|
HC CT FACE W/WO CONTRAST
|
Facility
OP
|
$3,009.00
|
|
|
Service Code
|
CPT 70488
|
| Hospital Charge Code |
01660473
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$620.88 |
| Max. Negotiated Rate |
$2,798.37 |
| Rate for Payer: Aetna Commercial |
$2,539.60
|
| Rate for Payer: Aetna Medicare |
$992.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$992.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,728.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,880.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$620.88
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,141.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,092.27
|
| Rate for Payer: Cash Price |
$1,865.58
|
| Rate for Payer: Cash Price |
$1,865.58
|
| Rate for Payer: Centivo All Commercial |
$1,534.59
|
| Rate for Payer: Cigna All Commercial |
$2,596.77
|
| Rate for Payer: CORVEL All Commercial |
$2,798.37
|
| Rate for Payer: Coventry All Commercial |
$2,647.92
|
| Rate for Payer: Encore All Commercial |
$2,769.78
|
| Rate for Payer: Frontpath All Commercial |
$2,768.28
|
| Rate for Payer: Humana ChoiceCare |
$2,598.87
|
| Rate for Payer: Humana Medicare |
$1,534.59
|
| Rate for Payer: Lucent All Commercial |
$1,534.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,708.10
|
| Rate for Payer: Managed Health Services Medicaid |
$620.88
|
| Rate for Payer: MDWise Medicaid |
$620.88
|
| Rate for Payer: PHCS All Commercial |
$2,256.75
|
| Rate for Payer: PHP All Commercial |
$2,282.03
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,173.51
|
| Rate for Payer: Sagamore Health Network All Products |
$2,322.95
|
| Rate for Payer: Signature Care EPO |
$2,497.47
|
| Rate for Payer: Signature Care PPO |
$2,647.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,557.65
|
| Rate for Payer: United Healthcare Commercial |
$2,371.09
|
| Rate for Payer: United Healthcare Medicare |
$992.97
|
|
|
HC CT GUIDANCE-RADIATION THERAPY
|
Facility
OP
|
$945.34
|
|
|
Service Code
|
CPT 77014
|
| Hospital Charge Code |
01667014
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$215.12 |
| Max. Negotiated Rate |
$879.16 |
| Rate for Payer: Aetna Commercial |
$797.86
|
| Rate for Payer: Aetna Medicare |
$311.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$311.96
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$542.91
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$590.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$215.12
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$358.76
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$343.16
|
| Rate for Payer: Cash Price |
$586.11
|
| Rate for Payer: Cash Price |
$586.11
|
| Rate for Payer: Centivo All Commercial |
$482.12
|
| Rate for Payer: Cigna All Commercial |
$815.82
|
| Rate for Payer: CORVEL All Commercial |
$879.16
|
| Rate for Payer: Coventry All Commercial |
$831.90
|
| Rate for Payer: Encore All Commercial |
$870.18
|
| Rate for Payer: Frontpath All Commercial |
$869.71
|
| Rate for Payer: Humana ChoiceCare |
$816.49
|
| Rate for Payer: Humana Medicare |
$482.12
|
| Rate for Payer: Lucent All Commercial |
$482.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$850.80
|
| Rate for Payer: Managed Health Services Medicaid |
$215.12
|
| Rate for Payer: MDWise Medicaid |
$215.12
|
| Rate for Payer: PHCS All Commercial |
$709.00
|
| Rate for Payer: PHP All Commercial |
$716.94
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$368.68
|
| Rate for Payer: Sagamore Health Network All Products |
$729.80
|
| Rate for Payer: Signature Care EPO |
$784.63
|
| Rate for Payer: Signature Care PPO |
$831.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$803.54
|
| Rate for Payer: United Healthcare Commercial |
$744.92
|
| Rate for Payer: United Healthcare Medicare |
$311.96
|
|
|
HC CT GUIDANCE-RADIATION THERAPY
|
Facility
IP
|
$945.34
|
|
|
Service Code
|
CPT 77014
|
| Hospital Charge Code |
01667014
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$709.00 |
| Max. Negotiated Rate |
$879.16 |
| Rate for Payer: Aetna Commercial |
$816.77
|
| Rate for Payer: Cash Price |
$586.11
|
| Rate for Payer: Cigna All Commercial |
$815.82
|
| Rate for Payer: CORVEL All Commercial |
$879.16
|
| Rate for Payer: Coventry All Commercial |
$831.90
|
| Rate for Payer: Encore All Commercial |
$870.18
|
| Rate for Payer: Frontpath All Commercial |
$869.71
|
| Rate for Payer: Humana ChoiceCare |
$816.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$850.80
|
| Rate for Payer: PHCS All Commercial |
$709.00
|
| Rate for Payer: PHP All Commercial |
$716.94
|
| Rate for Payer: Sagamore Health Network All Products |
$729.80
|
| Rate for Payer: Signature Care EPO |
$784.63
|
| Rate for Payer: Signature Care PPO |
$831.90
|
| Rate for Payer: United Healthcare Commercial |
$744.92
|
|
|
HC CT GUIDANCE-RADIATION THERAPY
|
Facility
IP
|
$1,909.44
|
|
|
Service Code
|
CPT 77014
|
| Hospital Charge Code |
01546370
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,432.08 |
| Max. Negotiated Rate |
$1,775.78 |
| Rate for Payer: Aetna Commercial |
$1,649.76
|
| Rate for Payer: Cash Price |
$1,183.85
|
| Rate for Payer: Cigna All Commercial |
$1,647.85
|
| Rate for Payer: CORVEL All Commercial |
$1,775.78
|
| Rate for Payer: Coventry All Commercial |
$1,680.31
|
| Rate for Payer: Encore All Commercial |
$1,757.64
|
| Rate for Payer: Frontpath All Commercial |
$1,756.68
|
| Rate for Payer: Humana ChoiceCare |
$1,649.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,718.50
|
| Rate for Payer: PHCS All Commercial |
$1,432.08
|
| Rate for Payer: PHP All Commercial |
$1,448.12
|
| Rate for Payer: Sagamore Health Network All Products |
$1,474.09
|
| Rate for Payer: Signature Care EPO |
$1,584.84
|
| Rate for Payer: Signature Care PPO |
$1,680.31
|
| Rate for Payer: United Healthcare Commercial |
$1,504.64
|
|
|
HC CT GUIDANCE-RADIATION THERAPY
|
Facility
OP
|
$1,909.44
|
|
|
Service Code
|
CPT 77014
|
| Hospital Charge Code |
01546370
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$215.12 |
| Max. Negotiated Rate |
$1,775.78 |
| Rate for Payer: Aetna Commercial |
$1,611.57
|
| Rate for Payer: Aetna Medicare |
$630.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$630.12
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,096.59
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,193.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$215.12
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$724.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$693.13
|
| Rate for Payer: Cash Price |
$1,183.85
|
| Rate for Payer: Cash Price |
$1,183.85
|
| Rate for Payer: Centivo All Commercial |
$973.81
|
| Rate for Payer: Cigna All Commercial |
$1,647.85
|
| Rate for Payer: CORVEL All Commercial |
$1,775.78
|
| Rate for Payer: Coventry All Commercial |
$1,680.31
|
| Rate for Payer: Encore All Commercial |
$1,757.64
|
| Rate for Payer: Frontpath All Commercial |
$1,756.68
|
| Rate for Payer: Humana ChoiceCare |
$1,649.18
|
| Rate for Payer: Humana Medicare |
$973.81
|
| Rate for Payer: Lucent All Commercial |
$973.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,718.50
|
| Rate for Payer: Managed Health Services Medicaid |
$215.12
|
| Rate for Payer: MDWise Medicaid |
$215.12
|
| Rate for Payer: PHCS All Commercial |
$1,432.08
|
| Rate for Payer: PHP All Commercial |
$1,448.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$744.68
|
| Rate for Payer: Sagamore Health Network All Products |
$1,474.09
|
| Rate for Payer: Signature Care EPO |
$1,584.84
|
| Rate for Payer: Signature Care PPO |
$1,680.31
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,623.02
|
| Rate for Payer: United Healthcare Commercial |
$1,504.64
|
| Rate for Payer: United Healthcare Medicare |
$630.12
|
|
|
HC CT GUIDE BIOPSY COMP
|
Facility
OP
|
$1,901.12
|
|
|
Service Code
|
CPT 77012
|
| Hospital Charge Code |
01666361
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$192.89 |
| Max. Negotiated Rate |
$1,768.04 |
| Rate for Payer: Aetna Commercial |
$1,604.54
|
| Rate for Payer: Aetna Medicare |
$627.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$627.37
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,091.81
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,188.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$192.89
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$721.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$690.11
|
| Rate for Payer: Cash Price |
$1,178.69
|
| Rate for Payer: Cash Price |
$1,178.69
|
| Rate for Payer: Centivo All Commercial |
$969.57
|
| Rate for Payer: Cigna All Commercial |
$1,640.66
|
| Rate for Payer: CORVEL All Commercial |
$1,768.04
|
| Rate for Payer: Coventry All Commercial |
$1,672.98
|
| Rate for Payer: Encore All Commercial |
$1,749.98
|
| Rate for Payer: Frontpath All Commercial |
$1,749.03
|
| Rate for Payer: Humana ChoiceCare |
$1,641.99
|
| Rate for Payer: Humana Medicare |
$969.57
|
| Rate for Payer: Lucent All Commercial |
$969.57
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,711.01
|
| Rate for Payer: Managed Health Services Medicaid |
$192.89
|
| Rate for Payer: MDWise Medicaid |
$192.89
|
| Rate for Payer: PHCS All Commercial |
$1,425.84
|
| Rate for Payer: PHP All Commercial |
$1,441.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$741.44
|
| Rate for Payer: Sagamore Health Network All Products |
$1,467.66
|
| Rate for Payer: Signature Care EPO |
$1,577.93
|
| Rate for Payer: Signature Care PPO |
$1,672.98
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,615.95
|
| Rate for Payer: United Healthcare Commercial |
$1,498.08
|
| Rate for Payer: United Healthcare Medicare |
$627.37
|
|
|
HC CT GUIDE BIOPSY COMP
|
Facility
IP
|
$1,901.12
|
|
|
Service Code
|
CPT 77012
|
| Hospital Charge Code |
01666361
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,425.84 |
| Max. Negotiated Rate |
$1,768.04 |
| Rate for Payer: Aetna Commercial |
$1,642.56
|
| Rate for Payer: Cash Price |
$1,178.69
|
| Rate for Payer: Cigna All Commercial |
$1,640.66
|
| Rate for Payer: CORVEL All Commercial |
$1,768.04
|
| Rate for Payer: Coventry All Commercial |
$1,672.98
|
| Rate for Payer: Encore All Commercial |
$1,749.98
|
| Rate for Payer: Frontpath All Commercial |
$1,749.03
|
| Rate for Payer: Humana ChoiceCare |
$1,641.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,711.01
|
| Rate for Payer: PHCS All Commercial |
$1,425.84
|
| Rate for Payer: PHP All Commercial |
$1,441.81
|
| Rate for Payer: Sagamore Health Network All Products |
$1,467.66
|
| Rate for Payer: Signature Care EPO |
$1,577.93
|
| Rate for Payer: Signature Care PPO |
$1,672.98
|
| Rate for Payer: United Healthcare Commercial |
$1,498.08
|
|
|
HC CT HEAD SCAN W/CONTRAST
|
Facility
OP
|
$2,038.98
|
|
|
Service Code
|
CPT 70460
|
| Hospital Charge Code |
01660460
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$305.92 |
| Max. Negotiated Rate |
$1,896.25 |
| Rate for Payer: Aetna Commercial |
$1,720.90
|
| Rate for Payer: Aetna Medicare |
$672.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$672.86
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,170.99
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,274.57
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$305.92
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$773.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$740.15
|
| Rate for Payer: Cash Price |
$1,264.17
|
| Rate for Payer: Cash Price |
$1,264.17
|
| Rate for Payer: Centivo All Commercial |
$1,039.88
|
| Rate for Payer: Cigna All Commercial |
$1,759.64
|
| Rate for Payer: CORVEL All Commercial |
$1,896.25
|
| Rate for Payer: Coventry All Commercial |
$1,794.30
|
| Rate for Payer: Encore All Commercial |
$1,876.88
|
| Rate for Payer: Frontpath All Commercial |
$1,875.86
|
| Rate for Payer: Humana ChoiceCare |
$1,761.07
|
| Rate for Payer: Humana Medicare |
$1,039.88
|
| Rate for Payer: Lucent All Commercial |
$1,039.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,835.08
|
| Rate for Payer: Managed Health Services Medicaid |
$305.92
|
| Rate for Payer: MDWise Medicaid |
$305.92
|
| Rate for Payer: PHCS All Commercial |
$1,529.24
|
| Rate for Payer: PHP All Commercial |
$1,546.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$795.20
|
| Rate for Payer: Sagamore Health Network All Products |
$1,574.09
|
| Rate for Payer: Signature Care EPO |
$1,692.35
|
| Rate for Payer: Signature Care PPO |
$1,794.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,733.13
|
| Rate for Payer: United Healthcare Commercial |
$1,606.72
|
| Rate for Payer: United Healthcare Medicare |
$672.86
|
|
|
HC CT HEAD SCAN W/CONTRAST
|
Facility
IP
|
$2,038.98
|
|
|
Service Code
|
CPT 70460
|
| Hospital Charge Code |
01660460
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,529.24 |
| Max. Negotiated Rate |
$1,896.25 |
| Rate for Payer: Aetna Commercial |
$1,761.68
|
| Rate for Payer: Cash Price |
$1,264.17
|
| Rate for Payer: Cigna All Commercial |
$1,759.64
|
| Rate for Payer: CORVEL All Commercial |
$1,896.25
|
| Rate for Payer: Coventry All Commercial |
$1,794.30
|
| Rate for Payer: Encore All Commercial |
$1,876.88
|
| Rate for Payer: Frontpath All Commercial |
$1,875.86
|
| Rate for Payer: Humana ChoiceCare |
$1,761.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,835.08
|
| Rate for Payer: PHCS All Commercial |
$1,529.24
|
| Rate for Payer: PHP All Commercial |
$1,546.36
|
| Rate for Payer: Sagamore Health Network All Products |
$1,574.09
|
| Rate for Payer: Signature Care EPO |
$1,692.35
|
| Rate for Payer: Signature Care PPO |
$1,794.30
|
| Rate for Payer: United Healthcare Commercial |
$1,606.72
|
|
|
HC CT HEAD SCAN W/O CONTRAST
|
Facility
OP
|
$1,734.00
|
|
|
Service Code
|
CPT 70450
|
| Hospital Charge Code |
01660450
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$220.90 |
| Max. Negotiated Rate |
$1,612.62 |
| Rate for Payer: Aetna Commercial |
$1,463.50
|
| Rate for Payer: Aetna Medicare |
$572.22
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$572.22
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,177.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,177.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$220.90
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$658.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$629.44
|
| Rate for Payer: Cash Price |
$1,075.08
|
| Rate for Payer: Cash Price |
$1,075.08
|
| Rate for Payer: Centivo All Commercial |
$884.34
|
| Rate for Payer: Cigna All Commercial |
$1,496.44
|
| Rate for Payer: CORVEL All Commercial |
$1,612.62
|
| Rate for Payer: Coventry All Commercial |
$1,525.92
|
| Rate for Payer: Encore All Commercial |
$1,596.15
|
| Rate for Payer: Frontpath All Commercial |
$1,595.28
|
| Rate for Payer: Humana ChoiceCare |
$1,497.66
|
| Rate for Payer: Humana Medicare |
$884.34
|
| Rate for Payer: Lucent All Commercial |
$884.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,560.60
|
| Rate for Payer: Managed Health Services Medicaid |
$220.90
|
| Rate for Payer: MDWise Medicaid |
$220.90
|
| Rate for Payer: PHCS All Commercial |
$1,300.50
|
| Rate for Payer: PHP All Commercial |
$1,315.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$676.26
|
| Rate for Payer: Sagamore Health Network All Products |
$1,338.65
|
| Rate for Payer: Signature Care EPO |
$1,439.22
|
| Rate for Payer: Signature Care PPO |
$1,525.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,473.90
|
| Rate for Payer: United Healthcare Commercial |
$1,366.39
|
| Rate for Payer: United Healthcare Medicare |
$572.22
|
|
|
HC CT HEAD SCAN W/O CONTRAST
|
Facility
IP
|
$1,734.00
|
|
|
Service Code
|
CPT 70450
|
| Hospital Charge Code |
01660450
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,300.50 |
| Max. Negotiated Rate |
$1,612.62 |
| Rate for Payer: Aetna Commercial |
$1,498.18
|
| Rate for Payer: Cash Price |
$1,075.08
|
| Rate for Payer: Cigna All Commercial |
$1,496.44
|
| Rate for Payer: CORVEL All Commercial |
$1,612.62
|
| Rate for Payer: Coventry All Commercial |
$1,525.92
|
| Rate for Payer: Encore All Commercial |
$1,596.15
|
| Rate for Payer: Frontpath All Commercial |
$1,595.28
|
| Rate for Payer: Humana ChoiceCare |
$1,497.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,560.60
|
| Rate for Payer: PHCS All Commercial |
$1,300.50
|
| Rate for Payer: PHP All Commercial |
$1,315.07
|
| Rate for Payer: Sagamore Health Network All Products |
$1,338.65
|
| Rate for Payer: Signature Care EPO |
$1,439.22
|
| Rate for Payer: Signature Care PPO |
$1,525.92
|
| Rate for Payer: United Healthcare Commercial |
$1,366.39
|
|
|
HC CT HEAD SCAN W/WO CONTRAST
|
Facility
OP
|
$3,009.00
|
|
|
Service Code
|
CPT 70470
|
| Hospital Charge Code |
01660470
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$378.38 |
| Max. Negotiated Rate |
$2,798.37 |
| Rate for Payer: Aetna Commercial |
$2,539.60
|
| Rate for Payer: Aetna Medicare |
$992.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$992.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,728.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,880.93
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$378.38
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,141.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,092.27
|
| Rate for Payer: Cash Price |
$1,865.58
|
| Rate for Payer: Cash Price |
$1,865.58
|
| Rate for Payer: Centivo All Commercial |
$1,534.59
|
| Rate for Payer: Cigna All Commercial |
$2,596.77
|
| Rate for Payer: CORVEL All Commercial |
$2,798.37
|
| Rate for Payer: Coventry All Commercial |
$2,647.92
|
| Rate for Payer: Encore All Commercial |
$2,769.78
|
| Rate for Payer: Frontpath All Commercial |
$2,768.28
|
| Rate for Payer: Humana ChoiceCare |
$2,598.87
|
| Rate for Payer: Humana Medicare |
$1,534.59
|
| Rate for Payer: Lucent All Commercial |
$1,534.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,708.10
|
| Rate for Payer: Managed Health Services Medicaid |
$378.38
|
| Rate for Payer: MDWise Medicaid |
$378.38
|
| Rate for Payer: PHCS All Commercial |
$2,256.75
|
| Rate for Payer: PHP All Commercial |
$2,282.03
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,173.51
|
| Rate for Payer: Sagamore Health Network All Products |
$2,322.95
|
| Rate for Payer: Signature Care EPO |
$2,497.47
|
| Rate for Payer: Signature Care PPO |
$2,647.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,557.65
|
| Rate for Payer: United Healthcare Commercial |
$2,371.09
|
| Rate for Payer: United Healthcare Medicare |
$992.97
|
|
|
HC CT HEAD SCAN W/WO CONTRAST
|
Facility
IP
|
$3,009.00
|
|
|
Service Code
|
CPT 70470
|
| Hospital Charge Code |
01660470
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$2,256.75 |
| Max. Negotiated Rate |
$2,798.37 |
| Rate for Payer: Aetna Commercial |
$2,599.78
|
| Rate for Payer: Cash Price |
$1,865.58
|
| Rate for Payer: Cigna All Commercial |
$2,596.77
|
| Rate for Payer: CORVEL All Commercial |
$2,798.37
|
| Rate for Payer: Coventry All Commercial |
$2,647.92
|
| Rate for Payer: Encore All Commercial |
$2,769.78
|
| Rate for Payer: Frontpath All Commercial |
$2,768.28
|
| Rate for Payer: Humana ChoiceCare |
$2,598.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,708.10
|
| Rate for Payer: PHCS All Commercial |
$2,256.75
|
| Rate for Payer: PHP All Commercial |
$2,282.03
|
| Rate for Payer: Sagamore Health Network All Products |
$2,322.95
|
| Rate for Payer: Signature Care EPO |
$2,497.47
|
| Rate for Payer: Signature Care PPO |
$2,647.92
|
| Rate for Payer: United Healthcare Commercial |
$2,371.09
|
|
|
HC CT HEART W/O CON (CALC SCORE)
|
Facility
IP
|
$50.00
|
|
|
Service Code
|
CPT 75571
|
| Hospital Charge Code |
01660144
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$37.50 |
| Max. Negotiated Rate |
$46.50 |
| Rate for Payer: Aetna Commercial |
$43.20
|
| Rate for Payer: Cash Price |
$31.00
|
| Rate for Payer: Cigna All Commercial |
$43.15
|
| Rate for Payer: CORVEL All Commercial |
$46.50
|
| Rate for Payer: Coventry All Commercial |
$44.00
|
| Rate for Payer: Encore All Commercial |
$46.02
|
| Rate for Payer: Frontpath All Commercial |
$46.00
|
| Rate for Payer: Humana ChoiceCare |
$43.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$45.00
|
| Rate for Payer: PHCS All Commercial |
$37.50
|
| Rate for Payer: PHP All Commercial |
$37.92
|
| Rate for Payer: Sagamore Health Network All Products |
$38.60
|
| Rate for Payer: Signature Care EPO |
$41.50
|
| Rate for Payer: Signature Care PPO |
$44.00
|
| Rate for Payer: United Healthcare Commercial |
$39.40
|
|
|
HC CT HEART W/O CON (CALC SCORE)
|
Facility
OP
|
$50.00
|
|
|
Service Code
|
CPT 75571
|
| Hospital Charge Code |
01660144
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$210.29 |
| Rate for Payer: Aetna Commercial |
$42.20
|
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$16.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$28.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$31.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$210.29
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$18.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$18.15
|
| Rate for Payer: Cash Price |
$31.00
|
| Rate for Payer: Cash Price |
$31.00
|
| Rate for Payer: Centivo All Commercial |
$25.50
|
| Rate for Payer: Cigna All Commercial |
$43.15
|
| Rate for Payer: CORVEL All Commercial |
$46.50
|
| Rate for Payer: Coventry All Commercial |
$44.00
|
| Rate for Payer: Encore All Commercial |
$46.02
|
| Rate for Payer: Frontpath All Commercial |
$46.00
|
| Rate for Payer: Humana ChoiceCare |
$43.18
|
| Rate for Payer: Humana Medicare |
$25.50
|
| Rate for Payer: Lucent All Commercial |
$25.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$45.00
|
| Rate for Payer: Managed Health Services Medicaid |
$210.29
|
| Rate for Payer: MDWise Medicaid |
$210.29
|
| Rate for Payer: PHCS All Commercial |
$37.50
|
| Rate for Payer: PHP All Commercial |
$37.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$19.50
|
| Rate for Payer: Sagamore Health Network All Products |
$38.60
|
| Rate for Payer: Signature Care EPO |
$41.50
|
| Rate for Payer: Signature Care PPO |
$44.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$42.50
|
| Rate for Payer: United Healthcare Commercial |
$39.40
|
| Rate for Payer: United Healthcare Medicare |
$16.50
|
|
|
HC CT LIMITED SINUS WO CONTR
|
Facility
OP
|
$1,428.00
|
|
|
Service Code
|
CPT 70486 52
|
| Hospital Charge Code |
01660016
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$471.24 |
| Max. Negotiated Rate |
$1,328.04 |
| Rate for Payer: Aetna Commercial |
$1,205.23
|
| Rate for Payer: Aetna Medicare |
$471.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$471.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,177.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,177.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$541.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$518.36
|
| Rate for Payer: Cash Price |
$885.36
|
| Rate for Payer: Cash Price |
$885.36
|
| Rate for Payer: Centivo All Commercial |
$728.28
|
| Rate for Payer: Cigna All Commercial |
$1,232.36
|
| Rate for Payer: CORVEL All Commercial |
$1,328.04
|
| Rate for Payer: Coventry All Commercial |
$1,256.64
|
| Rate for Payer: Encore All Commercial |
$1,314.47
|
| Rate for Payer: Frontpath All Commercial |
$1,313.76
|
| Rate for Payer: Humana ChoiceCare |
$1,233.36
|
| Rate for Payer: Humana Medicare |
$728.28
|
| Rate for Payer: Lucent All Commercial |
$728.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,285.20
|
| Rate for Payer: PHCS All Commercial |
$1,071.00
|
| Rate for Payer: PHP All Commercial |
$1,083.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$556.92
|
| Rate for Payer: Sagamore Health Network All Products |
$1,102.42
|
| Rate for Payer: Signature Care EPO |
$1,185.24
|
| Rate for Payer: Signature Care PPO |
$1,256.64
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,213.80
|
| Rate for Payer: United Healthcare Commercial |
$1,125.26
|
| Rate for Payer: United Healthcare Medicare |
$471.24
|
|
|
HC CT LIMITED SINUS WO CONTR
|
Facility
IP
|
$1,428.00
|
|
|
Service Code
|
CPT 70486 52
|
| Hospital Charge Code |
01660016
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,071.00 |
| Max. Negotiated Rate |
$1,328.04 |
| Rate for Payer: Aetna Commercial |
$1,233.79
|
| Rate for Payer: Cash Price |
$885.36
|
| Rate for Payer: Cigna All Commercial |
$1,232.36
|
| Rate for Payer: CORVEL All Commercial |
$1,328.04
|
| Rate for Payer: Coventry All Commercial |
$1,256.64
|
| Rate for Payer: Encore All Commercial |
$1,314.47
|
| Rate for Payer: Frontpath All Commercial |
$1,313.76
|
| Rate for Payer: Humana ChoiceCare |
$1,233.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,285.20
|
| Rate for Payer: PHCS All Commercial |
$1,071.00
|
| Rate for Payer: PHP All Commercial |
$1,083.00
|
| Rate for Payer: Sagamore Health Network All Products |
$1,102.42
|
| Rate for Payer: Signature Care EPO |
$1,185.24
|
| Rate for Payer: Signature Care PPO |
$1,256.64
|
| Rate for Payer: United Healthcare Commercial |
$1,125.26
|
|
|
HC CT LOWER EXT W/CONTRAST BI
|
Facility
OP
|
$2,856.00
|
|
|
Service Code
|
CPT 73701 50
|
| Hospital Charge Code |
21663701
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$942.48 |
| Max. Negotiated Rate |
$2,656.08 |
| Rate for Payer: Aetna Commercial |
$2,410.46
|
| Rate for Payer: Aetna Medicare |
$942.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$942.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,177.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,177.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,083.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,036.73
|
| Rate for Payer: Cash Price |
$1,770.72
|
| Rate for Payer: Cash Price |
$1,770.72
|
| Rate for Payer: Centivo All Commercial |
$1,456.56
|
| Rate for Payer: Cigna All Commercial |
$2,464.73
|
| Rate for Payer: CORVEL All Commercial |
$2,656.08
|
| Rate for Payer: Coventry All Commercial |
$2,513.28
|
| Rate for Payer: Encore All Commercial |
$2,628.95
|
| Rate for Payer: Frontpath All Commercial |
$2,627.52
|
| Rate for Payer: Humana ChoiceCare |
$2,466.73
|
| Rate for Payer: Humana Medicare |
$1,456.56
|
| Rate for Payer: Lucent All Commercial |
$1,456.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,570.40
|
| Rate for Payer: PHCS All Commercial |
$2,142.00
|
| Rate for Payer: PHP All Commercial |
$2,165.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,113.84
|
| Rate for Payer: Sagamore Health Network All Products |
$2,204.83
|
| Rate for Payer: Signature Care EPO |
$2,370.48
|
| Rate for Payer: Signature Care PPO |
$2,513.28
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,427.60
|
| Rate for Payer: United Healthcare Commercial |
$2,250.53
|
| Rate for Payer: United Healthcare Medicare |
$942.48
|
|
|
HC CT LOWER EXT W/CONTRAST BI
|
Facility
IP
|
$2,856.00
|
|
|
Service Code
|
CPT 73701 50
|
| Hospital Charge Code |
21663701
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$2,142.00 |
| Max. Negotiated Rate |
$2,656.08 |
| Rate for Payer: Aetna Commercial |
$2,467.58
|
| Rate for Payer: Cash Price |
$1,770.72
|
| Rate for Payer: Cigna All Commercial |
$2,464.73
|
| Rate for Payer: CORVEL All Commercial |
$2,656.08
|
| Rate for Payer: Coventry All Commercial |
$2,513.28
|
| Rate for Payer: Encore All Commercial |
$2,628.95
|
| Rate for Payer: Frontpath All Commercial |
$2,627.52
|
| Rate for Payer: Humana ChoiceCare |
$2,466.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,570.40
|
| Rate for Payer: PHCS All Commercial |
$2,142.00
|
| Rate for Payer: PHP All Commercial |
$2,165.99
|
| Rate for Payer: Sagamore Health Network All Products |
$2,204.83
|
| Rate for Payer: Signature Care EPO |
$2,370.48
|
| Rate for Payer: Signature Care PPO |
$2,513.28
|
| Rate for Payer: United Healthcare Commercial |
$2,250.53
|
|
|
HC CT LOWER EXT W/CONTRAST LT
|
Facility
IP
|
$2,038.98
|
|
|
Service Code
|
CPT 73701 LT
|
| Hospital Charge Code |
01663701
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,529.24 |
| Max. Negotiated Rate |
$1,896.25 |
| Rate for Payer: Aetna Commercial |
$1,761.68
|
| Rate for Payer: Cash Price |
$1,264.17
|
| Rate for Payer: Cigna All Commercial |
$1,759.64
|
| Rate for Payer: CORVEL All Commercial |
$1,896.25
|
| Rate for Payer: Coventry All Commercial |
$1,794.30
|
| Rate for Payer: Encore All Commercial |
$1,876.88
|
| Rate for Payer: Frontpath All Commercial |
$1,875.86
|
| Rate for Payer: Humana ChoiceCare |
$1,761.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,835.08
|
| Rate for Payer: PHCS All Commercial |
$1,529.24
|
| Rate for Payer: PHP All Commercial |
$1,546.36
|
| Rate for Payer: Sagamore Health Network All Products |
$1,574.09
|
| Rate for Payer: Signature Care EPO |
$1,692.35
|
| Rate for Payer: Signature Care PPO |
$1,794.30
|
| Rate for Payer: United Healthcare Commercial |
$1,606.72
|
|
|
HC CT LOWER EXT W/CONTRAST LT
|
Facility
OP
|
$2,038.98
|
|
|
Service Code
|
CPT 73701 LT
|
| Hospital Charge Code |
01663701
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$672.86 |
| Max. Negotiated Rate |
$1,896.25 |
| Rate for Payer: Aetna Commercial |
$1,720.90
|
| Rate for Payer: Aetna Medicare |
$672.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$672.86
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,177.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,177.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$773.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$740.15
|
| Rate for Payer: Cash Price |
$1,264.17
|
| Rate for Payer: Cash Price |
$1,264.17
|
| Rate for Payer: Centivo All Commercial |
$1,039.88
|
| Rate for Payer: Cigna All Commercial |
$1,759.64
|
| Rate for Payer: CORVEL All Commercial |
$1,896.25
|
| Rate for Payer: Coventry All Commercial |
$1,794.30
|
| Rate for Payer: Encore All Commercial |
$1,876.88
|
| Rate for Payer: Frontpath All Commercial |
$1,875.86
|
| Rate for Payer: Humana ChoiceCare |
$1,761.07
|
| Rate for Payer: Humana Medicare |
$1,039.88
|
| Rate for Payer: Lucent All Commercial |
$1,039.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,835.08
|
| Rate for Payer: PHCS All Commercial |
$1,529.24
|
| Rate for Payer: PHP All Commercial |
$1,546.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$795.20
|
| Rate for Payer: Sagamore Health Network All Products |
$1,574.09
|
| Rate for Payer: Signature Care EPO |
$1,692.35
|
| Rate for Payer: Signature Care PPO |
$1,794.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,733.13
|
| Rate for Payer: United Healthcare Commercial |
$1,606.72
|
| Rate for Payer: United Healthcare Medicare |
$672.86
|
|
|
HC CT LOWER EXT W/CONTRAST RT
|
Facility
IP
|
$2,038.98
|
|
|
Service Code
|
CPT 73701 RT
|
| Hospital Charge Code |
11663701
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,529.24 |
| Max. Negotiated Rate |
$1,896.25 |
| Rate for Payer: Aetna Commercial |
$1,761.68
|
| Rate for Payer: Cash Price |
$1,264.17
|
| Rate for Payer: Cigna All Commercial |
$1,759.64
|
| Rate for Payer: CORVEL All Commercial |
$1,896.25
|
| Rate for Payer: Coventry All Commercial |
$1,794.30
|
| Rate for Payer: Encore All Commercial |
$1,876.88
|
| Rate for Payer: Frontpath All Commercial |
$1,875.86
|
| Rate for Payer: Humana ChoiceCare |
$1,761.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,835.08
|
| Rate for Payer: PHCS All Commercial |
$1,529.24
|
| Rate for Payer: PHP All Commercial |
$1,546.36
|
| Rate for Payer: Sagamore Health Network All Products |
$1,574.09
|
| Rate for Payer: Signature Care EPO |
$1,692.35
|
| Rate for Payer: Signature Care PPO |
$1,794.30
|
| Rate for Payer: United Healthcare Commercial |
$1,606.72
|
|
|
HC CT LOWER EXT W/CONTRAST RT
|
Facility
OP
|
$2,038.98
|
|
|
Service Code
|
CPT 73701 RT
|
| Hospital Charge Code |
11663701
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$672.86 |
| Max. Negotiated Rate |
$1,896.25 |
| Rate for Payer: Aetna Commercial |
$1,720.90
|
| Rate for Payer: Aetna Medicare |
$672.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$672.86
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,177.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,177.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$773.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$740.15
|
| Rate for Payer: Cash Price |
$1,264.17
|
| Rate for Payer: Cash Price |
$1,264.17
|
| Rate for Payer: Centivo All Commercial |
$1,039.88
|
| Rate for Payer: Cigna All Commercial |
$1,759.64
|
| Rate for Payer: CORVEL All Commercial |
$1,896.25
|
| Rate for Payer: Coventry All Commercial |
$1,794.30
|
| Rate for Payer: Encore All Commercial |
$1,876.88
|
| Rate for Payer: Frontpath All Commercial |
$1,875.86
|
| Rate for Payer: Humana ChoiceCare |
$1,761.07
|
| Rate for Payer: Humana Medicare |
$1,039.88
|
| Rate for Payer: Lucent All Commercial |
$1,039.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,835.08
|
| Rate for Payer: PHCS All Commercial |
$1,529.24
|
| Rate for Payer: PHP All Commercial |
$1,546.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$795.20
|
| Rate for Payer: Sagamore Health Network All Products |
$1,574.09
|
| Rate for Payer: Signature Care EPO |
$1,692.35
|
| Rate for Payer: Signature Care PPO |
$1,794.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,733.13
|
| Rate for Payer: United Healthcare Commercial |
$1,606.72
|
| Rate for Payer: United Healthcare Medicare |
$672.86
|
|
|
HC CT LOWER EXT W/O CONTRAST BI
|
Facility
IP
|
$2,040.00
|
|
|
Service Code
|
CPT 73700 50
|
| Hospital Charge Code |
21663700
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,530.00 |
| Max. Negotiated Rate |
$1,897.20 |
| Rate for Payer: Aetna Commercial |
$1,762.56
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Cigna All Commercial |
$1,760.52
|
| Rate for Payer: CORVEL All Commercial |
$1,897.20
|
| Rate for Payer: Coventry All Commercial |
$1,795.20
|
| Rate for Payer: Encore All Commercial |
$1,877.82
|
| Rate for Payer: Frontpath All Commercial |
$1,876.80
|
| Rate for Payer: Humana ChoiceCare |
$1,761.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,836.00
|
| Rate for Payer: PHCS All Commercial |
$1,530.00
|
| Rate for Payer: PHP All Commercial |
$1,547.14
|
| Rate for Payer: Sagamore Health Network All Products |
$1,574.88
|
| Rate for Payer: Signature Care EPO |
$1,693.20
|
| Rate for Payer: Signature Care PPO |
$1,795.20
|
| Rate for Payer: United Healthcare Commercial |
$1,607.52
|
|
|
HC CT LOWER EXT W/O CONTRAST BI
|
Facility
OP
|
$2,040.00
|
|
|
Service Code
|
CPT 73700 50
|
| Hospital Charge Code |
21663700
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$673.20 |
| Max. Negotiated Rate |
$1,897.20 |
| Rate for Payer: Aetna Commercial |
$1,721.76
|
| Rate for Payer: Aetna Medicare |
$673.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$673.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,177.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,177.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$774.18
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$740.52
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Centivo All Commercial |
$1,040.40
|
| Rate for Payer: Cigna All Commercial |
$1,760.52
|
| Rate for Payer: CORVEL All Commercial |
$1,897.20
|
| Rate for Payer: Coventry All Commercial |
$1,795.20
|
| Rate for Payer: Encore All Commercial |
$1,877.82
|
| Rate for Payer: Frontpath All Commercial |
$1,876.80
|
| Rate for Payer: Humana ChoiceCare |
$1,761.95
|
| Rate for Payer: Humana Medicare |
$1,040.40
|
| Rate for Payer: Lucent All Commercial |
$1,040.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,836.00
|
| Rate for Payer: PHCS All Commercial |
$1,530.00
|
| Rate for Payer: PHP All Commercial |
$1,547.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$795.60
|
| Rate for Payer: Sagamore Health Network All Products |
$1,574.88
|
| Rate for Payer: Signature Care EPO |
$1,693.20
|
| Rate for Payer: Signature Care PPO |
$1,795.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,734.00
|
| Rate for Payer: United Healthcare Commercial |
$1,607.52
|
| Rate for Payer: United Healthcare Medicare |
$673.20
|
|
