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Service Code CPT C1713
Hospital Charge Code 41602680
Hospital Revenue Code 278
Min. Negotiated Rate $229.68
Max. Negotiated Rate $640.67
Rate for Payer: Aetna Commercial $587.42
Rate for Payer: Aetna Medicare $229.68
Rate for Payer: Anthem Exchange $399.71
Rate for Payer: Anthem Medicare $229.68
Rate for Payer: Anthem PPO $399.71
Rate for Payer: Anthem Traditional $435.07
Rate for Payer: Caresource Just 4 Me $264.13
Rate for Payer: Caresource Medicare $252.65
Rate for Payer: Centivo/Paragon All Products $354.96
Rate for Payer: Cigna All Products $600.65
Rate for Payer: Coventry/First Health All Products $612.48
Rate for Payer: Encore All Products $640.67
Rate for Payer: Frontpath All Products $640.32
Rate for Payer: Humana ChoiceCare $601.14
Rate for Payer: Humana Medicare $354.96
Rate for Payer: Lucent/Coldwater Veneers $354.96
Rate for Payer: Lutheran Preferred All Products $626.40
Rate for Payer: PHCS/Multiplan All Products $522.00
Rate for Payer: PHP All Products $527.85
Rate for Payer: Plain Church Group Ministry All Products $271.44
Rate for Payer: Sagamore All Products $537.31
Rate for Payer: Self Pay/Cash Rate $431.52
Rate for Payer: Signature Care EPO $577.68
Rate for Payer: Signature Care PPO $612.48
Rate for Payer: Three Rivers Preferred All Products $591.60
Rate for Payer: United Healthcare Commercial $548.45
Rate for Payer: United Healthcare Medicare $229.68
Service Code CPT C1713
Hospital Charge Code 41602696
Hospital Revenue Code 278
Min. Negotiated Rate $303.55
Max. Negotiated Rate $450.68
Rate for Payer: Aetna Commercial $423.01
Rate for Payer: Cigna All Products $422.52
Rate for Payer: Coventry/First Health All Products $430.85
Rate for Payer: Encore All Products $450.68
Rate for Payer: Frontpath All Products $450.43
Rate for Payer: Humana ChoiceCare $422.87
Rate for Payer: Lutheran Preferred All Products $440.64
Rate for Payer: PHCS/Multiplan All Products $367.20
Rate for Payer: PHP All Products $371.31
Rate for Payer: Sagamore All Products $377.97
Rate for Payer: Self Pay/Cash Rate $303.55
Rate for Payer: Signature Care EPO $406.37
Rate for Payer: Signature Care PPO $430.85
Rate for Payer: United Healthcare Commercial $385.80
Service Code CPT C1713
Hospital Charge Code 41602696
Hospital Revenue Code 278
Min. Negotiated Rate $161.57
Max. Negotiated Rate $450.68
Rate for Payer: Aetna Commercial $413.22
Rate for Payer: Aetna Medicare $161.57
Rate for Payer: Anthem Exchange $281.18
Rate for Payer: Anthem Medicare $161.57
Rate for Payer: Anthem PPO $281.18
Rate for Payer: Anthem Traditional $306.05
Rate for Payer: Caresource Just 4 Me $185.80
Rate for Payer: Caresource Medicare $177.72
Rate for Payer: Centivo/Paragon All Products $249.70
Rate for Payer: Cigna All Products $422.52
Rate for Payer: Coventry/First Health All Products $430.85
Rate for Payer: Encore All Products $450.68
Rate for Payer: Frontpath All Products $450.43
Rate for Payer: Humana ChoiceCare $422.87
Rate for Payer: Humana Medicare $249.70
Rate for Payer: Lucent/Coldwater Veneers $249.70
Rate for Payer: Lutheran Preferred All Products $440.64
Rate for Payer: PHCS/Multiplan All Products $367.20
Rate for Payer: PHP All Products $371.31
Rate for Payer: Plain Church Group Ministry All Products $190.94
Rate for Payer: Sagamore All Products $377.97
Rate for Payer: Self Pay/Cash Rate $303.55
Rate for Payer: Signature Care EPO $406.37
Rate for Payer: Signature Care PPO $430.85
Rate for Payer: Three Rivers Preferred All Products $416.16
Rate for Payer: United Healthcare Commercial $385.80
Rate for Payer: United Healthcare Medicare $161.57
Service Code CPT C1713
Hospital Charge Code 41602681
Hospital Revenue Code 278
Min. Negotiated Rate $229.68
Max. Negotiated Rate $640.67
Rate for Payer: Aetna Commercial $587.42
Rate for Payer: Aetna Medicare $229.68
Rate for Payer: Anthem Exchange $399.71
Rate for Payer: Anthem Medicare $229.68
Rate for Payer: Anthem PPO $399.71
Rate for Payer: Anthem Traditional $435.07
Rate for Payer: Caresource Just 4 Me $264.13
Rate for Payer: Caresource Medicare $252.65
Rate for Payer: Centivo/Paragon All Products $354.96
Rate for Payer: Cigna All Products $600.65
Rate for Payer: Coventry/First Health All Products $612.48
Rate for Payer: Encore All Products $640.67
Rate for Payer: Frontpath All Products $640.32
Rate for Payer: Humana ChoiceCare $601.14
Rate for Payer: Humana Medicare $354.96
Rate for Payer: Lucent/Coldwater Veneers $354.96
Rate for Payer: Lutheran Preferred All Products $626.40
Rate for Payer: PHCS/Multiplan All Products $522.00
Rate for Payer: PHP All Products $527.85
Rate for Payer: Plain Church Group Ministry All Products $271.44
Rate for Payer: Sagamore All Products $537.31
Rate for Payer: Self Pay/Cash Rate $431.52
Rate for Payer: Signature Care EPO $577.68
Rate for Payer: Signature Care PPO $612.48
Rate for Payer: Three Rivers Preferred All Products $591.60
Rate for Payer: United Healthcare Commercial $548.45
Rate for Payer: United Healthcare Medicare $229.68
Service Code CPT C1713
Hospital Charge Code 41602681
Hospital Revenue Code 278
Min. Negotiated Rate $431.52
Max. Negotiated Rate $640.67
Rate for Payer: Aetna Commercial $601.34
Rate for Payer: Cigna All Products $600.65
Rate for Payer: Coventry/First Health All Products $612.48
Rate for Payer: Encore All Products $640.67
Rate for Payer: Frontpath All Products $640.32
Rate for Payer: Humana ChoiceCare $601.14
Rate for Payer: Lutheran Preferred All Products $626.40
Rate for Payer: PHCS/Multiplan All Products $522.00
Rate for Payer: PHP All Products $527.85
Rate for Payer: Sagamore All Products $537.31
Rate for Payer: Self Pay/Cash Rate $431.52
Rate for Payer: Signature Care EPO $577.68
Rate for Payer: Signature Care PPO $612.48
Rate for Payer: United Healthcare Commercial $548.45
Service Code CPT C1713
Hospital Charge Code 41602697
Hospital Revenue Code 278
Min. Negotiated Rate $161.57
Max. Negotiated Rate $450.68
Rate for Payer: Aetna Commercial $413.22
Rate for Payer: Aetna Medicare $161.57
Rate for Payer: Anthem Exchange $281.18
Rate for Payer: Anthem Medicare $161.57
Rate for Payer: Anthem PPO $281.18
Rate for Payer: Anthem Traditional $306.05
Rate for Payer: Caresource Just 4 Me $185.80
Rate for Payer: Caresource Medicare $177.72
Rate for Payer: Centivo/Paragon All Products $249.70
Rate for Payer: Cigna All Products $422.52
Rate for Payer: Coventry/First Health All Products $430.85
Rate for Payer: Encore All Products $450.68
Rate for Payer: Frontpath All Products $450.43
Rate for Payer: Humana ChoiceCare $422.87
Rate for Payer: Humana Medicare $249.70
Rate for Payer: Lucent/Coldwater Veneers $249.70
Rate for Payer: Lutheran Preferred All Products $440.64
Rate for Payer: PHCS/Multiplan All Products $367.20
Rate for Payer: PHP All Products $371.31
Rate for Payer: Plain Church Group Ministry All Products $190.94
Rate for Payer: Sagamore All Products $377.97
Rate for Payer: Self Pay/Cash Rate $303.55
Rate for Payer: Signature Care EPO $406.37
Rate for Payer: Signature Care PPO $430.85
Rate for Payer: Three Rivers Preferred All Products $416.16
Rate for Payer: United Healthcare Commercial $385.80
Rate for Payer: United Healthcare Medicare $161.57
Service Code CPT C1713
Hospital Charge Code 41602697
Hospital Revenue Code 278
Min. Negotiated Rate $303.55
Max. Negotiated Rate $450.68
Rate for Payer: Aetna Commercial $423.01
Rate for Payer: Cigna All Products $422.52
Rate for Payer: Coventry/First Health All Products $430.85
Rate for Payer: Encore All Products $450.68
Rate for Payer: Frontpath All Products $450.43
Rate for Payer: Humana ChoiceCare $422.87
Rate for Payer: Lutheran Preferred All Products $440.64
Rate for Payer: PHCS/Multiplan All Products $367.20
Rate for Payer: PHP All Products $371.31
Rate for Payer: Sagamore All Products $377.97
Rate for Payer: Self Pay/Cash Rate $303.55
Rate for Payer: Signature Care EPO $406.37
Rate for Payer: Signature Care PPO $430.85
Rate for Payer: United Healthcare Commercial $385.80
Service Code CPT C1713
Hospital Charge Code 41602682
Hospital Revenue Code 278
Min. Negotiated Rate $431.52
Max. Negotiated Rate $640.67
Rate for Payer: Aetna Commercial $601.34
Rate for Payer: Cigna All Products $600.65
Rate for Payer: Coventry/First Health All Products $612.48
Rate for Payer: Encore All Products $640.67
Rate for Payer: Frontpath All Products $640.32
Rate for Payer: Humana ChoiceCare $601.14
Rate for Payer: Lutheran Preferred All Products $626.40
Rate for Payer: PHCS/Multiplan All Products $522.00
Rate for Payer: PHP All Products $527.85
Rate for Payer: Sagamore All Products $537.31
Rate for Payer: Self Pay/Cash Rate $431.52
Rate for Payer: Signature Care EPO $577.68
Rate for Payer: Signature Care PPO $612.48
Rate for Payer: United Healthcare Commercial $548.45
Service Code CPT C1713
Hospital Charge Code 41602682
Hospital Revenue Code 278
Min. Negotiated Rate $229.68
Max. Negotiated Rate $640.67
Rate for Payer: Aetna Commercial $587.42
Rate for Payer: Aetna Medicare $229.68
Rate for Payer: Anthem Exchange $399.71
Rate for Payer: Anthem Medicare $229.68
Rate for Payer: Anthem PPO $399.71
Rate for Payer: Anthem Traditional $435.07
Rate for Payer: Caresource Just 4 Me $264.13
Rate for Payer: Caresource Medicare $252.65
Rate for Payer: Centivo/Paragon All Products $354.96
Rate for Payer: Cigna All Products $600.65
Rate for Payer: Coventry/First Health All Products $612.48
Rate for Payer: Encore All Products $640.67
Rate for Payer: Frontpath All Products $640.32
Rate for Payer: Humana ChoiceCare $601.14
Rate for Payer: Humana Medicare $354.96
Rate for Payer: Lucent/Coldwater Veneers $354.96
Rate for Payer: Lutheran Preferred All Products $626.40
Rate for Payer: PHCS/Multiplan All Products $522.00
Rate for Payer: PHP All Products $527.85
Rate for Payer: Plain Church Group Ministry All Products $271.44
Rate for Payer: Sagamore All Products $537.31
Rate for Payer: Self Pay/Cash Rate $431.52
Rate for Payer: Signature Care EPO $577.68
Rate for Payer: Signature Care PPO $612.48
Rate for Payer: Three Rivers Preferred All Products $591.60
Rate for Payer: United Healthcare Commercial $548.45
Rate for Payer: United Healthcare Medicare $229.68
Service Code CPT C1713
Hospital Charge Code 41602698
Hospital Revenue Code 278
Min. Negotiated Rate $161.57
Max. Negotiated Rate $450.68
Rate for Payer: Aetna Commercial $413.22
Rate for Payer: Aetna Medicare $161.57
Rate for Payer: Anthem Exchange $281.18
Rate for Payer: Anthem Medicare $161.57
Rate for Payer: Anthem PPO $281.18
Rate for Payer: Anthem Traditional $306.05
Rate for Payer: Caresource Just 4 Me $185.80
Rate for Payer: Caresource Medicare $177.72
Rate for Payer: Centivo/Paragon All Products $249.70
Rate for Payer: Cigna All Products $422.52
Rate for Payer: Coventry/First Health All Products $430.85
Rate for Payer: Encore All Products $450.68
Rate for Payer: Frontpath All Products $450.43
Rate for Payer: Humana ChoiceCare $422.87
Rate for Payer: Humana Medicare $249.70
Rate for Payer: Lucent/Coldwater Veneers $249.70
Rate for Payer: Lutheran Preferred All Products $440.64
Rate for Payer: PHCS/Multiplan All Products $367.20
Rate for Payer: PHP All Products $371.31
Rate for Payer: Plain Church Group Ministry All Products $190.94
Rate for Payer: Sagamore All Products $377.97
Rate for Payer: Self Pay/Cash Rate $303.55
Rate for Payer: Signature Care EPO $406.37
Rate for Payer: Signature Care PPO $430.85
Rate for Payer: Three Rivers Preferred All Products $416.16
Rate for Payer: United Healthcare Commercial $385.80
Rate for Payer: United Healthcare Medicare $161.57
Service Code CPT C1713
Hospital Charge Code 41602698
Hospital Revenue Code 278
Min. Negotiated Rate $303.55
Max. Negotiated Rate $450.68
Rate for Payer: Aetna Commercial $423.01
Rate for Payer: Cigna All Products $422.52
Rate for Payer: Coventry/First Health All Products $430.85
Rate for Payer: Encore All Products $450.68
Rate for Payer: Frontpath All Products $450.43
Rate for Payer: Humana ChoiceCare $422.87
Rate for Payer: Lutheran Preferred All Products $440.64
Rate for Payer: PHCS/Multiplan All Products $367.20
Rate for Payer: PHP All Products $371.31
Rate for Payer: Sagamore All Products $377.97
Rate for Payer: Self Pay/Cash Rate $303.55
Rate for Payer: Signature Care EPO $406.37
Rate for Payer: Signature Care PPO $430.85
Rate for Payer: United Healthcare Commercial $385.80
Service Code CPT C1713
Hospital Charge Code 41602683
Hospital Revenue Code 278
Min. Negotiated Rate $431.52
Max. Negotiated Rate $640.67
Rate for Payer: Aetna Commercial $601.34
Rate for Payer: Cigna All Products $600.65
Rate for Payer: Coventry/First Health All Products $612.48
Rate for Payer: Encore All Products $640.67
Rate for Payer: Frontpath All Products $640.32
Rate for Payer: Humana ChoiceCare $601.14
Rate for Payer: Lutheran Preferred All Products $626.40
Rate for Payer: PHCS/Multiplan All Products $522.00
Rate for Payer: PHP All Products $527.85
Rate for Payer: Sagamore All Products $537.31
Rate for Payer: Self Pay/Cash Rate $431.52
Rate for Payer: Signature Care EPO $577.68
Rate for Payer: Signature Care PPO $612.48
Rate for Payer: United Healthcare Commercial $548.45
Service Code CPT C1713
Hospital Charge Code 41602683
Hospital Revenue Code 278
Min. Negotiated Rate $229.68
Max. Negotiated Rate $640.67
Rate for Payer: Aetna Commercial $587.42
Rate for Payer: Aetna Medicare $229.68
Rate for Payer: Anthem Exchange $399.71
Rate for Payer: Anthem Medicare $229.68
Rate for Payer: Anthem PPO $399.71
Rate for Payer: Anthem Traditional $435.07
Rate for Payer: Caresource Just 4 Me $264.13
Rate for Payer: Caresource Medicare $252.65
Rate for Payer: Centivo/Paragon All Products $354.96
Rate for Payer: Cigna All Products $600.65
Rate for Payer: Coventry/First Health All Products $612.48
Rate for Payer: Encore All Products $640.67
Rate for Payer: Frontpath All Products $640.32
Rate for Payer: Humana ChoiceCare $601.14
Rate for Payer: Humana Medicare $354.96
Rate for Payer: Lucent/Coldwater Veneers $354.96
Rate for Payer: Lutheran Preferred All Products $626.40
Rate for Payer: PHCS/Multiplan All Products $522.00
Rate for Payer: PHP All Products $527.85
Rate for Payer: Plain Church Group Ministry All Products $271.44
Rate for Payer: Sagamore All Products $537.31
Rate for Payer: Self Pay/Cash Rate $431.52
Rate for Payer: Signature Care EPO $577.68
Rate for Payer: Signature Care PPO $612.48
Rate for Payer: Three Rivers Preferred All Products $591.60
Rate for Payer: United Healthcare Commercial $548.45
Rate for Payer: United Healthcare Medicare $229.68
Service Code CPT C1713
Hospital Charge Code 41602699
Hospital Revenue Code 278
Min. Negotiated Rate $161.57
Max. Negotiated Rate $450.68
Rate for Payer: Aetna Commercial $413.22
Rate for Payer: Aetna Medicare $161.57
Rate for Payer: Anthem Exchange $281.18
Rate for Payer: Anthem Medicare $161.57
Rate for Payer: Anthem PPO $281.18
Rate for Payer: Anthem Traditional $306.05
Rate for Payer: Caresource Just 4 Me $185.80
Rate for Payer: Caresource Medicare $177.72
Rate for Payer: Centivo/Paragon All Products $249.70
Rate for Payer: Cigna All Products $422.52
Rate for Payer: Coventry/First Health All Products $430.85
Rate for Payer: Encore All Products $450.68
Rate for Payer: Frontpath All Products $450.43
Rate for Payer: Humana ChoiceCare $422.87
Rate for Payer: Humana Medicare $249.70
Rate for Payer: Lucent/Coldwater Veneers $249.70
Rate for Payer: Lutheran Preferred All Products $440.64
Rate for Payer: PHCS/Multiplan All Products $367.20
Rate for Payer: PHP All Products $371.31
Rate for Payer: Plain Church Group Ministry All Products $190.94
Rate for Payer: Sagamore All Products $377.97
Rate for Payer: Self Pay/Cash Rate $303.55
Rate for Payer: Signature Care EPO $406.37
Rate for Payer: Signature Care PPO $430.85
Rate for Payer: Three Rivers Preferred All Products $416.16
Rate for Payer: United Healthcare Commercial $385.80
Rate for Payer: United Healthcare Medicare $161.57
Service Code CPT C1713
Hospital Charge Code 41602699
Hospital Revenue Code 278
Min. Negotiated Rate $303.55
Max. Negotiated Rate $450.68
Rate for Payer: Aetna Commercial $423.01
Rate for Payer: Cigna All Products $422.52
Rate for Payer: Coventry/First Health All Products $430.85
Rate for Payer: Encore All Products $450.68
Rate for Payer: Frontpath All Products $450.43
Rate for Payer: Humana ChoiceCare $422.87
Rate for Payer: Lutheran Preferred All Products $440.64
Rate for Payer: PHCS/Multiplan All Products $367.20
Rate for Payer: PHP All Products $371.31
Rate for Payer: Sagamore All Products $377.97
Rate for Payer: Self Pay/Cash Rate $303.55
Rate for Payer: Signature Care EPO $406.37
Rate for Payer: Signature Care PPO $430.85
Rate for Payer: United Healthcare Commercial $385.80
Service Code CPT C1713
Hospital Charge Code 41602684
Hospital Revenue Code 278
Min. Negotiated Rate $431.52
Max. Negotiated Rate $640.67
Rate for Payer: Aetna Commercial $601.34
Rate for Payer: Cigna All Products $600.65
Rate for Payer: Coventry/First Health All Products $612.48
Rate for Payer: Encore All Products $640.67
Rate for Payer: Frontpath All Products $640.32
Rate for Payer: Humana ChoiceCare $601.14
Rate for Payer: Lutheran Preferred All Products $626.40
Rate for Payer: PHCS/Multiplan All Products $522.00
Rate for Payer: PHP All Products $527.85
Rate for Payer: Sagamore All Products $537.31
Rate for Payer: Self Pay/Cash Rate $431.52
Rate for Payer: Signature Care EPO $577.68
Rate for Payer: Signature Care PPO $612.48
Rate for Payer: United Healthcare Commercial $548.45
Service Code CPT C1713
Hospital Charge Code 41602684
Hospital Revenue Code 278
Min. Negotiated Rate $229.68
Max. Negotiated Rate $640.67
Rate for Payer: Aetna Commercial $587.42
Rate for Payer: Aetna Medicare $229.68
Rate for Payer: Anthem Exchange $399.71
Rate for Payer: Anthem Medicare $229.68
Rate for Payer: Anthem PPO $399.71
Rate for Payer: Anthem Traditional $435.07
Rate for Payer: Caresource Just 4 Me $264.13
Rate for Payer: Caresource Medicare $252.65
Rate for Payer: Centivo/Paragon All Products $354.96
Rate for Payer: Cigna All Products $600.65
Rate for Payer: Coventry/First Health All Products $612.48
Rate for Payer: Encore All Products $640.67
Rate for Payer: Frontpath All Products $640.32
Rate for Payer: Humana ChoiceCare $601.14
Rate for Payer: Humana Medicare $354.96
Rate for Payer: Lucent/Coldwater Veneers $354.96
Rate for Payer: Lutheran Preferred All Products $626.40
Rate for Payer: PHCS/Multiplan All Products $522.00
Rate for Payer: PHP All Products $527.85
Rate for Payer: Plain Church Group Ministry All Products $271.44
Rate for Payer: Sagamore All Products $537.31
Rate for Payer: Self Pay/Cash Rate $431.52
Rate for Payer: Signature Care EPO $577.68
Rate for Payer: Signature Care PPO $612.48
Rate for Payer: Three Rivers Preferred All Products $591.60
Rate for Payer: United Healthcare Commercial $548.45
Rate for Payer: United Healthcare Medicare $229.68
Service Code CPT C1713
Hospital Charge Code 41602700
Hospital Revenue Code 278
Min. Negotiated Rate $161.57
Max. Negotiated Rate $450.68
Rate for Payer: Aetna Commercial $413.22
Rate for Payer: Aetna Medicare $161.57
Rate for Payer: Anthem Exchange $281.18
Rate for Payer: Anthem Medicare $161.57
Rate for Payer: Anthem PPO $281.18
Rate for Payer: Anthem Traditional $306.05
Rate for Payer: Caresource Just 4 Me $185.80
Rate for Payer: Caresource Medicare $177.72
Rate for Payer: Centivo/Paragon All Products $249.70
Rate for Payer: Cigna All Products $422.52
Rate for Payer: Coventry/First Health All Products $430.85
Rate for Payer: Encore All Products $450.68
Rate for Payer: Frontpath All Products $450.43
Rate for Payer: Humana ChoiceCare $422.87
Rate for Payer: Humana Medicare $249.70
Rate for Payer: Lucent/Coldwater Veneers $249.70
Rate for Payer: Lutheran Preferred All Products $440.64
Rate for Payer: PHCS/Multiplan All Products $367.20
Rate for Payer: PHP All Products $371.31
Rate for Payer: Plain Church Group Ministry All Products $190.94
Rate for Payer: Sagamore All Products $377.97
Rate for Payer: Self Pay/Cash Rate $303.55
Rate for Payer: Signature Care EPO $406.37
Rate for Payer: Signature Care PPO $430.85
Rate for Payer: Three Rivers Preferred All Products $416.16
Rate for Payer: United Healthcare Commercial $385.80
Rate for Payer: United Healthcare Medicare $161.57
Service Code CPT C1713
Hospital Charge Code 41602700
Hospital Revenue Code 278
Min. Negotiated Rate $303.55
Max. Negotiated Rate $450.68
Rate for Payer: Aetna Commercial $423.01
Rate for Payer: Cigna All Products $422.52
Rate for Payer: Coventry/First Health All Products $430.85
Rate for Payer: Encore All Products $450.68
Rate for Payer: Frontpath All Products $450.43
Rate for Payer: Humana ChoiceCare $422.87
Rate for Payer: Lutheran Preferred All Products $440.64
Rate for Payer: PHCS/Multiplan All Products $367.20
Rate for Payer: PHP All Products $371.31
Rate for Payer: Sagamore All Products $377.97
Rate for Payer: Self Pay/Cash Rate $303.55
Rate for Payer: Signature Care EPO $406.37
Rate for Payer: Signature Care PPO $430.85
Rate for Payer: United Healthcare Commercial $385.80
Service Code CPT C1713
Hospital Charge Code 41602685
Hospital Revenue Code 278
Min. Negotiated Rate $229.68
Max. Negotiated Rate $640.67
Rate for Payer: Aetna Commercial $587.42
Rate for Payer: Aetna Medicare $229.68
Rate for Payer: Anthem Exchange $399.71
Rate for Payer: Anthem Medicare $229.68
Rate for Payer: Anthem PPO $399.71
Rate for Payer: Anthem Traditional $435.07
Rate for Payer: Caresource Just 4 Me $264.13
Rate for Payer: Caresource Medicare $252.65
Rate for Payer: Centivo/Paragon All Products $354.96
Rate for Payer: Cigna All Products $600.65
Rate for Payer: Coventry/First Health All Products $612.48
Rate for Payer: Encore All Products $640.67
Rate for Payer: Frontpath All Products $640.32
Rate for Payer: Humana ChoiceCare $601.14
Rate for Payer: Humana Medicare $354.96
Rate for Payer: Lucent/Coldwater Veneers $354.96
Rate for Payer: Lutheran Preferred All Products $626.40
Rate for Payer: PHCS/Multiplan All Products $522.00
Rate for Payer: PHP All Products $527.85
Rate for Payer: Plain Church Group Ministry All Products $271.44
Rate for Payer: Sagamore All Products $537.31
Rate for Payer: Self Pay/Cash Rate $431.52
Rate for Payer: Signature Care EPO $577.68
Rate for Payer: Signature Care PPO $612.48
Rate for Payer: Three Rivers Preferred All Products $591.60
Rate for Payer: United Healthcare Commercial $548.45
Rate for Payer: United Healthcare Medicare $229.68
Service Code CPT C1713
Hospital Charge Code 41602685
Hospital Revenue Code 278
Min. Negotiated Rate $431.52
Max. Negotiated Rate $640.67
Rate for Payer: Aetna Commercial $601.34
Rate for Payer: Cigna All Products $600.65
Rate for Payer: Coventry/First Health All Products $612.48
Rate for Payer: Encore All Products $640.67
Rate for Payer: Frontpath All Products $640.32
Rate for Payer: Humana ChoiceCare $601.14
Rate for Payer: Lutheran Preferred All Products $626.40
Rate for Payer: PHCS/Multiplan All Products $522.00
Rate for Payer: PHP All Products $527.85
Rate for Payer: Sagamore All Products $537.31
Rate for Payer: Self Pay/Cash Rate $431.52
Rate for Payer: Signature Care EPO $577.68
Rate for Payer: Signature Care PPO $612.48
Rate for Payer: United Healthcare Commercial $548.45
Service Code CPT C1713
Hospital Charge Code 41602701
Hospital Revenue Code 278
Min. Negotiated Rate $303.55
Max. Negotiated Rate $450.68
Rate for Payer: Aetna Commercial $423.01
Rate for Payer: Cigna All Products $422.52
Rate for Payer: Coventry/First Health All Products $430.85
Rate for Payer: Encore All Products $450.68
Rate for Payer: Frontpath All Products $450.43
Rate for Payer: Humana ChoiceCare $422.87
Rate for Payer: Lutheran Preferred All Products $440.64
Rate for Payer: PHCS/Multiplan All Products $367.20
Rate for Payer: PHP All Products $371.31
Rate for Payer: Sagamore All Products $377.97
Rate for Payer: Self Pay/Cash Rate $303.55
Rate for Payer: Signature Care EPO $406.37
Rate for Payer: Signature Care PPO $430.85
Rate for Payer: United Healthcare Commercial $385.80
Service Code CPT C1713
Hospital Charge Code 41602701
Hospital Revenue Code 278
Min. Negotiated Rate $161.57
Max. Negotiated Rate $450.68
Rate for Payer: Aetna Commercial $413.22
Rate for Payer: Aetna Medicare $161.57
Rate for Payer: Anthem Exchange $281.18
Rate for Payer: Anthem Medicare $161.57
Rate for Payer: Anthem PPO $281.18
Rate for Payer: Anthem Traditional $306.05
Rate for Payer: Caresource Just 4 Me $185.80
Rate for Payer: Caresource Medicare $177.72
Rate for Payer: Centivo/Paragon All Products $249.70
Rate for Payer: Cigna All Products $422.52
Rate for Payer: Coventry/First Health All Products $430.85
Rate for Payer: Encore All Products $450.68
Rate for Payer: Frontpath All Products $450.43
Rate for Payer: Humana ChoiceCare $422.87
Rate for Payer: Humana Medicare $249.70
Rate for Payer: Lucent/Coldwater Veneers $249.70
Rate for Payer: Lutheran Preferred All Products $440.64
Rate for Payer: PHCS/Multiplan All Products $367.20
Rate for Payer: PHP All Products $371.31
Rate for Payer: Plain Church Group Ministry All Products $190.94
Rate for Payer: Sagamore All Products $377.97
Rate for Payer: Self Pay/Cash Rate $303.55
Rate for Payer: Signature Care EPO $406.37
Rate for Payer: Signature Care PPO $430.85
Rate for Payer: Three Rivers Preferred All Products $416.16
Rate for Payer: United Healthcare Commercial $385.80
Rate for Payer: United Healthcare Medicare $161.57
Service Code CPT C1713
Hospital Charge Code 41602686
Hospital Revenue Code 278
Min. Negotiated Rate $229.68
Max. Negotiated Rate $640.67
Rate for Payer: Aetna Commercial $587.42
Rate for Payer: Aetna Medicare $229.68
Rate for Payer: Anthem Exchange $399.71
Rate for Payer: Anthem Medicare $229.68
Rate for Payer: Anthem PPO $399.71
Rate for Payer: Anthem Traditional $435.07
Rate for Payer: Caresource Just 4 Me $264.13
Rate for Payer: Caresource Medicare $252.65
Rate for Payer: Centivo/Paragon All Products $354.96
Rate for Payer: Cigna All Products $600.65
Rate for Payer: Coventry/First Health All Products $612.48
Rate for Payer: Encore All Products $640.67
Rate for Payer: Frontpath All Products $640.32
Rate for Payer: Humana ChoiceCare $601.14
Rate for Payer: Humana Medicare $354.96
Rate for Payer: Lucent/Coldwater Veneers $354.96
Rate for Payer: Lutheran Preferred All Products $626.40
Rate for Payer: PHCS/Multiplan All Products $522.00
Rate for Payer: PHP All Products $527.85
Rate for Payer: Plain Church Group Ministry All Products $271.44
Rate for Payer: Sagamore All Products $537.31
Rate for Payer: Self Pay/Cash Rate $431.52
Rate for Payer: Signature Care EPO $577.68
Rate for Payer: Signature Care PPO $612.48
Rate for Payer: Three Rivers Preferred All Products $591.60
Rate for Payer: United Healthcare Commercial $548.45
Rate for Payer: United Healthcare Medicare $229.68
Service Code CPT C1713
Hospital Charge Code 41602686
Hospital Revenue Code 278
Min. Negotiated Rate $431.52
Max. Negotiated Rate $640.67
Rate for Payer: Aetna Commercial $601.34
Rate for Payer: Cigna All Products $600.65
Rate for Payer: Coventry/First Health All Products $612.48
Rate for Payer: Encore All Products $640.67
Rate for Payer: Frontpath All Products $640.32
Rate for Payer: Humana ChoiceCare $601.14
Rate for Payer: Lutheran Preferred All Products $626.40
Rate for Payer: PHCS/Multiplan All Products $522.00
Rate for Payer: PHP All Products $527.85
Rate for Payer: Sagamore All Products $537.31
Rate for Payer: Self Pay/Cash Rate $431.52
Rate for Payer: Signature Care EPO $577.68
Rate for Payer: Signature Care PPO $612.48
Rate for Payer: United Healthcare Commercial $548.45