|
HC COPPER, URINE-B
|
Facility
IP
|
$34.30
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
63044037
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.73 |
| Max. Negotiated Rate |
$31.90 |
| Rate for Payer: Aetna Commercial |
$29.64
|
| Rate for Payer: Cash Price |
$21.27
|
| Rate for Payer: Cigna All Commercial |
$29.60
|
| Rate for Payer: CORVEL All Commercial |
$31.90
|
| Rate for Payer: Coventry All Commercial |
$30.19
|
| Rate for Payer: Encore All Commercial |
$31.58
|
| Rate for Payer: Frontpath All Commercial |
$31.56
|
| Rate for Payer: Humana ChoiceCare |
$29.63
|
| Rate for Payer: Lutheran Preferred All Commercial |
$30.87
|
| Rate for Payer: PHCS All Commercial |
$25.73
|
| Rate for Payer: PHP All Commercial |
$26.02
|
| Rate for Payer: Sagamore Health Network All Products |
$26.48
|
| Rate for Payer: Signature Care EPO |
$28.47
|
| Rate for Payer: Signature Care PPO |
$30.19
|
| Rate for Payer: United Healthcare Commercial |
$27.03
|
|
|
HC CORD DAC
|
Facility
OP
|
$133.99
|
|
| Hospital Charge Code |
41601908
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.22 |
| Max. Negotiated Rate |
$124.61 |
| Rate for Payer: Aetna Commercial |
$113.09
|
| Rate for Payer: Aetna Medicare |
$44.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$44.22
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$76.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$83.76
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$50.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$48.64
|
| Rate for Payer: Cash Price |
$83.07
|
| Rate for Payer: Cash Price |
$83.07
|
| Rate for Payer: Centivo All Commercial |
$68.33
|
| Rate for Payer: Cigna All Commercial |
$115.63
|
| Rate for Payer: CORVEL All Commercial |
$124.61
|
| Rate for Payer: Coventry All Commercial |
$117.91
|
| Rate for Payer: Encore All Commercial |
$123.34
|
| Rate for Payer: Frontpath All Commercial |
$123.27
|
| Rate for Payer: Humana ChoiceCare |
$115.73
|
| Rate for Payer: Humana Medicare |
$68.33
|
| Rate for Payer: Lucent All Commercial |
$68.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$120.59
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$100.49
|
| Rate for Payer: PHP All Commercial |
$101.62
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$52.26
|
| Rate for Payer: Sagamore Health Network All Products |
$103.44
|
| Rate for Payer: Signature Care EPO |
$111.21
|
| Rate for Payer: Signature Care PPO |
$117.91
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$113.89
|
| Rate for Payer: United Healthcare Commercial |
$105.58
|
| Rate for Payer: United Healthcare Medicare |
$44.22
|
|
|
HC CORD DAC
|
Facility
IP
|
$133.99
|
|
| Hospital Charge Code |
41601908
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$100.49 |
| Max. Negotiated Rate |
$124.61 |
| Rate for Payer: Aetna Commercial |
$115.77
|
| Rate for Payer: Cash Price |
$83.07
|
| Rate for Payer: Cigna All Commercial |
$115.63
|
| Rate for Payer: CORVEL All Commercial |
$124.61
|
| Rate for Payer: Coventry All Commercial |
$117.91
|
| Rate for Payer: Encore All Commercial |
$123.34
|
| Rate for Payer: Frontpath All Commercial |
$123.27
|
| Rate for Payer: Humana ChoiceCare |
$115.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$120.59
|
| Rate for Payer: PHCS All Commercial |
$100.49
|
| Rate for Payer: PHP All Commercial |
$101.62
|
| Rate for Payer: Sagamore Health Network All Products |
$103.44
|
| Rate for Payer: Signature Care EPO |
$111.21
|
| Rate for Payer: Signature Care PPO |
$117.91
|
| Rate for Payer: United Healthcare Commercial |
$105.58
|
|
|
HC CORTISOL-AM
|
Facility
OP
|
$235.62
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
63001309
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.30 |
| Max. Negotiated Rate |
$219.13 |
| Rate for Payer: Aetna Commercial |
$198.86
|
| Rate for Payer: Aetna Medicare |
$77.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$77.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$108.29
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$108.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$16.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$89.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$85.53
|
| Rate for Payer: Cash Price |
$146.08
|
| Rate for Payer: Cash Price |
$146.08
|
| Rate for Payer: Centivo All Commercial |
$120.17
|
| 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 |
$120.17
|
| Rate for Payer: Lucent All Commercial |
$120.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$212.06
|
| Rate for Payer: Managed Health Services Medicaid |
$16.30
|
| Rate for Payer: MDWise Medicaid |
$16.30
|
| 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 |
$77.75
|
|
|
HC CORTISOL-AM
|
Facility
IP
|
$235.62
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
63001309
|
|
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 |
$146.08
|
| 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 CORTISOL FREE URINE 24HR
|
Facility
OP
|
$233.38
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
63001499
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.71 |
| Max. Negotiated Rate |
$217.04 |
| Rate for Payer: Aetna Commercial |
$196.97
|
| Rate for Payer: Aetna Medicare |
$77.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$77.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$134.03
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$145.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$16.71
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$88.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$84.72
|
| Rate for Payer: Cash Price |
$144.69
|
| Rate for Payer: Cash Price |
$144.69
|
| Rate for Payer: Centivo All Commercial |
$119.02
|
| Rate for Payer: Cigna All Commercial |
$201.40
|
| Rate for Payer: CORVEL All Commercial |
$217.04
|
| Rate for Payer: Coventry All Commercial |
$205.37
|
| Rate for Payer: Encore All Commercial |
$214.82
|
| Rate for Payer: Frontpath All Commercial |
$214.71
|
| Rate for Payer: Humana ChoiceCare |
$201.57
|
| Rate for Payer: Humana Medicare |
$119.02
|
| Rate for Payer: Lucent All Commercial |
$119.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$210.04
|
| Rate for Payer: Managed Health Services Medicaid |
$16.71
|
| Rate for Payer: MDWise Medicaid |
$16.71
|
| Rate for Payer: PHCS All Commercial |
$175.03
|
| Rate for Payer: PHP All Commercial |
$176.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$91.02
|
| Rate for Payer: Sagamore Health Network All Products |
$180.17
|
| Rate for Payer: Signature Care EPO |
$193.70
|
| Rate for Payer: Signature Care PPO |
$205.37
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$198.37
|
| Rate for Payer: United Healthcare Commercial |
$183.90
|
| Rate for Payer: United Healthcare Medicare |
$77.01
|
|
|
HC CORTISOL FREE URINE 24HR
|
Facility
IP
|
$233.38
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
63001499
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$175.03 |
| Max. Negotiated Rate |
$217.04 |
| Rate for Payer: Aetna Commercial |
$201.64
|
| Rate for Payer: Cash Price |
$144.69
|
| Rate for Payer: Cigna All Commercial |
$201.40
|
| Rate for Payer: CORVEL All Commercial |
$217.04
|
| Rate for Payer: Coventry All Commercial |
$205.37
|
| Rate for Payer: Encore All Commercial |
$214.82
|
| Rate for Payer: Frontpath All Commercial |
$214.71
|
| Rate for Payer: Humana ChoiceCare |
$201.57
|
| Rate for Payer: Lutheran Preferred All Commercial |
$210.04
|
| Rate for Payer: PHCS All Commercial |
$175.03
|
| Rate for Payer: PHP All Commercial |
$176.99
|
| Rate for Payer: Sagamore Health Network All Products |
$180.17
|
| Rate for Payer: Signature Care EPO |
$193.70
|
| Rate for Payer: Signature Care PPO |
$205.37
|
| Rate for Payer: United Healthcare Commercial |
$183.90
|
|
|
HC CORTISOL-FREE UR RANDOM
|
Facility
IP
|
$233.38
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
63001500
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$175.03 |
| Max. Negotiated Rate |
$217.04 |
| Rate for Payer: Cigna All Commercial |
$201.40
|
| Rate for Payer: Aetna Commercial |
$201.64
|
| Rate for Payer: Cash Price |
$144.69
|
| Rate for Payer: CORVEL All Commercial |
$217.04
|
| Rate for Payer: Coventry All Commercial |
$205.37
|
| Rate for Payer: Encore All Commercial |
$214.82
|
| Rate for Payer: Frontpath All Commercial |
$214.71
|
| Rate for Payer: Humana ChoiceCare |
$201.57
|
| Rate for Payer: Lutheran Preferred All Commercial |
$210.04
|
| Rate for Payer: PHCS All Commercial |
$175.03
|
| Rate for Payer: PHP All Commercial |
$176.99
|
| Rate for Payer: Sagamore Health Network All Products |
$180.17
|
| Rate for Payer: Signature Care EPO |
$193.70
|
| Rate for Payer: Signature Care PPO |
$205.37
|
| Rate for Payer: United Healthcare Commercial |
$183.90
|
|
|
HC CORTISOL-FREE UR RANDOM
|
Facility
OP
|
$233.38
|
|
|
Service Code
|
CPT 82530
|
| Hospital Charge Code |
63001500
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.71 |
| Max. Negotiated Rate |
$217.04 |
| Rate for Payer: Aetna Commercial |
$196.97
|
| Rate for Payer: Aetna Medicare |
$77.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$77.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$134.03
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$145.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$16.71
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$88.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$84.72
|
| Rate for Payer: Cash Price |
$144.69
|
| Rate for Payer: Cash Price |
$144.69
|
| Rate for Payer: Centivo All Commercial |
$119.02
|
| Rate for Payer: Cigna All Commercial |
$201.40
|
| Rate for Payer: CORVEL All Commercial |
$217.04
|
| Rate for Payer: Coventry All Commercial |
$205.37
|
| Rate for Payer: Encore All Commercial |
$214.82
|
| Rate for Payer: Frontpath All Commercial |
$214.71
|
| Rate for Payer: Humana ChoiceCare |
$201.57
|
| Rate for Payer: Humana Medicare |
$119.02
|
| Rate for Payer: Lucent All Commercial |
$119.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$210.04
|
| Rate for Payer: Managed Health Services Medicaid |
$16.71
|
| Rate for Payer: MDWise Medicaid |
$16.71
|
| Rate for Payer: PHCS All Commercial |
$175.03
|
| Rate for Payer: PHP All Commercial |
$176.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$91.02
|
| Rate for Payer: Sagamore Health Network All Products |
$180.17
|
| Rate for Payer: Signature Care EPO |
$193.70
|
| Rate for Payer: Signature Care PPO |
$205.37
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$198.37
|
| Rate for Payer: United Healthcare Commercial |
$183.90
|
| Rate for Payer: United Healthcare Medicare |
$77.01
|
|
|
HC CORTISOL-PM
|
Facility
OP
|
$235.62
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
63001312
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.30 |
| Max. Negotiated Rate |
$219.13 |
| Rate for Payer: Aetna Commercial |
$198.86
|
| Rate for Payer: Aetna Medicare |
$77.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$77.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$108.29
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$108.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$16.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$89.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$85.53
|
| Rate for Payer: Cash Price |
$146.08
|
| Rate for Payer: Cash Price |
$146.08
|
| Rate for Payer: Centivo All Commercial |
$120.17
|
| 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 |
$120.17
|
| Rate for Payer: Lucent All Commercial |
$120.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$212.06
|
| Rate for Payer: Managed Health Services Medicaid |
$16.30
|
| Rate for Payer: MDWise Medicaid |
$16.30
|
| 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 |
$77.75
|
|
|
HC CORTISOL-PM
|
Facility
IP
|
$235.62
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
63001312
|
|
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 |
$146.08
|
| 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 CORTISOL -SALIVA
|
Facility
IP
|
$169.28
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
63001501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$126.96 |
| Max. Negotiated Rate |
$157.43 |
| Rate for Payer: Aetna Commercial |
$146.26
|
| Rate for Payer: Cash Price |
$104.95
|
| Rate for Payer: Cigna All Commercial |
$146.09
|
| Rate for Payer: CORVEL All Commercial |
$157.43
|
| Rate for Payer: Coventry All Commercial |
$148.97
|
| Rate for Payer: Encore All Commercial |
$155.82
|
| Rate for Payer: Frontpath All Commercial |
$155.74
|
| Rate for Payer: Humana ChoiceCare |
$146.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$152.35
|
| Rate for Payer: PHCS All Commercial |
$126.96
|
| Rate for Payer: PHP All Commercial |
$128.38
|
| Rate for Payer: Sagamore Health Network All Products |
$130.68
|
| Rate for Payer: Signature Care EPO |
$140.50
|
| Rate for Payer: Signature Care PPO |
$148.97
|
| Rate for Payer: United Healthcare Commercial |
$133.39
|
|
|
HC CORTISOL -SALIVA
|
Facility
OP
|
$169.28
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
63001501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.30 |
| Max. Negotiated Rate |
$157.43 |
| Rate for Payer: Aetna Commercial |
$142.87
|
| Rate for Payer: Aetna Medicare |
$55.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$55.86
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$77.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$77.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$16.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$64.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$61.45
|
| Rate for Payer: Cash Price |
$104.95
|
| Rate for Payer: Cash Price |
$104.95
|
| Rate for Payer: Centivo All Commercial |
$86.33
|
| Rate for Payer: Cigna All Commercial |
$146.09
|
| Rate for Payer: CORVEL All Commercial |
$157.43
|
| Rate for Payer: Coventry All Commercial |
$148.97
|
| Rate for Payer: Encore All Commercial |
$155.82
|
| Rate for Payer: Frontpath All Commercial |
$155.74
|
| Rate for Payer: Humana ChoiceCare |
$146.21
|
| Rate for Payer: Humana Medicare |
$86.33
|
| Rate for Payer: Lucent All Commercial |
$86.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$152.35
|
| Rate for Payer: Managed Health Services Medicaid |
$16.30
|
| Rate for Payer: MDWise Medicaid |
$16.30
|
| Rate for Payer: PHCS All Commercial |
$126.96
|
| Rate for Payer: PHP All Commercial |
$128.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$66.02
|
| Rate for Payer: Sagamore Health Network All Products |
$130.68
|
| Rate for Payer: Signature Care EPO |
$140.50
|
| Rate for Payer: Signature Care PPO |
$148.97
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$143.89
|
| Rate for Payer: United Healthcare Commercial |
$133.39
|
| Rate for Payer: United Healthcare Medicare |
$55.86
|
|
|
HC CORTISOL TOTAL
|
Facility
OP
|
$235.62
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
63001502
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.30 |
| Max. Negotiated Rate |
$219.13 |
| Rate for Payer: Aetna Commercial |
$198.86
|
| Rate for Payer: Aetna Medicare |
$77.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$77.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$108.29
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$108.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$16.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$89.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$85.53
|
| Rate for Payer: Cash Price |
$146.08
|
| Rate for Payer: Cash Price |
$146.08
|
| Rate for Payer: Centivo All Commercial |
$120.17
|
| 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 |
$120.17
|
| Rate for Payer: Lucent All Commercial |
$120.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$212.06
|
| Rate for Payer: Managed Health Services Medicaid |
$16.30
|
| Rate for Payer: MDWise Medicaid |
$16.30
|
| 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 |
$77.75
|
|
|
HC CORTISOL TOTAL
|
Facility
IP
|
$235.62
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
63001502
|
|
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 |
$146.08
|
| 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 COTININE SCREEN, BLOOD
|
Facility
OP
|
$167.44
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
63001396
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$55.26 |
| Max. Negotiated Rate |
$155.72 |
| Rate for Payer: Aetna Commercial |
$141.32
|
| Rate for Payer: Aetna Medicare |
$55.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$55.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$76.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$76.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$62.14
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$63.54
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$60.78
|
| Rate for Payer: Cash Price |
$103.82
|
| Rate for Payer: Cash Price |
$103.82
|
| Rate for Payer: Centivo All Commercial |
$85.40
|
| Rate for Payer: Cigna All Commercial |
$144.50
|
| Rate for Payer: CORVEL All Commercial |
$155.72
|
| Rate for Payer: Coventry All Commercial |
$147.35
|
| Rate for Payer: Encore All Commercial |
$154.13
|
| Rate for Payer: Frontpath All Commercial |
$154.05
|
| Rate for Payer: Humana ChoiceCare |
$144.62
|
| Rate for Payer: Humana Medicare |
$85.40
|
| Rate for Payer: Lucent All Commercial |
$85.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$150.70
|
| Rate for Payer: Managed Health Services Medicaid |
$62.14
|
| Rate for Payer: MDWise Medicaid |
$62.14
|
| Rate for Payer: PHCS All Commercial |
$125.58
|
| Rate for Payer: PHP All Commercial |
$126.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$65.30
|
| Rate for Payer: Sagamore Health Network All Products |
$129.27
|
| Rate for Payer: Signature Care EPO |
$138.98
|
| Rate for Payer: Signature Care PPO |
$147.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$142.33
|
| Rate for Payer: United Healthcare Commercial |
$131.95
|
| Rate for Payer: United Healthcare Medicare |
$55.26
|
|
|
HC COTININE SCREEN, BLOOD
|
Facility
IP
|
$167.44
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
63001396
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$125.58 |
| Max. Negotiated Rate |
$155.72 |
| Rate for Payer: Aetna Commercial |
$144.67
|
| Rate for Payer: Cash Price |
$103.82
|
| Rate for Payer: Cigna All Commercial |
$144.50
|
| Rate for Payer: CORVEL All Commercial |
$155.72
|
| Rate for Payer: Coventry All Commercial |
$147.35
|
| Rate for Payer: Encore All Commercial |
$154.13
|
| Rate for Payer: Frontpath All Commercial |
$154.05
|
| Rate for Payer: Humana ChoiceCare |
$144.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$150.70
|
| Rate for Payer: PHCS All Commercial |
$125.58
|
| Rate for Payer: PHP All Commercial |
$126.99
|
| Rate for Payer: Sagamore Health Network All Products |
$129.27
|
| Rate for Payer: Signature Care EPO |
$138.98
|
| Rate for Payer: Signature Care PPO |
$147.35
|
| Rate for Payer: United Healthcare Commercial |
$131.95
|
|
|
HC COTININE SCREEN, URINE
|
Facility
OP
|
$56.97
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
63001397
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.80 |
| Max. Negotiated Rate |
$62.14 |
| Rate for Payer: Aetna Commercial |
$48.08
|
| Rate for Payer: Aetna Medicare |
$18.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$18.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$26.18
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$26.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$62.14
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$21.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$20.68
|
| Rate for Payer: Cash Price |
$35.32
|
| Rate for Payer: Cash Price |
$35.32
|
| Rate for Payer: Centivo All Commercial |
$29.05
|
| Rate for Payer: Cigna All Commercial |
$49.16
|
| Rate for Payer: CORVEL All Commercial |
$52.98
|
| Rate for Payer: Coventry All Commercial |
$50.13
|
| Rate for Payer: Encore All Commercial |
$52.44
|
| Rate for Payer: Frontpath All Commercial |
$52.41
|
| Rate for Payer: Humana ChoiceCare |
$49.20
|
| Rate for Payer: Humana Medicare |
$29.05
|
| Rate for Payer: Lucent All Commercial |
$29.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$51.27
|
| Rate for Payer: Managed Health Services Medicaid |
$62.14
|
| Rate for Payer: MDWise Medicaid |
$62.14
|
| Rate for Payer: PHCS All Commercial |
$42.73
|
| Rate for Payer: PHP All Commercial |
$43.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$22.22
|
| Rate for Payer: Sagamore Health Network All Products |
$43.98
|
| Rate for Payer: Signature Care EPO |
$47.28
|
| Rate for Payer: Signature Care PPO |
$50.13
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$48.42
|
| Rate for Payer: United Healthcare Commercial |
$44.89
|
| Rate for Payer: United Healthcare Medicare |
$18.80
|
|
|
HC COTININE SCREEN, URINE
|
Facility
IP
|
$56.97
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
63001397
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$42.73 |
| Max. Negotiated Rate |
$52.98 |
| Rate for Payer: Aetna Commercial |
$49.22
|
| Rate for Payer: Cash Price |
$35.32
|
| Rate for Payer: Cigna All Commercial |
$49.16
|
| Rate for Payer: CORVEL All Commercial |
$52.98
|
| Rate for Payer: Coventry All Commercial |
$50.13
|
| Rate for Payer: Encore All Commercial |
$52.44
|
| Rate for Payer: Frontpath All Commercial |
$52.41
|
| Rate for Payer: Humana ChoiceCare |
$49.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$51.27
|
| Rate for Payer: PHCS All Commercial |
$42.73
|
| Rate for Payer: PHP All Commercial |
$43.20
|
| Rate for Payer: Sagamore Health Network All Products |
$43.98
|
| Rate for Payer: Signature Care EPO |
$47.28
|
| Rate for Payer: Signature Care PPO |
$50.13
|
| Rate for Payer: United Healthcare Commercial |
$44.89
|
|
|
HC COVID-19 ANTIBODIES TEST IN HOUSE
|
Facility
OP
|
$102.71
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
63086769
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.90 |
| Max. Negotiated Rate |
$95.52 |
| Rate for Payer: Aetna Commercial |
$86.69
|
| Rate for Payer: Aetna Medicare |
$33.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$33.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$58.99
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$64.21
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$42.13
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$38.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$37.29
|
| Rate for Payer: Cash Price |
$63.68
|
| Rate for Payer: Cash Price |
$63.68
|
| Rate for Payer: Centivo All Commercial |
$52.38
|
| Rate for Payer: Cigna All Commercial |
$88.64
|
| Rate for Payer: CORVEL All Commercial |
$95.52
|
| Rate for Payer: Coventry All Commercial |
$90.39
|
| Rate for Payer: Encore All Commercial |
$94.55
|
| Rate for Payer: Frontpath All Commercial |
$94.50
|
| Rate for Payer: Humana ChoiceCare |
$88.71
|
| Rate for Payer: Humana Medicare |
$52.38
|
| Rate for Payer: Lucent All Commercial |
$52.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$92.44
|
| Rate for Payer: Managed Health Services Medicaid |
$42.13
|
| Rate for Payer: MDWise Medicaid |
$42.13
|
| Rate for Payer: PHCS All Commercial |
$77.04
|
| Rate for Payer: PHP All Commercial |
$77.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$40.06
|
| Rate for Payer: Sagamore Health Network All Products |
$79.30
|
| Rate for Payer: Signature Care EPO |
$85.25
|
| Rate for Payer: Signature Care PPO |
$90.39
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$87.31
|
| Rate for Payer: United Healthcare Commercial |
$80.94
|
| Rate for Payer: United Healthcare Medicare |
$33.90
|
|
|
HC COVID-19 ANTIBODIES TEST IN HOUSE
|
Facility
IP
|
$102.71
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
63086769
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$77.04 |
| Max. Negotiated Rate |
$95.52 |
| Rate for Payer: Aetna Commercial |
$88.74
|
| Rate for Payer: Cash Price |
$63.68
|
| Rate for Payer: Cigna All Commercial |
$88.64
|
| Rate for Payer: CORVEL All Commercial |
$95.52
|
| Rate for Payer: Coventry All Commercial |
$90.39
|
| Rate for Payer: Encore All Commercial |
$94.55
|
| Rate for Payer: Frontpath All Commercial |
$94.50
|
| Rate for Payer: Humana ChoiceCare |
$88.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$92.44
|
| Rate for Payer: PHCS All Commercial |
$77.04
|
| Rate for Payer: PHP All Commercial |
$77.90
|
| Rate for Payer: Sagamore Health Network All Products |
$79.30
|
| Rate for Payer: Signature Care EPO |
$85.25
|
| Rate for Payer: Signature Care PPO |
$90.39
|
| Rate for Payer: United Healthcare Commercial |
$80.94
|
|
|
HC CPAP-BIPAP PER DAY
|
Facility
IP
|
$949.15
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
01704660
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$711.86 |
| Max. Negotiated Rate |
$882.71 |
| Rate for Payer: Aetna Commercial |
$820.07
|
| Rate for Payer: Cash Price |
$588.47
|
| Rate for Payer: Cigna All Commercial |
$819.12
|
| Rate for Payer: CORVEL All Commercial |
$882.71
|
| Rate for Payer: Coventry All Commercial |
$835.25
|
| Rate for Payer: Encore All Commercial |
$873.69
|
| Rate for Payer: Frontpath All Commercial |
$873.22
|
| Rate for Payer: Humana ChoiceCare |
$819.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$854.24
|
| Rate for Payer: PHCS All Commercial |
$711.86
|
| Rate for Payer: PHP All Commercial |
$719.84
|
| Rate for Payer: Sagamore Health Network All Products |
$732.74
|
| Rate for Payer: Signature Care EPO |
$787.80
|
| Rate for Payer: Signature Care PPO |
$835.25
|
| Rate for Payer: United Healthcare Commercial |
$747.93
|
|
|
HC CPAP-BIPAP PER DAY
|
Facility
OP
|
$949.15
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
01704660
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$24.84 |
| Max. Negotiated Rate |
$882.71 |
| Rate for Payer: Aetna Commercial |
$801.08
|
| Rate for Payer: Aetna Medicare |
$313.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$313.22
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$545.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$593.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$24.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$360.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$344.54
|
| Rate for Payer: Cash Price |
$588.47
|
| Rate for Payer: Cash Price |
$588.47
|
| Rate for Payer: Centivo All Commercial |
$484.07
|
| Rate for Payer: Cigna All Commercial |
$819.12
|
| Rate for Payer: CORVEL All Commercial |
$882.71
|
| Rate for Payer: Coventry All Commercial |
$835.25
|
| Rate for Payer: Encore All Commercial |
$873.69
|
| Rate for Payer: Frontpath All Commercial |
$873.22
|
| Rate for Payer: Humana ChoiceCare |
$819.78
|
| Rate for Payer: Humana Medicare |
$484.07
|
| Rate for Payer: Lucent All Commercial |
$484.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$854.24
|
| Rate for Payer: Managed Health Services Medicaid |
$24.84
|
| Rate for Payer: MDWise Medicaid |
$24.84
|
| Rate for Payer: PHCS All Commercial |
$711.86
|
| Rate for Payer: PHP All Commercial |
$719.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$370.17
|
| Rate for Payer: Sagamore Health Network All Products |
$732.74
|
| Rate for Payer: Signature Care EPO |
$787.80
|
| Rate for Payer: Signature Care PPO |
$835.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$806.78
|
| Rate for Payer: United Healthcare Commercial |
$747.93
|
| Rate for Payer: United Healthcare Medicare |
$313.22
|
|
|
HC C-PEPTIDE
|
Facility
OP
|
$204.98
|
|
|
Service Code
|
CPT 84681
|
| Hospital Charge Code |
63001004
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.81 |
| Max. Negotiated Rate |
$190.63 |
| Rate for Payer: Aetna Commercial |
$173.00
|
| Rate for Payer: Aetna Medicare |
$67.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$67.64
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$117.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$128.13
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$20.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$77.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$74.41
|
| Rate for Payer: Cash Price |
$127.09
|
| Rate for Payer: Cash Price |
$127.09
|
| Rate for Payer: Centivo All Commercial |
$104.54
|
| Rate for Payer: Cigna All Commercial |
$176.90
|
| Rate for Payer: CORVEL All Commercial |
$190.63
|
| Rate for Payer: Coventry All Commercial |
$180.38
|
| Rate for Payer: Encore All Commercial |
$188.68
|
| Rate for Payer: Frontpath All Commercial |
$188.58
|
| Rate for Payer: Humana ChoiceCare |
$177.04
|
| Rate for Payer: Humana Medicare |
$104.54
|
| Rate for Payer: Lucent All Commercial |
$104.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$184.48
|
| Rate for Payer: Managed Health Services Medicaid |
$20.81
|
| Rate for Payer: MDWise Medicaid |
$20.81
|
| Rate for Payer: PHCS All Commercial |
$153.73
|
| Rate for Payer: PHP All Commercial |
$155.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$79.94
|
| Rate for Payer: Sagamore Health Network All Products |
$158.24
|
| Rate for Payer: Signature Care EPO |
$170.13
|
| Rate for Payer: Signature Care PPO |
$180.38
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$174.23
|
| Rate for Payer: United Healthcare Commercial |
$161.52
|
| Rate for Payer: United Healthcare Medicare |
$67.64
|
|
|
HC C-PEPTIDE
|
Facility
IP
|
$204.98
|
|
|
Service Code
|
CPT 84681
|
| Hospital Charge Code |
63001004
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$153.73 |
| Max. Negotiated Rate |
$190.63 |
| Rate for Payer: Aetna Commercial |
$177.10
|
| Rate for Payer: Cash Price |
$127.09
|
| Rate for Payer: Cigna All Commercial |
$176.90
|
| Rate for Payer: CORVEL All Commercial |
$190.63
|
| Rate for Payer: Coventry All Commercial |
$180.38
|
| Rate for Payer: Encore All Commercial |
$188.68
|
| Rate for Payer: Frontpath All Commercial |
$188.58
|
| Rate for Payer: Humana ChoiceCare |
$177.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$184.48
|
| Rate for Payer: PHCS All Commercial |
$153.73
|
| Rate for Payer: PHP All Commercial |
$155.46
|
| Rate for Payer: Sagamore Health Network All Products |
$158.24
|
| Rate for Payer: Signature Care EPO |
$170.13
|
| Rate for Payer: Signature Care PPO |
$180.38
|
| Rate for Payer: United Healthcare Commercial |
$161.52
|
|
