|
HC CREATININE CLEARANCE
|
Facility
|
OP
|
$151.47
|
|
|
Service Code
|
CPT 82575
|
| Hospital Charge Code |
63001118
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.46 |
| Max. Negotiated Rate |
$140.87 |
| Rate for Payer: Aetna Commercial |
$127.84
|
| Rate for Payer: Aetna Medicare |
$48.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$9.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$46.96
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$69.62
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$69.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$9.46
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$55.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$53.32
|
| Rate for Payer: Cash Price |
$90.88
|
| Rate for Payer: Cash Price |
$90.88
|
| Rate for Payer: Centivo All Commercial |
$82.40
|
| Rate for Payer: Cigna All Commercial |
$130.72
|
| Rate for Payer: CORVEL All Commercial |
$140.87
|
| Rate for Payer: Coventry All Commercial |
$133.29
|
| Rate for Payer: Encore All Commercial |
$139.43
|
| Rate for Payer: Frontpath All Commercial |
$139.35
|
| Rate for Payer: Humana ChoiceCare |
$130.82
|
| Rate for Payer: Humana Medicare |
$48.47
|
| Rate for Payer: Lucent All Commercial |
$82.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$136.32
|
| Rate for Payer: Managed Health Services Medicaid |
$9.46
|
| Rate for Payer: MDWise Medicaid |
$9.46
|
| Rate for Payer: PHCS All Commercial |
$113.60
|
| Rate for Payer: PHP All Commercial |
$114.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$59.07
|
| Rate for Payer: Sagamore Health Network All Products |
$116.93
|
| Rate for Payer: Signature Care EPO |
$125.72
|
| Rate for Payer: Signature Care PPO |
$133.29
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$128.75
|
| Rate for Payer: United Healthcare Commercial |
$119.36
|
| Rate for Payer: United Healthcare Medicare |
$48.47
|
|
|
HC CREATININE SERUM
|
Facility
|
IP
|
$46.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
63001094
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$42.78 |
| Rate for Payer: Aetna Commercial |
$39.74
|
| Rate for Payer: Cash Price |
$27.60
|
| Rate for Payer: Cigna All Commercial |
$39.70
|
| Rate for Payer: CORVEL All Commercial |
$42.78
|
| Rate for Payer: Coventry All Commercial |
$40.48
|
| Rate for Payer: Encore All Commercial |
$42.34
|
| Rate for Payer: Frontpath All Commercial |
$42.32
|
| Rate for Payer: Humana ChoiceCare |
$39.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$41.40
|
| Rate for Payer: PHCS All Commercial |
$34.50
|
| Rate for Payer: PHP All Commercial |
$34.89
|
| Rate for Payer: Sagamore Health Network All Products |
$35.51
|
| Rate for Payer: Signature Care EPO |
$38.18
|
| Rate for Payer: Signature Care PPO |
$40.48
|
| Rate for Payer: United Healthcare Commercial |
$36.25
|
|
|
HC CREATININE SERUM
|
Facility
|
OP
|
$46.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
63001094
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.12 |
| Max. Negotiated Rate |
$42.78 |
| Rate for Payer: Aetna Commercial |
$38.82
|
| Rate for Payer: Aetna Medicare |
$14.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$5.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$14.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$21.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$21.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$5.12
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$16.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$16.19
|
| Rate for Payer: Cash Price |
$27.60
|
| Rate for Payer: Cash Price |
$27.60
|
| Rate for Payer: Centivo All Commercial |
$25.02
|
| Rate for Payer: Cigna All Commercial |
$39.70
|
| Rate for Payer: CORVEL All Commercial |
$42.78
|
| Rate for Payer: Coventry All Commercial |
$40.48
|
| Rate for Payer: Encore All Commercial |
$42.34
|
| Rate for Payer: Frontpath All Commercial |
$42.32
|
| Rate for Payer: Humana ChoiceCare |
$39.73
|
| Rate for Payer: Humana Medicare |
$14.72
|
| Rate for Payer: Lucent All Commercial |
$25.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$41.40
|
| Rate for Payer: Managed Health Services Medicaid |
$5.12
|
| Rate for Payer: MDWise Medicaid |
$5.12
|
| Rate for Payer: PHCS All Commercial |
$34.50
|
| Rate for Payer: PHP All Commercial |
$34.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$17.94
|
| Rate for Payer: Sagamore Health Network All Products |
$35.51
|
| Rate for Payer: Signature Care EPO |
$38.18
|
| Rate for Payer: Signature Care PPO |
$40.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$39.10
|
| Rate for Payer: United Healthcare Commercial |
$36.25
|
| Rate for Payer: United Healthcare Medicare |
$14.72
|
|
|
HC CREAT URINE
|
Facility
|
OP
|
$106.52
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
63001175
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.18 |
| Max. Negotiated Rate |
$99.06 |
| Rate for Payer: Aetna Commercial |
$89.90
|
| Rate for Payer: Aetna Medicare |
$34.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$5.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$33.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$48.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$48.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$5.18
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$39.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$37.50
|
| Rate for Payer: Cash Price |
$63.91
|
| Rate for Payer: Cash Price |
$63.91
|
| Rate for Payer: Centivo All Commercial |
$57.95
|
| Rate for Payer: Cigna All Commercial |
$91.93
|
| Rate for Payer: CORVEL All Commercial |
$99.06
|
| Rate for Payer: Coventry All Commercial |
$93.74
|
| Rate for Payer: Encore All Commercial |
$98.05
|
| Rate for Payer: Frontpath All Commercial |
$98.00
|
| Rate for Payer: Humana ChoiceCare |
$92.00
|
| Rate for Payer: Humana Medicare |
$34.09
|
| Rate for Payer: Lucent All Commercial |
$57.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$95.87
|
| Rate for Payer: Managed Health Services Medicaid |
$5.18
|
| Rate for Payer: MDWise Medicaid |
$5.18
|
| Rate for Payer: PHCS All Commercial |
$79.89
|
| Rate for Payer: PHP All Commercial |
$80.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$41.54
|
| Rate for Payer: Sagamore Health Network All Products |
$82.23
|
| Rate for Payer: Signature Care EPO |
$88.41
|
| Rate for Payer: Signature Care PPO |
$93.74
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$90.54
|
| Rate for Payer: United Healthcare Commercial |
$83.94
|
| Rate for Payer: United Healthcare Medicare |
$34.09
|
|
|
HC CREAT URINE
|
Facility
|
IP
|
$106.52
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
63001175
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$79.89 |
| Max. Negotiated Rate |
$99.06 |
| Rate for Payer: Aetna Commercial |
$92.03
|
| Rate for Payer: Cash Price |
$63.91
|
| Rate for Payer: Cigna All Commercial |
$91.93
|
| Rate for Payer: CORVEL All Commercial |
$99.06
|
| Rate for Payer: Coventry All Commercial |
$93.74
|
| Rate for Payer: Encore All Commercial |
$98.05
|
| Rate for Payer: Frontpath All Commercial |
$98.00
|
| Rate for Payer: Humana ChoiceCare |
$92.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$95.87
|
| Rate for Payer: PHCS All Commercial |
$79.89
|
| Rate for Payer: PHP All Commercial |
$80.78
|
| Rate for Payer: Sagamore Health Network All Products |
$82.23
|
| Rate for Payer: Signature Care EPO |
$88.41
|
| Rate for Payer: Signature Care PPO |
$93.74
|
| Rate for Payer: United Healthcare Commercial |
$83.94
|
|
|
HC CRE WG BALLOON DIL 15-18
|
Facility
|
IP
|
$1,099.35
|
|
| Hospital Charge Code |
41602100
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$824.51 |
| Max. Negotiated Rate |
$1,022.40 |
| Rate for Payer: Aetna Commercial |
$949.84
|
| Rate for Payer: Cash Price |
$659.61
|
| Rate for Payer: Cigna All Commercial |
$948.74
|
| Rate for Payer: CORVEL All Commercial |
$1,022.40
|
| Rate for Payer: Coventry All Commercial |
$967.43
|
| Rate for Payer: Encore All Commercial |
$1,011.95
|
| Rate for Payer: Frontpath All Commercial |
$1,011.40
|
| Rate for Payer: Humana ChoiceCare |
$949.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$989.41
|
| Rate for Payer: PHCS All Commercial |
$824.51
|
| Rate for Payer: PHP All Commercial |
$833.75
|
| Rate for Payer: Sagamore Health Network All Products |
$848.70
|
| Rate for Payer: Signature Care EPO |
$912.46
|
| Rate for Payer: Signature Care PPO |
$967.43
|
| Rate for Payer: United Healthcare Commercial |
$866.29
|
|
|
HC CRE WG BALLOON DIL 15-18
|
Facility
|
OP
|
$1,099.35
|
|
| Hospital Charge Code |
41602100
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$1,022.40 |
| Rate for Payer: Aetna Commercial |
$927.85
|
| Rate for Payer: Aetna Medicare |
$351.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$340.80
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$631.36
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$687.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$404.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$386.97
|
| Rate for Payer: Cash Price |
$659.61
|
| Rate for Payer: Cash Price |
$659.61
|
| Rate for Payer: Centivo All Commercial |
$598.05
|
| Rate for Payer: Cigna All Commercial |
$948.74
|
| Rate for Payer: CORVEL All Commercial |
$1,022.40
|
| Rate for Payer: Coventry All Commercial |
$967.43
|
| Rate for Payer: Encore All Commercial |
$1,011.95
|
| Rate for Payer: Frontpath All Commercial |
$1,011.40
|
| Rate for Payer: Humana ChoiceCare |
$949.51
|
| Rate for Payer: Humana Medicare |
$351.79
|
| Rate for Payer: Lucent All Commercial |
$598.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$989.41
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$824.51
|
| Rate for Payer: PHP All Commercial |
$833.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$428.75
|
| Rate for Payer: Sagamore Health Network All Products |
$848.70
|
| Rate for Payer: Signature Care EPO |
$912.46
|
| Rate for Payer: Signature Care PPO |
$967.43
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$934.45
|
| Rate for Payer: United Healthcare Commercial |
$866.29
|
| Rate for Payer: United Healthcare Medicare |
$351.79
|
|
|
HC CRITICAL TEAM RESPONSE<30 MIN
|
Facility
|
OP
|
$3,805.57
|
|
|
Service Code
|
CPT 99285
|
| Hospital Charge Code |
1291440
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$75.80 |
| Max. Negotiated Rate |
$3,539.18 |
| Rate for Payer: Aetna Commercial |
$3,211.90
|
| Rate for Payer: Aetna Medicare |
$1,217.78
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$75.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,179.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$2,185.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,378.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$75.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,400.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,339.56
|
| Rate for Payer: Cash Price |
$2,283.34
|
| Rate for Payer: Cash Price |
$2,283.34
|
| Rate for Payer: Centivo All Commercial |
$2,070.23
|
| Rate for Payer: Cigna All Commercial |
$3,284.21
|
| Rate for Payer: CORVEL All Commercial |
$3,539.18
|
| Rate for Payer: Coventry All Commercial |
$3,348.90
|
| Rate for Payer: Encore All Commercial |
$3,503.03
|
| Rate for Payer: Frontpath All Commercial |
$3,501.12
|
| Rate for Payer: Humana ChoiceCare |
$3,286.87
|
| Rate for Payer: Humana Medicare |
$1,217.78
|
| Rate for Payer: Lucent All Commercial |
$2,070.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,425.01
|
| Rate for Payer: Managed Health Services Medicaid |
$75.80
|
| Rate for Payer: MDWise Medicaid |
$75.80
|
| Rate for Payer: PHCS All Commercial |
$2,854.18
|
| Rate for Payer: PHP All Commercial |
$2,886.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,484.17
|
| Rate for Payer: Sagamore Health Network All Products |
$2,937.90
|
| Rate for Payer: Signature Care EPO |
$3,158.62
|
| Rate for Payer: Signature Care PPO |
$3,348.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,234.73
|
| Rate for Payer: United Healthcare Commercial |
$2,998.79
|
| Rate for Payer: United Healthcare Medicare |
$1,217.78
|
|
|
HC CRITICAL TEAM RESPONSE<30 MIN
|
Facility
|
IP
|
$3,805.57
|
|
|
Service Code
|
CPT 99285
|
| Hospital Charge Code |
1291440
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,854.18 |
| Max. Negotiated Rate |
$3,539.18 |
| Rate for Payer: Aetna Commercial |
$3,288.01
|
| Rate for Payer: Cash Price |
$2,283.34
|
| Rate for Payer: Cigna All Commercial |
$3,284.21
|
| Rate for Payer: CORVEL All Commercial |
$3,539.18
|
| Rate for Payer: Coventry All Commercial |
$3,348.90
|
| Rate for Payer: Encore All Commercial |
$3,503.03
|
| Rate for Payer: Frontpath All Commercial |
$3,501.12
|
| Rate for Payer: Humana ChoiceCare |
$3,286.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,425.01
|
| Rate for Payer: PHCS All Commercial |
$2,854.18
|
| Rate for Payer: PHP All Commercial |
$2,886.14
|
| Rate for Payer: Sagamore Health Network All Products |
$2,937.90
|
| Rate for Payer: Signature Care EPO |
$3,158.62
|
| Rate for Payer: Signature Care PPO |
$3,348.90
|
| Rate for Payer: United Healthcare Commercial |
$2,998.79
|
|
|
HC CRP, QUANTITATIVE
|
Facility
|
IP
|
$165.33
|
|
|
Service Code
|
CPT 86141
|
| Hospital Charge Code |
63001194
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$124.00 |
| Max. Negotiated Rate |
$153.76 |
| Rate for Payer: Aetna Commercial |
$142.85
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cigna All Commercial |
$142.68
|
| Rate for Payer: CORVEL All Commercial |
$153.76
|
| Rate for Payer: Coventry All Commercial |
$145.49
|
| Rate for Payer: Encore All Commercial |
$152.19
|
| Rate for Payer: Frontpath All Commercial |
$152.10
|
| Rate for Payer: Humana ChoiceCare |
$142.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$148.80
|
| Rate for Payer: PHCS All Commercial |
$124.00
|
| Rate for Payer: PHP All Commercial |
$125.39
|
| Rate for Payer: Sagamore Health Network All Products |
$127.63
|
| Rate for Payer: Signature Care EPO |
$137.22
|
| Rate for Payer: Signature Care PPO |
$145.49
|
| Rate for Payer: United Healthcare Commercial |
$130.28
|
|
|
HC CRP, QUANTITATIVE
|
Facility
|
OP
|
$165.33
|
|
|
Service Code
|
CPT 86141
|
| Hospital Charge Code |
63001194
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.95 |
| Max. Negotiated Rate |
$153.76 |
| Rate for Payer: Aetna Commercial |
$139.54
|
| Rate for Payer: Aetna Medicare |
$52.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$12.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$51.25
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$75.99
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$75.99
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$12.95
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$60.84
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$58.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Centivo All Commercial |
$89.94
|
| Rate for Payer: Cigna All Commercial |
$142.68
|
| Rate for Payer: CORVEL All Commercial |
$153.76
|
| Rate for Payer: Coventry All Commercial |
$145.49
|
| Rate for Payer: Encore All Commercial |
$152.19
|
| Rate for Payer: Frontpath All Commercial |
$152.10
|
| Rate for Payer: Humana ChoiceCare |
$142.80
|
| Rate for Payer: Humana Medicare |
$52.91
|
| Rate for Payer: Lucent All Commercial |
$89.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$148.80
|
| Rate for Payer: Managed Health Services Medicaid |
$12.95
|
| Rate for Payer: MDWise Medicaid |
$12.95
|
| Rate for Payer: PHCS All Commercial |
$124.00
|
| Rate for Payer: PHP All Commercial |
$125.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$64.48
|
| Rate for Payer: Sagamore Health Network All Products |
$127.63
|
| Rate for Payer: Signature Care EPO |
$137.22
|
| Rate for Payer: Signature Care PPO |
$145.49
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$140.53
|
| Rate for Payer: United Healthcare Commercial |
$130.28
|
| Rate for Payer: United Healthcare Medicare |
$52.91
|
|
|
HC CRYOGLOBULIN
|
Facility
|
OP
|
$83.64
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
63001284
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.47 |
| Max. Negotiated Rate |
$77.79 |
| Rate for Payer: Aetna Commercial |
$70.59
|
| Rate for Payer: Aetna Medicare |
$26.76
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$6.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$25.93
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$38.44
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$38.44
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$6.47
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$30.78
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$29.44
|
| Rate for Payer: Cash Price |
$50.18
|
| Rate for Payer: Cash Price |
$50.18
|
| Rate for Payer: Centivo All Commercial |
$45.50
|
| Rate for Payer: Cigna All Commercial |
$72.18
|
| Rate for Payer: CORVEL All Commercial |
$77.79
|
| Rate for Payer: Coventry All Commercial |
$73.60
|
| Rate for Payer: Encore All Commercial |
$76.99
|
| Rate for Payer: Frontpath All Commercial |
$76.95
|
| Rate for Payer: Humana ChoiceCare |
$72.24
|
| Rate for Payer: Humana Medicare |
$26.76
|
| Rate for Payer: Lucent All Commercial |
$45.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$75.28
|
| Rate for Payer: Managed Health Services Medicaid |
$6.47
|
| Rate for Payer: MDWise Medicaid |
$6.47
|
| Rate for Payer: PHCS All Commercial |
$62.73
|
| Rate for Payer: PHP All Commercial |
$63.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$32.62
|
| Rate for Payer: Sagamore Health Network All Products |
$64.57
|
| Rate for Payer: Signature Care EPO |
$69.42
|
| Rate for Payer: Signature Care PPO |
$73.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$71.09
|
| Rate for Payer: United Healthcare Commercial |
$65.91
|
| Rate for Payer: United Healthcare Medicare |
$26.76
|
|
|
HC CRYOGLOBULIN
|
Facility
|
IP
|
$83.64
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
63001284
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$62.73 |
| Max. Negotiated Rate |
$77.79 |
| Rate for Payer: Aetna Commercial |
$72.26
|
| Rate for Payer: Cash Price |
$50.18
|
| Rate for Payer: Cigna All Commercial |
$72.18
|
| Rate for Payer: CORVEL All Commercial |
$77.79
|
| Rate for Payer: Coventry All Commercial |
$73.60
|
| Rate for Payer: Encore All Commercial |
$76.99
|
| Rate for Payer: Frontpath All Commercial |
$76.95
|
| Rate for Payer: Humana ChoiceCare |
$72.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$75.28
|
| Rate for Payer: PHCS All Commercial |
$62.73
|
| Rate for Payer: PHP All Commercial |
$63.43
|
| Rate for Payer: Sagamore Health Network All Products |
$64.57
|
| Rate for Payer: Signature Care EPO |
$69.42
|
| Rate for Payer: Signature Care PPO |
$73.60
|
| Rate for Payer: United Healthcare Commercial |
$65.91
|
|
|
HC CRYOPRECIPITATE CROSSMATC
|
Facility
|
OP
|
$2,048.16
|
|
|
Service Code
|
CPT P9012
|
| Hospital Charge Code |
63002210
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$634.93 |
| Max. Negotiated Rate |
$1,904.79 |
| Rate for Payer: Aetna Commercial |
$1,728.65
|
| Rate for Payer: Aetna Medicare |
$655.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$634.93
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$941.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$941.33
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$753.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$720.95
|
| Rate for Payer: Cash Price |
$1,228.90
|
| Rate for Payer: Centivo All Commercial |
$1,114.20
|
| Rate for Payer: Cigna All Commercial |
$1,767.56
|
| Rate for Payer: CORVEL All Commercial |
$1,904.79
|
| Rate for Payer: Coventry All Commercial |
$1,802.38
|
| Rate for Payer: Encore All Commercial |
$1,885.33
|
| Rate for Payer: Frontpath All Commercial |
$1,884.31
|
| Rate for Payer: Humana ChoiceCare |
$1,769.00
|
| Rate for Payer: Humana Medicare |
$655.41
|
| Rate for Payer: Lucent All Commercial |
$1,114.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,843.34
|
| Rate for Payer: PHCS All Commercial |
$1,536.12
|
| Rate for Payer: PHP All Commercial |
$1,553.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$798.78
|
| Rate for Payer: Sagamore Health Network All Products |
$1,581.18
|
| Rate for Payer: Signature Care EPO |
$1,699.97
|
| Rate for Payer: Signature Care PPO |
$1,802.38
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,740.94
|
| Rate for Payer: United Healthcare Commercial |
$1,613.95
|
| Rate for Payer: United Healthcare Medicare |
$655.41
|
|
|
HC CRYOPRECIPITATE CROSSMATC
|
Facility
|
IP
|
$2,048.16
|
|
|
Service Code
|
CPT P9012
|
| Hospital Charge Code |
63002210
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$1,536.12 |
| Max. Negotiated Rate |
$1,904.79 |
| Rate for Payer: Aetna Commercial |
$1,769.61
|
| Rate for Payer: Cash Price |
$1,228.90
|
| Rate for Payer: Cigna All Commercial |
$1,767.56
|
| Rate for Payer: CORVEL All Commercial |
$1,904.79
|
| Rate for Payer: Coventry All Commercial |
$1,802.38
|
| Rate for Payer: Encore All Commercial |
$1,885.33
|
| Rate for Payer: Frontpath All Commercial |
$1,884.31
|
| Rate for Payer: Humana ChoiceCare |
$1,769.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,843.34
|
| Rate for Payer: PHCS All Commercial |
$1,536.12
|
| Rate for Payer: PHP All Commercial |
$1,553.32
|
| Rate for Payer: Sagamore Health Network All Products |
$1,581.18
|
| Rate for Payer: Signature Care EPO |
$1,699.97
|
| Rate for Payer: Signature Care PPO |
$1,802.38
|
| Rate for Payer: United Healthcare Commercial |
$1,613.95
|
|
|
HC CRYPTOCOCCAL AG CSF
|
Facility
|
IP
|
$86.19
|
|
|
Service Code
|
CPT 86403
|
| Hospital Charge Code |
63001911
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$64.64 |
| Max. Negotiated Rate |
$80.16 |
| Rate for Payer: Aetna Commercial |
$74.47
|
| Rate for Payer: Cash Price |
$51.71
|
| Rate for Payer: Cigna All Commercial |
$74.38
|
| Rate for Payer: CORVEL All Commercial |
$80.16
|
| Rate for Payer: Coventry All Commercial |
$75.85
|
| Rate for Payer: Encore All Commercial |
$79.34
|
| Rate for Payer: Frontpath All Commercial |
$79.29
|
| Rate for Payer: Humana ChoiceCare |
$74.44
|
| Rate for Payer: Lutheran Preferred All Commercial |
$77.57
|
| Rate for Payer: PHCS All Commercial |
$64.64
|
| Rate for Payer: PHP All Commercial |
$65.37
|
| Rate for Payer: Sagamore Health Network All Products |
$66.54
|
| Rate for Payer: Signature Care EPO |
$71.54
|
| Rate for Payer: Signature Care PPO |
$75.85
|
| Rate for Payer: United Healthcare Commercial |
$67.92
|
|
|
HC CRYPTOCOCCAL AG CSF
|
Facility
|
OP
|
$86.19
|
|
|
Service Code
|
CPT 86403
|
| Hospital Charge Code |
63001911
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.54 |
| Max. Negotiated Rate |
$80.16 |
| Rate for Payer: Aetna Commercial |
$72.74
|
| Rate for Payer: Aetna Medicare |
$27.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$11.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$26.72
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$39.61
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$39.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$11.54
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$31.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$30.34
|
| Rate for Payer: Cash Price |
$51.71
|
| Rate for Payer: Cash Price |
$51.71
|
| Rate for Payer: Centivo All Commercial |
$46.89
|
| Rate for Payer: Cigna All Commercial |
$74.38
|
| Rate for Payer: CORVEL All Commercial |
$80.16
|
| Rate for Payer: Coventry All Commercial |
$75.85
|
| Rate for Payer: Encore All Commercial |
$79.34
|
| Rate for Payer: Frontpath All Commercial |
$79.29
|
| Rate for Payer: Humana ChoiceCare |
$74.44
|
| Rate for Payer: Humana Medicare |
$27.58
|
| Rate for Payer: Lucent All Commercial |
$46.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$77.57
|
| Rate for Payer: Managed Health Services Medicaid |
$11.54
|
| Rate for Payer: MDWise Medicaid |
$11.54
|
| Rate for Payer: PHCS All Commercial |
$64.64
|
| Rate for Payer: PHP All Commercial |
$65.37
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$33.61
|
| Rate for Payer: Sagamore Health Network All Products |
$66.54
|
| Rate for Payer: Signature Care EPO |
$71.54
|
| Rate for Payer: Signature Care PPO |
$75.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$73.26
|
| Rate for Payer: United Healthcare Commercial |
$67.92
|
| Rate for Payer: United Healthcare Medicare |
$27.58
|
|
|
HC CRYPTOCOCCUS ANTIGEN, SERUM
|
Facility
|
IP
|
$106.86
|
|
|
Service Code
|
CPT 86403
|
| Hospital Charge Code |
63001913
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$80.14 |
| Max. Negotiated Rate |
$99.38 |
| Rate for Payer: Aetna Commercial |
$92.33
|
| Rate for Payer: Cash Price |
$64.12
|
| Rate for Payer: Cigna All Commercial |
$92.22
|
| Rate for Payer: CORVEL All Commercial |
$99.38
|
| Rate for Payer: Coventry All Commercial |
$94.04
|
| Rate for Payer: Encore All Commercial |
$98.36
|
| Rate for Payer: Frontpath All Commercial |
$98.31
|
| Rate for Payer: Humana ChoiceCare |
$92.29
|
| Rate for Payer: Lutheran Preferred All Commercial |
$96.17
|
| Rate for Payer: PHCS All Commercial |
$80.14
|
| Rate for Payer: PHP All Commercial |
$81.04
|
| Rate for Payer: Sagamore Health Network All Products |
$82.50
|
| Rate for Payer: Signature Care EPO |
$88.69
|
| Rate for Payer: Signature Care PPO |
$94.04
|
| Rate for Payer: United Healthcare Commercial |
$84.21
|
|
|
HC CRYPTOCOCCUS ANTIGEN, SERUM
|
Facility
|
OP
|
$106.86
|
|
|
Service Code
|
CPT 86403
|
| Hospital Charge Code |
63001913
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.54 |
| Max. Negotiated Rate |
$99.38 |
| Rate for Payer: Aetna Commercial |
$90.19
|
| Rate for Payer: Aetna Medicare |
$34.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$11.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$33.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$49.11
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$49.11
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$11.54
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$39.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$37.61
|
| Rate for Payer: Cash Price |
$64.12
|
| Rate for Payer: Cash Price |
$64.12
|
| Rate for Payer: Centivo All Commercial |
$58.13
|
| Rate for Payer: Cigna All Commercial |
$92.22
|
| Rate for Payer: CORVEL All Commercial |
$99.38
|
| Rate for Payer: Coventry All Commercial |
$94.04
|
| Rate for Payer: Encore All Commercial |
$98.36
|
| Rate for Payer: Frontpath All Commercial |
$98.31
|
| Rate for Payer: Humana ChoiceCare |
$92.29
|
| Rate for Payer: Humana Medicare |
$34.20
|
| Rate for Payer: Lucent All Commercial |
$58.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$96.17
|
| Rate for Payer: Managed Health Services Medicaid |
$11.54
|
| Rate for Payer: MDWise Medicaid |
$11.54
|
| Rate for Payer: PHCS All Commercial |
$80.14
|
| Rate for Payer: PHP All Commercial |
$81.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$41.68
|
| Rate for Payer: Sagamore Health Network All Products |
$82.50
|
| Rate for Payer: Signature Care EPO |
$88.69
|
| Rate for Payer: Signature Care PPO |
$94.04
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$90.83
|
| Rate for Payer: United Healthcare Commercial |
$84.21
|
| Rate for Payer: United Healthcare Medicare |
$34.20
|
|
|
HC CRYSTALS BODY FLUID
|
Facility
|
IP
|
$107.59
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
63001296
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$80.69 |
| Max. Negotiated Rate |
$100.06 |
| Rate for Payer: Aetna Commercial |
$92.96
|
| Rate for Payer: Cash Price |
$64.55
|
| Rate for Payer: Cigna All Commercial |
$92.85
|
| Rate for Payer: CORVEL All Commercial |
$100.06
|
| Rate for Payer: Coventry All Commercial |
$94.68
|
| Rate for Payer: Encore All Commercial |
$99.04
|
| Rate for Payer: Frontpath All Commercial |
$98.98
|
| Rate for Payer: Humana ChoiceCare |
$92.93
|
| Rate for Payer: Lutheran Preferred All Commercial |
$96.83
|
| Rate for Payer: PHCS All Commercial |
$80.69
|
| Rate for Payer: PHP All Commercial |
$81.60
|
| Rate for Payer: Sagamore Health Network All Products |
$83.06
|
| Rate for Payer: Signature Care EPO |
$89.30
|
| Rate for Payer: Signature Care PPO |
$94.68
|
| Rate for Payer: United Healthcare Commercial |
$84.78
|
|
|
HC CRYSTALS BODY FLUID
|
Facility
|
OP
|
$107.59
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
63001296
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$100.06 |
| Rate for Payer: Aetna Commercial |
$90.81
|
| Rate for Payer: Aetna Medicare |
$34.43
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$7.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$33.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$49.45
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$49.45
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$7.33
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$39.59
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$37.87
|
| Rate for Payer: Cash Price |
$64.55
|
| Rate for Payer: Cash Price |
$64.55
|
| Rate for Payer: Centivo All Commercial |
$58.53
|
| Rate for Payer: Cigna All Commercial |
$92.85
|
| Rate for Payer: CORVEL All Commercial |
$100.06
|
| Rate for Payer: Coventry All Commercial |
$94.68
|
| Rate for Payer: Encore All Commercial |
$99.04
|
| Rate for Payer: Frontpath All Commercial |
$98.98
|
| Rate for Payer: Humana ChoiceCare |
$92.93
|
| Rate for Payer: Humana Medicare |
$34.43
|
| Rate for Payer: Lucent All Commercial |
$58.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$96.83
|
| Rate for Payer: Managed Health Services Medicaid |
$7.33
|
| Rate for Payer: MDWise Medicaid |
$7.33
|
| Rate for Payer: PHCS All Commercial |
$80.69
|
| Rate for Payer: PHP All Commercial |
$81.60
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$41.96
|
| Rate for Payer: Sagamore Health Network All Products |
$83.06
|
| Rate for Payer: Signature Care EPO |
$89.30
|
| Rate for Payer: Signature Care PPO |
$94.68
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$91.45
|
| Rate for Payer: United Healthcare Commercial |
$84.78
|
| Rate for Payer: United Healthcare Medicare |
$34.43
|
|
|
HC CRYTOSPORIDIUM AG
|
Facility
|
OP
|
$142.33
|
|
|
Service Code
|
CPT 87328
|
| Hospital Charge Code |
63002026
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.82 |
| Max. Negotiated Rate |
$132.37 |
| Rate for Payer: Aetna Commercial |
$120.13
|
| Rate for Payer: Aetna Medicare |
$45.55
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$13.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$44.12
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$65.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$65.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$13.82
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$52.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$50.10
|
| Rate for Payer: Cash Price |
$85.40
|
| Rate for Payer: Cash Price |
$85.40
|
| Rate for Payer: Centivo All Commercial |
$77.43
|
| Rate for Payer: Cigna All Commercial |
$122.83
|
| Rate for Payer: CORVEL All Commercial |
$132.37
|
| Rate for Payer: Coventry All Commercial |
$125.25
|
| Rate for Payer: Encore All Commercial |
$131.01
|
| Rate for Payer: Frontpath All Commercial |
$130.94
|
| Rate for Payer: Humana ChoiceCare |
$122.93
|
| Rate for Payer: Humana Medicare |
$45.55
|
| Rate for Payer: Lucent All Commercial |
$77.43
|
| Rate for Payer: Lutheran Preferred All Commercial |
$128.10
|
| Rate for Payer: Managed Health Services Medicaid |
$13.82
|
| Rate for Payer: MDWise Medicaid |
$13.82
|
| Rate for Payer: PHCS All Commercial |
$106.75
|
| Rate for Payer: PHP All Commercial |
$107.94
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$55.51
|
| Rate for Payer: Sagamore Health Network All Products |
$109.88
|
| Rate for Payer: Signature Care EPO |
$118.13
|
| Rate for Payer: Signature Care PPO |
$125.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$120.98
|
| Rate for Payer: United Healthcare Commercial |
$112.16
|
| Rate for Payer: United Healthcare Medicare |
$45.55
|
|
|
HC CRYTOSPORIDIUM AG
|
Facility
|
IP
|
$142.33
|
|
|
Service Code
|
CPT 87328
|
| Hospital Charge Code |
63002026
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$106.75 |
| Max. Negotiated Rate |
$132.37 |
| Rate for Payer: Aetna Commercial |
$122.97
|
| Rate for Payer: Cash Price |
$85.40
|
| Rate for Payer: Cigna All Commercial |
$122.83
|
| Rate for Payer: CORVEL All Commercial |
$132.37
|
| Rate for Payer: Coventry All Commercial |
$125.25
|
| Rate for Payer: Encore All Commercial |
$131.01
|
| Rate for Payer: Frontpath All Commercial |
$130.94
|
| Rate for Payer: Humana ChoiceCare |
$122.93
|
| Rate for Payer: Lutheran Preferred All Commercial |
$128.10
|
| Rate for Payer: PHCS All Commercial |
$106.75
|
| Rate for Payer: PHP All Commercial |
$107.94
|
| Rate for Payer: Sagamore Health Network All Products |
$109.88
|
| Rate for Payer: Signature Care EPO |
$118.13
|
| Rate for Payer: Signature Care PPO |
$125.25
|
| Rate for Payer: United Healthcare Commercial |
$112.16
|
|
|
HC CSF CULTURE
|
Facility
|
IP
|
$218.24
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
63001069
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$163.68 |
| Max. Negotiated Rate |
$202.96 |
| Rate for Payer: Aetna Commercial |
$188.56
|
| Rate for Payer: Cash Price |
$130.94
|
| Rate for Payer: Cigna All Commercial |
$188.34
|
| Rate for Payer: CORVEL All Commercial |
$202.96
|
| Rate for Payer: Coventry All Commercial |
$192.05
|
| Rate for Payer: Encore All Commercial |
$200.89
|
| Rate for Payer: Frontpath All Commercial |
$200.78
|
| Rate for Payer: Humana ChoiceCare |
$188.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$196.42
|
| Rate for Payer: PHCS All Commercial |
$163.68
|
| Rate for Payer: PHP All Commercial |
$165.51
|
| Rate for Payer: Sagamore Health Network All Products |
$168.48
|
| Rate for Payer: Signature Care EPO |
$181.14
|
| Rate for Payer: Signature Care PPO |
$192.05
|
| Rate for Payer: United Healthcare Commercial |
$171.97
|
|
|
HC CSF CULTURE
|
Facility
|
OP
|
$218.24
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
63001069
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.62 |
| Max. Negotiated Rate |
$202.96 |
| Rate for Payer: Aetna Commercial |
$184.19
|
| Rate for Payer: Aetna Medicare |
$69.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$8.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$67.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$100.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$100.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$8.62
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$80.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$76.82
|
| Rate for Payer: Cash Price |
$130.94
|
| Rate for Payer: Cash Price |
$130.94
|
| Rate for Payer: Centivo All Commercial |
$118.72
|
| Rate for Payer: Cigna All Commercial |
$188.34
|
| Rate for Payer: CORVEL All Commercial |
$202.96
|
| Rate for Payer: Coventry All Commercial |
$192.05
|
| Rate for Payer: Encore All Commercial |
$200.89
|
| Rate for Payer: Frontpath All Commercial |
$200.78
|
| Rate for Payer: Humana ChoiceCare |
$188.49
|
| Rate for Payer: Humana Medicare |
$69.84
|
| Rate for Payer: Lucent All Commercial |
$118.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$196.42
|
| Rate for Payer: Managed Health Services Medicaid |
$8.62
|
| Rate for Payer: MDWise Medicaid |
$8.62
|
| Rate for Payer: PHCS All Commercial |
$163.68
|
| Rate for Payer: PHP All Commercial |
$165.51
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$85.11
|
| Rate for Payer: Sagamore Health Network All Products |
$168.48
|
| Rate for Payer: Signature Care EPO |
$181.14
|
| Rate for Payer: Signature Care PPO |
$192.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$185.50
|
| Rate for Payer: United Healthcare Commercial |
$171.97
|
| Rate for Payer: United Healthcare Medicare |
$69.84
|
|
