPO $326.20
Rate for Payer: Anthem Traditional $355.06
Rate for Payer: Caresource Just 4 Me $215.56
Rate for Payer: Caresource Medicare $206.18
Rate for Payer: Centivo/Paragon All Products $289.68
Rate for Payer: Cigna All Products $490.18
Rate for Payer: Coventry/First Health All Products $499.84
Rate for Payer: Encore All Products $522.84
Rate for Payer: Frontpath All Products $522.56
Rate for Payer: Humana ChoiceCare $490.58
Rate for Payer: Humana Medicare $289.68
Rate for Payer: Lucent/Coldwater Veneers $289.68
Rate for Payer: Lutheran Preferred All Products $511.20
Rate for Payer: PHCS/Multiplan All Products $426.00
Rate for Payer: PHP All Products $430.77
Rate for Payer: Plain Church Group Ministry All Products $221.52
Rate for Payer: Sagamore All Products $438.50
Rate for Payer: Self Pay/Cash Rate $352.16
Rate for Payer: Signature Care EPO $471.44
Rate for Payer: Signature Care PPO $499.84
Rate for Payer: Three Rivers Preferred All Products $482.80
Rate for Payer: United Healthcare Commercial $447.58
Rate for Payer: United Healthcare Medicare $187.44
Service Code CPT C1713
Hospital Charge Code 41602927
Hospital Revenue Code 278
Min. Negotiated Rate $352.16
Max. Negotiated Rate $522.84
Rate for Payer: Aetna Commercial $490.75
Rate for Payer: Cigna All Products $490.18
Rate for Payer: Coventry/First Health All Products $499.84
Rate for Payer: Encore All Products $522.84
Rate for Payer: Frontpath All Products $522.56
Rate for Payer: Humana ChoiceCare $490.58
Rate for Payer: Lutheran Preferred All Products $511.20
Rate for Payer: PHCS/Multiplan All Products $426.00
Rate for Payer: PHP All Products $430.77
Rate for Payer: Sagamore All Products $438.50
Rate for Payer: Self Pay/Cash Rate $352.16
Rate for Payer: Signature Care EPO $471.44
Rate for Payer: Signature Care PPO $499.84
Rate for Payer: United Healthcare Commercial $447.58
Service Code CPT C1713
Hospital Charge Code 41602896
Hospital Revenue Code 278
Min. Negotiated Rate $352.16
Max. Negotiated Rate $522.84
Rate for Payer: Aetna Commercial $490.75
Rate for Payer: Cigna All Products $490.18
Rate for Payer: Coventry/First Health All Products $499.84
Rate for Payer: Encore All Products $522.84
Rate for Payer: Frontpath All Products $522.56
Rate for Payer: Humana ChoiceCare $490.58
Rate for Payer: Lutheran Preferred All Products $511.20
Rate for Payer: PHCS/Multiplan All Products $426.00
Rate for Payer: PHP All Products $430.77
Rate for Payer: Sagamore All Products $438.50
Rate for Payer: Self Pay/Cash Rate $352.16
Rate for Payer: Signature Care EPO $471.44
Rate for Payer: Signature Care PPO $499.84
Rate for Payer: United Healthcare Commercial $447.58
Service Code CPT C1713
Hospital Charge Code 41602896
Hospital Revenue Code 278
Min. Negotiated Rate $187.44
Max. Negotiated Rate $522.84
Rate for Payer: Aetna Commercial $479.39
Rate for Payer: Aetna Medicare $187.44
Rate for Payer: Anthem Exchange $326.20
Rate for Payer: Anthem Medicare $187.44
Rate for Payer: Anthem PPO $326.20
Rate for Payer: Anthem Traditional $355.06
Rate for Payer: Caresource Just 4 Me $215.56
Rate for Payer: Caresource Medicare $206.18
Rate for Payer: Centivo/Paragon All Products $289.68
Rate for Payer: Cigna All Products $490.18
Rate for Payer: Coventry/First Health All Products $499.84
Rate for Payer: Encore All Products $522.84
Rate for Payer: Frontpath All Products $522.56
Rate for Payer: Humana ChoiceCare $490.58
Rate for Payer: Humana Medicare $289.68
Rate for Payer: Lucent/Coldwater Veneers $289.68
Rate for Payer: Lutheran Preferred All Products $511.20
Rate for Payer: PHCS/Multiplan All Products $426.00
Rate for Payer: PHP All Products $430.77
Rate for Payer: Plain Church Group Ministry All Products $221.52
Rate for Payer: Sagamore All Products $438.50
Rate for Payer: Self Pay/Cash Rate $352.16
Rate for Payer: Signature Care EPO $471.44
Rate for Payer: Signature Care PPO $499.84
Rate for Payer: Three Rivers Preferred All Products $482.80
Rate for Payer: United Healthcare Commercial $447.58
Rate for Payer: United Healthcare Medicare $187.44
Service Code CPT C1713
Hospital Charge Code 41602730
Hospital Revenue Code 278
Min. Negotiated Rate $352.16
Max. Negotiated Rate $522.84
Rate for Payer: Aetna Commercial $490.75
Rate for Payer: Cigna All Products $490.18
Rate for Payer: Coventry/First Health All Products $499.84
Rate for Payer: Encore All Products $522.84
Rate for Payer: Frontpath All Products $522.56
Rate for Payer: Humana ChoiceCare $490.58
Rate for Payer: Lutheran Preferred All Products $511.20
Rate for Payer: PHCS/Multiplan All Products $426.00
Rate for Payer: PHP All Products $430.77
Rate for Payer: Sagamore All Products $438.50
Rate for Payer: Self Pay/Cash Rate $352.16
Rate for Payer: Signature Care EPO $471.44
Rate for Payer: Signature Care PPO $499.84
Rate for Payer: United Healthcare Commercial $447.58
Service Code CPT C1713
Hospital Charge Code 41602730
Hospital Revenue Code 278
Min. Negotiated Rate $187.44
Max. Negotiated Rate $522.84
Rate for Payer: Aetna Commercial $479.39
Rate for Payer: Aetna Medicare $187.44
Rate for Payer: Anthem Exchange $326.20
Rate for Payer: Anthem Medicare $187.44
Rate for Payer: Anthem PPO $326.20
Rate for Payer: Anthem Traditional $355.06
Rate for Payer: Caresource Just 4 Me $215.56
Rate for Payer: Caresource Medicare $206.18
Rate for Payer: Centivo/Paragon All Products $289.68
Rate for Payer: Cigna All Products $490.18
Rate for Payer: Coventry/First Health All Products $499.84
Rate for Payer: Encore All Products $522.84
Rate for Payer: Frontpath All Products $522.56
Rate for Payer: Humana ChoiceCare $490.58
Rate for Payer: Humana Medicare $289.68
Rate for Payer: Lucent/Coldwater Veneers $289.68
Rate for Payer: Lutheran Preferred All Products $511.20
Rate for Payer: PHCS/Multiplan All Products $426.00
Rate for Payer: PHP All Products $430.77
Rate for Payer: Plain Church Group Ministry All Products $221.52
Rate for Payer: Sagamore All Products $438.50
Rate for Payer: Self Pay/Cash Rate $352.16
Rate for Payer: Signature Care EPO $471.44
Rate for Payer: Signature Care PPO $499.84
Rate for Payer: Three Rivers Preferred All Products $482.80
Rate for Payer: United Healthcare Commercial $447.58
Rate for Payer: United Healthcare Medicare $187.44
Service Code CPT C1713
Hospital Charge Code 41602928
Hospital Revenue Code 278
Min. Negotiated Rate $352.16
Max. Negotiated Rate $522.84
Rate for Payer: Aetna Commercial $490.75
Rate for Payer: Cigna All Products $490.18
Rate for Payer: Coventry/First Health All Products $499.84
Rate for Payer: Encore All Products $522.84
Rate for Payer: Frontpath All Products $522.56
Rate for Payer: Humana ChoiceCare $490.58
Rate for Payer: Lutheran Preferred All Products $511.20
Rate for Payer: PHCS/Multiplan All Products $426.00
Rate for Payer: PHP All Products $430.77
Rate for Payer: Sagamore All Products $438.50
Rate for Payer: Self Pay/Cash Rate $352.16
Rate for Payer: Signature Care EPO $471.44
Rate for Payer: Signature Care PPO $499.84
Rate for Payer: United Healthcare Commercial $447.58
Service Code CPT C1713
Hospital Charge Code 41602928
Hospital Revenue Code 278
Min. Negotiated Rate $187.44
Max. Negotiated Rate $522.84
Rate for Payer: Aetna Commercial $479.39
Rate for Payer: Aetna Medicare $187.44
Rate for Payer: Anthem Exchange $326.20
Rate for Payer: Anthem Medicare $187.44
Rate for Payer: Anthem PPO $326.20
Rate for Payer: Anthem Traditional $355.06
Rate for Payer: Caresource Just 4 Me $215.56
Rate for Payer: Caresource Medicare $206.18
Rate for Payer: Centivo/Paragon All Products $289.68
Rate for Payer: Cigna All Products $490.18
Rate for Payer: Coventry/First Health All Products $499.84
Rate for Payer: Encore All Products $522.84
Rate for Payer: Frontpath All Products $522.56
Rate for Payer: Humana ChoiceCare $490.58
Rate for Payer: Humana Medicare $289.68
Rate for Payer: Lucent/Coldwater Veneers $289.68
Rate for Payer: Lutheran Preferred All Products $511.20
Rate for Payer: PHCS/Multiplan All Products $426.00
Rate for Payer: PHP All Products $430.77
Rate for Payer: Plain Church Group Ministry All Products $221.52
Rate for Payer: Sagamore All Products $438.50
Rate for Payer: Self Pay/Cash Rate $352.16
Rate for Payer: Signature Care EPO $471.44
Rate for Payer: Signature Care PPO $499.84
Rate for Payer: Three Rivers Preferred All Products $482.80
Rate for Payer: United Healthcare Commercial $447.58
Rate for Payer: United Healthcare Medicare $187.44