|
HC CADMIUM
|
Facility
|
OP
|
$96.83
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
63001472
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$23.64 |
| Max. Negotiated Rate |
$90.05 |
| Rate for Payer: Aetna Commercial |
$81.72
|
| Rate for Payer: Aetna Medicare |
$30.99
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$23.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$30.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$44.50
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$44.50
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$23.64
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$35.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$34.08
|
| Rate for Payer: Cash Price |
$58.10
|
| Rate for Payer: Cash Price |
$58.10
|
| Rate for Payer: Centivo All Commercial |
$52.68
|
| Rate for Payer: Cigna All Commercial |
$83.56
|
| Rate for Payer: CORVEL All Commercial |
$90.05
|
| Rate for Payer: Coventry All Commercial |
$85.21
|
| Rate for Payer: Encore All Commercial |
$89.13
|
| Rate for Payer: Frontpath All Commercial |
$89.08
|
| Rate for Payer: Humana ChoiceCare |
$83.63
|
| Rate for Payer: Humana Medicare |
$30.99
|
| Rate for Payer: Lucent All Commercial |
$52.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$87.15
|
| Rate for Payer: Managed Health Services Medicaid |
$23.64
|
| Rate for Payer: MDWise Medicaid |
$23.64
|
| Rate for Payer: PHCS All Commercial |
$72.62
|
| Rate for Payer: PHP All Commercial |
$73.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$37.76
|
| Rate for Payer: Sagamore Health Network All Products |
$74.75
|
| Rate for Payer: Signature Care EPO |
$80.37
|
| Rate for Payer: Signature Care PPO |
$85.21
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$82.31
|
| Rate for Payer: United Healthcare Commercial |
$76.30
|
| Rate for Payer: United Healthcare Medicare |
$30.99
|
|
|
HC CADMIUM
|
Facility
|
IP
|
$96.83
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
63001472
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$72.62 |
| Max. Negotiated Rate |
$90.05 |
| Rate for Payer: Aetna Commercial |
$83.66
|
| Rate for Payer: Cash Price |
$58.10
|
| Rate for Payer: Cigna All Commercial |
$83.56
|
| Rate for Payer: CORVEL All Commercial |
$90.05
|
| Rate for Payer: Coventry All Commercial |
$85.21
|
| Rate for Payer: Encore All Commercial |
$89.13
|
| Rate for Payer: Frontpath All Commercial |
$89.08
|
| Rate for Payer: Humana ChoiceCare |
$83.63
|
| Rate for Payer: Lutheran Preferred All Commercial |
$87.15
|
| Rate for Payer: PHCS All Commercial |
$72.62
|
| Rate for Payer: PHP All Commercial |
$73.44
|
| Rate for Payer: Sagamore Health Network All Products |
$74.75
|
| Rate for Payer: Signature Care EPO |
$80.37
|
| Rate for Payer: Signature Care PPO |
$85.21
|
| Rate for Payer: United Healthcare Commercial |
$76.30
|
|
|
HC CALCITONIN
|
Facility
|
OP
|
$319.64
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
63001474
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$26.79 |
| Max. Negotiated Rate |
$297.27 |
| Rate for Payer: Aetna Commercial |
$269.78
|
| Rate for Payer: Aetna Medicare |
$102.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$26.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$99.09
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$146.91
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$146.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$26.79
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$117.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$112.51
|
| Rate for Payer: Cash Price |
$191.78
|
| Rate for Payer: Cash Price |
$191.78
|
| Rate for Payer: Centivo All Commercial |
$173.88
|
| Rate for Payer: Cigna All Commercial |
$275.85
|
| Rate for Payer: CORVEL All Commercial |
$297.27
|
| Rate for Payer: Coventry All Commercial |
$281.28
|
| Rate for Payer: Encore All Commercial |
$294.23
|
| Rate for Payer: Frontpath All Commercial |
$294.07
|
| Rate for Payer: Humana ChoiceCare |
$276.07
|
| Rate for Payer: Humana Medicare |
$102.28
|
| Rate for Payer: Lucent All Commercial |
$173.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$287.68
|
| Rate for Payer: Managed Health Services Medicaid |
$26.79
|
| Rate for Payer: MDWise Medicaid |
$26.79
|
| Rate for Payer: PHCS All Commercial |
$239.73
|
| Rate for Payer: PHP All Commercial |
$242.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$124.66
|
| Rate for Payer: Sagamore Health Network All Products |
$246.76
|
| Rate for Payer: Signature Care EPO |
$265.30
|
| Rate for Payer: Signature Care PPO |
$281.28
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$271.69
|
| Rate for Payer: United Healthcare Commercial |
$251.88
|
| Rate for Payer: United Healthcare Medicare |
$102.28
|
|
|
HC CALCITONIN
|
Facility
|
IP
|
$319.64
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
63001474
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$239.73 |
| Max. Negotiated Rate |
$297.27 |
| Rate for Payer: Aetna Commercial |
$276.17
|
| Rate for Payer: Cash Price |
$191.78
|
| Rate for Payer: Cigna All Commercial |
$275.85
|
| Rate for Payer: CORVEL All Commercial |
$297.27
|
| Rate for Payer: Coventry All Commercial |
$281.28
|
| Rate for Payer: Encore All Commercial |
$294.23
|
| Rate for Payer: Frontpath All Commercial |
$294.07
|
| Rate for Payer: Humana ChoiceCare |
$276.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$287.68
|
| Rate for Payer: PHCS All Commercial |
$239.73
|
| Rate for Payer: PHP All Commercial |
$242.41
|
| Rate for Payer: Sagamore Health Network All Products |
$246.76
|
| Rate for Payer: Signature Care EPO |
$265.30
|
| Rate for Payer: Signature Care PPO |
$281.28
|
| Rate for Payer: United Healthcare Commercial |
$251.88
|
|
|
HC CALCIUM 24HR URINE
|
Facility
|
OP
|
$103.22
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
63001086
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$95.99 |
| Rate for Payer: Aetna Commercial |
$87.12
|
| Rate for Payer: Aetna Medicare |
$33.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$6.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$32.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$47.44
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$47.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$6.03
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$37.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$36.33
|
| Rate for Payer: Cash Price |
$61.93
|
| Rate for Payer: Cash Price |
$61.93
|
| Rate for Payer: Centivo All Commercial |
$56.15
|
| Rate for Payer: Cigna All Commercial |
$89.08
|
| Rate for Payer: CORVEL All Commercial |
$95.99
|
| Rate for Payer: Coventry All Commercial |
$90.83
|
| Rate for Payer: Encore All Commercial |
$95.01
|
| Rate for Payer: Frontpath All Commercial |
$94.96
|
| Rate for Payer: Humana ChoiceCare |
$89.15
|
| Rate for Payer: Humana Medicare |
$33.03
|
| Rate for Payer: Lucent All Commercial |
$56.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$92.90
|
| Rate for Payer: Managed Health Services Medicaid |
$6.03
|
| Rate for Payer: MDWise Medicaid |
$6.03
|
| Rate for Payer: PHCS All Commercial |
$77.42
|
| Rate for Payer: PHP All Commercial |
$78.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$40.26
|
| Rate for Payer: Sagamore Health Network All Products |
$79.69
|
| Rate for Payer: Signature Care EPO |
$85.67
|
| Rate for Payer: Signature Care PPO |
$90.83
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$87.74
|
| Rate for Payer: United Healthcare Commercial |
$81.34
|
| Rate for Payer: United Healthcare Medicare |
$33.03
|
|
|
HC CALCIUM 24HR URINE
|
Facility
|
IP
|
$103.22
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
63001086
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$77.42 |
| Max. Negotiated Rate |
$95.99 |
| Rate for Payer: Aetna Commercial |
$89.18
|
| Rate for Payer: Cash Price |
$61.93
|
| Rate for Payer: Cigna All Commercial |
$89.08
|
| Rate for Payer: CORVEL All Commercial |
$95.99
|
| Rate for Payer: Coventry All Commercial |
$90.83
|
| Rate for Payer: Encore All Commercial |
$95.01
|
| Rate for Payer: Frontpath All Commercial |
$94.96
|
| Rate for Payer: Humana ChoiceCare |
$89.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$92.90
|
| Rate for Payer: PHCS All Commercial |
$77.42
|
| Rate for Payer: PHP All Commercial |
$78.28
|
| Rate for Payer: Sagamore Health Network All Products |
$79.69
|
| Rate for Payer: Signature Care EPO |
$85.67
|
| Rate for Payer: Signature Care PPO |
$90.83
|
| Rate for Payer: United Healthcare Commercial |
$81.34
|
|
|
HC CALCIUM SERUM
|
Facility
|
OP
|
$47.14
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
63001092
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.16 |
| Max. Negotiated Rate |
$43.84 |
| Rate for Payer: Aetna Commercial |
$39.79
|
| Rate for Payer: Aetna Medicare |
$15.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$5.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$14.61
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$21.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$21.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$5.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$17.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$16.59
|
| Rate for Payer: Cash Price |
$28.28
|
| Rate for Payer: Cash Price |
$28.28
|
| Rate for Payer: Centivo All Commercial |
$25.64
|
| Rate for Payer: Cigna All Commercial |
$40.68
|
| Rate for Payer: CORVEL All Commercial |
$43.84
|
| Rate for Payer: Coventry All Commercial |
$41.48
|
| Rate for Payer: Encore All Commercial |
$43.39
|
| Rate for Payer: Frontpath All Commercial |
$43.37
|
| Rate for Payer: Humana ChoiceCare |
$40.71
|
| Rate for Payer: Humana Medicare |
$15.08
|
| Rate for Payer: Lucent All Commercial |
$25.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$42.43
|
| Rate for Payer: Managed Health Services Medicaid |
$5.16
|
| Rate for Payer: MDWise Medicaid |
$5.16
|
| Rate for Payer: PHCS All Commercial |
$35.35
|
| Rate for Payer: PHP All Commercial |
$35.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$18.38
|
| Rate for Payer: Sagamore Health Network All Products |
$36.39
|
| Rate for Payer: Signature Care EPO |
$39.13
|
| Rate for Payer: Signature Care PPO |
$41.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$40.07
|
| Rate for Payer: United Healthcare Commercial |
$37.15
|
| Rate for Payer: United Healthcare Medicare |
$15.08
|
|
|
HC CALCIUM SERUM
|
Facility
|
IP
|
$47.14
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
63001092
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$35.35 |
| Max. Negotiated Rate |
$43.84 |
| Rate for Payer: Aetna Commercial |
$40.73
|
| Rate for Payer: Cash Price |
$28.28
|
| Rate for Payer: Cigna All Commercial |
$40.68
|
| Rate for Payer: CORVEL All Commercial |
$43.84
|
| Rate for Payer: Coventry All Commercial |
$41.48
|
| Rate for Payer: Encore All Commercial |
$43.39
|
| Rate for Payer: Frontpath All Commercial |
$43.37
|
| Rate for Payer: Humana ChoiceCare |
$40.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$42.43
|
| Rate for Payer: PHCS All Commercial |
$35.35
|
| Rate for Payer: PHP All Commercial |
$35.75
|
| Rate for Payer: Sagamore Health Network All Products |
$36.39
|
| Rate for Payer: Signature Care EPO |
$39.13
|
| Rate for Payer: Signature Care PPO |
$41.48
|
| Rate for Payer: United Healthcare Commercial |
$37.15
|
|
|
HC CALCIUM UR
|
Facility
|
OP
|
$47.14
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
63001475
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.16 |
| Max. Negotiated Rate |
$43.84 |
| Rate for Payer: Aetna Commercial |
$39.79
|
| Rate for Payer: Aetna Medicare |
$15.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$5.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$14.61
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$21.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$21.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$5.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$17.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$16.59
|
| Rate for Payer: Cash Price |
$28.28
|
| Rate for Payer: Cash Price |
$28.28
|
| Rate for Payer: Centivo All Commercial |
$25.64
|
| Rate for Payer: Cigna All Commercial |
$40.68
|
| Rate for Payer: CORVEL All Commercial |
$43.84
|
| Rate for Payer: Coventry All Commercial |
$41.48
|
| Rate for Payer: Encore All Commercial |
$43.39
|
| Rate for Payer: Frontpath All Commercial |
$43.37
|
| Rate for Payer: Humana ChoiceCare |
$40.71
|
| Rate for Payer: Humana Medicare |
$15.08
|
| Rate for Payer: Lucent All Commercial |
$25.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$42.43
|
| Rate for Payer: Managed Health Services Medicaid |
$5.16
|
| Rate for Payer: MDWise Medicaid |
$5.16
|
| Rate for Payer: PHCS All Commercial |
$35.35
|
| Rate for Payer: PHP All Commercial |
$35.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$18.38
|
| Rate for Payer: Sagamore Health Network All Products |
$36.39
|
| Rate for Payer: Signature Care EPO |
$39.13
|
| Rate for Payer: Signature Care PPO |
$41.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$40.07
|
| Rate for Payer: United Healthcare Commercial |
$37.15
|
| Rate for Payer: United Healthcare Medicare |
$15.08
|
|
|
HC CALCIUM UR
|
Facility
|
IP
|
$47.14
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
63001475
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$35.35 |
| Max. Negotiated Rate |
$43.84 |
| Rate for Payer: Aetna Commercial |
$40.73
|
| Rate for Payer: Cash Price |
$28.28
|
| Rate for Payer: Cigna All Commercial |
$40.68
|
| Rate for Payer: CORVEL All Commercial |
$43.84
|
| Rate for Payer: Coventry All Commercial |
$41.48
|
| Rate for Payer: Encore All Commercial |
$43.39
|
| Rate for Payer: Frontpath All Commercial |
$43.37
|
| Rate for Payer: Humana ChoiceCare |
$40.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$42.43
|
| Rate for Payer: PHCS All Commercial |
$35.35
|
| Rate for Payer: PHP All Commercial |
$35.75
|
| Rate for Payer: Sagamore Health Network All Products |
$36.39
|
| Rate for Payer: Signature Care EPO |
$39.13
|
| Rate for Payer: Signature Care PPO |
$41.48
|
| Rate for Payer: United Healthcare Commercial |
$37.15
|
|
|
HC CALPROTECTIN, FECES
|
Facility
|
IP
|
$403.92
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
63001652
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$302.94 |
| Max. Negotiated Rate |
$375.65 |
| Rate for Payer: Aetna Commercial |
$348.99
|
| Rate for Payer: Cash Price |
$242.35
|
| Rate for Payer: Cigna All Commercial |
$348.58
|
| Rate for Payer: CORVEL All Commercial |
$375.65
|
| Rate for Payer: Coventry All Commercial |
$355.45
|
| Rate for Payer: Encore All Commercial |
$371.81
|
| Rate for Payer: Frontpath All Commercial |
$371.61
|
| Rate for Payer: Humana ChoiceCare |
$348.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$363.53
|
| Rate for Payer: PHCS All Commercial |
$302.94
|
| Rate for Payer: PHP All Commercial |
$306.33
|
| Rate for Payer: Sagamore Health Network All Products |
$311.83
|
| Rate for Payer: Signature Care EPO |
$335.25
|
| Rate for Payer: Signature Care PPO |
$355.45
|
| Rate for Payer: United Healthcare Commercial |
$318.29
|
|
|
HC CALPROTECTIN, FECES
|
Facility
|
OP
|
$403.92
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
63001652
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.63 |
| Max. Negotiated Rate |
$375.65 |
| Rate for Payer: Aetna Commercial |
$340.91
|
| Rate for Payer: Aetna Medicare |
$129.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$19.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$125.22
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$185.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$185.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$19.63
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$148.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$142.18
|
| Rate for Payer: Cash Price |
$242.35
|
| Rate for Payer: Cash Price |
$242.35
|
| Rate for Payer: Centivo All Commercial |
$219.73
|
| Rate for Payer: Cigna All Commercial |
$348.58
|
| Rate for Payer: CORVEL All Commercial |
$375.65
|
| Rate for Payer: Coventry All Commercial |
$355.45
|
| Rate for Payer: Encore All Commercial |
$371.81
|
| Rate for Payer: Frontpath All Commercial |
$371.61
|
| Rate for Payer: Humana ChoiceCare |
$348.87
|
| Rate for Payer: Humana Medicare |
$129.25
|
| Rate for Payer: Lucent All Commercial |
$219.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$363.53
|
| Rate for Payer: Managed Health Services Medicaid |
$19.63
|
| Rate for Payer: MDWise Medicaid |
$19.63
|
| Rate for Payer: PHCS All Commercial |
$302.94
|
| Rate for Payer: PHP All Commercial |
$306.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$157.53
|
| Rate for Payer: Sagamore Health Network All Products |
$311.83
|
| Rate for Payer: Signature Care EPO |
$335.25
|
| Rate for Payer: Signature Care PPO |
$355.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$343.33
|
| Rate for Payer: United Healthcare Commercial |
$318.29
|
| Rate for Payer: United Healthcare Medicare |
$129.25
|
|
|
HC CALRETICULIN (CALR) MUTATION ANALYSIS
|
Facility
|
IP
|
$397.80
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
63044024
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$298.35 |
| Max. Negotiated Rate |
$369.95 |
| Rate for Payer: Aetna Commercial |
$343.70
|
| Rate for Payer: Cash Price |
$238.68
|
| Rate for Payer: Cigna All Commercial |
$343.30
|
| Rate for Payer: CORVEL All Commercial |
$369.95
|
| Rate for Payer: Coventry All Commercial |
$350.06
|
| Rate for Payer: Encore All Commercial |
$366.17
|
| Rate for Payer: Frontpath All Commercial |
$365.98
|
| Rate for Payer: Humana ChoiceCare |
$343.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$358.02
|
| Rate for Payer: PHCS All Commercial |
$298.35
|
| Rate for Payer: PHP All Commercial |
$301.69
|
| Rate for Payer: Sagamore Health Network All Products |
$307.10
|
| Rate for Payer: Signature Care EPO |
$330.17
|
| Rate for Payer: Signature Care PPO |
$350.06
|
| Rate for Payer: United Healthcare Commercial |
$313.47
|
|
|
HC CALRETICULIN (CALR) MUTATION ANALYSIS
|
Facility
|
OP
|
$397.80
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
63044024
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$121.63 |
| Max. Negotiated Rate |
$369.95 |
| Rate for Payer: Aetna Commercial |
$335.74
|
| Rate for Payer: Aetna Medicare |
$127.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$121.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$123.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$182.83
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$182.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$121.63
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$146.39
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$140.03
|
| Rate for Payer: Cash Price |
$238.68
|
| Rate for Payer: Cash Price |
$238.68
|
| Rate for Payer: Centivo All Commercial |
$216.40
|
| Rate for Payer: Cigna All Commercial |
$343.30
|
| Rate for Payer: CORVEL All Commercial |
$369.95
|
| Rate for Payer: Coventry All Commercial |
$350.06
|
| Rate for Payer: Encore All Commercial |
$366.17
|
| Rate for Payer: Frontpath All Commercial |
$365.98
|
| Rate for Payer: Humana ChoiceCare |
$343.58
|
| Rate for Payer: Humana Medicare |
$127.30
|
| Rate for Payer: Lucent All Commercial |
$216.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$358.02
|
| Rate for Payer: Managed Health Services Medicaid |
$121.63
|
| Rate for Payer: MDWise Medicaid |
$121.63
|
| Rate for Payer: PHCS All Commercial |
$298.35
|
| Rate for Payer: PHP All Commercial |
$301.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$155.14
|
| Rate for Payer: Sagamore Health Network All Products |
$307.10
|
| Rate for Payer: Signature Care EPO |
$330.17
|
| Rate for Payer: Signature Care PPO |
$350.06
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$338.13
|
| Rate for Payer: United Healthcare Commercial |
$313.47
|
| Rate for Payer: United Healthcare Medicare |
$127.30
|
|
|
HC CANALITH PROCEDURE - PT
|
Facility
|
OP
|
$255.00
|
|
|
Service Code
|
CPT 95992 GP
|
| Hospital Charge Code |
1722016
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$47.81 |
| Max. Negotiated Rate |
$237.15 |
| Rate for Payer: Aetna Commercial |
$215.22
|
| Rate for Payer: Aetna Medicare |
$81.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$47.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$79.05
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$146.45
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$159.40
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$47.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$93.84
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$89.76
|
| Rate for Payer: Cash Price |
$153.00
|
| Rate for Payer: Cash Price |
$153.00
|
| Rate for Payer: Centivo All Commercial |
$138.72
|
| Rate for Payer: Cigna All Commercial |
$220.06
|
| Rate for Payer: CORVEL All Commercial |
$237.15
|
| Rate for Payer: Coventry All Commercial |
$224.40
|
| Rate for Payer: Encore All Commercial |
$234.73
|
| Rate for Payer: Frontpath All Commercial |
$234.60
|
| Rate for Payer: Humana ChoiceCare |
$220.24
|
| Rate for Payer: Humana Medicare |
$81.60
|
| Rate for Payer: Lucent All Commercial |
$138.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$229.50
|
| Rate for Payer: Managed Health Services Medicaid |
$47.81
|
| Rate for Payer: MDWise Medicaid |
$47.81
|
| Rate for Payer: PHCS All Commercial |
$191.25
|
| Rate for Payer: PHP All Commercial |
$193.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$99.45
|
| Rate for Payer: Sagamore Health Network All Products |
$196.86
|
| Rate for Payer: Signature Care EPO |
$211.65
|
| Rate for Payer: Signature Care PPO |
$224.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$216.75
|
| Rate for Payer: United Healthcare Commercial |
$200.94
|
| Rate for Payer: United Healthcare Medicare |
$81.60
|
|
|
HC CANALITH PROCEDURE - PT
|
Facility
|
IP
|
$255.00
|
|
|
Service Code
|
CPT 95992 GP
|
| Hospital Charge Code |
1722016
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$191.25 |
| Max. Negotiated Rate |
$237.15 |
| Rate for Payer: Aetna Commercial |
$220.32
|
| Rate for Payer: Cash Price |
$153.00
|
| Rate for Payer: Cigna All Commercial |
$220.06
|
| Rate for Payer: CORVEL All Commercial |
$237.15
|
| Rate for Payer: Coventry All Commercial |
$224.40
|
| Rate for Payer: Encore All Commercial |
$234.73
|
| Rate for Payer: Frontpath All Commercial |
$234.60
|
| Rate for Payer: Humana ChoiceCare |
$220.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$229.50
|
| Rate for Payer: PHCS All Commercial |
$191.25
|
| Rate for Payer: PHP All Commercial |
$193.39
|
| Rate for Payer: Sagamore Health Network All Products |
$196.86
|
| Rate for Payer: Signature Care EPO |
$211.65
|
| Rate for Payer: Signature Care PPO |
$224.40
|
| Rate for Payer: United Healthcare Commercial |
$200.94
|
|
|
HC CANDIDA ALBICANS ABS
|
Facility
|
OP
|
$88.64
|
|
|
Service Code
|
CPT 86628
|
| Hospital Charge Code |
63001928
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.01 |
| Max. Negotiated Rate |
$82.44 |
| Rate for Payer: Aetna Commercial |
$74.81
|
| Rate for Payer: Aetna Medicare |
$28.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$12.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$27.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$40.74
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$40.74
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$12.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$32.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$31.20
|
| Rate for Payer: Cash Price |
$53.18
|
| Rate for Payer: Cash Price |
$53.18
|
| Rate for Payer: Centivo All Commercial |
$48.22
|
| Rate for Payer: Cigna All Commercial |
$76.50
|
| Rate for Payer: CORVEL All Commercial |
$82.44
|
| Rate for Payer: Coventry All Commercial |
$78.00
|
| Rate for Payer: Encore All Commercial |
$81.59
|
| Rate for Payer: Frontpath All Commercial |
$81.55
|
| Rate for Payer: Humana ChoiceCare |
$76.56
|
| Rate for Payer: Humana Medicare |
$28.36
|
| Rate for Payer: Lucent All Commercial |
$48.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$79.78
|
| Rate for Payer: Managed Health Services Medicaid |
$12.01
|
| Rate for Payer: MDWise Medicaid |
$12.01
|
| Rate for Payer: PHCS All Commercial |
$66.48
|
| Rate for Payer: PHP All Commercial |
$67.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$34.57
|
| Rate for Payer: Sagamore Health Network All Products |
$68.43
|
| Rate for Payer: Signature Care EPO |
$73.57
|
| Rate for Payer: Signature Care PPO |
$78.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$75.34
|
| Rate for Payer: United Healthcare Commercial |
$69.85
|
| Rate for Payer: United Healthcare Medicare |
$28.36
|
|
|
HC CANDIDA ALBICANS ABS
|
Facility
|
IP
|
$88.64
|
|
|
Service Code
|
CPT 86628
|
| Hospital Charge Code |
63001928
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$66.48 |
| Max. Negotiated Rate |
$82.44 |
| Rate for Payer: Aetna Commercial |
$76.58
|
| Rate for Payer: Cash Price |
$53.18
|
| Rate for Payer: Cigna All Commercial |
$76.50
|
| Rate for Payer: CORVEL All Commercial |
$82.44
|
| Rate for Payer: Coventry All Commercial |
$78.00
|
| Rate for Payer: Encore All Commercial |
$81.59
|
| Rate for Payer: Frontpath All Commercial |
$81.55
|
| Rate for Payer: Humana ChoiceCare |
$76.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$79.78
|
| Rate for Payer: PHCS All Commercial |
$66.48
|
| Rate for Payer: PHP All Commercial |
$67.22
|
| Rate for Payer: Sagamore Health Network All Products |
$68.43
|
| Rate for Payer: Signature Care EPO |
$73.57
|
| Rate for Payer: Signature Care PPO |
$78.00
|
| Rate for Payer: United Healthcare Commercial |
$69.85
|
|
|
HC CANDIDA AURIS SCREEN
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 87106
|
| Hospital Charge Code |
63087810
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$45.90 |
| Max. Negotiated Rate |
$56.92 |
| Rate for Payer: Aetna Commercial |
$52.88
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cigna All Commercial |
$52.82
|
| Rate for Payer: CORVEL All Commercial |
$56.92
|
| Rate for Payer: Coventry All Commercial |
$53.86
|
| Rate for Payer: Encore All Commercial |
$56.33
|
| Rate for Payer: Frontpath All Commercial |
$56.30
|
| Rate for Payer: Humana ChoiceCare |
$52.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$55.08
|
| Rate for Payer: PHCS All Commercial |
$45.90
|
| Rate for Payer: PHP All Commercial |
$46.41
|
| Rate for Payer: Sagamore Health Network All Products |
$47.25
|
| Rate for Payer: Signature Care EPO |
$50.80
|
| Rate for Payer: Signature Care PPO |
$53.86
|
| Rate for Payer: United Healthcare Commercial |
$48.23
|
|
|
HC CANDIDA AURIS SCREEN
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 87106
|
| Hospital Charge Code |
63087810
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.32 |
| Max. Negotiated Rate |
$56.92 |
| Rate for Payer: Aetna Commercial |
$51.65
|
| Rate for Payer: Aetna Medicare |
$19.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$10.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$18.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$28.13
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$28.13
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$10.32
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$22.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$21.54
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Centivo All Commercial |
$33.29
|
| Rate for Payer: Cigna All Commercial |
$52.82
|
| Rate for Payer: CORVEL All Commercial |
$56.92
|
| Rate for Payer: Coventry All Commercial |
$53.86
|
| Rate for Payer: Encore All Commercial |
$56.33
|
| Rate for Payer: Frontpath All Commercial |
$56.30
|
| Rate for Payer: Humana ChoiceCare |
$52.86
|
| Rate for Payer: Humana Medicare |
$19.58
|
| Rate for Payer: Lucent All Commercial |
$33.29
|
| Rate for Payer: Lutheran Preferred All Commercial |
$55.08
|
| Rate for Payer: Managed Health Services Medicaid |
$10.32
|
| Rate for Payer: MDWise Medicaid |
$10.32
|
| Rate for Payer: PHCS All Commercial |
$45.90
|
| Rate for Payer: PHP All Commercial |
$46.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$23.87
|
| Rate for Payer: Sagamore Health Network All Products |
$47.25
|
| Rate for Payer: Signature Care EPO |
$50.80
|
| Rate for Payer: Signature Care PPO |
$53.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$52.02
|
| Rate for Payer: United Healthcare Commercial |
$48.23
|
| Rate for Payer: United Healthcare Medicare |
$19.58
|
|
|
HC CANISTERS 500CC GEL-5
|
Facility
|
OP
|
$246.99
|
|
| Hospital Charge Code |
41606591
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$229.70 |
| Rate for Payer: Aetna Commercial |
$208.46
|
| Rate for Payer: Aetna Medicare |
$79.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$76.57
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$141.85
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$154.39
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$90.89
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$86.94
|
| Rate for Payer: Cash Price |
$148.19
|
| Rate for Payer: Cash Price |
$148.19
|
| Rate for Payer: Centivo All Commercial |
$134.36
|
| Rate for Payer: Cigna All Commercial |
$213.15
|
| Rate for Payer: CORVEL All Commercial |
$229.70
|
| Rate for Payer: Coventry All Commercial |
$217.35
|
| Rate for Payer: Encore All Commercial |
$227.35
|
| Rate for Payer: Frontpath All Commercial |
$227.23
|
| Rate for Payer: Humana ChoiceCare |
$213.33
|
| Rate for Payer: Humana Medicare |
$79.04
|
| Rate for Payer: Lucent All Commercial |
$134.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$222.29
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$185.24
|
| Rate for Payer: PHP All Commercial |
$187.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$96.33
|
| Rate for Payer: Sagamore Health Network All Products |
$190.68
|
| Rate for Payer: Signature Care EPO |
$205.00
|
| Rate for Payer: Signature Care PPO |
$217.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$209.94
|
| Rate for Payer: United Healthcare Commercial |
$194.63
|
| Rate for Payer: United Healthcare Medicare |
$79.04
|
|
|
HC CANISTERS 500CC GEL-5
|
Facility
|
IP
|
$246.99
|
|
| Hospital Charge Code |
41606591
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$185.24 |
| Max. Negotiated Rate |
$229.70 |
| Rate for Payer: Aetna Commercial |
$213.40
|
| Rate for Payer: Cash Price |
$148.19
|
| Rate for Payer: Cigna All Commercial |
$213.15
|
| Rate for Payer: CORVEL All Commercial |
$229.70
|
| Rate for Payer: Coventry All Commercial |
$217.35
|
| Rate for Payer: Encore All Commercial |
$227.35
|
| Rate for Payer: Frontpath All Commercial |
$227.23
|
| Rate for Payer: Humana ChoiceCare |
$213.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$222.29
|
| Rate for Payer: PHCS All Commercial |
$185.24
|
| Rate for Payer: PHP All Commercial |
$187.32
|
| Rate for Payer: Sagamore Health Network All Products |
$190.68
|
| Rate for Payer: Signature Care EPO |
$205.00
|
| Rate for Payer: Signature Care PPO |
$217.35
|
| Rate for Payer: United Healthcare Commercial |
$194.63
|
|
|
HC CAPILLARY BLOOD DRAW
|
Facility
|
IP
|
$56.10
|
|
|
Service Code
|
CPT 36416
|
| Hospital Charge Code |
63001358
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$42.08 |
| Max. Negotiated Rate |
$52.17 |
| Rate for Payer: Aetna Commercial |
$48.47
|
| Rate for Payer: Cash Price |
$33.66
|
| Rate for Payer: Cigna All Commercial |
$48.41
|
| Rate for Payer: CORVEL All Commercial |
$52.17
|
| Rate for Payer: Coventry All Commercial |
$49.37
|
| Rate for Payer: Encore All Commercial |
$51.64
|
| Rate for Payer: Frontpath All Commercial |
$51.61
|
| Rate for Payer: Humana ChoiceCare |
$48.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$50.49
|
| Rate for Payer: PHCS All Commercial |
$42.08
|
| Rate for Payer: PHP All Commercial |
$42.55
|
| Rate for Payer: Sagamore Health Network All Products |
$43.31
|
| Rate for Payer: Signature Care EPO |
$46.56
|
| Rate for Payer: Signature Care PPO |
$49.37
|
| Rate for Payer: United Healthcare Commercial |
$44.21
|
|
|
HC CAPILLARY BLOOD DRAW
|
Facility
|
OP
|
$56.10
|
|
|
Service Code
|
CPT 36416
|
| Hospital Charge Code |
63001358
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.81 |
| Max. Negotiated Rate |
$52.17 |
| Rate for Payer: Aetna Commercial |
$47.35
|
| Rate for Payer: Aetna Medicare |
$17.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$3.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$17.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$25.78
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$25.78
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$3.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$20.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$19.75
|
| Rate for Payer: Cash Price |
$33.66
|
| Rate for Payer: Cash Price |
$33.66
|
| Rate for Payer: Centivo All Commercial |
$30.52
|
| Rate for Payer: Cigna All Commercial |
$48.41
|
| Rate for Payer: CORVEL All Commercial |
$52.17
|
| Rate for Payer: Coventry All Commercial |
$49.37
|
| Rate for Payer: Encore All Commercial |
$51.64
|
| Rate for Payer: Frontpath All Commercial |
$51.61
|
| Rate for Payer: Humana ChoiceCare |
$48.45
|
| Rate for Payer: Humana Medicare |
$17.95
|
| Rate for Payer: Lucent All Commercial |
$30.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$50.49
|
| Rate for Payer: Managed Health Services Medicaid |
$3.81
|
| Rate for Payer: MDWise Medicaid |
$3.81
|
| Rate for Payer: PHCS All Commercial |
$42.08
|
| Rate for Payer: PHP All Commercial |
$42.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$21.88
|
| Rate for Payer: Sagamore Health Network All Products |
$43.31
|
| Rate for Payer: Signature Care EPO |
$46.56
|
| Rate for Payer: Signature Care PPO |
$49.37
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$47.69
|
| Rate for Payer: United Healthcare Commercial |
$44.21
|
| Rate for Payer: United Healthcare Medicare |
$17.95
|
|
|
HC CAPTIVATOR 10MM
|
Facility
|
IP
|
$91.00
|
|
| Hospital Charge Code |
41608236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.25 |
| Max. Negotiated Rate |
$84.63 |
| Rate for Payer: Aetna Commercial |
$78.62
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna All Commercial |
$78.53
|
| Rate for Payer: CORVEL All Commercial |
$84.63
|
| Rate for Payer: Coventry All Commercial |
$80.08
|
| Rate for Payer: Encore All Commercial |
$83.77
|
| Rate for Payer: Frontpath All Commercial |
$83.72
|
| Rate for Payer: Humana ChoiceCare |
$78.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$81.90
|
| Rate for Payer: PHCS All Commercial |
$68.25
|
| Rate for Payer: PHP All Commercial |
$69.01
|
| Rate for Payer: Sagamore Health Network All Products |
$70.25
|
| Rate for Payer: Signature Care EPO |
$75.53
|
| Rate for Payer: Signature Care PPO |
$80.08
|
| Rate for Payer: United Healthcare Commercial |
$71.71
|
|
