|
HC ASPERGILLUS AB - CF
|
Facility
|
OP
|
$103.02
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
63001918
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.05 |
| Max. Negotiated Rate |
$95.81 |
| Rate for Payer: Aetna Commercial |
$86.95
|
| Rate for Payer: Aetna Medicare |
$32.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$15.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$31.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$47.35
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$47.35
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$15.05
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$37.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$36.26
|
| Rate for Payer: Cash Price |
$61.81
|
| Rate for Payer: Cash Price |
$61.81
|
| Rate for Payer: Centivo All Commercial |
$56.04
|
| Rate for Payer: Cigna All Commercial |
$88.91
|
| Rate for Payer: CORVEL All Commercial |
$95.81
|
| Rate for Payer: Coventry All Commercial |
$90.66
|
| Rate for Payer: Encore All Commercial |
$94.83
|
| Rate for Payer: Frontpath All Commercial |
$94.78
|
| Rate for Payer: Humana ChoiceCare |
$88.98
|
| Rate for Payer: Humana Medicare |
$32.97
|
| Rate for Payer: Lucent All Commercial |
$56.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$92.72
|
| Rate for Payer: Managed Health Services Medicaid |
$15.05
|
| Rate for Payer: MDWise Medicaid |
$15.05
|
| Rate for Payer: PHCS All Commercial |
$77.27
|
| Rate for Payer: PHP All Commercial |
$78.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$40.18
|
| Rate for Payer: Sagamore Health Network All Products |
$79.53
|
| Rate for Payer: Signature Care EPO |
$85.51
|
| Rate for Payer: Signature Care PPO |
$90.66
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$87.57
|
| Rate for Payer: United Healthcare Commercial |
$81.18
|
| Rate for Payer: United Healthcare Medicare |
$32.97
|
|
|
HC ASPERGILLUS GALACTOMANNAN ANTIGEN DETECTION, BRONCHOALVEOLAR LAVAGE OR SERUM
|
Facility
|
OP
|
$145.35
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
63044020
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.98 |
| Max. Negotiated Rate |
$135.18 |
| Rate for Payer: Aetna Commercial |
$122.68
|
| Rate for Payer: Aetna Medicare |
$46.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$11.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$45.06
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$66.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$66.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$11.98
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$53.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$51.16
|
| Rate for Payer: Cash Price |
$87.21
|
| Rate for Payer: Cash Price |
$87.21
|
| Rate for Payer: Centivo All Commercial |
$79.07
|
| Rate for Payer: Cigna All Commercial |
$125.44
|
| Rate for Payer: CORVEL All Commercial |
$135.18
|
| Rate for Payer: Coventry All Commercial |
$127.91
|
| Rate for Payer: Encore All Commercial |
$133.79
|
| Rate for Payer: Frontpath All Commercial |
$133.72
|
| Rate for Payer: Humana ChoiceCare |
$125.54
|
| Rate for Payer: Humana Medicare |
$46.51
|
| Rate for Payer: Lucent All Commercial |
$79.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$130.81
|
| Rate for Payer: Managed Health Services Medicaid |
$11.98
|
| Rate for Payer: MDWise Medicaid |
$11.98
|
| Rate for Payer: PHCS All Commercial |
$109.01
|
| Rate for Payer: PHP All Commercial |
$110.23
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$56.69
|
| Rate for Payer: Sagamore Health Network All Products |
$112.21
|
| Rate for Payer: Signature Care EPO |
$120.64
|
| Rate for Payer: Signature Care PPO |
$127.91
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$123.55
|
| Rate for Payer: United Healthcare Commercial |
$114.54
|
| Rate for Payer: United Healthcare Medicare |
$46.51
|
|
|
HC ASPERGILLUS GALACTOMANNAN ANTIGEN DETECTION, BRONCHOALVEOLAR LAVAGE OR SERUM
|
Facility
|
IP
|
$145.35
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
63044020
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$109.01 |
| Max. Negotiated Rate |
$135.18 |
| Rate for Payer: Aetna Commercial |
$125.58
|
| Rate for Payer: Cash Price |
$87.21
|
| Rate for Payer: Cigna All Commercial |
$125.44
|
| Rate for Payer: CORVEL All Commercial |
$135.18
|
| Rate for Payer: Coventry All Commercial |
$127.91
|
| Rate for Payer: Encore All Commercial |
$133.79
|
| Rate for Payer: Frontpath All Commercial |
$133.72
|
| Rate for Payer: Humana ChoiceCare |
$125.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$130.81
|
| Rate for Payer: PHCS All Commercial |
$109.01
|
| Rate for Payer: PHP All Commercial |
$110.23
|
| Rate for Payer: Sagamore Health Network All Products |
$112.21
|
| Rate for Payer: Signature Care EPO |
$120.64
|
| Rate for Payer: Signature Care PPO |
$127.91
|
| Rate for Payer: United Healthcare Commercial |
$114.54
|
|
|
HC ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ
|
Facility
|
OP
|
$221.34
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
1620612
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$68.62 |
| Max. Negotiated Rate |
$205.85 |
| Rate for Payer: Aetna Commercial |
$186.81
|
| Rate for Payer: Aetna Medicare |
$70.83
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$73.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$68.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$127.12
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$138.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$73.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$81.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$77.91
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Centivo All Commercial |
$120.41
|
| Rate for Payer: Cigna All Commercial |
$191.02
|
| Rate for Payer: CORVEL All Commercial |
$205.85
|
| Rate for Payer: Coventry All Commercial |
$194.78
|
| Rate for Payer: Encore All Commercial |
$203.74
|
| Rate for Payer: Frontpath All Commercial |
$203.63
|
| Rate for Payer: Humana ChoiceCare |
$191.17
|
| Rate for Payer: Humana Medicare |
$70.83
|
| Rate for Payer: Lucent All Commercial |
$120.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$199.21
|
| Rate for Payer: Managed Health Services Medicaid |
$73.30
|
| Rate for Payer: MDWise Medicaid |
$73.30
|
| Rate for Payer: PHCS All Commercial |
$166.00
|
| Rate for Payer: PHP All Commercial |
$167.86
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$86.32
|
| Rate for Payer: Sagamore Health Network All Products |
$170.87
|
| Rate for Payer: Signature Care EPO |
$183.71
|
| Rate for Payer: Signature Care PPO |
$194.78
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$188.14
|
| Rate for Payer: United Healthcare Commercial |
$174.42
|
| Rate for Payer: United Healthcare Medicare |
$70.83
|
|
|
HC ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ
|
Facility
|
IP
|
$221.34
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
1620612
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$166.00 |
| Max. Negotiated Rate |
$205.85 |
| Rate for Payer: Aetna Commercial |
$191.24
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cigna All Commercial |
$191.02
|
| Rate for Payer: CORVEL All Commercial |
$205.85
|
| Rate for Payer: Coventry All Commercial |
$194.78
|
| Rate for Payer: Encore All Commercial |
$203.74
|
| Rate for Payer: Frontpath All Commercial |
$203.63
|
| Rate for Payer: Humana ChoiceCare |
$191.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$199.21
|
| Rate for Payer: PHCS All Commercial |
$166.00
|
| Rate for Payer: PHP All Commercial |
$167.86
|
| Rate for Payer: Sagamore Health Network All Products |
$170.87
|
| Rate for Payer: Signature Care EPO |
$183.71
|
| Rate for Payer: Signature Care PPO |
$194.78
|
| Rate for Payer: United Healthcare Commercial |
$174.42
|
|
|
HC ASPIRATION & INJECTION TREATMENT BONE CYST
|
Facility
|
OP
|
$5,124.48
|
|
|
Service Code
|
CPT 20615
|
| Hospital Charge Code |
1620615
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$73.30 |
| Max. Negotiated Rate |
$4,765.77 |
| Rate for Payer: Aetna Commercial |
$4,325.06
|
| Rate for Payer: Aetna Medicare |
$1,639.83
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$73.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,588.59
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$2,942.99
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,203.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$73.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,885.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,803.82
|
| Rate for Payer: Cash Price |
$3,074.69
|
| Rate for Payer: Cash Price |
$3,074.69
|
| Rate for Payer: Centivo All Commercial |
$2,787.72
|
| Rate for Payer: Cigna All Commercial |
$4,422.43
|
| Rate for Payer: CORVEL All Commercial |
$4,765.77
|
| Rate for Payer: Coventry All Commercial |
$4,509.54
|
| Rate for Payer: Encore All Commercial |
$4,717.08
|
| Rate for Payer: Frontpath All Commercial |
$4,714.52
|
| Rate for Payer: Humana ChoiceCare |
$4,426.01
|
| Rate for Payer: Humana Medicare |
$1,639.83
|
| Rate for Payer: Lucent All Commercial |
$2,787.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,612.03
|
| Rate for Payer: Managed Health Services Medicaid |
$73.30
|
| Rate for Payer: MDWise Medicaid |
$73.30
|
| Rate for Payer: PHCS All Commercial |
$3,843.36
|
| Rate for Payer: PHP All Commercial |
$3,886.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,998.55
|
| Rate for Payer: Sagamore Health Network All Products |
$3,956.10
|
| Rate for Payer: Signature Care EPO |
$4,253.32
|
| Rate for Payer: Signature Care PPO |
$4,509.54
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,355.81
|
| Rate for Payer: United Healthcare Commercial |
$4,038.09
|
| Rate for Payer: United Healthcare Medicare |
$1,639.83
|
|
|
HC ASPIRATION & INJECTION TREATMENT BONE CYST
|
Facility
|
IP
|
$5,124.48
|
|
|
Service Code
|
CPT 20615
|
| Hospital Charge Code |
1620615
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,843.36 |
| Max. Negotiated Rate |
$4,765.77 |
| Rate for Payer: Aetna Commercial |
$4,427.55
|
| Rate for Payer: Cash Price |
$3,074.69
|
| Rate for Payer: Cigna All Commercial |
$4,422.43
|
| Rate for Payer: CORVEL All Commercial |
$4,765.77
|
| Rate for Payer: Coventry All Commercial |
$4,509.54
|
| Rate for Payer: Encore All Commercial |
$4,717.08
|
| Rate for Payer: Frontpath All Commercial |
$4,714.52
|
| Rate for Payer: Humana ChoiceCare |
$4,426.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,612.03
|
| Rate for Payer: PHCS All Commercial |
$3,843.36
|
| Rate for Payer: PHP All Commercial |
$3,886.41
|
| Rate for Payer: Sagamore Health Network All Products |
$3,956.10
|
| Rate for Payer: Signature Care EPO |
$4,253.32
|
| Rate for Payer: Signature Care PPO |
$4,509.54
|
| Rate for Payer: United Healthcare Commercial |
$4,038.09
|
|
|
HC AVITENE FLOUR 0.5GM
|
Facility
|
IP
|
$525.00
|
|
| Hospital Charge Code |
41601893
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$393.75 |
| Max. Negotiated Rate |
$488.25 |
| Rate for Payer: Aetna Commercial |
$453.60
|
| Rate for Payer: Cash Price |
$315.00
|
| Rate for Payer: Cigna All Commercial |
$453.07
|
| Rate for Payer: CORVEL All Commercial |
$488.25
|
| Rate for Payer: Coventry All Commercial |
$462.00
|
| Rate for Payer: Encore All Commercial |
$483.26
|
| Rate for Payer: Frontpath All Commercial |
$483.00
|
| Rate for Payer: Humana ChoiceCare |
$453.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$472.50
|
| Rate for Payer: PHCS All Commercial |
$393.75
|
| Rate for Payer: PHP All Commercial |
$398.16
|
| Rate for Payer: Sagamore Health Network All Products |
$405.30
|
| Rate for Payer: Signature Care EPO |
$435.75
|
| Rate for Payer: Signature Care PPO |
$462.00
|
| Rate for Payer: United Healthcare Commercial |
$413.70
|
|
|
HC AVITENE FLOUR 0.5GM
|
Facility
|
OP
|
$525.00
|
|
| Hospital Charge Code |
41601893
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$488.25 |
| Rate for Payer: Aetna Commercial |
$443.10
|
| Rate for Payer: Aetna Medicare |
$168.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$162.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$301.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$328.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$193.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$184.80
|
| Rate for Payer: Cash Price |
$315.00
|
| Rate for Payer: Cash Price |
$315.00
|
| Rate for Payer: Centivo All Commercial |
$285.60
|
| Rate for Payer: Cigna All Commercial |
$453.07
|
| Rate for Payer: CORVEL All Commercial |
$488.25
|
| Rate for Payer: Coventry All Commercial |
$462.00
|
| Rate for Payer: Encore All Commercial |
$483.26
|
| Rate for Payer: Frontpath All Commercial |
$483.00
|
| Rate for Payer: Humana ChoiceCare |
$453.44
|
| Rate for Payer: Humana Medicare |
$168.00
|
| Rate for Payer: Lucent All Commercial |
$285.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$472.50
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$393.75
|
| Rate for Payer: PHP All Commercial |
$398.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$204.75
|
| Rate for Payer: Sagamore Health Network All Products |
$405.30
|
| Rate for Payer: Signature Care EPO |
$435.75
|
| Rate for Payer: Signature Care PPO |
$462.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$446.25
|
| Rate for Payer: United Healthcare Commercial |
$413.70
|
| Rate for Payer: United Healthcare Medicare |
$168.00
|
|
|
HC BABY ABO TYPE
|
Facility
|
OP
|
$84.57
|
|
|
Service Code
|
CPT 86900
|
| Hospital Charge Code |
63001352
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$78.65 |
| Rate for Payer: Aetna Commercial |
$71.38
|
| Rate for Payer: Aetna Medicare |
$27.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$2.99
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$26.22
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$38.87
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$38.87
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$2.99
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$31.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$29.77
|
| Rate for Payer: Cash Price |
$50.74
|
| Rate for Payer: Cash Price |
$50.74
|
| Rate for Payer: Centivo All Commercial |
$46.01
|
| Rate for Payer: Cigna All Commercial |
$72.98
|
| Rate for Payer: CORVEL All Commercial |
$78.65
|
| Rate for Payer: Coventry All Commercial |
$74.42
|
| Rate for Payer: Encore All Commercial |
$77.85
|
| Rate for Payer: Frontpath All Commercial |
$77.80
|
| Rate for Payer: Humana ChoiceCare |
$73.04
|
| Rate for Payer: Humana Medicare |
$27.06
|
| Rate for Payer: Lucent All Commercial |
$46.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$76.11
|
| Rate for Payer: Managed Health Services Medicaid |
$2.99
|
| Rate for Payer: MDWise Medicaid |
$2.99
|
| Rate for Payer: PHCS All Commercial |
$63.43
|
| Rate for Payer: PHP All Commercial |
$64.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$32.98
|
| Rate for Payer: Sagamore Health Network All Products |
$65.29
|
| Rate for Payer: Signature Care EPO |
$70.19
|
| Rate for Payer: Signature Care PPO |
$74.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$71.88
|
| Rate for Payer: United Healthcare Commercial |
$66.64
|
| Rate for Payer: United Healthcare Medicare |
$27.06
|
|
|
HC BABY ABO TYPE
|
Facility
|
IP
|
$84.57
|
|
|
Service Code
|
CPT 86900
|
| Hospital Charge Code |
63001352
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$63.43 |
| Max. Negotiated Rate |
$78.65 |
| Rate for Payer: Aetna Commercial |
$73.07
|
| Rate for Payer: Cash Price |
$50.74
|
| Rate for Payer: Cigna All Commercial |
$72.98
|
| Rate for Payer: CORVEL All Commercial |
$78.65
|
| Rate for Payer: Coventry All Commercial |
$74.42
|
| Rate for Payer: Encore All Commercial |
$77.85
|
| Rate for Payer: Frontpath All Commercial |
$77.80
|
| Rate for Payer: Humana ChoiceCare |
$73.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$76.11
|
| Rate for Payer: PHCS All Commercial |
$63.43
|
| Rate for Payer: PHP All Commercial |
$64.14
|
| Rate for Payer: Sagamore Health Network All Products |
$65.29
|
| Rate for Payer: Signature Care EPO |
$70.19
|
| Rate for Payer: Signature Care PPO |
$74.42
|
| Rate for Payer: United Healthcare Commercial |
$66.64
|
|
|
HC BABY RH
|
Facility
|
IP
|
$69.56
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
63001354
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$52.17 |
| Max. Negotiated Rate |
$64.69 |
| Rate for Payer: Aetna Commercial |
$60.10
|
| Rate for Payer: Cash Price |
$41.74
|
| Rate for Payer: Cigna All Commercial |
$60.03
|
| Rate for Payer: CORVEL All Commercial |
$64.69
|
| Rate for Payer: Coventry All Commercial |
$61.21
|
| Rate for Payer: Encore All Commercial |
$64.03
|
| Rate for Payer: Frontpath All Commercial |
$64.00
|
| Rate for Payer: Humana ChoiceCare |
$60.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$62.60
|
| Rate for Payer: PHCS All Commercial |
$52.17
|
| Rate for Payer: PHP All Commercial |
$52.75
|
| Rate for Payer: Sagamore Health Network All Products |
$53.70
|
| Rate for Payer: Signature Care EPO |
$57.73
|
| Rate for Payer: Signature Care PPO |
$61.21
|
| Rate for Payer: United Healthcare Commercial |
$54.81
|
|
|
HC BABY RH
|
Facility
|
OP
|
$69.56
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
63001354
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$64.69 |
| Rate for Payer: Aetna Commercial |
$58.71
|
| Rate for Payer: Aetna Medicare |
$22.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$2.99
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$21.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$31.97
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$31.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$2.99
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$25.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$24.49
|
| Rate for Payer: Cash Price |
$41.74
|
| Rate for Payer: Cash Price |
$41.74
|
| Rate for Payer: Centivo All Commercial |
$37.84
|
| Rate for Payer: Cigna All Commercial |
$60.03
|
| Rate for Payer: CORVEL All Commercial |
$64.69
|
| Rate for Payer: Coventry All Commercial |
$61.21
|
| Rate for Payer: Encore All Commercial |
$64.03
|
| Rate for Payer: Frontpath All Commercial |
$64.00
|
| Rate for Payer: Humana ChoiceCare |
$60.08
|
| Rate for Payer: Humana Medicare |
$22.26
|
| Rate for Payer: Lucent All Commercial |
$37.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$62.60
|
| Rate for Payer: Managed Health Services Medicaid |
$2.99
|
| Rate for Payer: MDWise Medicaid |
$2.99
|
| Rate for Payer: PHCS All Commercial |
$52.17
|
| Rate for Payer: PHP All Commercial |
$52.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$27.13
|
| Rate for Payer: Sagamore Health Network All Products |
$53.70
|
| Rate for Payer: Signature Care EPO |
$57.73
|
| Rate for Payer: Signature Care PPO |
$61.21
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$59.13
|
| Rate for Payer: United Healthcare Commercial |
$54.81
|
| Rate for Payer: United Healthcare Medicare |
$22.26
|
|
|
HC BACTERIA ANAEROBE ID
|
Facility
|
OP
|
$135.46
|
|
|
Service Code
|
CPT 87076
|
| Hospital Charge Code |
63001079
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$125.98 |
| Rate for Payer: Aetna Commercial |
$114.33
|
| Rate for Payer: Aetna Medicare |
$43.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$8.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$41.99
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$62.26
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$62.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$8.08
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$49.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$47.68
|
| Rate for Payer: Cash Price |
$81.28
|
| Rate for Payer: Cash Price |
$81.28
|
| Rate for Payer: Centivo All Commercial |
$73.69
|
| Rate for Payer: Cigna All Commercial |
$116.90
|
| Rate for Payer: CORVEL All Commercial |
$125.98
|
| Rate for Payer: Coventry All Commercial |
$119.20
|
| Rate for Payer: Encore All Commercial |
$124.69
|
| Rate for Payer: Frontpath All Commercial |
$124.62
|
| Rate for Payer: Humana ChoiceCare |
$117.00
|
| Rate for Payer: Humana Medicare |
$43.35
|
| Rate for Payer: Lucent All Commercial |
$73.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$121.91
|
| Rate for Payer: Managed Health Services Medicaid |
$8.08
|
| Rate for Payer: MDWise Medicaid |
$8.08
|
| Rate for Payer: PHCS All Commercial |
$101.59
|
| Rate for Payer: PHP All Commercial |
$102.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$52.83
|
| Rate for Payer: Sagamore Health Network All Products |
$104.58
|
| Rate for Payer: Signature Care EPO |
$112.43
|
| Rate for Payer: Signature Care PPO |
$119.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$115.14
|
| Rate for Payer: United Healthcare Commercial |
$106.74
|
| Rate for Payer: United Healthcare Medicare |
$43.35
|
|
|
HC BACTERIA ANAEROBE ID
|
Facility
|
IP
|
$135.46
|
|
|
Service Code
|
CPT 87076
|
| Hospital Charge Code |
63001079
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$101.59 |
| Max. Negotiated Rate |
$125.98 |
| Rate for Payer: Aetna Commercial |
$117.04
|
| Rate for Payer: Cash Price |
$81.28
|
| Rate for Payer: Cigna All Commercial |
$116.90
|
| Rate for Payer: CORVEL All Commercial |
$125.98
|
| Rate for Payer: Coventry All Commercial |
$119.20
|
| Rate for Payer: Encore All Commercial |
$124.69
|
| Rate for Payer: Frontpath All Commercial |
$124.62
|
| Rate for Payer: Humana ChoiceCare |
$117.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$121.91
|
| Rate for Payer: PHCS All Commercial |
$101.59
|
| Rate for Payer: PHP All Commercial |
$102.73
|
| Rate for Payer: Sagamore Health Network All Products |
$104.58
|
| Rate for Payer: Signature Care EPO |
$112.43
|
| Rate for Payer: Signature Care PPO |
$119.20
|
| Rate for Payer: United Healthcare Commercial |
$106.74
|
|
|
HC BAG RESUS AD W/VALVE CO2 DETEC
|
Facility
|
IP
|
$140.97
|
|
| Hospital Charge Code |
41607944
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$105.73 |
| Max. Negotiated Rate |
$131.10 |
| Rate for Payer: Aetna Commercial |
$121.80
|
| Rate for Payer: Cash Price |
$84.58
|
| Rate for Payer: Cigna All Commercial |
$121.66
|
| Rate for Payer: CORVEL All Commercial |
$131.10
|
| Rate for Payer: Coventry All Commercial |
$124.05
|
| Rate for Payer: Encore All Commercial |
$129.76
|
| Rate for Payer: Frontpath All Commercial |
$129.69
|
| Rate for Payer: Humana ChoiceCare |
$121.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$126.87
|
| Rate for Payer: PHCS All Commercial |
$105.73
|
| Rate for Payer: PHP All Commercial |
$106.91
|
| Rate for Payer: Sagamore Health Network All Products |
$108.83
|
| Rate for Payer: Signature Care EPO |
$117.01
|
| Rate for Payer: Signature Care PPO |
$124.05
|
| Rate for Payer: United Healthcare Commercial |
$111.08
|
|
|
HC BAG RESUS AD W/VALVE CO2 DETEC
|
Facility
|
OP
|
$140.97
|
|
| Hospital Charge Code |
41607944
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.83 |
| Max. Negotiated Rate |
$131.10 |
| Rate for Payer: Aetna Commercial |
$118.98
|
| Rate for Payer: Aetna Medicare |
$45.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$24.83
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$43.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$80.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$88.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$24.83
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$51.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$49.62
|
| Rate for Payer: Cash Price |
$84.58
|
| Rate for Payer: Cash Price |
$84.58
|
| Rate for Payer: Centivo All Commercial |
$76.69
|
| Rate for Payer: Cigna All Commercial |
$121.66
|
| Rate for Payer: CORVEL All Commercial |
$131.10
|
| Rate for Payer: Coventry All Commercial |
$124.05
|
| Rate for Payer: Encore All Commercial |
$129.76
|
| Rate for Payer: Frontpath All Commercial |
$129.69
|
| Rate for Payer: Humana ChoiceCare |
$121.76
|
| Rate for Payer: Humana Medicare |
$45.11
|
| Rate for Payer: Lucent All Commercial |
$76.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$126.87
|
| Rate for Payer: Managed Health Services Medicaid |
$24.83
|
| Rate for Payer: MDWise Medicaid |
$24.83
|
| Rate for Payer: PHCS All Commercial |
$105.73
|
| Rate for Payer: PHP All Commercial |
$106.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$54.98
|
| Rate for Payer: Sagamore Health Network All Products |
$108.83
|
| Rate for Payer: Signature Care EPO |
$117.01
|
| Rate for Payer: Signature Care PPO |
$124.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$119.82
|
| Rate for Payer: United Healthcare Commercial |
$111.08
|
| Rate for Payer: United Healthcare Medicare |
$45.11
|
|
|
HC BAG URINARY DRAINAGE
|
Facility
|
IP
|
$18.48
|
|
| Hospital Charge Code |
41607785
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.86 |
| Max. Negotiated Rate |
$17.19 |
| Rate for Payer: Aetna Commercial |
$15.97
|
| Rate for Payer: Cash Price |
$11.09
|
| Rate for Payer: Cigna All Commercial |
$15.95
|
| Rate for Payer: CORVEL All Commercial |
$17.19
|
| Rate for Payer: Coventry All Commercial |
$16.26
|
| Rate for Payer: Encore All Commercial |
$17.01
|
| Rate for Payer: Frontpath All Commercial |
$17.00
|
| Rate for Payer: Humana ChoiceCare |
$15.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$16.63
|
| Rate for Payer: PHCS All Commercial |
$13.86
|
| Rate for Payer: PHP All Commercial |
$14.02
|
| Rate for Payer: Sagamore Health Network All Products |
$14.27
|
| Rate for Payer: Signature Care EPO |
$15.34
|
| Rate for Payer: Signature Care PPO |
$16.26
|
| Rate for Payer: United Healthcare Commercial |
$14.56
|
|
|
HC BAG URINARY DRAINAGE
|
Facility
|
OP
|
$18.48
|
|
| Hospital Charge Code |
41607785
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.73 |
| Max. Negotiated Rate |
$31.20 |
| Rate for Payer: Aetna Commercial |
$15.60
|
| Rate for Payer: Aetna Medicare |
$5.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$10.61
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$11.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6.80
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$6.50
|
| Rate for Payer: Cash Price |
$11.09
|
| Rate for Payer: Cash Price |
$11.09
|
| Rate for Payer: Centivo All Commercial |
$10.05
|
| Rate for Payer: Cigna All Commercial |
$15.95
|
| Rate for Payer: CORVEL All Commercial |
$17.19
|
| Rate for Payer: Coventry All Commercial |
$16.26
|
| Rate for Payer: Encore All Commercial |
$17.01
|
| Rate for Payer: Frontpath All Commercial |
$17.00
|
| Rate for Payer: Humana ChoiceCare |
$15.96
|
| Rate for Payer: Humana Medicare |
$5.91
|
| Rate for Payer: Lucent All Commercial |
$10.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$16.63
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$13.86
|
| Rate for Payer: PHP All Commercial |
$14.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$7.21
|
| Rate for Payer: Sagamore Health Network All Products |
$14.27
|
| Rate for Payer: Signature Care EPO |
$15.34
|
| Rate for Payer: Signature Care PPO |
$16.26
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$15.71
|
| Rate for Payer: United Healthcare Commercial |
$14.56
|
| Rate for Payer: United Healthcare Medicare |
$5.91
|
|
|
HC BAG URINE DRAINAGE LEG
|
Facility
|
IP
|
$15.47
|
|
| Hospital Charge Code |
41601794
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.60 |
| Max. Negotiated Rate |
$14.39 |
| Rate for Payer: Aetna Commercial |
$13.37
|
| Rate for Payer: Cash Price |
$9.28
|
| Rate for Payer: Cigna All Commercial |
$13.35
|
| Rate for Payer: CORVEL All Commercial |
$14.39
|
| Rate for Payer: Coventry All Commercial |
$13.61
|
| Rate for Payer: Encore All Commercial |
$14.24
|
| Rate for Payer: Frontpath All Commercial |
$14.23
|
| Rate for Payer: Humana ChoiceCare |
$13.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13.92
|
| Rate for Payer: PHCS All Commercial |
$11.60
|
| Rate for Payer: PHP All Commercial |
$11.73
|
| Rate for Payer: Sagamore Health Network All Products |
$11.94
|
| Rate for Payer: Signature Care EPO |
$12.84
|
| Rate for Payer: Signature Care PPO |
$13.61
|
| Rate for Payer: United Healthcare Commercial |
$12.19
|
|
|
HC BAG URINE DRAINAGE LEG
|
Facility
|
OP
|
$15.47
|
|
| Hospital Charge Code |
41601794
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$21.01 |
| Rate for Payer: Aetna Commercial |
$13.06
|
| Rate for Payer: Aetna Medicare |
$4.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$21.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$8.88
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$21.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5.45
|
| Rate for Payer: Cash Price |
$9.28
|
| Rate for Payer: Cash Price |
$9.28
|
| Rate for Payer: Centivo All Commercial |
$8.42
|
| Rate for Payer: Cigna All Commercial |
$13.35
|
| Rate for Payer: CORVEL All Commercial |
$14.39
|
| Rate for Payer: Coventry All Commercial |
$13.61
|
| Rate for Payer: Encore All Commercial |
$14.24
|
| Rate for Payer: Frontpath All Commercial |
$14.23
|
| Rate for Payer: Humana ChoiceCare |
$13.36
|
| Rate for Payer: Humana Medicare |
$4.95
|
| Rate for Payer: Lucent All Commercial |
$8.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13.92
|
| Rate for Payer: Managed Health Services Medicaid |
$21.01
|
| Rate for Payer: MDWise Medicaid |
$21.01
|
| Rate for Payer: PHCS All Commercial |
$11.60
|
| Rate for Payer: PHP All Commercial |
$11.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$6.03
|
| Rate for Payer: Sagamore Health Network All Products |
$11.94
|
| Rate for Payer: Signature Care EPO |
$12.84
|
| Rate for Payer: Signature Care PPO |
$13.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13.15
|
| Rate for Payer: United Healthcare Commercial |
$12.19
|
| Rate for Payer: United Healthcare Medicare |
$4.95
|
|
|
HC BAG URINE METER
|
Facility
|
OP
|
$47.53
|
|
| Hospital Charge Code |
41601008
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$14.73 |
| Max. Negotiated Rate |
$44.20 |
| Rate for Payer: Aetna Commercial |
$40.12
|
| Rate for Payer: Aetna Medicare |
$15.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$21.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$14.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$27.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$29.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$21.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$17.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$16.73
|
| Rate for Payer: Cash Price |
$28.52
|
| Rate for Payer: Cash Price |
$28.52
|
| Rate for Payer: Centivo All Commercial |
$25.86
|
| Rate for Payer: Cigna All Commercial |
$41.02
|
| Rate for Payer: CORVEL All Commercial |
$44.20
|
| Rate for Payer: Coventry All Commercial |
$41.83
|
| Rate for Payer: Encore All Commercial |
$43.75
|
| Rate for Payer: Frontpath All Commercial |
$43.73
|
| Rate for Payer: Humana ChoiceCare |
$41.05
|
| Rate for Payer: Humana Medicare |
$15.21
|
| Rate for Payer: Lucent All Commercial |
$25.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$42.78
|
| Rate for Payer: Managed Health Services Medicaid |
$21.01
|
| Rate for Payer: MDWise Medicaid |
$21.01
|
| Rate for Payer: PHCS All Commercial |
$35.65
|
| Rate for Payer: PHP All Commercial |
$36.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$18.54
|
| Rate for Payer: Sagamore Health Network All Products |
$36.69
|
| Rate for Payer: Signature Care EPO |
$39.45
|
| Rate for Payer: Signature Care PPO |
$41.83
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$40.40
|
| Rate for Payer: United Healthcare Commercial |
$37.45
|
| Rate for Payer: United Healthcare Medicare |
$15.21
|
|
|
HC BAG URINE METER
|
Facility
|
IP
|
$47.53
|
|
| Hospital Charge Code |
41601008
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$35.65 |
| Max. Negotiated Rate |
$44.20 |
| Rate for Payer: Aetna Commercial |
$41.07
|
| Rate for Payer: Cash Price |
$28.52
|
| Rate for Payer: Cigna All Commercial |
$41.02
|
| Rate for Payer: CORVEL All Commercial |
$44.20
|
| Rate for Payer: Coventry All Commercial |
$41.83
|
| Rate for Payer: Encore All Commercial |
$43.75
|
| Rate for Payer: Frontpath All Commercial |
$43.73
|
| Rate for Payer: Humana ChoiceCare |
$41.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$42.78
|
| Rate for Payer: PHCS All Commercial |
$35.65
|
| Rate for Payer: PHP All Commercial |
$36.05
|
| Rate for Payer: Sagamore Health Network All Products |
$36.69
|
| Rate for Payer: Signature Care EPO |
$39.45
|
| Rate for Payer: Signature Care PPO |
$41.83
|
| Rate for Payer: United Healthcare Commercial |
$37.45
|
|
|
HC BALLOON DILATION 10-12
|
Facility
|
IP
|
$964.80
|
|
|
Service Code
|
CPT C1726
|
| Hospital Charge Code |
41608204
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$723.60 |
| Max. Negotiated Rate |
$897.26 |
| Rate for Payer: Aetna Commercial |
$833.59
|
| Rate for Payer: Cash Price |
$578.88
|
| Rate for Payer: Cigna All Commercial |
$832.62
|
| Rate for Payer: CORVEL All Commercial |
$897.26
|
| Rate for Payer: Coventry All Commercial |
$849.02
|
| Rate for Payer: Encore All Commercial |
$888.10
|
| Rate for Payer: Frontpath All Commercial |
$887.62
|
| Rate for Payer: Humana ChoiceCare |
$833.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$868.32
|
| Rate for Payer: PHCS All Commercial |
$723.60
|
| Rate for Payer: PHP All Commercial |
$731.70
|
| Rate for Payer: Sagamore Health Network All Products |
$744.83
|
| Rate for Payer: Signature Care EPO |
$800.78
|
| Rate for Payer: Signature Care PPO |
$849.02
|
| Rate for Payer: United Healthcare Commercial |
$760.26
|
|
|
HC BALLOON DILATION 10-12
|
Facility
|
OP
|
$964.80
|
|
|
Service Code
|
CPT C1726
|
| Hospital Charge Code |
41608204
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$897.26 |
| Rate for Payer: Aetna Commercial |
$814.29
|
| Rate for Payer: Aetna Medicare |
$308.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$299.09
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$554.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$603.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$355.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$339.61
|
| Rate for Payer: Cash Price |
$578.88
|
| Rate for Payer: Cash Price |
$578.88
|
| Rate for Payer: Centivo All Commercial |
$524.85
|
| Rate for Payer: Cigna All Commercial |
$832.62
|
| Rate for Payer: CORVEL All Commercial |
$897.26
|
| Rate for Payer: Coventry All Commercial |
$849.02
|
| Rate for Payer: Encore All Commercial |
$888.10
|
| Rate for Payer: Frontpath All Commercial |
$887.62
|
| Rate for Payer: Humana ChoiceCare |
$833.30
|
| Rate for Payer: Humana Medicare |
$308.74
|
| Rate for Payer: Lucent All Commercial |
$524.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$868.32
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$723.60
|
| Rate for Payer: PHP All Commercial |
$731.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$376.27
|
| Rate for Payer: Sagamore Health Network All Products |
$744.83
|
| Rate for Payer: Signature Care EPO |
$800.78
|
| Rate for Payer: Signature Care PPO |
$849.02
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$820.08
|
| Rate for Payer: United Healthcare Commercial |
$760.26
|
| Rate for Payer: United Healthcare Medicare |
$308.74
|
|
