|
HC ALLERGEN WHITE PINE TREE
|
Facility
|
OP
|
$102.46
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
63001852
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.22 |
| Max. Negotiated Rate |
$95.29 |
| Rate for Payer: Aetna Commercial |
$86.48
|
| Rate for Payer: Aetna Medicare |
$32.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$5.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$31.76
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$47.09
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$47.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$5.22
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$37.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$36.07
|
| Rate for Payer: Cash Price |
$61.48
|
| Rate for Payer: Cash Price |
$61.48
|
| Rate for Payer: Centivo All Commercial |
$55.74
|
| Rate for Payer: Cigna All Commercial |
$88.42
|
| Rate for Payer: CORVEL All Commercial |
$95.29
|
| Rate for Payer: Coventry All Commercial |
$90.16
|
| Rate for Payer: Encore All Commercial |
$94.31
|
| Rate for Payer: Frontpath All Commercial |
$94.26
|
| Rate for Payer: Humana ChoiceCare |
$88.49
|
| Rate for Payer: Humana Medicare |
$32.79
|
| Rate for Payer: Lucent All Commercial |
$55.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$92.21
|
| Rate for Payer: Managed Health Services Medicaid |
$5.22
|
| Rate for Payer: MDWise Medicaid |
$5.22
|
| Rate for Payer: PHCS All Commercial |
$76.84
|
| Rate for Payer: PHP All Commercial |
$77.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$39.96
|
| Rate for Payer: Sagamore Health Network All Products |
$79.10
|
| Rate for Payer: Signature Care EPO |
$85.04
|
| Rate for Payer: Signature Care PPO |
$90.16
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$87.09
|
| Rate for Payer: United Healthcare Commercial |
$80.74
|
| Rate for Payer: United Healthcare Medicare |
$32.79
|
|
|
HC ALLERGEN WILLOW IGE
|
Facility
|
IP
|
$102.46
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
63001853
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$76.84 |
| Max. Negotiated Rate |
$95.29 |
| Rate for Payer: Aetna Commercial |
$88.53
|
| Rate for Payer: Cash Price |
$61.48
|
| Rate for Payer: Cigna All Commercial |
$88.42
|
| Rate for Payer: CORVEL All Commercial |
$95.29
|
| Rate for Payer: Coventry All Commercial |
$90.16
|
| Rate for Payer: Encore All Commercial |
$94.31
|
| Rate for Payer: Frontpath All Commercial |
$94.26
|
| Rate for Payer: Humana ChoiceCare |
$88.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$92.21
|
| Rate for Payer: PHCS All Commercial |
$76.84
|
| Rate for Payer: PHP All Commercial |
$77.71
|
| Rate for Payer: Sagamore Health Network All Products |
$79.10
|
| Rate for Payer: Signature Care EPO |
$85.04
|
| Rate for Payer: Signature Care PPO |
$90.16
|
| Rate for Payer: United Healthcare Commercial |
$80.74
|
|
|
HC ALLERGEN WILLOW IGE
|
Facility
|
OP
|
$102.46
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
63001853
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.22 |
| Max. Negotiated Rate |
$95.29 |
| Rate for Payer: Aetna Commercial |
$86.48
|
| Rate for Payer: Aetna Medicare |
$32.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$5.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$31.76
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$47.09
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$47.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$5.22
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$37.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$36.07
|
| Rate for Payer: Cash Price |
$61.48
|
| Rate for Payer: Cash Price |
$61.48
|
| Rate for Payer: Centivo All Commercial |
$55.74
|
| Rate for Payer: Cigna All Commercial |
$88.42
|
| Rate for Payer: CORVEL All Commercial |
$95.29
|
| Rate for Payer: Coventry All Commercial |
$90.16
|
| Rate for Payer: Encore All Commercial |
$94.31
|
| Rate for Payer: Frontpath All Commercial |
$94.26
|
| Rate for Payer: Humana ChoiceCare |
$88.49
|
| Rate for Payer: Humana Medicare |
$32.79
|
| Rate for Payer: Lucent All Commercial |
$55.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$92.21
|
| Rate for Payer: Managed Health Services Medicaid |
$5.22
|
| Rate for Payer: MDWise Medicaid |
$5.22
|
| Rate for Payer: PHCS All Commercial |
$76.84
|
| Rate for Payer: PHP All Commercial |
$77.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$39.96
|
| Rate for Payer: Sagamore Health Network All Products |
$79.10
|
| Rate for Payer: Signature Care EPO |
$85.04
|
| Rate for Payer: Signature Care PPO |
$90.16
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$87.09
|
| Rate for Payer: United Healthcare Commercial |
$80.74
|
| Rate for Payer: United Healthcare Medicare |
$32.79
|
|
|
HC ALLOSYNC GEL 10CC
|
Facility
|
OP
|
$4,752.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606215
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$4,419.36 |
| Rate for Payer: Aetna Commercial |
$4,010.69
|
| Rate for Payer: Aetna Medicare |
$1,520.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,473.12
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$2,729.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,970.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,748.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,672.70
|
| Rate for Payer: Cash Price |
$2,851.20
|
| Rate for Payer: Cash Price |
$2,851.20
|
| Rate for Payer: Centivo All Commercial |
$2,585.09
|
| Rate for Payer: Cigna All Commercial |
$4,100.98
|
| Rate for Payer: CORVEL All Commercial |
$4,419.36
|
| Rate for Payer: Coventry All Commercial |
$4,181.76
|
| Rate for Payer: Encore All Commercial |
$4,374.22
|
| Rate for Payer: Frontpath All Commercial |
$4,371.84
|
| Rate for Payer: Humana ChoiceCare |
$4,104.30
|
| Rate for Payer: Humana Medicare |
$1,520.64
|
| Rate for Payer: Lucent All Commercial |
$2,585.09
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,276.80
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$3,564.00
|
| Rate for Payer: PHP All Commercial |
$3,603.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,853.28
|
| Rate for Payer: Sagamore Health Network All Products |
$3,668.54
|
| Rate for Payer: Signature Care EPO |
$3,944.16
|
| Rate for Payer: Signature Care PPO |
$4,181.76
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,039.20
|
| Rate for Payer: United Healthcare Commercial |
$3,744.58
|
| Rate for Payer: United Healthcare Medicare |
$1,520.64
|
|
|
HC ALLOSYNC GEL 10CC
|
Facility
|
IP
|
$4,752.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606215
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,564.00 |
| Max. Negotiated Rate |
$4,419.36 |
| Rate for Payer: Aetna Commercial |
$4,105.73
|
| Rate for Payer: Cash Price |
$2,851.20
|
| Rate for Payer: Cigna All Commercial |
$4,100.98
|
| Rate for Payer: CORVEL All Commercial |
$4,419.36
|
| Rate for Payer: Coventry All Commercial |
$4,181.76
|
| Rate for Payer: Encore All Commercial |
$4,374.22
|
| Rate for Payer: Frontpath All Commercial |
$4,371.84
|
| Rate for Payer: Humana ChoiceCare |
$4,104.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,276.80
|
| Rate for Payer: PHCS All Commercial |
$3,564.00
|
| Rate for Payer: PHP All Commercial |
$3,603.92
|
| Rate for Payer: Sagamore Health Network All Products |
$3,668.54
|
| Rate for Payer: Signature Care EPO |
$3,944.16
|
| Rate for Payer: Signature Care PPO |
$4,181.76
|
| Rate for Payer: United Healthcare Commercial |
$3,744.58
|
|
|
HC ALPHA-1-ANTITRYPSIN
|
Facility
|
IP
|
$178.17
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
63001452
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$133.63 |
| Max. Negotiated Rate |
$165.70 |
| Rate for Payer: Aetna Commercial |
$153.94
|
| Rate for Payer: Cash Price |
$106.90
|
| Rate for Payer: Cigna All Commercial |
$153.76
|
| Rate for Payer: CORVEL All Commercial |
$165.70
|
| Rate for Payer: Coventry All Commercial |
$156.79
|
| Rate for Payer: Encore All Commercial |
$164.01
|
| Rate for Payer: Frontpath All Commercial |
$163.92
|
| Rate for Payer: Humana ChoiceCare |
$153.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$160.35
|
| Rate for Payer: PHCS All Commercial |
$133.63
|
| Rate for Payer: PHP All Commercial |
$135.12
|
| Rate for Payer: Sagamore Health Network All Products |
$137.55
|
| Rate for Payer: Signature Care EPO |
$147.88
|
| Rate for Payer: Signature Care PPO |
$156.79
|
| Rate for Payer: United Healthcare Commercial |
$140.40
|
|
|
HC ALPHA-1-ANTITRYPSIN
|
Facility
|
OP
|
$178.17
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
63001452
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.44 |
| Max. Negotiated Rate |
$165.70 |
| Rate for Payer: Aetna Commercial |
$150.38
|
| Rate for Payer: Aetna Medicare |
$57.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$13.44
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$55.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$81.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$81.89
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$13.44
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$65.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$62.72
|
| Rate for Payer: Cash Price |
$106.90
|
| Rate for Payer: Cash Price |
$106.90
|
| Rate for Payer: Centivo All Commercial |
$96.92
|
| Rate for Payer: Cigna All Commercial |
$153.76
|
| Rate for Payer: CORVEL All Commercial |
$165.70
|
| Rate for Payer: Coventry All Commercial |
$156.79
|
| Rate for Payer: Encore All Commercial |
$164.01
|
| Rate for Payer: Frontpath All Commercial |
$163.92
|
| Rate for Payer: Humana ChoiceCare |
$153.89
|
| Rate for Payer: Humana Medicare |
$57.01
|
| Rate for Payer: Lucent All Commercial |
$96.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$160.35
|
| Rate for Payer: Managed Health Services Medicaid |
$13.44
|
| Rate for Payer: MDWise Medicaid |
$13.44
|
| Rate for Payer: PHCS All Commercial |
$133.63
|
| Rate for Payer: PHP All Commercial |
$135.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$69.49
|
| Rate for Payer: Sagamore Health Network All Products |
$137.55
|
| Rate for Payer: Signature Care EPO |
$147.88
|
| Rate for Payer: Signature Care PPO |
$156.79
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$151.44
|
| Rate for Payer: United Healthcare Commercial |
$140.40
|
| Rate for Payer: United Healthcare Medicare |
$57.01
|
|
|
HC ALPHA-1-ANTITRYPSIN W/PHENOTYPE
|
Facility
|
IP
|
$178.17
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
63001454
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$133.63 |
| Max. Negotiated Rate |
$165.70 |
| Rate for Payer: Aetna Commercial |
$153.94
|
| Rate for Payer: Cash Price |
$106.90
|
| Rate for Payer: Cigna All Commercial |
$153.76
|
| Rate for Payer: CORVEL All Commercial |
$165.70
|
| Rate for Payer: Coventry All Commercial |
$156.79
|
| Rate for Payer: Encore All Commercial |
$164.01
|
| Rate for Payer: Frontpath All Commercial |
$163.92
|
| Rate for Payer: Humana ChoiceCare |
$153.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$160.35
|
| Rate for Payer: PHCS All Commercial |
$133.63
|
| Rate for Payer: PHP All Commercial |
$135.12
|
| Rate for Payer: Sagamore Health Network All Products |
$137.55
|
| Rate for Payer: Signature Care EPO |
$147.88
|
| Rate for Payer: Signature Care PPO |
$156.79
|
| Rate for Payer: United Healthcare Commercial |
$140.40
|
|
|
HC ALPHA-1-ANTITRYPSIN W/PHENOTYPE
|
Facility
|
OP
|
$178.17
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
63001454
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.44 |
| Max. Negotiated Rate |
$165.70 |
| Rate for Payer: Aetna Commercial |
$150.38
|
| Rate for Payer: Aetna Medicare |
$57.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$13.44
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$55.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$81.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$81.89
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$13.44
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$65.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$62.72
|
| Rate for Payer: Cash Price |
$106.90
|
| Rate for Payer: Cash Price |
$106.90
|
| Rate for Payer: Centivo All Commercial |
$96.92
|
| Rate for Payer: Cigna All Commercial |
$153.76
|
| Rate for Payer: CORVEL All Commercial |
$165.70
|
| Rate for Payer: Coventry All Commercial |
$156.79
|
| Rate for Payer: Encore All Commercial |
$164.01
|
| Rate for Payer: Frontpath All Commercial |
$163.92
|
| Rate for Payer: Humana ChoiceCare |
$153.89
|
| Rate for Payer: Humana Medicare |
$57.01
|
| Rate for Payer: Lucent All Commercial |
$96.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$160.35
|
| Rate for Payer: Managed Health Services Medicaid |
$13.44
|
| Rate for Payer: MDWise Medicaid |
$13.44
|
| Rate for Payer: PHCS All Commercial |
$133.63
|
| Rate for Payer: PHP All Commercial |
$135.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$69.49
|
| Rate for Payer: Sagamore Health Network All Products |
$137.55
|
| Rate for Payer: Signature Care EPO |
$147.88
|
| Rate for Payer: Signature Care PPO |
$156.79
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$151.44
|
| Rate for Payer: United Healthcare Commercial |
$140.40
|
| Rate for Payer: United Healthcare Medicare |
$57.01
|
|
|
HC AMIKACIN PEAK
|
Facility
|
OP
|
$184.17
|
|
|
Service Code
|
CPT 80150
|
| Hospital Charge Code |
63001106
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.08 |
| Max. Negotiated Rate |
$171.28 |
| Rate for Payer: Aetna Commercial |
$155.44
|
| Rate for Payer: Aetna Medicare |
$58.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$15.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$57.09
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$84.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$84.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$15.08
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$67.77
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$64.83
|
| Rate for Payer: Cash Price |
$110.50
|
| Rate for Payer: Cash Price |
$110.50
|
| Rate for Payer: Centivo All Commercial |
$100.19
|
| Rate for Payer: Cigna All Commercial |
$158.94
|
| Rate for Payer: CORVEL All Commercial |
$171.28
|
| Rate for Payer: Coventry All Commercial |
$162.07
|
| Rate for Payer: Encore All Commercial |
$169.53
|
| Rate for Payer: Frontpath All Commercial |
$169.44
|
| Rate for Payer: Humana ChoiceCare |
$159.07
|
| Rate for Payer: Humana Medicare |
$58.93
|
| Rate for Payer: Lucent All Commercial |
$100.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$165.75
|
| Rate for Payer: Managed Health Services Medicaid |
$15.08
|
| Rate for Payer: MDWise Medicaid |
$15.08
|
| Rate for Payer: PHCS All Commercial |
$138.13
|
| Rate for Payer: PHP All Commercial |
$139.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$71.83
|
| Rate for Payer: Sagamore Health Network All Products |
$142.18
|
| Rate for Payer: Signature Care EPO |
$152.86
|
| Rate for Payer: Signature Care PPO |
$162.07
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$156.54
|
| Rate for Payer: United Healthcare Commercial |
$145.13
|
| Rate for Payer: United Healthcare Medicare |
$58.93
|
|
|
HC AMIKACIN PEAK
|
Facility
|
IP
|
$184.17
|
|
|
Service Code
|
CPT 80150
|
| Hospital Charge Code |
63001106
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$138.13 |
| Max. Negotiated Rate |
$171.28 |
| Rate for Payer: Aetna Commercial |
$159.12
|
| Rate for Payer: Cash Price |
$110.50
|
| Rate for Payer: Cigna All Commercial |
$158.94
|
| Rate for Payer: CORVEL All Commercial |
$171.28
|
| Rate for Payer: Coventry All Commercial |
$162.07
|
| Rate for Payer: Encore All Commercial |
$169.53
|
| Rate for Payer: Frontpath All Commercial |
$169.44
|
| Rate for Payer: Humana ChoiceCare |
$159.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$165.75
|
| Rate for Payer: PHCS All Commercial |
$138.13
|
| Rate for Payer: PHP All Commercial |
$139.67
|
| Rate for Payer: Sagamore Health Network All Products |
$142.18
|
| Rate for Payer: Signature Care EPO |
$152.86
|
| Rate for Payer: Signature Care PPO |
$162.07
|
| Rate for Payer: United Healthcare Commercial |
$145.13
|
|
|
HC AMIKACIN TROUGH
|
Facility
|
IP
|
$184.17
|
|
|
Service Code
|
CPT 80150
|
| Hospital Charge Code |
63001107
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$138.13 |
| Max. Negotiated Rate |
$171.28 |
| Rate for Payer: Aetna Commercial |
$159.12
|
| Rate for Payer: Cash Price |
$110.50
|
| Rate for Payer: Cigna All Commercial |
$158.94
|
| Rate for Payer: CORVEL All Commercial |
$171.28
|
| Rate for Payer: Coventry All Commercial |
$162.07
|
| Rate for Payer: Encore All Commercial |
$169.53
|
| Rate for Payer: Frontpath All Commercial |
$169.44
|
| Rate for Payer: Humana ChoiceCare |
$159.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$165.75
|
| Rate for Payer: PHCS All Commercial |
$138.13
|
| Rate for Payer: PHP All Commercial |
$139.67
|
| Rate for Payer: Sagamore Health Network All Products |
$142.18
|
| Rate for Payer: Signature Care EPO |
$152.86
|
| Rate for Payer: Signature Care PPO |
$162.07
|
| Rate for Payer: United Healthcare Commercial |
$145.13
|
|
|
HC AMIKACIN TROUGH
|
Facility
|
OP
|
$184.17
|
|
|
Service Code
|
CPT 80150
|
| Hospital Charge Code |
63001107
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.08 |
| Max. Negotiated Rate |
$171.28 |
| Rate for Payer: Aetna Commercial |
$155.44
|
| Rate for Payer: Aetna Medicare |
$58.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$15.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$57.09
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$84.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$84.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$15.08
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$67.77
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$64.83
|
| Rate for Payer: Cash Price |
$110.50
|
| Rate for Payer: Cash Price |
$110.50
|
| Rate for Payer: Centivo All Commercial |
$100.19
|
| Rate for Payer: Cigna All Commercial |
$158.94
|
| Rate for Payer: CORVEL All Commercial |
$171.28
|
| Rate for Payer: Coventry All Commercial |
$162.07
|
| Rate for Payer: Encore All Commercial |
$169.53
|
| Rate for Payer: Frontpath All Commercial |
$169.44
|
| Rate for Payer: Humana ChoiceCare |
$159.07
|
| Rate for Payer: Humana Medicare |
$58.93
|
| Rate for Payer: Lucent All Commercial |
$100.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$165.75
|
| Rate for Payer: Managed Health Services Medicaid |
$15.08
|
| Rate for Payer: MDWise Medicaid |
$15.08
|
| Rate for Payer: PHCS All Commercial |
$138.13
|
| Rate for Payer: PHP All Commercial |
$139.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$71.83
|
| Rate for Payer: Sagamore Health Network All Products |
$142.18
|
| Rate for Payer: Signature Care EPO |
$152.86
|
| Rate for Payer: Signature Care PPO |
$162.07
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$156.54
|
| Rate for Payer: United Healthcare Commercial |
$145.13
|
| Rate for Payer: United Healthcare Medicare |
$58.93
|
|
|
HC AMMONIA
|
Facility
|
OP
|
$230.01
|
|
|
Service Code
|
CPT 82140
|
| Hospital Charge Code |
63001149
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.57 |
| Max. Negotiated Rate |
$213.91 |
| Rate for Payer: Aetna Commercial |
$194.13
|
| Rate for Payer: Aetna Medicare |
$73.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$14.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$71.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$105.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$105.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$14.57
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$84.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$80.96
|
| Rate for Payer: Cash Price |
$138.01
|
| Rate for Payer: Cash Price |
$138.01
|
| Rate for Payer: Centivo All Commercial |
$125.13
|
| Rate for Payer: Cigna All Commercial |
$198.50
|
| Rate for Payer: CORVEL All Commercial |
$213.91
|
| Rate for Payer: Coventry All Commercial |
$202.41
|
| Rate for Payer: Encore All Commercial |
$211.72
|
| Rate for Payer: Frontpath All Commercial |
$211.61
|
| Rate for Payer: Humana ChoiceCare |
$198.66
|
| Rate for Payer: Humana Medicare |
$73.60
|
| Rate for Payer: Lucent All Commercial |
$125.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$207.01
|
| Rate for Payer: Managed Health Services Medicaid |
$14.57
|
| Rate for Payer: MDWise Medicaid |
$14.57
|
| Rate for Payer: PHCS All Commercial |
$172.51
|
| Rate for Payer: PHP All Commercial |
$174.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$89.70
|
| Rate for Payer: Sagamore Health Network All Products |
$177.57
|
| Rate for Payer: Signature Care EPO |
$190.91
|
| Rate for Payer: Signature Care PPO |
$202.41
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$195.51
|
| Rate for Payer: United Healthcare Commercial |
$181.25
|
| Rate for Payer: United Healthcare Medicare |
$73.60
|
|
|
HC AMMONIA
|
Facility
|
IP
|
$230.01
|
|
|
Service Code
|
CPT 82140
|
| Hospital Charge Code |
63001149
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$172.51 |
| Max. Negotiated Rate |
$213.91 |
| Rate for Payer: Aetna Commercial |
$198.73
|
| Rate for Payer: Cash Price |
$138.01
|
| Rate for Payer: Cigna All Commercial |
$198.50
|
| Rate for Payer: CORVEL All Commercial |
$213.91
|
| Rate for Payer: Coventry All Commercial |
$202.41
|
| Rate for Payer: Encore All Commercial |
$211.72
|
| Rate for Payer: Frontpath All Commercial |
$211.61
|
| Rate for Payer: Humana ChoiceCare |
$198.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$207.01
|
| Rate for Payer: PHCS All Commercial |
$172.51
|
| Rate for Payer: PHP All Commercial |
$174.44
|
| Rate for Payer: Sagamore Health Network All Products |
$177.57
|
| Rate for Payer: Signature Care EPO |
$190.91
|
| Rate for Payer: Signature Care PPO |
$202.41
|
| Rate for Payer: United Healthcare Commercial |
$181.25
|
|
|
HC AMPHETAMINE/METHAMPHETAMINE QT-URINE
|
Facility
|
IP
|
$156.37
|
|
|
Service Code
|
CPT 80326
|
| Hospital Charge Code |
63001407
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$117.28 |
| Max. Negotiated Rate |
$145.42 |
| Rate for Payer: Aetna Commercial |
$135.10
|
| Rate for Payer: Cash Price |
$93.82
|
| Rate for Payer: Cigna All Commercial |
$134.95
|
| Rate for Payer: CORVEL All Commercial |
$145.42
|
| Rate for Payer: Coventry All Commercial |
$137.61
|
| Rate for Payer: Encore All Commercial |
$143.94
|
| Rate for Payer: Frontpath All Commercial |
$143.86
|
| Rate for Payer: Humana ChoiceCare |
$135.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$140.73
|
| Rate for Payer: PHCS All Commercial |
$117.28
|
| Rate for Payer: PHP All Commercial |
$118.59
|
| Rate for Payer: Sagamore Health Network All Products |
$120.72
|
| Rate for Payer: Signature Care EPO |
$129.79
|
| Rate for Payer: Signature Care PPO |
$137.61
|
| Rate for Payer: United Healthcare Commercial |
$123.22
|
|
|
HC AMPHETAMINE/METHAMPHETAMINE QT-URINE
|
Facility
|
OP
|
$156.37
|
|
|
Service Code
|
CPT G0480
|
| Hospital Charge Code |
63001407
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$48.47 |
| Max. Negotiated Rate |
$145.42 |
| Rate for Payer: Aetna Commercial |
$131.98
|
| Rate for Payer: Aetna Medicare |
$50.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$114.43
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$48.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$71.87
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$71.87
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$114.43
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$57.54
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$55.04
|
| Rate for Payer: Cash Price |
$93.82
|
| Rate for Payer: Cash Price |
$93.82
|
| Rate for Payer: Centivo All Commercial |
$85.07
|
| Rate for Payer: Cigna All Commercial |
$134.95
|
| Rate for Payer: CORVEL All Commercial |
$145.42
|
| Rate for Payer: Coventry All Commercial |
$137.61
|
| Rate for Payer: Encore All Commercial |
$143.94
|
| Rate for Payer: Frontpath All Commercial |
$143.86
|
| Rate for Payer: Humana ChoiceCare |
$135.06
|
| Rate for Payer: Humana Medicare |
$50.04
|
| Rate for Payer: Lucent All Commercial |
$85.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$140.73
|
| Rate for Payer: Managed Health Services Medicaid |
$114.43
|
| Rate for Payer: MDWise Medicaid |
$114.43
|
| Rate for Payer: PHCS All Commercial |
$117.28
|
| Rate for Payer: PHP All Commercial |
$118.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$60.98
|
| Rate for Payer: Sagamore Health Network All Products |
$120.72
|
| Rate for Payer: Signature Care EPO |
$129.79
|
| Rate for Payer: Signature Care PPO |
$137.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$132.91
|
| Rate for Payer: United Healthcare Commercial |
$123.22
|
| Rate for Payer: United Healthcare Medicare |
$50.04
|
|
|
HC AMPHETAMINE/METHAMPHETAMINE QT-URINE
|
Facility
|
IP
|
$156.37
|
|
|
Service Code
|
CPT G0480
|
| Hospital Charge Code |
63001407
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$117.28 |
| Max. Negotiated Rate |
$145.42 |
| Rate for Payer: Aetna Commercial |
$135.10
|
| Rate for Payer: Cash Price |
$93.82
|
| Rate for Payer: Cigna All Commercial |
$134.95
|
| Rate for Payer: CORVEL All Commercial |
$145.42
|
| Rate for Payer: Coventry All Commercial |
$137.61
|
| Rate for Payer: Encore All Commercial |
$143.94
|
| Rate for Payer: Frontpath All Commercial |
$143.86
|
| Rate for Payer: Humana ChoiceCare |
$135.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$140.73
|
| Rate for Payer: PHCS All Commercial |
$117.28
|
| Rate for Payer: PHP All Commercial |
$118.59
|
| Rate for Payer: Sagamore Health Network All Products |
$120.72
|
| Rate for Payer: Signature Care EPO |
$129.79
|
| Rate for Payer: Signature Care PPO |
$137.61
|
| Rate for Payer: United Healthcare Commercial |
$123.22
|
|
|
HC AMPHETAMINE/METHAMPHETAMINE QT-URINE
|
Facility
|
OP
|
$156.37
|
|
|
Service Code
|
CPT 80326
|
| Hospital Charge Code |
63001407
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$48.47 |
| Max. Negotiated Rate |
$145.42 |
| Rate for Payer: Aetna Commercial |
$131.98
|
| Rate for Payer: Aetna Medicare |
$50.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$48.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$71.87
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$71.87
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$57.54
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$55.04
|
| Rate for Payer: Cash Price |
$93.82
|
| Rate for Payer: Centivo All Commercial |
$85.07
|
| Rate for Payer: Cigna All Commercial |
$134.95
|
| Rate for Payer: CORVEL All Commercial |
$145.42
|
| Rate for Payer: Coventry All Commercial |
$137.61
|
| Rate for Payer: Encore All Commercial |
$143.94
|
| Rate for Payer: Frontpath All Commercial |
$143.86
|
| Rate for Payer: Humana ChoiceCare |
$135.06
|
| Rate for Payer: Humana Medicare |
$50.04
|
| Rate for Payer: Lucent All Commercial |
$85.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$140.73
|
| Rate for Payer: PHCS All Commercial |
$117.28
|
| Rate for Payer: PHP All Commercial |
$118.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$60.98
|
| Rate for Payer: Sagamore Health Network All Products |
$120.72
|
| Rate for Payer: Signature Care EPO |
$129.79
|
| Rate for Payer: Signature Care PPO |
$137.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$132.91
|
| Rate for Payer: United Healthcare Commercial |
$123.22
|
| Rate for Payer: United Healthcare Medicare |
$50.04
|
|
|
HC AMPLIFIED PROBE, EACH ORGANISM
|
Facility
|
OP
|
$66.66
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
63002052
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$20.66 |
| Max. Negotiated Rate |
$61.99 |
| Rate for Payer: Aetna Commercial |
$56.26
|
| Rate for Payer: Aetna Medicare |
$21.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$35.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$20.66
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$30.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$30.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$35.09
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$24.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$23.46
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Centivo All Commercial |
$36.26
|
| Rate for Payer: Cigna All Commercial |
$57.53
|
| Rate for Payer: CORVEL All Commercial |
$61.99
|
| Rate for Payer: Coventry All Commercial |
$58.66
|
| Rate for Payer: Encore All Commercial |
$61.36
|
| Rate for Payer: Frontpath All Commercial |
$61.33
|
| Rate for Payer: Humana ChoiceCare |
$57.57
|
| Rate for Payer: Humana Medicare |
$21.33
|
| Rate for Payer: Lucent All Commercial |
$36.26
|
| Rate for Payer: Lutheran Preferred All Commercial |
$59.99
|
| Rate for Payer: Managed Health Services Medicaid |
$35.09
|
| Rate for Payer: MDWise Medicaid |
$35.09
|
| Rate for Payer: PHCS All Commercial |
$49.99
|
| Rate for Payer: PHP All Commercial |
$50.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$26.00
|
| Rate for Payer: Sagamore Health Network All Products |
$51.46
|
| Rate for Payer: Signature Care EPO |
$55.33
|
| Rate for Payer: Signature Care PPO |
$58.66
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$56.66
|
| Rate for Payer: United Healthcare Commercial |
$52.53
|
| Rate for Payer: United Healthcare Medicare |
$21.33
|
|
|
HC AMPLIFIED PROBE, EACH ORGANISM
|
Facility
|
IP
|
$66.66
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
63002052
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$49.99 |
| Max. Negotiated Rate |
$61.99 |
| Rate for Payer: Aetna Commercial |
$57.59
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cigna All Commercial |
$57.53
|
| Rate for Payer: CORVEL All Commercial |
$61.99
|
| Rate for Payer: Coventry All Commercial |
$58.66
|
| Rate for Payer: Encore All Commercial |
$61.36
|
| Rate for Payer: Frontpath All Commercial |
$61.33
|
| Rate for Payer: Humana ChoiceCare |
$57.57
|
| Rate for Payer: Lutheran Preferred All Commercial |
$59.99
|
| Rate for Payer: PHCS All Commercial |
$49.99
|
| Rate for Payer: PHP All Commercial |
$50.55
|
| Rate for Payer: Sagamore Health Network All Products |
$51.46
|
| Rate for Payer: Signature Care EPO |
$55.33
|
| Rate for Payer: Signature Care PPO |
$58.66
|
| Rate for Payer: United Healthcare Commercial |
$52.53
|
|
|
HC AMYLASE SERUM
|
Facility
|
OP
|
$166.06
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
63001091
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.48 |
| Max. Negotiated Rate |
$154.44 |
| Rate for Payer: Aetna Commercial |
$140.15
|
| Rate for Payer: Aetna Medicare |
$53.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$6.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$51.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$76.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$76.32
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$6.48
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$61.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$58.45
|
| Rate for Payer: Cash Price |
$99.64
|
| Rate for Payer: Cash Price |
$99.64
|
| Rate for Payer: Centivo All Commercial |
$90.34
|
| Rate for Payer: Cigna All Commercial |
$143.31
|
| Rate for Payer: CORVEL All Commercial |
$154.44
|
| Rate for Payer: Coventry All Commercial |
$146.13
|
| Rate for Payer: Encore All Commercial |
$152.86
|
| Rate for Payer: Frontpath All Commercial |
$152.78
|
| Rate for Payer: Humana ChoiceCare |
$143.43
|
| Rate for Payer: Humana Medicare |
$53.14
|
| Rate for Payer: Lucent All Commercial |
$90.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$149.45
|
| Rate for Payer: Managed Health Services Medicaid |
$6.48
|
| Rate for Payer: MDWise Medicaid |
$6.48
|
| Rate for Payer: PHCS All Commercial |
$124.55
|
| Rate for Payer: PHP All Commercial |
$125.94
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$64.76
|
| Rate for Payer: Sagamore Health Network All Products |
$128.20
|
| Rate for Payer: Signature Care EPO |
$137.83
|
| Rate for Payer: Signature Care PPO |
$146.13
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$141.15
|
| Rate for Payer: United Healthcare Commercial |
$130.86
|
| Rate for Payer: United Healthcare Medicare |
$53.14
|
|
|
HC AMYLASE SERUM
|
Facility
|
IP
|
$166.06
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
63001091
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$124.55 |
| Max. Negotiated Rate |
$154.44 |
| Rate for Payer: Aetna Commercial |
$143.48
|
| Rate for Payer: Cash Price |
$99.64
|
| Rate for Payer: Cigna All Commercial |
$143.31
|
| Rate for Payer: CORVEL All Commercial |
$154.44
|
| Rate for Payer: Coventry All Commercial |
$146.13
|
| Rate for Payer: Encore All Commercial |
$152.86
|
| Rate for Payer: Frontpath All Commercial |
$152.78
|
| Rate for Payer: Humana ChoiceCare |
$143.43
|
| Rate for Payer: Lutheran Preferred All Commercial |
$149.45
|
| Rate for Payer: PHCS All Commercial |
$124.55
|
| Rate for Payer: PHP All Commercial |
$125.94
|
| Rate for Payer: Sagamore Health Network All Products |
$128.20
|
| Rate for Payer: Signature Care EPO |
$137.83
|
| Rate for Payer: Signature Care PPO |
$146.13
|
| Rate for Payer: United Healthcare Commercial |
$130.86
|
|
|
HC ANA - ANTINUCLEAR AB W/ TITER IF IND
|
Facility
|
OP
|
$104.35
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
63001857
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.09 |
| Max. Negotiated Rate |
$97.05 |
| Rate for Payer: Aetna Commercial |
$88.07
|
| Rate for Payer: Aetna Medicare |
$33.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$12.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$32.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$47.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$47.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$12.09
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$38.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$36.73
|
| Rate for Payer: Cash Price |
$62.61
|
| Rate for Payer: Cash Price |
$62.61
|
| Rate for Payer: Centivo All Commercial |
$56.77
|
| Rate for Payer: Cigna All Commercial |
$90.05
|
| Rate for Payer: CORVEL All Commercial |
$97.05
|
| Rate for Payer: Coventry All Commercial |
$91.83
|
| Rate for Payer: Encore All Commercial |
$96.05
|
| Rate for Payer: Frontpath All Commercial |
$96.00
|
| Rate for Payer: Humana ChoiceCare |
$90.13
|
| Rate for Payer: Humana Medicare |
$33.39
|
| Rate for Payer: Lucent All Commercial |
$56.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$93.92
|
| Rate for Payer: Managed Health Services Medicaid |
$12.09
|
| Rate for Payer: MDWise Medicaid |
$12.09
|
| Rate for Payer: PHCS All Commercial |
$78.26
|
| Rate for Payer: PHP All Commercial |
$79.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$40.70
|
| Rate for Payer: Sagamore Health Network All Products |
$80.56
|
| Rate for Payer: Signature Care EPO |
$86.61
|
| Rate for Payer: Signature Care PPO |
$91.83
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$88.70
|
| Rate for Payer: United Healthcare Commercial |
$82.23
|
| Rate for Payer: United Healthcare Medicare |
$33.39
|
|
|
HC ANA - ANTINUCLEAR AB W/ TITER IF IND
|
Facility
|
IP
|
$104.35
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
63001857
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$78.26 |
| Max. Negotiated Rate |
$97.05 |
| Rate for Payer: Aetna Commercial |
$90.16
|
| Rate for Payer: Cash Price |
$62.61
|
| Rate for Payer: Cigna All Commercial |
$90.05
|
| Rate for Payer: CORVEL All Commercial |
$97.05
|
| Rate for Payer: Coventry All Commercial |
$91.83
|
| Rate for Payer: Encore All Commercial |
$96.05
|
| Rate for Payer: Frontpath All Commercial |
$96.00
|
| Rate for Payer: Humana ChoiceCare |
$90.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$93.92
|
| Rate for Payer: PHCS All Commercial |
$78.26
|
| Rate for Payer: PHP All Commercial |
$79.14
|
| Rate for Payer: Sagamore Health Network All Products |
$80.56
|
| Rate for Payer: Signature Care EPO |
$86.61
|
| Rate for Payer: Signature Care PPO |
$91.83
|
| Rate for Payer: United Healthcare Commercial |
$82.23
|
|
