|
HC AR PLATE TUB 4H LOCK
|
Facility
|
OP
|
$1,875.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608172
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$1,743.75 |
| Rate for Payer: Aetna Commercial |
$1,582.50
|
| Rate for Payer: Aetna Medicare |
$600.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$581.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,076.81
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,172.06
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$690.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$660.00
|
| Rate for Payer: Cash Price |
$1,125.00
|
| Rate for Payer: Cash Price |
$1,125.00
|
| Rate for Payer: Centivo All Commercial |
$1,020.00
|
| Rate for Payer: Cigna All Commercial |
$1,618.12
|
| Rate for Payer: CORVEL All Commercial |
$1,743.75
|
| Rate for Payer: Coventry All Commercial |
$1,650.00
|
| Rate for Payer: Encore All Commercial |
$1,725.94
|
| Rate for Payer: Frontpath All Commercial |
$1,725.00
|
| Rate for Payer: Humana ChoiceCare |
$1,619.44
|
| Rate for Payer: Humana Medicare |
$600.00
|
| Rate for Payer: Lucent All Commercial |
$1,020.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,687.50
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$1,406.25
|
| Rate for Payer: PHP All Commercial |
$1,422.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$731.25
|
| Rate for Payer: Sagamore Health Network All Products |
$1,447.50
|
| Rate for Payer: Signature Care EPO |
$1,556.25
|
| Rate for Payer: Signature Care PPO |
$1,650.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,593.75
|
| Rate for Payer: United Healthcare Commercial |
$1,477.50
|
| Rate for Payer: United Healthcare Medicare |
$600.00
|
|
|
HC AR PLATE TUB 6H LOCK
|
Facility
|
IP
|
$2,000.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608445
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,500.00 |
| Max. Negotiated Rate |
$1,860.00 |
| Rate for Payer: Aetna Commercial |
$1,728.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cigna All Commercial |
$1,726.00
|
| Rate for Payer: CORVEL All Commercial |
$1,860.00
|
| Rate for Payer: Coventry All Commercial |
$1,760.00
|
| Rate for Payer: Encore All Commercial |
$1,841.00
|
| Rate for Payer: Frontpath All Commercial |
$1,840.00
|
| Rate for Payer: Humana ChoiceCare |
$1,727.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,800.00
|
| Rate for Payer: PHCS All Commercial |
$1,500.00
|
| Rate for Payer: PHP All Commercial |
$1,516.80
|
| Rate for Payer: Sagamore Health Network All Products |
$1,544.00
|
| Rate for Payer: Signature Care EPO |
$1,660.00
|
| Rate for Payer: Signature Care PPO |
$1,760.00
|
| Rate for Payer: United Healthcare Commercial |
$1,576.00
|
|
|
HC AR PLATE TUB 6H LOCK
|
Facility
|
OP
|
$2,000.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608445
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$1,860.00 |
| Rate for Payer: Aetna Commercial |
$1,688.00
|
| Rate for Payer: Aetna Medicare |
$640.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$620.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,148.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,250.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$736.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$704.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Centivo All Commercial |
$1,088.00
|
| Rate for Payer: Cigna All Commercial |
$1,726.00
|
| Rate for Payer: CORVEL All Commercial |
$1,860.00
|
| Rate for Payer: Coventry All Commercial |
$1,760.00
|
| Rate for Payer: Encore All Commercial |
$1,841.00
|
| Rate for Payer: Frontpath All Commercial |
$1,840.00
|
| Rate for Payer: Humana ChoiceCare |
$1,727.40
|
| Rate for Payer: Humana Medicare |
$640.00
|
| Rate for Payer: Lucent All Commercial |
$1,088.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,800.00
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$1,500.00
|
| Rate for Payer: PHP All Commercial |
$1,516.80
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$780.00
|
| Rate for Payer: Sagamore Health Network All Products |
$1,544.00
|
| Rate for Payer: Signature Care EPO |
$1,660.00
|
| Rate for Payer: Signature Care PPO |
$1,760.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,700.00
|
| Rate for Payer: United Healthcare Commercial |
$1,576.00
|
| Rate for Payer: United Healthcare Medicare |
$640.00
|
|
|
HC AR PORTAL SKID
|
Facility
|
OP
|
$346.50
|
|
| Hospital Charge Code |
41606980
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$322.25 |
| Rate for Payer: Aetna Commercial |
$292.45
|
| Rate for Payer: Aetna Medicare |
$110.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$107.42
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$198.99
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$216.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$127.51
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$121.97
|
| Rate for Payer: Cash Price |
$207.90
|
| Rate for Payer: Cash Price |
$207.90
|
| Rate for Payer: Centivo All Commercial |
$188.50
|
| Rate for Payer: Cigna All Commercial |
$299.03
|
| Rate for Payer: CORVEL All Commercial |
$322.25
|
| Rate for Payer: Coventry All Commercial |
$304.92
|
| Rate for Payer: Encore All Commercial |
$318.95
|
| Rate for Payer: Frontpath All Commercial |
$318.78
|
| Rate for Payer: Humana ChoiceCare |
$299.27
|
| Rate for Payer: Humana Medicare |
$110.88
|
| Rate for Payer: Lucent All Commercial |
$188.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.85
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$259.88
|
| Rate for Payer: PHP All Commercial |
$262.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$135.13
|
| Rate for Payer: Sagamore Health Network All Products |
$267.50
|
| Rate for Payer: Signature Care EPO |
$287.60
|
| Rate for Payer: Signature Care PPO |
$304.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$294.52
|
| Rate for Payer: United Healthcare Commercial |
$273.04
|
| Rate for Payer: United Healthcare Medicare |
$110.88
|
|
|
HC AR PORTAL SKID
|
Facility
|
IP
|
$346.50
|
|
| Hospital Charge Code |
41606980
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$259.88 |
| Max. Negotiated Rate |
$322.25 |
| Rate for Payer: Aetna Commercial |
$299.38
|
| Rate for Payer: Cash Price |
$207.90
|
| Rate for Payer: Cigna All Commercial |
$299.03
|
| Rate for Payer: CORVEL All Commercial |
$322.25
|
| Rate for Payer: Coventry All Commercial |
$304.92
|
| Rate for Payer: Encore All Commercial |
$318.95
|
| Rate for Payer: Frontpath All Commercial |
$318.78
|
| Rate for Payer: Humana ChoiceCare |
$299.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$311.85
|
| Rate for Payer: PHCS All Commercial |
$259.88
|
| Rate for Payer: PHP All Commercial |
$262.79
|
| Rate for Payer: Sagamore Health Network All Products |
$267.50
|
| Rate for Payer: Signature Care EPO |
$287.60
|
| Rate for Payer: Signature Care PPO |
$304.92
|
| Rate for Payer: United Healthcare Commercial |
$273.04
|
|
|
HC AR PROFILE DRILL MINI CMP FT
|
Facility
|
IP
|
$825.00
|
|
| Hospital Charge Code |
41602615
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$618.75 |
| Max. Negotiated Rate |
$767.25 |
| Rate for Payer: Aetna Commercial |
$712.80
|
| Rate for Payer: Cash Price |
$495.00
|
| Rate for Payer: Cigna All Commercial |
$711.98
|
| Rate for Payer: CORVEL All Commercial |
$767.25
|
| Rate for Payer: Coventry All Commercial |
$726.00
|
| Rate for Payer: Encore All Commercial |
$759.41
|
| Rate for Payer: Frontpath All Commercial |
$759.00
|
| Rate for Payer: Humana ChoiceCare |
$712.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$742.50
|
| Rate for Payer: PHCS All Commercial |
$618.75
|
| Rate for Payer: PHP All Commercial |
$625.68
|
| Rate for Payer: Sagamore Health Network All Products |
$636.90
|
| Rate for Payer: Signature Care EPO |
$684.75
|
| Rate for Payer: Signature Care PPO |
$726.00
|
| Rate for Payer: United Healthcare Commercial |
$650.10
|
|
|
HC AR PROFILE DRILL MINI CMP FT
|
Facility
|
OP
|
$825.00
|
|
| Hospital Charge Code |
41602615
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$767.25 |
| Rate for Payer: Aetna Commercial |
$696.30
|
| Rate for Payer: Aetna Medicare |
$264.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$255.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$473.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$515.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$303.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$290.40
|
| Rate for Payer: Cash Price |
$495.00
|
| Rate for Payer: Cash Price |
$495.00
|
| Rate for Payer: Centivo All Commercial |
$448.80
|
| Rate for Payer: Cigna All Commercial |
$711.98
|
| Rate for Payer: CORVEL All Commercial |
$767.25
|
| Rate for Payer: Coventry All Commercial |
$726.00
|
| Rate for Payer: Encore All Commercial |
$759.41
|
| Rate for Payer: Frontpath All Commercial |
$759.00
|
| Rate for Payer: Humana ChoiceCare |
$712.55
|
| Rate for Payer: Humana Medicare |
$264.00
|
| Rate for Payer: Lucent All Commercial |
$448.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$742.50
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$618.75
|
| Rate for Payer: PHP All Commercial |
$625.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$321.75
|
| Rate for Payer: Sagamore Health Network All Products |
$636.90
|
| Rate for Payer: Signature Care EPO |
$684.75
|
| Rate for Payer: Signature Care PPO |
$726.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$701.25
|
| Rate for Payer: United Healthcare Commercial |
$650.10
|
| Rate for Payer: United Healthcare Medicare |
$264.00
|
|
|
HC AR QUADLINK GRAFT
|
Facility
|
OP
|
$8,892.00
|
|
|
Service Code
|
CPT C1762
|
| Hospital Charge Code |
41608032
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$8,269.56 |
| Rate for Payer: Aetna Commercial |
$7,504.85
|
| Rate for Payer: Aetna Medicare |
$2,845.44
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,756.52
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$5,106.68
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,558.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,272.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,129.98
|
| Rate for Payer: Cash Price |
$5,335.20
|
| Rate for Payer: Cash Price |
$5,335.20
|
| Rate for Payer: Centivo All Commercial |
$4,837.25
|
| Rate for Payer: Cigna All Commercial |
$7,673.80
|
| Rate for Payer: CORVEL All Commercial |
$8,269.56
|
| Rate for Payer: Coventry All Commercial |
$7,824.96
|
| Rate for Payer: Encore All Commercial |
$8,185.09
|
| Rate for Payer: Frontpath All Commercial |
$8,180.64
|
| Rate for Payer: Humana ChoiceCare |
$7,680.02
|
| Rate for Payer: Humana Medicare |
$2,845.44
|
| Rate for Payer: Lucent All Commercial |
$4,837.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,002.80
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$6,669.00
|
| Rate for Payer: PHP All Commercial |
$6,743.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,467.88
|
| Rate for Payer: Sagamore Health Network All Products |
$6,864.62
|
| Rate for Payer: Signature Care EPO |
$7,380.36
|
| Rate for Payer: Signature Care PPO |
$7,824.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,558.20
|
| Rate for Payer: United Healthcare Commercial |
$7,006.90
|
| Rate for Payer: United Healthcare Medicare |
$2,845.44
|
|
|
HC AR QUADLINK GRAFT
|
Facility
|
IP
|
$8,892.00
|
|
|
Service Code
|
CPT C1762
|
| Hospital Charge Code |
41608032
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,669.00 |
| Max. Negotiated Rate |
$8,269.56 |
| Rate for Payer: Aetna Commercial |
$7,682.69
|
| Rate for Payer: Cash Price |
$5,335.20
|
| Rate for Payer: Cigna All Commercial |
$7,673.80
|
| Rate for Payer: CORVEL All Commercial |
$8,269.56
|
| Rate for Payer: Coventry All Commercial |
$7,824.96
|
| Rate for Payer: Encore All Commercial |
$8,185.09
|
| Rate for Payer: Frontpath All Commercial |
$8,180.64
|
| Rate for Payer: Humana ChoiceCare |
$7,680.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,002.80
|
| Rate for Payer: PHCS All Commercial |
$6,669.00
|
| Rate for Payer: PHP All Commercial |
$6,743.69
|
| Rate for Payer: Sagamore Health Network All Products |
$6,864.62
|
| Rate for Payer: Signature Care EPO |
$7,380.36
|
| Rate for Payer: Signature Care PPO |
$7,824.96
|
| Rate for Payer: United Healthcare Commercial |
$7,006.90
|
|
|
HC AR QUADLINK IMPLANT SYSTEM 11MM
|
Facility
|
OP
|
$13,050.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608424
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$12,136.50 |
| Rate for Payer: Aetna Commercial |
$11,014.20
|
| Rate for Payer: Aetna Medicare |
$4,176.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,045.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$7,494.61
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$8,157.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,802.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,593.60
|
| Rate for Payer: Cash Price |
$7,830.00
|
| Rate for Payer: Cash Price |
$7,830.00
|
| Rate for Payer: Centivo All Commercial |
$7,099.20
|
| Rate for Payer: Cigna All Commercial |
$11,262.15
|
| Rate for Payer: CORVEL All Commercial |
$12,136.50
|
| Rate for Payer: Coventry All Commercial |
$11,484.00
|
| Rate for Payer: Encore All Commercial |
$12,012.52
|
| Rate for Payer: Frontpath All Commercial |
$12,006.00
|
| Rate for Payer: Humana ChoiceCare |
$11,271.28
|
| Rate for Payer: Humana Medicare |
$4,176.00
|
| Rate for Payer: Lucent All Commercial |
$7,099.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,745.00
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$9,787.50
|
| Rate for Payer: PHP All Commercial |
$9,897.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,089.50
|
| Rate for Payer: Sagamore Health Network All Products |
$10,074.60
|
| Rate for Payer: Signature Care EPO |
$10,831.50
|
| Rate for Payer: Signature Care PPO |
$11,484.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,092.50
|
| Rate for Payer: United Healthcare Commercial |
$10,283.40
|
| Rate for Payer: United Healthcare Medicare |
$4,176.00
|
|
|
HC AR QUADLINK IMPLANT SYSTEM 11MM
|
Facility
|
IP
|
$13,050.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608424
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,787.50 |
| Max. Negotiated Rate |
$12,136.50 |
| Rate for Payer: Aetna Commercial |
$11,275.20
|
| Rate for Payer: Cash Price |
$7,830.00
|
| Rate for Payer: Cigna All Commercial |
$11,262.15
|
| Rate for Payer: CORVEL All Commercial |
$12,136.50
|
| Rate for Payer: Coventry All Commercial |
$11,484.00
|
| Rate for Payer: Encore All Commercial |
$12,012.52
|
| Rate for Payer: Frontpath All Commercial |
$12,006.00
|
| Rate for Payer: Humana ChoiceCare |
$11,271.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,745.00
|
| Rate for Payer: PHCS All Commercial |
$9,787.50
|
| Rate for Payer: PHP All Commercial |
$9,897.12
|
| Rate for Payer: Sagamore Health Network All Products |
$10,074.60
|
| Rate for Payer: Signature Care EPO |
$10,831.50
|
| Rate for Payer: Signature Care PPO |
$11,484.00
|
| Rate for Payer: United Healthcare Commercial |
$10,283.40
|
|
|
HC AR QUADLINK IMPLANT SYSTEM 8MM
|
Facility
|
OP
|
$13,050.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608384
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$12,136.50 |
| Rate for Payer: Aetna Commercial |
$11,014.20
|
| Rate for Payer: Aetna Medicare |
$4,176.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,045.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$7,494.61
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$8,157.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,802.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,593.60
|
| Rate for Payer: Cash Price |
$7,830.00
|
| Rate for Payer: Cash Price |
$7,830.00
|
| Rate for Payer: Centivo All Commercial |
$7,099.20
|
| Rate for Payer: Cigna All Commercial |
$11,262.15
|
| Rate for Payer: CORVEL All Commercial |
$12,136.50
|
| Rate for Payer: Coventry All Commercial |
$11,484.00
|
| Rate for Payer: Encore All Commercial |
$12,012.52
|
| Rate for Payer: Frontpath All Commercial |
$12,006.00
|
| Rate for Payer: Humana ChoiceCare |
$11,271.28
|
| Rate for Payer: Humana Medicare |
$4,176.00
|
| Rate for Payer: Lucent All Commercial |
$7,099.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,745.00
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$9,787.50
|
| Rate for Payer: PHP All Commercial |
$9,897.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,089.50
|
| Rate for Payer: Sagamore Health Network All Products |
$10,074.60
|
| Rate for Payer: Signature Care EPO |
$10,831.50
|
| Rate for Payer: Signature Care PPO |
$11,484.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,092.50
|
| Rate for Payer: United Healthcare Commercial |
$10,283.40
|
| Rate for Payer: United Healthcare Medicare |
$4,176.00
|
|
|
HC AR QUADLINK IMPLANT SYSTEM 8MM
|
Facility
|
IP
|
$13,050.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608384
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,787.50 |
| Max. Negotiated Rate |
$12,136.50 |
| Rate for Payer: Aetna Commercial |
$11,275.20
|
| Rate for Payer: Cash Price |
$7,830.00
|
| Rate for Payer: Cigna All Commercial |
$11,262.15
|
| Rate for Payer: CORVEL All Commercial |
$12,136.50
|
| Rate for Payer: Coventry All Commercial |
$11,484.00
|
| Rate for Payer: Encore All Commercial |
$12,012.52
|
| Rate for Payer: Frontpath All Commercial |
$12,006.00
|
| Rate for Payer: Humana ChoiceCare |
$11,271.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,745.00
|
| Rate for Payer: PHCS All Commercial |
$9,787.50
|
| Rate for Payer: PHP All Commercial |
$9,897.12
|
| Rate for Payer: Sagamore Health Network All Products |
$10,074.60
|
| Rate for Payer: Signature Care EPO |
$10,831.50
|
| Rate for Payer: Signature Care PPO |
$11,484.00
|
| Rate for Payer: United Healthcare Commercial |
$10,283.40
|
|
|
HC AR QUAD TENDON FLEXIGRAFT
|
Facility
|
IP
|
$8,892.00
|
|
|
Service Code
|
CPT C9356
|
| Hospital Charge Code |
41607382
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,669.00 |
| Max. Negotiated Rate |
$8,269.56 |
| Rate for Payer: Aetna Commercial |
$7,682.69
|
| Rate for Payer: Cash Price |
$5,335.20
|
| Rate for Payer: Cigna All Commercial |
$7,673.80
|
| Rate for Payer: CORVEL All Commercial |
$8,269.56
|
| Rate for Payer: Coventry All Commercial |
$7,824.96
|
| Rate for Payer: Encore All Commercial |
$8,185.09
|
| Rate for Payer: Frontpath All Commercial |
$8,180.64
|
| Rate for Payer: Humana ChoiceCare |
$7,680.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,002.80
|
| Rate for Payer: PHCS All Commercial |
$6,669.00
|
| Rate for Payer: PHP All Commercial |
$6,743.69
|
| Rate for Payer: Sagamore Health Network All Products |
$6,864.62
|
| Rate for Payer: Signature Care EPO |
$7,380.36
|
| Rate for Payer: Signature Care PPO |
$7,824.96
|
| Rate for Payer: United Healthcare Commercial |
$7,006.90
|
|
|
HC AR QUAD TENDON FLEXIGRAFT
|
Facility
|
OP
|
$8,892.00
|
|
|
Service Code
|
CPT C9356
|
| Hospital Charge Code |
41607382
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$8,269.56 |
| Rate for Payer: Aetna Commercial |
$7,504.85
|
| Rate for Payer: Aetna Medicare |
$2,845.44
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,756.52
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$5,106.68
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,558.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,272.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,129.98
|
| Rate for Payer: Cash Price |
$5,335.20
|
| Rate for Payer: Cash Price |
$5,335.20
|
| Rate for Payer: Centivo All Commercial |
$4,837.25
|
| Rate for Payer: Cigna All Commercial |
$7,673.80
|
| Rate for Payer: CORVEL All Commercial |
$8,269.56
|
| Rate for Payer: Coventry All Commercial |
$7,824.96
|
| Rate for Payer: Encore All Commercial |
$8,185.09
|
| Rate for Payer: Frontpath All Commercial |
$8,180.64
|
| Rate for Payer: Humana ChoiceCare |
$7,680.02
|
| Rate for Payer: Humana Medicare |
$2,845.44
|
| Rate for Payer: Lucent All Commercial |
$4,837.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,002.80
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$6,669.00
|
| Rate for Payer: PHP All Commercial |
$6,743.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,467.88
|
| Rate for Payer: Sagamore Health Network All Products |
$6,864.62
|
| Rate for Payer: Signature Care EPO |
$7,380.36
|
| Rate for Payer: Signature Care PPO |
$7,824.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,558.20
|
| Rate for Payer: United Healthcare Commercial |
$7,006.90
|
| Rate for Payer: United Healthcare Medicare |
$2,845.44
|
|
|
HC AR QUAD TENDON W/BONE BLK
|
Facility
|
IP
|
$6,732.00
|
|
|
Service Code
|
CPT C1762
|
| Hospital Charge Code |
41607961
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,049.00 |
| Max. Negotiated Rate |
$6,260.76 |
| Rate for Payer: Aetna Commercial |
$5,816.45
|
| Rate for Payer: Cash Price |
$4,039.20
|
| Rate for Payer: Cigna All Commercial |
$5,809.72
|
| Rate for Payer: CORVEL All Commercial |
$6,260.76
|
| Rate for Payer: Coventry All Commercial |
$5,924.16
|
| Rate for Payer: Encore All Commercial |
$6,196.81
|
| Rate for Payer: Frontpath All Commercial |
$6,193.44
|
| Rate for Payer: Humana ChoiceCare |
$5,814.43
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,058.80
|
| Rate for Payer: PHCS All Commercial |
$5,049.00
|
| Rate for Payer: PHP All Commercial |
$5,105.55
|
| Rate for Payer: Sagamore Health Network All Products |
$5,197.10
|
| Rate for Payer: Signature Care EPO |
$5,587.56
|
| Rate for Payer: Signature Care PPO |
$5,924.16
|
| Rate for Payer: United Healthcare Commercial |
$5,304.82
|
|
|
HC AR QUAD TENDON W/BONE BLK
|
Facility
|
OP
|
$6,732.00
|
|
|
Service Code
|
CPT C1762
|
| Hospital Charge Code |
41607961
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$6,260.76 |
| Rate for Payer: Aetna Commercial |
$5,681.81
|
| Rate for Payer: Aetna Medicare |
$2,154.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,086.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$3,866.19
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,208.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,477.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,369.66
|
| Rate for Payer: Cash Price |
$4,039.20
|
| Rate for Payer: Cash Price |
$4,039.20
|
| Rate for Payer: Centivo All Commercial |
$3,662.21
|
| Rate for Payer: Cigna All Commercial |
$5,809.72
|
| Rate for Payer: CORVEL All Commercial |
$6,260.76
|
| Rate for Payer: Coventry All Commercial |
$5,924.16
|
| Rate for Payer: Encore All Commercial |
$6,196.81
|
| Rate for Payer: Frontpath All Commercial |
$6,193.44
|
| Rate for Payer: Humana ChoiceCare |
$5,814.43
|
| Rate for Payer: Humana Medicare |
$2,154.24
|
| Rate for Payer: Lucent All Commercial |
$3,662.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,058.80
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$5,049.00
|
| Rate for Payer: PHP All Commercial |
$5,105.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,625.48
|
| Rate for Payer: Sagamore Health Network All Products |
$5,197.10
|
| Rate for Payer: Signature Care EPO |
$5,587.56
|
| Rate for Payer: Signature Care PPO |
$5,924.16
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,722.20
|
| Rate for Payer: United Healthcare Commercial |
$5,304.82
|
| Rate for Payer: United Healthcare Medicare |
$2,154.24
|
|
|
HC AR REAMER 6 CANN
|
Facility
|
IP
|
$1,182.50
|
|
| Hospital Charge Code |
41607090
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$886.88 |
| Max. Negotiated Rate |
$1,099.72 |
| Rate for Payer: Aetna Commercial |
$1,021.68
|
| Rate for Payer: Cash Price |
$709.50
|
| Rate for Payer: Cigna All Commercial |
$1,020.50
|
| Rate for Payer: CORVEL All Commercial |
$1,099.72
|
| Rate for Payer: Coventry All Commercial |
$1,040.60
|
| Rate for Payer: Encore All Commercial |
$1,088.49
|
| Rate for Payer: Frontpath All Commercial |
$1,087.90
|
| Rate for Payer: Humana ChoiceCare |
$1,021.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,064.25
|
| Rate for Payer: PHCS All Commercial |
$886.88
|
| Rate for Payer: PHP All Commercial |
$896.81
|
| Rate for Payer: Sagamore Health Network All Products |
$912.89
|
| Rate for Payer: Signature Care EPO |
$981.48
|
| Rate for Payer: Signature Care PPO |
$1,040.60
|
| Rate for Payer: United Healthcare Commercial |
$931.81
|
|
|
HC AR REAMER 6 CANN
|
Facility
|
OP
|
$1,182.50
|
|
| Hospital Charge Code |
41607090
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$1,099.72 |
| Rate for Payer: Aetna Commercial |
$998.03
|
| Rate for Payer: Aetna Medicare |
$378.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$366.57
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$679.11
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$739.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$435.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$416.24
|
| Rate for Payer: Cash Price |
$709.50
|
| Rate for Payer: Cash Price |
$709.50
|
| Rate for Payer: Centivo All Commercial |
$643.28
|
| Rate for Payer: Cigna All Commercial |
$1,020.50
|
| Rate for Payer: CORVEL All Commercial |
$1,099.72
|
| Rate for Payer: Coventry All Commercial |
$1,040.60
|
| Rate for Payer: Encore All Commercial |
$1,088.49
|
| Rate for Payer: Frontpath All Commercial |
$1,087.90
|
| Rate for Payer: Humana ChoiceCare |
$1,021.33
|
| Rate for Payer: Humana Medicare |
$378.40
|
| Rate for Payer: Lucent All Commercial |
$643.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,064.25
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$886.88
|
| Rate for Payer: PHP All Commercial |
$896.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$461.18
|
| Rate for Payer: Sagamore Health Network All Products |
$912.89
|
| Rate for Payer: Signature Care EPO |
$981.48
|
| Rate for Payer: Signature Care PPO |
$1,040.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,005.12
|
| Rate for Payer: United Healthcare Commercial |
$931.81
|
| Rate for Payer: United Healthcare Medicare |
$378.40
|
|
|
HC AR REAMER 7 LP
|
Facility
|
OP
|
$1,625.00
|
|
| Hospital Charge Code |
41608381
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$1,511.25 |
| Rate for Payer: Aetna Commercial |
$1,371.50
|
| Rate for Payer: Aetna Medicare |
$520.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$503.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$933.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,015.79
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$598.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$572.00
|
| Rate for Payer: Cash Price |
$975.00
|
| Rate for Payer: Cash Price |
$975.00
|
| Rate for Payer: Centivo All Commercial |
$884.00
|
| Rate for Payer: Cigna All Commercial |
$1,402.38
|
| Rate for Payer: CORVEL All Commercial |
$1,511.25
|
| Rate for Payer: Coventry All Commercial |
$1,430.00
|
| Rate for Payer: Encore All Commercial |
$1,495.81
|
| Rate for Payer: Frontpath All Commercial |
$1,495.00
|
| Rate for Payer: Humana ChoiceCare |
$1,403.51
|
| Rate for Payer: Humana Medicare |
$520.00
|
| Rate for Payer: Lucent All Commercial |
$884.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,462.50
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$1,218.75
|
| Rate for Payer: PHP All Commercial |
$1,232.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$633.75
|
| Rate for Payer: Sagamore Health Network All Products |
$1,254.50
|
| Rate for Payer: Signature Care EPO |
$1,348.75
|
| Rate for Payer: Signature Care PPO |
$1,430.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,381.25
|
| Rate for Payer: United Healthcare Commercial |
$1,280.50
|
| Rate for Payer: United Healthcare Medicare |
$520.00
|
|
|
HC AR REAMER 7 LP
|
Facility
|
IP
|
$1,625.00
|
|
| Hospital Charge Code |
41608381
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,218.75 |
| Max. Negotiated Rate |
$1,511.25 |
| Rate for Payer: Aetna Commercial |
$1,404.00
|
| Rate for Payer: Cash Price |
$975.00
|
| Rate for Payer: Cigna All Commercial |
$1,402.38
|
| Rate for Payer: CORVEL All Commercial |
$1,511.25
|
| Rate for Payer: Coventry All Commercial |
$1,430.00
|
| Rate for Payer: Encore All Commercial |
$1,495.81
|
| Rate for Payer: Frontpath All Commercial |
$1,495.00
|
| Rate for Payer: Humana ChoiceCare |
$1,403.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,462.50
|
| Rate for Payer: PHCS All Commercial |
$1,218.75
|
| Rate for Payer: PHP All Commercial |
$1,232.40
|
| Rate for Payer: Sagamore Health Network All Products |
$1,254.50
|
| Rate for Payer: Signature Care EPO |
$1,348.75
|
| Rate for Payer: Signature Care PPO |
$1,430.00
|
| Rate for Payer: United Healthcare Commercial |
$1,280.50
|
|
|
HC AR REAMER 8.0
|
Facility
|
IP
|
$1,182.50
|
|
| Hospital Charge Code |
41606749
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$886.88 |
| Max. Negotiated Rate |
$1,099.72 |
| Rate for Payer: Aetna Commercial |
$1,021.68
|
| Rate for Payer: Cash Price |
$709.50
|
| Rate for Payer: Cigna All Commercial |
$1,020.50
|
| Rate for Payer: CORVEL All Commercial |
$1,099.72
|
| Rate for Payer: Coventry All Commercial |
$1,040.60
|
| Rate for Payer: Encore All Commercial |
$1,088.49
|
| Rate for Payer: Frontpath All Commercial |
$1,087.90
|
| Rate for Payer: Humana ChoiceCare |
$1,021.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,064.25
|
| Rate for Payer: PHCS All Commercial |
$886.88
|
| Rate for Payer: PHP All Commercial |
$896.81
|
| Rate for Payer: Sagamore Health Network All Products |
$912.89
|
| Rate for Payer: Signature Care EPO |
$981.48
|
| Rate for Payer: Signature Care PPO |
$1,040.60
|
| Rate for Payer: United Healthcare Commercial |
$931.81
|
|
|
HC AR REAMER 8.0
|
Facility
|
OP
|
$1,182.50
|
|
| Hospital Charge Code |
41606749
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$1,099.72 |
| Rate for Payer: Aetna Commercial |
$998.03
|
| Rate for Payer: Aetna Medicare |
$378.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$366.57
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$679.11
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$739.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$435.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$416.24
|
| Rate for Payer: Cash Price |
$709.50
|
| Rate for Payer: Cash Price |
$709.50
|
| Rate for Payer: Centivo All Commercial |
$643.28
|
| Rate for Payer: Cigna All Commercial |
$1,020.50
|
| Rate for Payer: CORVEL All Commercial |
$1,099.72
|
| Rate for Payer: Coventry All Commercial |
$1,040.60
|
| Rate for Payer: Encore All Commercial |
$1,088.49
|
| Rate for Payer: Frontpath All Commercial |
$1,087.90
|
| Rate for Payer: Humana ChoiceCare |
$1,021.33
|
| Rate for Payer: Humana Medicare |
$378.40
|
| Rate for Payer: Lucent All Commercial |
$643.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,064.25
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$886.88
|
| Rate for Payer: PHP All Commercial |
$896.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$461.18
|
| Rate for Payer: Sagamore Health Network All Products |
$912.89
|
| Rate for Payer: Signature Care EPO |
$981.48
|
| Rate for Payer: Signature Care PPO |
$1,040.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,005.12
|
| Rate for Payer: United Healthcare Commercial |
$931.81
|
| Rate for Payer: United Healthcare Medicare |
$378.40
|
|
|
HC AR REAMER LP
|
Facility
|
OP
|
$1,072.50
|
|
| Hospital Charge Code |
41605855
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$997.42 |
| Rate for Payer: Aetna Commercial |
$905.19
|
| Rate for Payer: Aetna Medicare |
$343.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$332.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$615.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$670.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$394.68
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$377.52
|
| Rate for Payer: Cash Price |
$643.50
|
| Rate for Payer: Cash Price |
$643.50
|
| Rate for Payer: Centivo All Commercial |
$583.44
|
| Rate for Payer: Cigna All Commercial |
$925.57
|
| Rate for Payer: CORVEL All Commercial |
$997.42
|
| Rate for Payer: Coventry All Commercial |
$943.80
|
| Rate for Payer: Encore All Commercial |
$987.24
|
| Rate for Payer: Frontpath All Commercial |
$986.70
|
| Rate for Payer: Humana ChoiceCare |
$926.32
|
| Rate for Payer: Humana Medicare |
$343.20
|
| Rate for Payer: Lucent All Commercial |
$583.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$965.25
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$804.38
|
| Rate for Payer: PHP All Commercial |
$813.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$418.27
|
| Rate for Payer: Sagamore Health Network All Products |
$827.97
|
| Rate for Payer: Signature Care EPO |
$890.17
|
| Rate for Payer: Signature Care PPO |
$943.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$911.62
|
| Rate for Payer: United Healthcare Commercial |
$845.13
|
| Rate for Payer: United Healthcare Medicare |
$343.20
|
|
|
HC AR REAMER LP
|
Facility
|
IP
|
$1,072.50
|
|
| Hospital Charge Code |
41605855
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$804.38 |
| Max. Negotiated Rate |
$997.42 |
| Rate for Payer: Aetna Commercial |
$926.64
|
| Rate for Payer: Cash Price |
$643.50
|
| Rate for Payer: Cigna All Commercial |
$925.57
|
| Rate for Payer: CORVEL All Commercial |
$997.42
|
| Rate for Payer: Coventry All Commercial |
$943.80
|
| Rate for Payer: Encore All Commercial |
$987.24
|
| Rate for Payer: Frontpath All Commercial |
$986.70
|
| Rate for Payer: Humana ChoiceCare |
$926.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$965.25
|
| Rate for Payer: PHCS All Commercial |
$804.38
|
| Rate for Payer: PHP All Commercial |
$813.38
|
| Rate for Payer: Sagamore Health Network All Products |
$827.97
|
| Rate for Payer: Signature Care EPO |
$890.17
|
| Rate for Payer: Signature Care PPO |
$943.80
|
| Rate for Payer: United Healthcare Commercial |
$845.13
|
|
