|
HC BETA CULT
|
Facility
|
OP
|
$138.01
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
63002001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.63 |
| Max. Negotiated Rate |
$128.35 |
| Rate for Payer: Aetna Commercial |
$116.48
|
| Rate for Payer: Aetna Medicare |
$44.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$6.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$42.78
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$63.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$63.43
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$6.63
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$50.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$48.58
|
| Rate for Payer: Cash Price |
$82.81
|
| Rate for Payer: Cash Price |
$82.81
|
| Rate for Payer: Centivo All Commercial |
$75.08
|
| Rate for Payer: Cigna All Commercial |
$119.10
|
| Rate for Payer: CORVEL All Commercial |
$128.35
|
| Rate for Payer: Coventry All Commercial |
$121.45
|
| Rate for Payer: Encore All Commercial |
$127.04
|
| Rate for Payer: Frontpath All Commercial |
$126.97
|
| Rate for Payer: Humana ChoiceCare |
$119.20
|
| Rate for Payer: Humana Medicare |
$44.16
|
| Rate for Payer: Lucent All Commercial |
$75.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$124.21
|
| Rate for Payer: Managed Health Services Medicaid |
$6.63
|
| Rate for Payer: MDWise Medicaid |
$6.63
|
| Rate for Payer: PHCS All Commercial |
$103.51
|
| Rate for Payer: PHP All Commercial |
$104.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$53.82
|
| Rate for Payer: Sagamore Health Network All Products |
$106.54
|
| Rate for Payer: Signature Care EPO |
$114.55
|
| Rate for Payer: Signature Care PPO |
$121.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$117.31
|
| Rate for Payer: United Healthcare Commercial |
$108.75
|
| Rate for Payer: United Healthcare Medicare |
$44.16
|
|
|
HC BETA CULT
|
Facility
|
IP
|
$138.01
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
63002001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$103.51 |
| Max. Negotiated Rate |
$128.35 |
| Rate for Payer: Aetna Commercial |
$119.24
|
| Rate for Payer: Cash Price |
$82.81
|
| Rate for Payer: Cigna All Commercial |
$119.10
|
| Rate for Payer: CORVEL All Commercial |
$128.35
|
| Rate for Payer: Coventry All Commercial |
$121.45
|
| Rate for Payer: Encore All Commercial |
$127.04
|
| Rate for Payer: Frontpath All Commercial |
$126.97
|
| Rate for Payer: Humana ChoiceCare |
$119.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$124.21
|
| Rate for Payer: PHCS All Commercial |
$103.51
|
| Rate for Payer: PHP All Commercial |
$104.67
|
| Rate for Payer: Sagamore Health Network All Products |
$106.54
|
| Rate for Payer: Signature Care EPO |
$114.55
|
| Rate for Payer: Signature Care PPO |
$121.45
|
| Rate for Payer: United Healthcare Commercial |
$108.75
|
|
|
HC BETA HCG
|
Facility
|
IP
|
$146.91
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
63001341
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$110.18 |
| Max. Negotiated Rate |
$136.63 |
| Rate for Payer: Aetna Commercial |
$126.93
|
| Rate for Payer: Cash Price |
$88.15
|
| Rate for Payer: Cigna All Commercial |
$126.78
|
| Rate for Payer: CORVEL All Commercial |
$136.63
|
| Rate for Payer: Coventry All Commercial |
$129.28
|
| Rate for Payer: Encore All Commercial |
$135.23
|
| Rate for Payer: Frontpath All Commercial |
$135.16
|
| Rate for Payer: Humana ChoiceCare |
$126.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$132.22
|
| Rate for Payer: PHCS All Commercial |
$110.18
|
| Rate for Payer: PHP All Commercial |
$111.42
|
| Rate for Payer: Sagamore Health Network All Products |
$113.41
|
| Rate for Payer: Signature Care EPO |
$121.94
|
| Rate for Payer: Signature Care PPO |
$129.28
|
| Rate for Payer: United Healthcare Commercial |
$115.77
|
|
|
HC BETA HCG
|
Facility
|
OP
|
$146.91
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
63001341
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.05 |
| Max. Negotiated Rate |
$136.63 |
| Rate for Payer: Aetna Commercial |
$123.99
|
| Rate for Payer: Aetna Medicare |
$47.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$15.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$45.54
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$67.52
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$67.52
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$15.05
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$54.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$51.71
|
| Rate for Payer: Cash Price |
$88.15
|
| Rate for Payer: Cash Price |
$88.15
|
| Rate for Payer: Centivo All Commercial |
$79.92
|
| Rate for Payer: Cigna All Commercial |
$126.78
|
| Rate for Payer: CORVEL All Commercial |
$136.63
|
| Rate for Payer: Coventry All Commercial |
$129.28
|
| Rate for Payer: Encore All Commercial |
$135.23
|
| Rate for Payer: Frontpath All Commercial |
$135.16
|
| Rate for Payer: Humana ChoiceCare |
$126.89
|
| Rate for Payer: Humana Medicare |
$47.01
|
| Rate for Payer: Lucent All Commercial |
$79.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$132.22
|
| Rate for Payer: Managed Health Services Medicaid |
$15.05
|
| Rate for Payer: MDWise Medicaid |
$15.05
|
| Rate for Payer: PHCS All Commercial |
$110.18
|
| Rate for Payer: PHP All Commercial |
$111.42
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$57.29
|
| Rate for Payer: Sagamore Health Network All Products |
$113.41
|
| Rate for Payer: Signature Care EPO |
$121.94
|
| Rate for Payer: Signature Care PPO |
$129.28
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$124.87
|
| Rate for Payer: United Healthcare Commercial |
$115.77
|
| Rate for Payer: United Healthcare Medicare |
$47.01
|
|
|
HC BETA HCG TUMOR MARKER
|
Facility
|
OP
|
$146.91
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
63001720
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.05 |
| Max. Negotiated Rate |
$136.63 |
| Rate for Payer: Aetna Commercial |
$123.99
|
| Rate for Payer: Aetna Medicare |
$47.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$15.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$45.54
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$67.52
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$67.52
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$15.05
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$54.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$51.71
|
| Rate for Payer: Cash Price |
$88.15
|
| Rate for Payer: Cash Price |
$88.15
|
| Rate for Payer: Centivo All Commercial |
$79.92
|
| Rate for Payer: Cigna All Commercial |
$126.78
|
| Rate for Payer: CORVEL All Commercial |
$136.63
|
| Rate for Payer: Coventry All Commercial |
$129.28
|
| Rate for Payer: Encore All Commercial |
$135.23
|
| Rate for Payer: Frontpath All Commercial |
$135.16
|
| Rate for Payer: Humana ChoiceCare |
$126.89
|
| Rate for Payer: Humana Medicare |
$47.01
|
| Rate for Payer: Lucent All Commercial |
$79.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$132.22
|
| Rate for Payer: Managed Health Services Medicaid |
$15.05
|
| Rate for Payer: MDWise Medicaid |
$15.05
|
| Rate for Payer: PHCS All Commercial |
$110.18
|
| Rate for Payer: PHP All Commercial |
$111.42
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$57.29
|
| Rate for Payer: Sagamore Health Network All Products |
$113.41
|
| Rate for Payer: Signature Care EPO |
$121.94
|
| Rate for Payer: Signature Care PPO |
$129.28
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$124.87
|
| Rate for Payer: United Healthcare Commercial |
$115.77
|
| Rate for Payer: United Healthcare Medicare |
$47.01
|
|
|
HC BETA HCG TUMOR MARKER
|
Facility
|
IP
|
$146.91
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
63001720
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$110.18 |
| Max. Negotiated Rate |
$136.63 |
| Rate for Payer: Aetna Commercial |
$126.93
|
| Rate for Payer: Cash Price |
$88.15
|
| Rate for Payer: Cigna All Commercial |
$126.78
|
| Rate for Payer: CORVEL All Commercial |
$136.63
|
| Rate for Payer: Coventry All Commercial |
$129.28
|
| Rate for Payer: Encore All Commercial |
$135.23
|
| Rate for Payer: Frontpath All Commercial |
$135.16
|
| Rate for Payer: Humana ChoiceCare |
$126.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$132.22
|
| Rate for Payer: PHCS All Commercial |
$110.18
|
| Rate for Payer: PHP All Commercial |
$111.42
|
| Rate for Payer: Sagamore Health Network All Products |
$113.41
|
| Rate for Payer: Signature Care EPO |
$121.94
|
| Rate for Payer: Signature Care PPO |
$129.28
|
| Rate for Payer: United Healthcare Commercial |
$115.77
|
|
|
HC BETA-HYDROXYBUTYRATE, SERUM OR PLASMA
|
Facility
|
OP
|
$131.27
|
|
|
Service Code
|
CPT 82010
|
| Hospital Charge Code |
63001171
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$122.08 |
| Rate for Payer: Aetna Commercial |
$110.79
|
| Rate for Payer: Aetna Medicare |
$42.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$8.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$40.69
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$60.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$60.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$8.17
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$48.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$46.21
|
| Rate for Payer: Cash Price |
$78.76
|
| Rate for Payer: Cash Price |
$78.76
|
| Rate for Payer: Centivo All Commercial |
$71.41
|
| Rate for Payer: Cigna All Commercial |
$113.29
|
| Rate for Payer: CORVEL All Commercial |
$122.08
|
| Rate for Payer: Coventry All Commercial |
$115.52
|
| Rate for Payer: Encore All Commercial |
$120.83
|
| Rate for Payer: Frontpath All Commercial |
$120.77
|
| Rate for Payer: Humana ChoiceCare |
$113.38
|
| Rate for Payer: Humana Medicare |
$42.01
|
| Rate for Payer: Lucent All Commercial |
$71.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$118.14
|
| Rate for Payer: Managed Health Services Medicaid |
$8.17
|
| Rate for Payer: MDWise Medicaid |
$8.17
|
| Rate for Payer: PHCS All Commercial |
$98.45
|
| Rate for Payer: PHP All Commercial |
$99.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$51.20
|
| Rate for Payer: Sagamore Health Network All Products |
$101.34
|
| Rate for Payer: Signature Care EPO |
$108.95
|
| Rate for Payer: Signature Care PPO |
$115.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$111.58
|
| Rate for Payer: United Healthcare Commercial |
$103.44
|
| Rate for Payer: United Healthcare Medicare |
$42.01
|
|
|
HC BETA-HYDROXYBUTYRATE, SERUM OR PLASMA
|
Facility
|
IP
|
$131.27
|
|
|
Service Code
|
CPT 82010
|
| Hospital Charge Code |
63001171
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$98.45 |
| Max. Negotiated Rate |
$122.08 |
| Rate for Payer: Aetna Commercial |
$113.42
|
| Rate for Payer: Cash Price |
$78.76
|
| Rate for Payer: Cigna All Commercial |
$113.29
|
| Rate for Payer: CORVEL All Commercial |
$122.08
|
| Rate for Payer: Coventry All Commercial |
$115.52
|
| Rate for Payer: Encore All Commercial |
$120.83
|
| Rate for Payer: Frontpath All Commercial |
$120.77
|
| Rate for Payer: Humana ChoiceCare |
$113.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$118.14
|
| Rate for Payer: PHCS All Commercial |
$98.45
|
| Rate for Payer: PHP All Commercial |
$99.56
|
| Rate for Payer: Sagamore Health Network All Products |
$101.34
|
| Rate for Payer: Signature Care EPO |
$108.95
|
| Rate for Payer: Signature Care PPO |
$115.52
|
| Rate for Payer: United Healthcare Commercial |
$103.44
|
|
|
HC BIL APP COMPRESS LOW LEG; ANKLE/FOOT PT
|
Facility
|
OP
|
$393.76
|
|
|
Service Code
|
CPT 29581 50,GP
|
| Hospital Charge Code |
1722010
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$47.81 |
| Max. Negotiated Rate |
$366.20 |
| Rate for Payer: Aetna Commercial |
$332.33
|
| Rate for Payer: Aetna Medicare |
$126.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$47.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$122.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$226.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$246.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$47.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$144.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$138.60
|
| Rate for Payer: Cash Price |
$236.26
|
| Rate for Payer: Cash Price |
$236.26
|
| Rate for Payer: Centivo All Commercial |
$214.21
|
| Rate for Payer: Cigna All Commercial |
$339.81
|
| Rate for Payer: CORVEL All Commercial |
$366.20
|
| Rate for Payer: Coventry All Commercial |
$346.51
|
| Rate for Payer: Encore All Commercial |
$362.46
|
| Rate for Payer: Frontpath All Commercial |
$362.26
|
| Rate for Payer: Humana ChoiceCare |
$340.09
|
| Rate for Payer: Humana Medicare |
$126.00
|
| Rate for Payer: Lucent All Commercial |
$214.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$354.38
|
| Rate for Payer: Managed Health Services Medicaid |
$47.81
|
| Rate for Payer: MDWise Medicaid |
$47.81
|
| Rate for Payer: PHCS All Commercial |
$295.32
|
| Rate for Payer: PHP All Commercial |
$298.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$153.57
|
| Rate for Payer: Sagamore Health Network All Products |
$303.98
|
| Rate for Payer: Signature Care EPO |
$326.82
|
| Rate for Payer: Signature Care PPO |
$346.51
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$334.70
|
| Rate for Payer: United Healthcare Commercial |
$310.28
|
| Rate for Payer: United Healthcare Medicare |
$126.00
|
|
|
HC BIL APP COMPRESS LOW LEG; ANKLE/FOOT PT
|
Facility
|
IP
|
$393.76
|
|
|
Service Code
|
CPT 29581 50,GP
|
| Hospital Charge Code |
1722010
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$295.32 |
| Max. Negotiated Rate |
$366.20 |
| Rate for Payer: Aetna Commercial |
$340.21
|
| Rate for Payer: Cash Price |
$236.26
|
| Rate for Payer: Cigna All Commercial |
$339.81
|
| Rate for Payer: CORVEL All Commercial |
$366.20
|
| Rate for Payer: Coventry All Commercial |
$346.51
|
| Rate for Payer: Encore All Commercial |
$362.46
|
| Rate for Payer: Frontpath All Commercial |
$362.26
|
| Rate for Payer: Humana ChoiceCare |
$340.09
|
| Rate for Payer: Lutheran Preferred All Commercial |
$354.38
|
| Rate for Payer: PHCS All Commercial |
$295.32
|
| Rate for Payer: PHP All Commercial |
$298.63
|
| Rate for Payer: Sagamore Health Network All Products |
$303.98
|
| Rate for Payer: Signature Care EPO |
$326.82
|
| Rate for Payer: Signature Care PPO |
$346.51
|
| Rate for Payer: United Healthcare Commercial |
$310.28
|
|
|
HC BIL APP COMPRESS UPPER ARM/FA/H/F PT
|
Facility
|
IP
|
$393.76
|
|
|
Service Code
|
CPT 29584 50,GP
|
| Hospital Charge Code |
1722013
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$295.32 |
| Max. Negotiated Rate |
$366.20 |
| Rate for Payer: Aetna Commercial |
$340.21
|
| Rate for Payer: Cash Price |
$236.26
|
| Rate for Payer: Cigna All Commercial |
$339.81
|
| Rate for Payer: CORVEL All Commercial |
$366.20
|
| Rate for Payer: Coventry All Commercial |
$346.51
|
| Rate for Payer: Encore All Commercial |
$362.46
|
| Rate for Payer: Frontpath All Commercial |
$362.26
|
| Rate for Payer: Humana ChoiceCare |
$340.09
|
| Rate for Payer: Lutheran Preferred All Commercial |
$354.38
|
| Rate for Payer: PHCS All Commercial |
$295.32
|
| Rate for Payer: PHP All Commercial |
$298.63
|
| Rate for Payer: Sagamore Health Network All Products |
$303.98
|
| Rate for Payer: Signature Care EPO |
$326.82
|
| Rate for Payer: Signature Care PPO |
$346.51
|
| Rate for Payer: United Healthcare Commercial |
$310.28
|
|
|
HC BIL APP COMPRESS UPPER ARM/FA/H/F PT
|
Facility
|
OP
|
$393.76
|
|
|
Service Code
|
CPT 29584 50,GP
|
| Hospital Charge Code |
1722013
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$47.81 |
| Max. Negotiated Rate |
$366.20 |
| Rate for Payer: Aetna Commercial |
$332.33
|
| Rate for Payer: Aetna Medicare |
$126.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$47.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$122.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$226.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$246.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$47.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$144.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$138.60
|
| Rate for Payer: Cash Price |
$236.26
|
| Rate for Payer: Cash Price |
$236.26
|
| Rate for Payer: Centivo All Commercial |
$214.21
|
| Rate for Payer: Cigna All Commercial |
$339.81
|
| Rate for Payer: CORVEL All Commercial |
$366.20
|
| Rate for Payer: Coventry All Commercial |
$346.51
|
| Rate for Payer: Encore All Commercial |
$362.46
|
| Rate for Payer: Frontpath All Commercial |
$362.26
|
| Rate for Payer: Humana ChoiceCare |
$340.09
|
| Rate for Payer: Humana Medicare |
$126.00
|
| Rate for Payer: Lucent All Commercial |
$214.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$354.38
|
| Rate for Payer: Managed Health Services Medicaid |
$47.81
|
| Rate for Payer: MDWise Medicaid |
$47.81
|
| Rate for Payer: PHCS All Commercial |
$295.32
|
| Rate for Payer: PHP All Commercial |
$298.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$153.57
|
| Rate for Payer: Sagamore Health Network All Products |
$303.98
|
| Rate for Payer: Signature Care EPO |
$326.82
|
| Rate for Payer: Signature Care PPO |
$346.51
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$334.70
|
| Rate for Payer: United Healthcare Commercial |
$310.28
|
| Rate for Payer: United Healthcare Medicare |
$126.00
|
|
|
HC BILE ACID - FRACT
|
Facility
|
IP
|
$208.85
|
|
|
Service Code
|
CPT 83789
|
| Hospital Charge Code |
63001631
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$156.64 |
| Max. Negotiated Rate |
$194.23 |
| Rate for Payer: Aetna Commercial |
$180.45
|
| Rate for Payer: Cash Price |
$125.31
|
| Rate for Payer: Cigna All Commercial |
$180.24
|
| Rate for Payer: CORVEL All Commercial |
$194.23
|
| Rate for Payer: Coventry All Commercial |
$183.79
|
| Rate for Payer: Encore All Commercial |
$192.25
|
| Rate for Payer: Frontpath All Commercial |
$192.14
|
| Rate for Payer: Humana ChoiceCare |
$180.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$187.97
|
| Rate for Payer: PHCS All Commercial |
$156.64
|
| Rate for Payer: PHP All Commercial |
$158.39
|
| Rate for Payer: Sagamore Health Network All Products |
$161.23
|
| Rate for Payer: Signature Care EPO |
$173.35
|
| Rate for Payer: Signature Care PPO |
$183.79
|
| Rate for Payer: United Healthcare Commercial |
$164.57
|
|
|
HC BILE ACID - FRACT
|
Facility
|
OP
|
$208.85
|
|
|
Service Code
|
CPT 83789
|
| Hospital Charge Code |
63001631
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.11 |
| Max. Negotiated Rate |
$194.23 |
| Rate for Payer: Aetna Commercial |
$176.27
|
| Rate for Payer: Aetna Medicare |
$66.83
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$24.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$64.74
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$95.99
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$95.99
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$24.11
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$76.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$73.52
|
| Rate for Payer: Cash Price |
$125.31
|
| Rate for Payer: Cash Price |
$125.31
|
| Rate for Payer: Centivo All Commercial |
$113.61
|
| Rate for Payer: Cigna All Commercial |
$180.24
|
| Rate for Payer: CORVEL All Commercial |
$194.23
|
| Rate for Payer: Coventry All Commercial |
$183.79
|
| Rate for Payer: Encore All Commercial |
$192.25
|
| Rate for Payer: Frontpath All Commercial |
$192.14
|
| Rate for Payer: Humana ChoiceCare |
$180.38
|
| Rate for Payer: Humana Medicare |
$66.83
|
| Rate for Payer: Lucent All Commercial |
$113.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$187.97
|
| Rate for Payer: Managed Health Services Medicaid |
$24.11
|
| Rate for Payer: MDWise Medicaid |
$24.11
|
| Rate for Payer: PHCS All Commercial |
$156.64
|
| Rate for Payer: PHP All Commercial |
$158.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$81.45
|
| Rate for Payer: Sagamore Health Network All Products |
$161.23
|
| Rate for Payer: Signature Care EPO |
$173.35
|
| Rate for Payer: Signature Care PPO |
$183.79
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$177.52
|
| Rate for Payer: United Healthcare Commercial |
$164.57
|
| Rate for Payer: United Healthcare Medicare |
$66.83
|
|
|
HC BILIRUBIN DIRECT
|
Facility
|
IP
|
$46.00
|
|
|
Service Code
|
CPT 82248
|
| Hospital Charge Code |
63001132
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$42.78 |
| Rate for Payer: Aetna Commercial |
$39.74
|
| Rate for Payer: Cash Price |
$27.60
|
| Rate for Payer: Cigna All Commercial |
$39.70
|
| Rate for Payer: CORVEL All Commercial |
$42.78
|
| Rate for Payer: Coventry All Commercial |
$40.48
|
| Rate for Payer: Encore All Commercial |
$42.34
|
| Rate for Payer: Frontpath All Commercial |
$42.32
|
| Rate for Payer: Humana ChoiceCare |
$39.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$41.40
|
| Rate for Payer: PHCS All Commercial |
$34.50
|
| Rate for Payer: PHP All Commercial |
$34.89
|
| Rate for Payer: Sagamore Health Network All Products |
$35.51
|
| Rate for Payer: Signature Care EPO |
$38.18
|
| Rate for Payer: Signature Care PPO |
$40.48
|
| Rate for Payer: United Healthcare Commercial |
$36.25
|
|
|
HC BILIRUBIN DIRECT
|
Facility
|
OP
|
$46.00
|
|
|
Service Code
|
CPT 82248
|
| Hospital Charge Code |
63001132
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.02 |
| Max. Negotiated Rate |
$42.78 |
| Rate for Payer: Aetna Commercial |
$38.82
|
| Rate for Payer: Aetna Medicare |
$14.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$5.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$14.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$21.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$21.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$5.02
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$16.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$16.19
|
| Rate for Payer: Cash Price |
$27.60
|
| Rate for Payer: Cash Price |
$27.60
|
| Rate for Payer: Centivo All Commercial |
$25.02
|
| Rate for Payer: Cigna All Commercial |
$39.70
|
| Rate for Payer: CORVEL All Commercial |
$42.78
|
| Rate for Payer: Coventry All Commercial |
$40.48
|
| Rate for Payer: Encore All Commercial |
$42.34
|
| Rate for Payer: Frontpath All Commercial |
$42.32
|
| Rate for Payer: Humana ChoiceCare |
$39.73
|
| Rate for Payer: Humana Medicare |
$14.72
|
| Rate for Payer: Lucent All Commercial |
$25.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$41.40
|
| Rate for Payer: Managed Health Services Medicaid |
$5.02
|
| Rate for Payer: MDWise Medicaid |
$5.02
|
| Rate for Payer: PHCS All Commercial |
$34.50
|
| Rate for Payer: PHP All Commercial |
$34.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$17.94
|
| Rate for Payer: Sagamore Health Network All Products |
$35.51
|
| Rate for Payer: Signature Care EPO |
$38.18
|
| Rate for Payer: Signature Care PPO |
$40.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$39.10
|
| Rate for Payer: United Healthcare Commercial |
$36.25
|
| Rate for Payer: United Healthcare Medicare |
$14.72
|
|
|
HC BILIRUBIN TOTAL
|
Facility
|
IP
|
$46.00
|
|
|
Service Code
|
CPT 82247
|
| Hospital Charge Code |
63001141
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$42.78 |
| Rate for Payer: Aetna Commercial |
$39.74
|
| Rate for Payer: Cash Price |
$27.60
|
| Rate for Payer: Cigna All Commercial |
$39.70
|
| Rate for Payer: CORVEL All Commercial |
$42.78
|
| Rate for Payer: Coventry All Commercial |
$40.48
|
| Rate for Payer: Encore All Commercial |
$42.34
|
| Rate for Payer: Frontpath All Commercial |
$42.32
|
| Rate for Payer: Humana ChoiceCare |
$39.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$41.40
|
| Rate for Payer: PHCS All Commercial |
$34.50
|
| Rate for Payer: PHP All Commercial |
$34.89
|
| Rate for Payer: Sagamore Health Network All Products |
$35.51
|
| Rate for Payer: Signature Care EPO |
$38.18
|
| Rate for Payer: Signature Care PPO |
$40.48
|
| Rate for Payer: United Healthcare Commercial |
$36.25
|
|
|
HC BILIRUBIN TOTAL
|
Facility
|
OP
|
$46.00
|
|
|
Service Code
|
CPT 82247
|
| Hospital Charge Code |
63001141
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.02 |
| Max. Negotiated Rate |
$42.78 |
| Rate for Payer: Aetna Commercial |
$38.82
|
| Rate for Payer: Aetna Medicare |
$14.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$5.02
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$14.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$21.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$21.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$5.02
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$16.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$16.19
|
| Rate for Payer: Cash Price |
$27.60
|
| Rate for Payer: Cash Price |
$27.60
|
| Rate for Payer: Centivo All Commercial |
$25.02
|
| Rate for Payer: Cigna All Commercial |
$39.70
|
| Rate for Payer: CORVEL All Commercial |
$42.78
|
| Rate for Payer: Coventry All Commercial |
$40.48
|
| Rate for Payer: Encore All Commercial |
$42.34
|
| Rate for Payer: Frontpath All Commercial |
$42.32
|
| Rate for Payer: Humana ChoiceCare |
$39.73
|
| Rate for Payer: Humana Medicare |
$14.72
|
| Rate for Payer: Lucent All Commercial |
$25.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$41.40
|
| Rate for Payer: Managed Health Services Medicaid |
$5.02
|
| Rate for Payer: MDWise Medicaid |
$5.02
|
| Rate for Payer: PHCS All Commercial |
$34.50
|
| Rate for Payer: PHP All Commercial |
$34.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$17.94
|
| Rate for Payer: Sagamore Health Network All Products |
$35.51
|
| Rate for Payer: Signature Care EPO |
$38.18
|
| Rate for Payer: Signature Care PPO |
$40.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$39.10
|
| Rate for Payer: United Healthcare Commercial |
$36.25
|
| Rate for Payer: United Healthcare Medicare |
$14.72
|
|
|
HC BIOPSY SITE IDENTIFIER 14G TRIBELL SHAPE
|
Facility
|
IP
|
$640.07
|
|
| Hospital Charge Code |
41602084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$480.05 |
| Max. Negotiated Rate |
$595.27 |
| Rate for Payer: Aetna Commercial |
$553.02
|
| Rate for Payer: Cash Price |
$384.04
|
| Rate for Payer: Cigna All Commercial |
$552.38
|
| Rate for Payer: CORVEL All Commercial |
$595.27
|
| Rate for Payer: Coventry All Commercial |
$563.26
|
| Rate for Payer: Encore All Commercial |
$589.18
|
| Rate for Payer: Frontpath All Commercial |
$588.86
|
| Rate for Payer: Humana ChoiceCare |
$552.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$576.06
|
| Rate for Payer: PHCS All Commercial |
$480.05
|
| Rate for Payer: PHP All Commercial |
$485.43
|
| Rate for Payer: Sagamore Health Network All Products |
$494.13
|
| Rate for Payer: Signature Care EPO |
$531.26
|
| Rate for Payer: Signature Care PPO |
$563.26
|
| Rate for Payer: United Healthcare Commercial |
$504.38
|
|
|
HC BIOPSY SITE IDENTIFIER 14G TRIBELL SHAPE
|
Facility
|
OP
|
$640.07
|
|
| Hospital Charge Code |
41602084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$595.27 |
| Rate for Payer: Aetna Commercial |
$540.22
|
| Rate for Payer: Aetna Medicare |
$204.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$198.42
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$367.59
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$400.11
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$235.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$225.30
|
| Rate for Payer: Cash Price |
$384.04
|
| Rate for Payer: Cash Price |
$384.04
|
| Rate for Payer: Centivo All Commercial |
$348.20
|
| Rate for Payer: Cigna All Commercial |
$552.38
|
| Rate for Payer: CORVEL All Commercial |
$595.27
|
| Rate for Payer: Coventry All Commercial |
$563.26
|
| Rate for Payer: Encore All Commercial |
$589.18
|
| Rate for Payer: Frontpath All Commercial |
$588.86
|
| Rate for Payer: Humana ChoiceCare |
$552.83
|
| Rate for Payer: Humana Medicare |
$204.82
|
| Rate for Payer: Lucent All Commercial |
$348.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$576.06
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$480.05
|
| Rate for Payer: PHP All Commercial |
$485.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$249.63
|
| Rate for Payer: Sagamore Health Network All Products |
$494.13
|
| Rate for Payer: Signature Care EPO |
$531.26
|
| Rate for Payer: Signature Care PPO |
$563.26
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$544.06
|
| Rate for Payer: United Healthcare Commercial |
$504.38
|
| Rate for Payer: United Healthcare Medicare |
$204.82
|
|
|
HC BIOPSY VALVE IRRIG LINE
|
Facility
|
OP
|
$78.75
|
|
| Hospital Charge Code |
41601897
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.41 |
| Max. Negotiated Rate |
$73.24 |
| Rate for Payer: Aetna Commercial |
$66.47
|
| Rate for Payer: Aetna Medicare |
$25.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$24.41
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$45.23
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$49.23
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$28.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$27.72
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Centivo All Commercial |
$42.84
|
| Rate for Payer: Cigna All Commercial |
$67.96
|
| Rate for Payer: CORVEL All Commercial |
$73.24
|
| Rate for Payer: Coventry All Commercial |
$69.30
|
| Rate for Payer: Encore All Commercial |
$72.49
|
| Rate for Payer: Frontpath All Commercial |
$72.45
|
| Rate for Payer: Humana ChoiceCare |
$68.02
|
| Rate for Payer: Humana Medicare |
$25.20
|
| Rate for Payer: Lucent All Commercial |
$42.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$70.88
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$59.06
|
| Rate for Payer: PHP All Commercial |
$59.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$30.71
|
| Rate for Payer: Sagamore Health Network All Products |
$60.80
|
| Rate for Payer: Signature Care EPO |
$65.36
|
| Rate for Payer: Signature Care PPO |
$69.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$66.94
|
| Rate for Payer: United Healthcare Commercial |
$62.05
|
| Rate for Payer: United Healthcare Medicare |
$25.20
|
|
|
HC BIOPSY VALVE IRRIG LINE
|
Facility
|
IP
|
$78.75
|
|
| Hospital Charge Code |
41601897
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.06 |
| Max. Negotiated Rate |
$73.24 |
| Rate for Payer: Aetna Commercial |
$68.04
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cigna All Commercial |
$67.96
|
| Rate for Payer: CORVEL All Commercial |
$73.24
|
| Rate for Payer: Coventry All Commercial |
$69.30
|
| Rate for Payer: Encore All Commercial |
$72.49
|
| Rate for Payer: Frontpath All Commercial |
$72.45
|
| Rate for Payer: Humana ChoiceCare |
$68.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$70.88
|
| Rate for Payer: PHCS All Commercial |
$59.06
|
| Rate for Payer: PHP All Commercial |
$59.72
|
| Rate for Payer: Sagamore Health Network All Products |
$60.80
|
| Rate for Payer: Signature Care EPO |
$65.36
|
| Rate for Payer: Signature Care PPO |
$69.30
|
| Rate for Payer: United Healthcare Commercial |
$62.05
|
|
|
HC BK VIRUS QT-PCR-BLOOD
|
Facility
|
IP
|
$497.05
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
63001030
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$372.79 |
| Max. Negotiated Rate |
$462.26 |
| Rate for Payer: Aetna Commercial |
$429.45
|
| Rate for Payer: Cash Price |
$298.23
|
| Rate for Payer: Cigna All Commercial |
$428.95
|
| Rate for Payer: CORVEL All Commercial |
$462.26
|
| Rate for Payer: Coventry All Commercial |
$437.40
|
| Rate for Payer: Encore All Commercial |
$457.53
|
| Rate for Payer: Frontpath All Commercial |
$457.29
|
| Rate for Payer: Humana ChoiceCare |
$429.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$447.35
|
| Rate for Payer: PHCS All Commercial |
$372.79
|
| Rate for Payer: PHP All Commercial |
$376.96
|
| Rate for Payer: Sagamore Health Network All Products |
$383.72
|
| Rate for Payer: Signature Care EPO |
$412.55
|
| Rate for Payer: Signature Care PPO |
$437.40
|
| Rate for Payer: United Healthcare Commercial |
$391.68
|
|
|
HC BK VIRUS QT-PCR-BLOOD
|
Facility
|
OP
|
$497.05
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
63001030
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$42.84 |
| Max. Negotiated Rate |
$462.26 |
| Rate for Payer: Aetna Commercial |
$419.51
|
| Rate for Payer: Aetna Medicare |
$159.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$42.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$154.09
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$228.44
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$228.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$42.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$182.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$174.96
|
| Rate for Payer: Cash Price |
$298.23
|
| Rate for Payer: Cash Price |
$298.23
|
| Rate for Payer: Centivo All Commercial |
$270.40
|
| Rate for Payer: Cigna All Commercial |
$428.95
|
| Rate for Payer: CORVEL All Commercial |
$462.26
|
| Rate for Payer: Coventry All Commercial |
$437.40
|
| Rate for Payer: Encore All Commercial |
$457.53
|
| Rate for Payer: Frontpath All Commercial |
$457.29
|
| Rate for Payer: Humana ChoiceCare |
$429.30
|
| Rate for Payer: Humana Medicare |
$159.06
|
| Rate for Payer: Lucent All Commercial |
$270.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$447.35
|
| Rate for Payer: Managed Health Services Medicaid |
$42.84
|
| Rate for Payer: MDWise Medicaid |
$42.84
|
| Rate for Payer: PHCS All Commercial |
$372.79
|
| Rate for Payer: PHP All Commercial |
$376.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$193.85
|
| Rate for Payer: Sagamore Health Network All Products |
$383.72
|
| Rate for Payer: Signature Care EPO |
$412.55
|
| Rate for Payer: Signature Care PPO |
$437.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$422.49
|
| Rate for Payer: United Healthcare Commercial |
$391.68
|
| Rate for Payer: United Healthcare Medicare |
$159.06
|
|
|
HC BK VIRUS QT-PCR-URINE
|
Facility
|
OP
|
$497.05
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
63002053
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$42.84 |
| Max. Negotiated Rate |
$462.26 |
| Rate for Payer: Aetna Commercial |
$419.51
|
| Rate for Payer: Aetna Medicare |
$159.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$42.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$154.09
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$228.44
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$228.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$42.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$182.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$174.96
|
| Rate for Payer: Cash Price |
$298.23
|
| Rate for Payer: Cash Price |
$298.23
|
| Rate for Payer: Centivo All Commercial |
$270.40
|
| Rate for Payer: Cigna All Commercial |
$428.95
|
| Rate for Payer: CORVEL All Commercial |
$462.26
|
| Rate for Payer: Coventry All Commercial |
$437.40
|
| Rate for Payer: Encore All Commercial |
$457.53
|
| Rate for Payer: Frontpath All Commercial |
$457.29
|
| Rate for Payer: Humana ChoiceCare |
$429.30
|
| Rate for Payer: Humana Medicare |
$159.06
|
| Rate for Payer: Lucent All Commercial |
$270.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$447.35
|
| Rate for Payer: Managed Health Services Medicaid |
$42.84
|
| Rate for Payer: MDWise Medicaid |
$42.84
|
| Rate for Payer: PHCS All Commercial |
$372.79
|
| Rate for Payer: PHP All Commercial |
$376.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$193.85
|
| Rate for Payer: Sagamore Health Network All Products |
$383.72
|
| Rate for Payer: Signature Care EPO |
$412.55
|
| Rate for Payer: Signature Care PPO |
$437.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$422.49
|
| Rate for Payer: United Healthcare Commercial |
$391.68
|
| Rate for Payer: United Healthcare Medicare |
$159.06
|
|
