|
HC DS MENISCAL REPAIR 12
|
Facility
IP
|
$3,074.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606367
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,305.80 |
| Max. Negotiated Rate |
$2,859.19 |
| Rate for Payer: Aetna Commercial |
$2,656.28
|
| Rate for Payer: Cash Price |
$1,906.13
|
| Rate for Payer: Cigna All Commercial |
$2,653.21
|
| Rate for Payer: CORVEL All Commercial |
$2,859.19
|
| Rate for Payer: Coventry All Commercial |
$2,705.47
|
| Rate for Payer: Encore All Commercial |
$2,829.99
|
| Rate for Payer: Frontpath All Commercial |
$2,828.45
|
| Rate for Payer: Humana ChoiceCare |
$2,655.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,766.96
|
| Rate for Payer: PHCS All Commercial |
$2,305.80
|
| Rate for Payer: PHP All Commercial |
$2,331.62
|
| Rate for Payer: Sagamore Health Network All Products |
$2,373.44
|
| Rate for Payer: Signature Care EPO |
$2,551.75
|
| Rate for Payer: Signature Care PPO |
$2,705.47
|
| Rate for Payer: United Healthcare Commercial |
$2,422.63
|
|
|
HC DS MENISCAL REPAIR 12
|
Facility
OP
|
$3,074.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606367
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,859.19 |
| Rate for Payer: Aetna Commercial |
$2,594.79
|
| Rate for Payer: Aetna Medicare |
$1,014.55
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,014.55
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,765.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,921.81
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,166.73
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,116.01
|
| Rate for Payer: Cash Price |
$1,906.13
|
| Rate for Payer: Cash Price |
$1,906.13
|
| Rate for Payer: Centivo All Commercial |
$1,567.94
|
| Rate for Payer: Cigna All Commercial |
$2,653.21
|
| Rate for Payer: CORVEL All Commercial |
$2,859.19
|
| Rate for Payer: Coventry All Commercial |
$2,705.47
|
| Rate for Payer: Encore All Commercial |
$2,829.99
|
| Rate for Payer: Frontpath All Commercial |
$2,828.45
|
| Rate for Payer: Humana ChoiceCare |
$2,655.36
|
| Rate for Payer: Humana Medicare |
$1,567.94
|
| Rate for Payer: Lucent All Commercial |
$1,567.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,766.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,305.80
|
| Rate for Payer: PHP All Commercial |
$2,331.62
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,199.02
|
| Rate for Payer: Sagamore Health Network All Products |
$2,373.44
|
| Rate for Payer: Signature Care EPO |
$2,551.75
|
| Rate for Payer: Signature Care PPO |
$2,705.47
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,613.24
|
| Rate for Payer: United Healthcare Commercial |
$2,422.63
|
| Rate for Payer: United Healthcare Medicare |
$1,014.55
|
|
|
HC DS MENISCAL REPAIR 24
|
Facility
OP
|
$2,869.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606366
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,668.36 |
| Rate for Payer: Aetna Commercial |
$2,421.60
|
| Rate for Payer: Aetna Medicare |
$946.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$946.84
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,647.78
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,793.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,088.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,041.52
|
| Rate for Payer: Cash Price |
$1,778.90
|
| Rate for Payer: Cash Price |
$1,778.90
|
| Rate for Payer: Centivo All Commercial |
$1,463.29
|
| Rate for Payer: Cigna All Commercial |
$2,476.12
|
| Rate for Payer: CORVEL All Commercial |
$2,668.36
|
| Rate for Payer: Coventry All Commercial |
$2,524.90
|
| Rate for Payer: Encore All Commercial |
$2,641.10
|
| Rate for Payer: Frontpath All Commercial |
$2,639.66
|
| Rate for Payer: Humana ChoiceCare |
$2,478.13
|
| Rate for Payer: Humana Medicare |
$1,463.29
|
| Rate for Payer: Lucent All Commercial |
$1,463.29
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,582.28
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,151.90
|
| Rate for Payer: PHP All Commercial |
$2,176.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,118.99
|
| Rate for Payer: Sagamore Health Network All Products |
$2,215.02
|
| Rate for Payer: Signature Care EPO |
$2,381.44
|
| Rate for Payer: Signature Care PPO |
$2,524.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,438.82
|
| Rate for Payer: United Healthcare Commercial |
$2,260.93
|
| Rate for Payer: United Healthcare Medicare |
$946.84
|
|
|
HC DS MENISCAL REPAIR 24
|
Facility
IP
|
$2,869.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606366
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,151.90 |
| Max. Negotiated Rate |
$2,668.36 |
| Rate for Payer: Aetna Commercial |
$2,478.99
|
| Rate for Payer: Cash Price |
$1,778.90
|
| Rate for Payer: Cigna All Commercial |
$2,476.12
|
| Rate for Payer: CORVEL All Commercial |
$2,668.36
|
| Rate for Payer: Coventry All Commercial |
$2,524.90
|
| Rate for Payer: Encore All Commercial |
$2,641.10
|
| Rate for Payer: Frontpath All Commercial |
$2,639.66
|
| Rate for Payer: Humana ChoiceCare |
$2,478.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,582.28
|
| Rate for Payer: PHCS All Commercial |
$2,151.90
|
| Rate for Payer: PHP All Commercial |
$2,176.00
|
| Rate for Payer: Sagamore Health Network All Products |
$2,215.02
|
| Rate for Payer: Signature Care EPO |
$2,381.44
|
| Rate for Payer: Signature Care PPO |
$2,524.90
|
| Rate for Payer: United Healthcare Commercial |
$2,260.93
|
|
|
HC DS NAIL 10/130 X170 CANN TFNA
|
Facility
OP
|
$11,595.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607689
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$10,783.91 |
| Rate for Payer: Aetna Commercial |
$9,786.69
|
| Rate for Payer: Aetna Medicare |
$3,826.55
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$3,826.55
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$6,659.35
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,248.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,400.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,209.20
|
| Rate for Payer: Cash Price |
$7,189.27
|
| Rate for Payer: Cash Price |
$7,189.27
|
| Rate for Payer: Centivo All Commercial |
$5,913.76
|
| Rate for Payer: Cigna All Commercial |
$10,007.00
|
| Rate for Payer: CORVEL All Commercial |
$10,783.91
|
| Rate for Payer: Coventry All Commercial |
$10,204.13
|
| Rate for Payer: Encore All Commercial |
$10,673.75
|
| Rate for Payer: Frontpath All Commercial |
$10,667.95
|
| Rate for Payer: Humana ChoiceCare |
$10,015.12
|
| Rate for Payer: Humana Medicare |
$5,913.76
|
| Rate for Payer: Lucent All Commercial |
$5,913.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,436.04
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$8,696.70
|
| Rate for Payer: PHP All Commercial |
$8,794.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,522.28
|
| Rate for Payer: Sagamore Health Network All Products |
$8,951.80
|
| Rate for Payer: Signature Care EPO |
$9,624.35
|
| Rate for Payer: Signature Care PPO |
$10,204.13
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$9,856.26
|
| Rate for Payer: United Healthcare Commercial |
$9,137.33
|
| Rate for Payer: United Healthcare Medicare |
$3,826.55
|
|
|
HC DS NAIL 10/130 X170 CANN TFNA
|
Facility
IP
|
$11,595.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607689
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,696.70 |
| Max. Negotiated Rate |
$10,783.91 |
| Rate for Payer: Aetna Commercial |
$10,018.60
|
| Rate for Payer: Cash Price |
$7,189.27
|
| Rate for Payer: Cigna All Commercial |
$10,007.00
|
| Rate for Payer: CORVEL All Commercial |
$10,783.91
|
| Rate for Payer: Coventry All Commercial |
$10,204.13
|
| Rate for Payer: Encore All Commercial |
$10,673.75
|
| Rate for Payer: Frontpath All Commercial |
$10,667.95
|
| Rate for Payer: Humana ChoiceCare |
$10,015.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,436.04
|
| Rate for Payer: PHCS All Commercial |
$8,696.70
|
| Rate for Payer: PHP All Commercial |
$8,794.10
|
| Rate for Payer: Sagamore Health Network All Products |
$8,951.80
|
| Rate for Payer: Signature Care EPO |
$9,624.35
|
| Rate for Payer: Signature Care PPO |
$10,204.13
|
| Rate for Payer: United Healthcare Commercial |
$9,137.33
|
|
|
HC DS NAIL 10X315 TIB CANN
|
Facility
OP
|
$8,115.84
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607113
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,547.73 |
| Rate for Payer: Aetna Commercial |
$6,849.77
|
| Rate for Payer: Aetna Medicare |
$2,678.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,678.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,660.93
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,073.21
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,079.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,946.05
|
| Rate for Payer: Cash Price |
$5,031.82
|
| Rate for Payer: Cash Price |
$5,031.82
|
| Rate for Payer: Centivo All Commercial |
$4,139.08
|
| Rate for Payer: Cigna All Commercial |
$7,003.97
|
| Rate for Payer: CORVEL All Commercial |
$7,547.73
|
| Rate for Payer: Coventry All Commercial |
$7,141.94
|
| Rate for Payer: Encore All Commercial |
$7,470.63
|
| Rate for Payer: Frontpath All Commercial |
$7,466.57
|
| Rate for Payer: Humana ChoiceCare |
$7,009.65
|
| Rate for Payer: Humana Medicare |
$4,139.08
|
| Rate for Payer: Lucent All Commercial |
$4,139.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,304.26
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,086.88
|
| Rate for Payer: PHP All Commercial |
$6,155.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,165.18
|
| Rate for Payer: Sagamore Health Network All Products |
$6,265.43
|
| Rate for Payer: Signature Care EPO |
$6,736.15
|
| Rate for Payer: Signature Care PPO |
$7,141.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,898.46
|
| Rate for Payer: United Healthcare Commercial |
$6,395.28
|
| Rate for Payer: United Healthcare Medicare |
$2,678.23
|
|
|
HC DS NAIL 10X315 TIB CANN
|
Facility
IP
|
$8,115.84
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607113
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,086.88 |
| Max. Negotiated Rate |
$7,547.73 |
| Rate for Payer: Aetna Commercial |
$7,012.09
|
| Rate for Payer: Cash Price |
$5,031.82
|
| Rate for Payer: Cigna All Commercial |
$7,003.97
|
| Rate for Payer: CORVEL All Commercial |
$7,547.73
|
| Rate for Payer: Coventry All Commercial |
$7,141.94
|
| Rate for Payer: Encore All Commercial |
$7,470.63
|
| Rate for Payer: Frontpath All Commercial |
$7,466.57
|
| Rate for Payer: Humana ChoiceCare |
$7,009.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,304.26
|
| Rate for Payer: PHCS All Commercial |
$6,086.88
|
| Rate for Payer: PHP All Commercial |
$6,155.05
|
| Rate for Payer: Sagamore Health Network All Products |
$6,265.43
|
| Rate for Payer: Signature Care EPO |
$6,736.15
|
| Rate for Payer: Signature Care PPO |
$7,141.94
|
| Rate for Payer: United Healthcare Commercial |
$6,395.28
|
|
|
HC DS NAIL 11/130X170 CANN TFNA
|
Facility
IP
|
$8,453.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606223
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,339.79 |
| Max. Negotiated Rate |
$7,861.34 |
| Rate for Payer: Aetna Commercial |
$7,303.44
|
| Rate for Payer: Cash Price |
$5,240.89
|
| Rate for Payer: Cigna All Commercial |
$7,294.98
|
| Rate for Payer: CORVEL All Commercial |
$7,861.34
|
| Rate for Payer: Coventry All Commercial |
$7,438.68
|
| Rate for Payer: Encore All Commercial |
$7,781.03
|
| Rate for Payer: Frontpath All Commercial |
$7,776.81
|
| Rate for Payer: Humana ChoiceCare |
$7,300.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,607.74
|
| Rate for Payer: PHCS All Commercial |
$6,339.79
|
| Rate for Payer: PHP All Commercial |
$6,410.79
|
| Rate for Payer: Sagamore Health Network All Products |
$6,525.75
|
| Rate for Payer: Signature Care EPO |
$7,016.03
|
| Rate for Payer: Signature Care PPO |
$7,438.68
|
| Rate for Payer: United Healthcare Commercial |
$6,661.00
|
|
|
HC DS NAIL 11/130X170 CANN TFNA
|
Facility
OP
|
$8,453.05
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606223
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,861.34 |
| Rate for Payer: Aetna Commercial |
$7,134.37
|
| Rate for Payer: Aetna Medicare |
$2,789.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,789.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,854.59
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,284.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,207.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,068.46
|
| Rate for Payer: Cash Price |
$5,240.89
|
| Rate for Payer: Cash Price |
$5,240.89
|
| Rate for Payer: Centivo All Commercial |
$4,311.06
|
| Rate for Payer: Cigna All Commercial |
$7,294.98
|
| Rate for Payer: CORVEL All Commercial |
$7,861.34
|
| Rate for Payer: Coventry All Commercial |
$7,438.68
|
| Rate for Payer: Encore All Commercial |
$7,781.03
|
| Rate for Payer: Frontpath All Commercial |
$7,776.81
|
| Rate for Payer: Humana ChoiceCare |
$7,300.90
|
| Rate for Payer: Humana Medicare |
$4,311.06
|
| Rate for Payer: Lucent All Commercial |
$4,311.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,607.74
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,339.79
|
| Rate for Payer: PHP All Commercial |
$6,410.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,296.69
|
| Rate for Payer: Sagamore Health Network All Products |
$6,525.75
|
| Rate for Payer: Signature Care EPO |
$7,016.03
|
| Rate for Payer: Signature Care PPO |
$7,438.68
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,185.09
|
| Rate for Payer: United Healthcare Commercial |
$6,661.00
|
| Rate for Payer: United Healthcare Medicare |
$2,789.51
|
|
|
HC DS NAIL 2.0X440
|
Facility
IP
|
$3,254.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607468
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,440.80 |
| Max. Negotiated Rate |
$3,026.59 |
| Rate for Payer: Aetna Commercial |
$2,811.80
|
| Rate for Payer: Cash Price |
$2,017.73
|
| Rate for Payer: Cigna All Commercial |
$2,808.55
|
| Rate for Payer: CORVEL All Commercial |
$3,026.59
|
| Rate for Payer: Coventry All Commercial |
$2,863.87
|
| Rate for Payer: Encore All Commercial |
$2,995.68
|
| Rate for Payer: Frontpath All Commercial |
$2,994.05
|
| Rate for Payer: Humana ChoiceCare |
$2,810.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,928.96
|
| Rate for Payer: PHCS All Commercial |
$2,440.80
|
| Rate for Payer: PHP All Commercial |
$2,468.14
|
| Rate for Payer: Sagamore Health Network All Products |
$2,512.40
|
| Rate for Payer: Signature Care EPO |
$2,701.15
|
| Rate for Payer: Signature Care PPO |
$2,863.87
|
| Rate for Payer: United Healthcare Commercial |
$2,564.47
|
|
|
HC DS NAIL 2.0X440
|
Facility
OP
|
$3,254.40
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607468
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,026.59 |
| Rate for Payer: Aetna Commercial |
$2,746.71
|
| Rate for Payer: Aetna Medicare |
$1,073.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,073.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,869.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,034.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,235.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,181.35
|
| Rate for Payer: Cash Price |
$2,017.73
|
| Rate for Payer: Cash Price |
$2,017.73
|
| Rate for Payer: Centivo All Commercial |
$1,659.74
|
| Rate for Payer: Cigna All Commercial |
$2,808.55
|
| Rate for Payer: CORVEL All Commercial |
$3,026.59
|
| Rate for Payer: Coventry All Commercial |
$2,863.87
|
| Rate for Payer: Encore All Commercial |
$2,995.68
|
| Rate for Payer: Frontpath All Commercial |
$2,994.05
|
| Rate for Payer: Humana ChoiceCare |
$2,810.83
|
| Rate for Payer: Humana Medicare |
$1,659.74
|
| Rate for Payer: Lucent All Commercial |
$1,659.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,928.96
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,440.80
|
| Rate for Payer: PHP All Commercial |
$2,468.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,269.22
|
| Rate for Payer: Sagamore Health Network All Products |
$2,512.40
|
| Rate for Payer: Signature Care EPO |
$2,701.15
|
| Rate for Payer: Signature Care PPO |
$2,863.87
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,766.24
|
| Rate for Payer: United Healthcare Commercial |
$2,564.47
|
| Rate for Payer: United Healthcare Medicare |
$1,073.95
|
|
|
HC DS OUTER SLEEVE 12MM
|
Facility
OP
|
$848.00
|
|
| Hospital Charge Code |
41607103
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$788.64 |
| Rate for Payer: Aetna Commercial |
$715.71
|
| Rate for Payer: Aetna Medicare |
$279.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$279.84
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$487.01
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$530.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$321.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$307.82
|
| Rate for Payer: Cash Price |
$525.76
|
| Rate for Payer: Cash Price |
$525.76
|
| Rate for Payer: Centivo All Commercial |
$432.48
|
| Rate for Payer: Cigna All Commercial |
$731.82
|
| Rate for Payer: CORVEL All Commercial |
$788.64
|
| Rate for Payer: Coventry All Commercial |
$746.24
|
| Rate for Payer: Encore All Commercial |
$780.58
|
| Rate for Payer: Frontpath All Commercial |
$780.16
|
| Rate for Payer: Humana ChoiceCare |
$732.42
|
| Rate for Payer: Humana Medicare |
$432.48
|
| Rate for Payer: Lucent All Commercial |
$432.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$763.20
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$636.00
|
| Rate for Payer: PHP All Commercial |
$643.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$330.72
|
| Rate for Payer: Sagamore Health Network All Products |
$654.66
|
| Rate for Payer: Signature Care EPO |
$703.84
|
| Rate for Payer: Signature Care PPO |
$746.24
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$720.80
|
| Rate for Payer: United Healthcare Commercial |
$668.22
|
| Rate for Payer: United Healthcare Medicare |
$279.84
|
|
|
HC DS OUTER SLEEVE 12MM
|
Facility
IP
|
$848.00
|
|
| Hospital Charge Code |
41607103
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$636.00 |
| Max. Negotiated Rate |
$788.64 |
| Rate for Payer: Aetna Commercial |
$732.67
|
| Rate for Payer: Cash Price |
$525.76
|
| Rate for Payer: Cigna All Commercial |
$731.82
|
| Rate for Payer: CORVEL All Commercial |
$788.64
|
| Rate for Payer: Coventry All Commercial |
$746.24
|
| Rate for Payer: Encore All Commercial |
$780.58
|
| Rate for Payer: Frontpath All Commercial |
$780.16
|
| Rate for Payer: Humana ChoiceCare |
$732.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$763.20
|
| Rate for Payer: PHCS All Commercial |
$636.00
|
| Rate for Payer: PHP All Commercial |
$643.12
|
| Rate for Payer: Sagamore Health Network All Products |
$654.66
|
| Rate for Payer: Signature Care EPO |
$703.84
|
| Rate for Payer: Signature Care PPO |
$746.24
|
| Rate for Payer: United Healthcare Commercial |
$668.22
|
|
|
HC DS OUTER SLEEVE 14.5MM
|
Facility
OP
|
$848.00
|
|
| Hospital Charge Code |
41607104
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$788.64 |
| Rate for Payer: Aetna Commercial |
$715.71
|
| Rate for Payer: Aetna Medicare |
$279.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$279.84
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$487.01
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$530.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$321.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$307.82
|
| Rate for Payer: Cash Price |
$525.76
|
| Rate for Payer: Cash Price |
$525.76
|
| Rate for Payer: Centivo All Commercial |
$432.48
|
| Rate for Payer: Cigna All Commercial |
$731.82
|
| Rate for Payer: CORVEL All Commercial |
$788.64
|
| Rate for Payer: Coventry All Commercial |
$746.24
|
| Rate for Payer: Encore All Commercial |
$780.58
|
| Rate for Payer: Frontpath All Commercial |
$780.16
|
| Rate for Payer: Humana ChoiceCare |
$732.42
|
| Rate for Payer: Humana Medicare |
$432.48
|
| Rate for Payer: Lucent All Commercial |
$432.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$763.20
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$636.00
|
| Rate for Payer: PHP All Commercial |
$643.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$330.72
|
| Rate for Payer: Sagamore Health Network All Products |
$654.66
|
| Rate for Payer: Signature Care EPO |
$703.84
|
| Rate for Payer: Signature Care PPO |
$746.24
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$720.80
|
| Rate for Payer: United Healthcare Commercial |
$668.22
|
| Rate for Payer: United Healthcare Medicare |
$279.84
|
|
|
HC DS OUTER SLEEVE 14.5MM
|
Facility
IP
|
$848.00
|
|
| Hospital Charge Code |
41607104
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$636.00 |
| Max. Negotiated Rate |
$788.64 |
| Rate for Payer: Aetna Commercial |
$732.67
|
| Rate for Payer: Cash Price |
$525.76
|
| Rate for Payer: Cigna All Commercial |
$731.82
|
| Rate for Payer: CORVEL All Commercial |
$788.64
|
| Rate for Payer: Coventry All Commercial |
$746.24
|
| Rate for Payer: Encore All Commercial |
$780.58
|
| Rate for Payer: Frontpath All Commercial |
$780.16
|
| Rate for Payer: Humana ChoiceCare |
$732.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$763.20
|
| Rate for Payer: PHCS All Commercial |
$636.00
|
| Rate for Payer: PHP All Commercial |
$643.12
|
| Rate for Payer: Sagamore Health Network All Products |
$654.66
|
| Rate for Payer: Signature Care EPO |
$703.84
|
| Rate for Payer: Signature Care PPO |
$746.24
|
| Rate for Payer: United Healthcare Commercial |
$668.22
|
|
|
HC DS PLATE DSTL HUM 3.5 10-H 230
|
Facility
OP
|
$11,995.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607691
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,155.54 |
| Rate for Payer: Aetna Commercial |
$10,123.95
|
| Rate for Payer: Aetna Medicare |
$3,958.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$3,958.42
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$6,888.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,498.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,552.18
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,354.26
|
| Rate for Payer: Cash Price |
$7,437.02
|
| Rate for Payer: Cash Price |
$7,437.02
|
| Rate for Payer: Centivo All Commercial |
$6,117.55
|
| Rate for Payer: Cigna All Commercial |
$10,351.86
|
| Rate for Payer: CORVEL All Commercial |
$11,155.54
|
| Rate for Payer: Coventry All Commercial |
$10,555.78
|
| Rate for Payer: Encore All Commercial |
$11,041.58
|
| Rate for Payer: Frontpath All Commercial |
$11,035.58
|
| Rate for Payer: Humana ChoiceCare |
$10,360.25
|
| Rate for Payer: Humana Medicare |
$6,117.55
|
| Rate for Payer: Lucent All Commercial |
$6,117.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,795.68
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$8,996.40
|
| Rate for Payer: PHP All Commercial |
$9,097.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,678.13
|
| Rate for Payer: Sagamore Health Network All Products |
$9,260.29
|
| Rate for Payer: Signature Care EPO |
$9,956.02
|
| Rate for Payer: Signature Care PPO |
$10,555.78
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,195.92
|
| Rate for Payer: United Healthcare Commercial |
$9,452.22
|
| Rate for Payer: United Healthcare Medicare |
$3,958.42
|
|
|
HC DS PLATE DSTL HUM 3.5 10-H 230
|
Facility
IP
|
$11,995.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607691
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,996.40 |
| Max. Negotiated Rate |
$11,155.54 |
| Rate for Payer: Aetna Commercial |
$10,363.85
|
| Rate for Payer: Cash Price |
$7,437.02
|
| Rate for Payer: Cigna All Commercial |
$10,351.86
|
| Rate for Payer: CORVEL All Commercial |
$11,155.54
|
| Rate for Payer: Coventry All Commercial |
$10,555.78
|
| Rate for Payer: Encore All Commercial |
$11,041.58
|
| Rate for Payer: Frontpath All Commercial |
$11,035.58
|
| Rate for Payer: Humana ChoiceCare |
$10,360.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,795.68
|
| Rate for Payer: PHCS All Commercial |
$8,996.40
|
| Rate for Payer: PHP All Commercial |
$9,097.16
|
| Rate for Payer: Sagamore Health Network All Products |
$9,260.29
|
| Rate for Payer: Signature Care EPO |
$9,956.02
|
| Rate for Payer: Signature Care PPO |
$10,555.78
|
| Rate for Payer: United Healthcare Commercial |
$9,452.22
|
|
|
HC DS PLATE HUM 2.7/3.5 9-H R 173
|
Facility
OP
|
$6,962.04
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606937
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,474.70 |
| Rate for Payer: Aetna Commercial |
$5,875.96
|
| Rate for Payer: Aetna Medicare |
$2,297.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,297.47
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,998.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,351.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,642.09
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,527.22
|
| Rate for Payer: Cash Price |
$4,316.47
|
| Rate for Payer: Cash Price |
$4,316.47
|
| Rate for Payer: Centivo All Commercial |
$3,550.64
|
| Rate for Payer: Cigna All Commercial |
$6,008.24
|
| Rate for Payer: CORVEL All Commercial |
$6,474.70
|
| Rate for Payer: Coventry All Commercial |
$6,126.60
|
| Rate for Payer: Encore All Commercial |
$6,408.56
|
| Rate for Payer: Frontpath All Commercial |
$6,405.08
|
| Rate for Payer: Humana ChoiceCare |
$6,013.11
|
| Rate for Payer: Humana Medicare |
$3,550.64
|
| Rate for Payer: Lucent All Commercial |
$3,550.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,265.84
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,221.53
|
| Rate for Payer: PHP All Commercial |
$5,280.01
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,715.20
|
| Rate for Payer: Sagamore Health Network All Products |
$5,374.69
|
| Rate for Payer: Signature Care EPO |
$5,778.49
|
| Rate for Payer: Signature Care PPO |
$6,126.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,917.73
|
| Rate for Payer: United Healthcare Commercial |
$5,486.09
|
| Rate for Payer: United Healthcare Medicare |
$2,297.47
|
|
|
HC DS PLATE HUM 2.7/3.5 9-H R 173
|
Facility
IP
|
$6,962.04
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606937
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,221.53 |
| Max. Negotiated Rate |
$6,474.70 |
| Rate for Payer: Aetna Commercial |
$6,015.20
|
| Rate for Payer: Cash Price |
$4,316.47
|
| Rate for Payer: Cigna All Commercial |
$6,008.24
|
| Rate for Payer: CORVEL All Commercial |
$6,474.70
|
| Rate for Payer: Coventry All Commercial |
$6,126.60
|
| Rate for Payer: Encore All Commercial |
$6,408.56
|
| Rate for Payer: Frontpath All Commercial |
$6,405.08
|
| Rate for Payer: Humana ChoiceCare |
$6,013.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,265.84
|
| Rate for Payer: PHCS All Commercial |
$5,221.53
|
| Rate for Payer: PHP All Commercial |
$5,280.01
|
| Rate for Payer: Sagamore Health Network All Products |
$5,374.69
|
| Rate for Payer: Signature Care EPO |
$5,778.49
|
| Rate for Payer: Signature Care PPO |
$6,126.60
|
| Rate for Payer: United Healthcare Commercial |
$5,486.09
|
|
|
HC DS PLATE MD PXML TIBA 3.5 6H L
|
Facility
IP
|
$8,193.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606340
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,145.20 |
| Max. Negotiated Rate |
$7,620.05 |
| Rate for Payer: Aetna Commercial |
$7,079.27
|
| Rate for Payer: Cash Price |
$5,080.03
|
| Rate for Payer: Cigna All Commercial |
$7,071.08
|
| Rate for Payer: CORVEL All Commercial |
$7,620.05
|
| Rate for Payer: Coventry All Commercial |
$7,210.37
|
| Rate for Payer: Encore All Commercial |
$7,542.21
|
| Rate for Payer: Frontpath All Commercial |
$7,538.11
|
| Rate for Payer: Humana ChoiceCare |
$7,076.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,374.24
|
| Rate for Payer: PHCS All Commercial |
$6,145.20
|
| Rate for Payer: PHP All Commercial |
$6,214.03
|
| Rate for Payer: Sagamore Health Network All Products |
$6,325.46
|
| Rate for Payer: Signature Care EPO |
$6,800.69
|
| Rate for Payer: Signature Care PPO |
$7,210.37
|
| Rate for Payer: United Healthcare Commercial |
$6,456.56
|
|
|
HC DS PLATE MD PXML TIBA 3.5 6H L
|
Facility
OP
|
$8,193.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606340
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,620.05 |
| Rate for Payer: Aetna Commercial |
$6,915.40
|
| Rate for Payer: Aetna Medicare |
$2,703.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,703.89
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,705.58
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,121.82
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,109.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,974.28
|
| Rate for Payer: Cash Price |
$5,080.03
|
| Rate for Payer: Cash Price |
$5,080.03
|
| Rate for Payer: Centivo All Commercial |
$4,178.74
|
| Rate for Payer: Cigna All Commercial |
$7,071.08
|
| Rate for Payer: CORVEL All Commercial |
$7,620.05
|
| Rate for Payer: Coventry All Commercial |
$7,210.37
|
| Rate for Payer: Encore All Commercial |
$7,542.21
|
| Rate for Payer: Frontpath All Commercial |
$7,538.11
|
| Rate for Payer: Humana ChoiceCare |
$7,076.81
|
| Rate for Payer: Humana Medicare |
$4,178.74
|
| Rate for Payer: Lucent All Commercial |
$4,178.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,374.24
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,145.20
|
| Rate for Payer: PHP All Commercial |
$6,214.03
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,195.50
|
| Rate for Payer: Sagamore Health Network All Products |
$6,325.46
|
| Rate for Payer: Signature Care EPO |
$6,800.69
|
| Rate for Payer: Signature Care PPO |
$7,210.37
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,964.56
|
| Rate for Payer: United Healthcare Commercial |
$6,456.56
|
| Rate for Payer: United Healthcare Medicare |
$2,703.89
|
|
|
HC DS PLATE PROX HUM 3.5 3-H 90
|
Facility
IP
|
$8,182.08
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607050
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,136.56 |
| Max. Negotiated Rate |
$7,609.33 |
| Rate for Payer: Aetna Commercial |
$7,069.32
|
| Rate for Payer: Cash Price |
$5,072.89
|
| Rate for Payer: Cigna All Commercial |
$7,061.14
|
| Rate for Payer: CORVEL All Commercial |
$7,609.33
|
| Rate for Payer: Coventry All Commercial |
$7,200.23
|
| Rate for Payer: Encore All Commercial |
$7,531.60
|
| Rate for Payer: Frontpath All Commercial |
$7,527.51
|
| Rate for Payer: Humana ChoiceCare |
$7,066.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,363.87
|
| Rate for Payer: PHCS All Commercial |
$6,136.56
|
| Rate for Payer: PHP All Commercial |
$6,205.29
|
| Rate for Payer: Sagamore Health Network All Products |
$6,316.57
|
| Rate for Payer: Signature Care EPO |
$6,791.13
|
| Rate for Payer: Signature Care PPO |
$7,200.23
|
| Rate for Payer: United Healthcare Commercial |
$6,447.48
|
|
|
HC DS PLATE PROX HUM 3.5 3-H 90
|
Facility
OP
|
$8,182.08
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607050
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,609.33 |
| Rate for Payer: Aetna Commercial |
$6,905.68
|
| Rate for Payer: Aetna Medicare |
$2,700.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,700.09
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,698.97
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,114.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,105.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,970.10
|
| Rate for Payer: Cash Price |
$5,072.89
|
| Rate for Payer: Cash Price |
$5,072.89
|
| Rate for Payer: Centivo All Commercial |
$4,172.86
|
| Rate for Payer: Cigna All Commercial |
$7,061.14
|
| Rate for Payer: CORVEL All Commercial |
$7,609.33
|
| Rate for Payer: Coventry All Commercial |
$7,200.23
|
| Rate for Payer: Encore All Commercial |
$7,531.60
|
| Rate for Payer: Frontpath All Commercial |
$7,527.51
|
| Rate for Payer: Humana ChoiceCare |
$7,066.86
|
| Rate for Payer: Humana Medicare |
$4,172.86
|
| Rate for Payer: Lucent All Commercial |
$4,172.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,363.87
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,136.56
|
| Rate for Payer: PHP All Commercial |
$6,205.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,191.01
|
| Rate for Payer: Sagamore Health Network All Products |
$6,316.57
|
| Rate for Payer: Signature Care EPO |
$6,791.13
|
| Rate for Payer: Signature Care PPO |
$7,200.23
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,954.77
|
| Rate for Payer: United Healthcare Commercial |
$6,447.48
|
| Rate for Payer: United Healthcare Medicare |
$2,700.09
|
|
|
HC DS PLATE PROX TIBIS SM 12H L
|
Facility
IP
|
$10,670.15
|
|
| Hospital Charge Code |
41606341
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,002.61 |
| Max. Negotiated Rate |
$9,923.24 |
| Rate for Payer: Aetna Commercial |
$9,219.01
|
| Rate for Payer: Cash Price |
$6,615.49
|
| Rate for Payer: Cigna All Commercial |
$9,208.34
|
| Rate for Payer: CORVEL All Commercial |
$9,923.24
|
| Rate for Payer: Coventry All Commercial |
$9,389.73
|
| Rate for Payer: Encore All Commercial |
$9,821.87
|
| Rate for Payer: Frontpath All Commercial |
$9,816.54
|
| Rate for Payer: Humana ChoiceCare |
$9,215.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$9,603.14
|
| Rate for Payer: PHCS All Commercial |
$8,002.61
|
| Rate for Payer: PHP All Commercial |
$8,092.24
|
| Rate for Payer: Sagamore Health Network All Products |
$8,237.36
|
| Rate for Payer: Signature Care EPO |
$8,856.22
|
| Rate for Payer: Signature Care PPO |
$9,389.73
|
| Rate for Payer: United Healthcare Commercial |
$8,408.08
|
|
