|
HC EVAL SPEECH SOUND LANG COMPREHEN 30 MIN
|
Facility
OP
|
$414.99
|
|
|
Service Code
|
CPT 92523 GN
|
| Hospital Charge Code |
01744523
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$136.95 |
| Max. Negotiated Rate |
$385.94 |
| Rate for Payer: Aetna Commercial |
$350.25
|
| Rate for Payer: Aetna Medicare |
$136.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$136.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$238.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$259.41
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$157.49
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$150.64
|
| Rate for Payer: Cash Price |
$257.29
|
| Rate for Payer: Centivo All Commercial |
$211.64
|
| Rate for Payer: Cigna All Commercial |
$358.13
|
| Rate for Payer: CORVEL All Commercial |
$385.94
|
| Rate for Payer: Coventry All Commercial |
$365.19
|
| Rate for Payer: Encore All Commercial |
$382.00
|
| Rate for Payer: Frontpath All Commercial |
$381.79
|
| Rate for Payer: Humana ChoiceCare |
$358.42
|
| Rate for Payer: Humana Medicare |
$211.64
|
| Rate for Payer: Lucent All Commercial |
$211.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$373.49
|
| Rate for Payer: PHCS All Commercial |
$311.24
|
| Rate for Payer: PHP All Commercial |
$314.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$161.84
|
| Rate for Payer: Sagamore Health Network All Products |
$320.37
|
| Rate for Payer: Signature Care EPO |
$344.44
|
| Rate for Payer: Signature Care PPO |
$365.19
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$352.74
|
| Rate for Payer: United Healthcare Commercial |
$327.01
|
| Rate for Payer: United Healthcare Medicare |
$136.95
|
|
|
HC EVAL SPEECH SOUND LANG COMPREHEN 45 MIN
|
Facility
IP
|
$426.44
|
|
|
Service Code
|
CPT 92523 GN
|
| Hospital Charge Code |
01745523
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$319.83 |
| Max. Negotiated Rate |
$396.59 |
| Rate for Payer: Aetna Commercial |
$368.45
|
| Rate for Payer: Cash Price |
$264.39
|
| Rate for Payer: Cigna All Commercial |
$368.02
|
| Rate for Payer: CORVEL All Commercial |
$396.59
|
| Rate for Payer: Coventry All Commercial |
$375.27
|
| Rate for Payer: Encore All Commercial |
$392.54
|
| Rate for Payer: Frontpath All Commercial |
$392.33
|
| Rate for Payer: Humana ChoiceCare |
$368.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$383.80
|
| Rate for Payer: PHCS All Commercial |
$319.83
|
| Rate for Payer: PHP All Commercial |
$323.41
|
| Rate for Payer: Sagamore Health Network All Products |
$329.21
|
| Rate for Payer: Signature Care EPO |
$353.95
|
| Rate for Payer: Signature Care PPO |
$375.27
|
| Rate for Payer: United Healthcare Commercial |
$336.04
|
|
|
HC EVAL SPEECH SOUND LANG COMPREHEN 45 MIN
|
Facility
OP
|
$426.44
|
|
|
Service Code
|
CPT 92523 GN
|
| Hospital Charge Code |
01745523
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$140.73 |
| Max. Negotiated Rate |
$396.59 |
| Rate for Payer: Aetna Commercial |
$359.92
|
| Rate for Payer: Aetna Medicare |
$140.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$140.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$244.91
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$266.57
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$161.83
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$154.80
|
| Rate for Payer: Cash Price |
$264.39
|
| Rate for Payer: Centivo All Commercial |
$217.49
|
| Rate for Payer: Cigna All Commercial |
$368.02
|
| Rate for Payer: CORVEL All Commercial |
$396.59
|
| Rate for Payer: Coventry All Commercial |
$375.27
|
| Rate for Payer: Encore All Commercial |
$392.54
|
| Rate for Payer: Frontpath All Commercial |
$392.33
|
| Rate for Payer: Humana ChoiceCare |
$368.32
|
| Rate for Payer: Humana Medicare |
$217.49
|
| Rate for Payer: Lucent All Commercial |
$217.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$383.80
|
| Rate for Payer: PHCS All Commercial |
$319.83
|
| Rate for Payer: PHP All Commercial |
$323.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$166.31
|
| Rate for Payer: Sagamore Health Network All Products |
$329.21
|
| Rate for Payer: Signature Care EPO |
$353.95
|
| Rate for Payer: Signature Care PPO |
$375.27
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$362.48
|
| Rate for Payer: United Healthcare Commercial |
$336.04
|
| Rate for Payer: United Healthcare Medicare |
$140.73
|
|
|
HC EVAL SPEECH SOUND LANG COMPREHEN 60 MIN
|
Facility
OP
|
$435.67
|
|
|
Service Code
|
CPT 92523 GN
|
| Hospital Charge Code |
01742523
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$143.77 |
| Max. Negotiated Rate |
$405.18 |
| Rate for Payer: Aetna Commercial |
$367.71
|
| Rate for Payer: Aetna Medicare |
$143.77
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$143.77
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$250.21
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$272.34
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$165.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$158.15
|
| Rate for Payer: Cash Price |
$270.12
|
| Rate for Payer: Centivo All Commercial |
$222.19
|
| Rate for Payer: Cigna All Commercial |
$375.99
|
| Rate for Payer: CORVEL All Commercial |
$405.18
|
| Rate for Payer: Coventry All Commercial |
$383.39
|
| Rate for Payer: Encore All Commercial |
$401.04
|
| Rate for Payer: Frontpath All Commercial |
$400.82
|
| Rate for Payer: Humana ChoiceCare |
$376.29
|
| Rate for Payer: Humana Medicare |
$222.19
|
| Rate for Payer: Lucent All Commercial |
$222.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$392.11
|
| Rate for Payer: PHCS All Commercial |
$326.75
|
| Rate for Payer: PHP All Commercial |
$330.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$169.91
|
| Rate for Payer: Sagamore Health Network All Products |
$336.34
|
| Rate for Payer: Signature Care EPO |
$361.61
|
| Rate for Payer: Signature Care PPO |
$383.39
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$370.32
|
| Rate for Payer: United Healthcare Commercial |
$343.31
|
| Rate for Payer: United Healthcare Medicare |
$143.77
|
|
|
HC EVAL SPEECH SOUND LANG COMPREHEN 60 MIN
|
Facility
IP
|
$435.67
|
|
|
Service Code
|
CPT 92523 GN
|
| Hospital Charge Code |
01742523
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$326.75 |
| Max. Negotiated Rate |
$405.18 |
| Rate for Payer: Aetna Commercial |
$376.42
|
| Rate for Payer: Cash Price |
$270.12
|
| Rate for Payer: Cigna All Commercial |
$375.99
|
| Rate for Payer: CORVEL All Commercial |
$405.18
|
| Rate for Payer: Coventry All Commercial |
$383.39
|
| Rate for Payer: Encore All Commercial |
$401.04
|
| Rate for Payer: Frontpath All Commercial |
$400.82
|
| Rate for Payer: Humana ChoiceCare |
$376.29
|
| Rate for Payer: Lutheran Preferred All Commercial |
$392.11
|
| Rate for Payer: PHCS All Commercial |
$326.75
|
| Rate for Payer: PHP All Commercial |
$330.41
|
| Rate for Payer: Sagamore Health Network All Products |
$336.34
|
| Rate for Payer: Signature Care EPO |
$361.61
|
| Rate for Payer: Signature Care PPO |
$383.39
|
| Rate for Payer: United Healthcare Commercial |
$343.31
|
|
|
HC EVAL SPEECH SOUND LANG COMPREHEN - SP
|
Facility
IP
|
$456.71
|
|
|
Service Code
|
CPT 92523 GN
|
| Hospital Charge Code |
01749075
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$342.53 |
| Max. Negotiated Rate |
$424.74 |
| Rate for Payer: Aetna Commercial |
$394.59
|
| Rate for Payer: Cash Price |
$283.16
|
| Rate for Payer: Cigna All Commercial |
$394.14
|
| Rate for Payer: CORVEL All Commercial |
$424.74
|
| Rate for Payer: Coventry All Commercial |
$401.90
|
| Rate for Payer: Encore All Commercial |
$420.40
|
| Rate for Payer: Frontpath All Commercial |
$420.17
|
| Rate for Payer: Humana ChoiceCare |
$394.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$411.03
|
| Rate for Payer: PHCS All Commercial |
$342.53
|
| Rate for Payer: PHP All Commercial |
$346.37
|
| Rate for Payer: Sagamore Health Network All Products |
$352.58
|
| Rate for Payer: Signature Care EPO |
$379.07
|
| Rate for Payer: Signature Care PPO |
$401.90
|
| Rate for Payer: United Healthcare Commercial |
$359.88
|
|
|
HC EVAL SPEECH SOUND LANG COMPREHEN - SP
|
Facility
OP
|
$456.71
|
|
|
Service Code
|
CPT 92523 GN
|
| Hospital Charge Code |
01749075
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$150.71 |
| Max. Negotiated Rate |
$424.74 |
| Rate for Payer: Aetna Commercial |
$385.46
|
| Rate for Payer: Aetna Medicare |
$150.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$150.71
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$262.29
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$285.49
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$173.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$165.78
|
| Rate for Payer: Cash Price |
$283.16
|
| Rate for Payer: Centivo All Commercial |
$232.92
|
| Rate for Payer: Cigna All Commercial |
$394.14
|
| Rate for Payer: CORVEL All Commercial |
$424.74
|
| Rate for Payer: Coventry All Commercial |
$401.90
|
| Rate for Payer: Encore All Commercial |
$420.40
|
| Rate for Payer: Frontpath All Commercial |
$420.17
|
| Rate for Payer: Humana ChoiceCare |
$394.46
|
| Rate for Payer: Humana Medicare |
$232.92
|
| Rate for Payer: Lucent All Commercial |
$232.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$411.03
|
| Rate for Payer: PHCS All Commercial |
$342.53
|
| Rate for Payer: PHP All Commercial |
$346.37
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$178.11
|
| Rate for Payer: Sagamore Health Network All Products |
$352.58
|
| Rate for Payer: Signature Care EPO |
$379.07
|
| Rate for Payer: Signature Care PPO |
$401.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$388.20
|
| Rate for Payer: United Healthcare Commercial |
$359.88
|
| Rate for Payer: United Healthcare Medicare |
$150.71
|
|
|
HC EVAL SP GEN DEVICE/INITL HR-SP
|
Facility
IP
|
$416.30
|
|
|
Service Code
|
CPT 92607 GN
|
| Hospital Charge Code |
01748037
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$312.23 |
| Max. Negotiated Rate |
$387.16 |
| Rate for Payer: Aetna Commercial |
$359.69
|
| Rate for Payer: Cash Price |
$258.11
|
| Rate for Payer: Cigna All Commercial |
$359.27
|
| Rate for Payer: CORVEL All Commercial |
$387.16
|
| Rate for Payer: Coventry All Commercial |
$366.35
|
| Rate for Payer: Encore All Commercial |
$383.21
|
| Rate for Payer: Frontpath All Commercial |
$383.00
|
| Rate for Payer: Humana ChoiceCare |
$359.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$374.67
|
| Rate for Payer: PHCS All Commercial |
$312.23
|
| Rate for Payer: PHP All Commercial |
$315.72
|
| Rate for Payer: Sagamore Health Network All Products |
$321.39
|
| Rate for Payer: Signature Care EPO |
$345.53
|
| Rate for Payer: Signature Care PPO |
$366.35
|
| Rate for Payer: United Healthcare Commercial |
$328.05
|
|
|
HC EVAL SP GEN DEVICE/INITL HR-SP
|
Facility
OP
|
$416.30
|
|
|
Service Code
|
CPT 92607 GN
|
| Hospital Charge Code |
01748037
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$137.38 |
| Max. Negotiated Rate |
$387.16 |
| Rate for Payer: Aetna Commercial |
$351.36
|
| Rate for Payer: Aetna Medicare |
$137.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$137.38
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$239.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$260.23
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$157.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$151.12
|
| Rate for Payer: Cash Price |
$258.11
|
| Rate for Payer: Centivo All Commercial |
$212.31
|
| Rate for Payer: Cigna All Commercial |
$359.27
|
| Rate for Payer: CORVEL All Commercial |
$387.16
|
| Rate for Payer: Coventry All Commercial |
$366.35
|
| Rate for Payer: Encore All Commercial |
$383.21
|
| Rate for Payer: Frontpath All Commercial |
$383.00
|
| Rate for Payer: Humana ChoiceCare |
$359.56
|
| Rate for Payer: Humana Medicare |
$212.31
|
| Rate for Payer: Lucent All Commercial |
$212.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$374.67
|
| Rate for Payer: PHCS All Commercial |
$312.23
|
| Rate for Payer: PHP All Commercial |
$315.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$162.36
|
| Rate for Payer: Sagamore Health Network All Products |
$321.39
|
| Rate for Payer: Signature Care EPO |
$345.53
|
| Rate for Payer: Signature Care PPO |
$366.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$353.86
|
| Rate for Payer: United Healthcare Commercial |
$328.05
|
| Rate for Payer: United Healthcare Medicare |
$137.38
|
|
|
HC EVALUATE SPEECH PRODUCTION 15 MIN
|
Facility
IP
|
$449.08
|
|
|
Service Code
|
CPT 92522 GN
|
| Hospital Charge Code |
01743522
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$336.81 |
| Max. Negotiated Rate |
$417.64 |
| Rate for Payer: Aetna Commercial |
$388.00
|
| Rate for Payer: Cash Price |
$278.43
|
| Rate for Payer: Cigna All Commercial |
$387.55
|
| Rate for Payer: CORVEL All Commercial |
$417.64
|
| Rate for Payer: Coventry All Commercial |
$395.19
|
| Rate for Payer: Encore All Commercial |
$413.37
|
| Rate for Payer: Frontpath All Commercial |
$413.15
|
| Rate for Payer: Humana ChoiceCare |
$387.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$404.17
|
| Rate for Payer: PHCS All Commercial |
$336.81
|
| Rate for Payer: PHP All Commercial |
$340.58
|
| Rate for Payer: Sagamore Health Network All Products |
$346.69
|
| Rate for Payer: Signature Care EPO |
$372.73
|
| Rate for Payer: Signature Care PPO |
$395.19
|
| Rate for Payer: United Healthcare Commercial |
$353.87
|
|
|
HC EVALUATE SPEECH PRODUCTION 15 MIN
|
Facility
OP
|
$449.08
|
|
|
Service Code
|
CPT 92522 GN
|
| Hospital Charge Code |
01743522
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$148.19 |
| Max. Negotiated Rate |
$417.64 |
| Rate for Payer: Aetna Commercial |
$379.02
|
| Rate for Payer: Aetna Medicare |
$148.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$148.19
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$257.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$280.72
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$170.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$163.01
|
| Rate for Payer: Cash Price |
$278.43
|
| Rate for Payer: Centivo All Commercial |
$229.03
|
| Rate for Payer: Cigna All Commercial |
$387.55
|
| Rate for Payer: CORVEL All Commercial |
$417.64
|
| Rate for Payer: Coventry All Commercial |
$395.19
|
| Rate for Payer: Encore All Commercial |
$413.37
|
| Rate for Payer: Frontpath All Commercial |
$413.15
|
| Rate for Payer: Humana ChoiceCare |
$387.87
|
| Rate for Payer: Humana Medicare |
$229.03
|
| Rate for Payer: Lucent All Commercial |
$229.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$404.17
|
| Rate for Payer: PHCS All Commercial |
$336.81
|
| Rate for Payer: PHP All Commercial |
$340.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$175.14
|
| Rate for Payer: Sagamore Health Network All Products |
$346.69
|
| Rate for Payer: Signature Care EPO |
$372.73
|
| Rate for Payer: Signature Care PPO |
$395.19
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$381.71
|
| Rate for Payer: United Healthcare Commercial |
$353.87
|
| Rate for Payer: United Healthcare Medicare |
$148.19
|
|
|
HC EVALUATE SPEECH PRODUCTION 30 MIN
|
Facility
IP
|
$444.45
|
|
|
Service Code
|
CPT 92522 GN
|
| Hospital Charge Code |
01744522
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$333.34 |
| Max. Negotiated Rate |
$413.34 |
| Rate for Payer: Aetna Commercial |
$384.01
|
| Rate for Payer: Cash Price |
$275.56
|
| Rate for Payer: Cigna All Commercial |
$383.56
|
| Rate for Payer: CORVEL All Commercial |
$413.34
|
| Rate for Payer: Coventry All Commercial |
$391.12
|
| Rate for Payer: Encore All Commercial |
$409.12
|
| Rate for Payer: Frontpath All Commercial |
$408.90
|
| Rate for Payer: Humana ChoiceCare |
$383.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$400.01
|
| Rate for Payer: PHCS All Commercial |
$333.34
|
| Rate for Payer: PHP All Commercial |
$337.07
|
| Rate for Payer: Sagamore Health Network All Products |
$343.12
|
| Rate for Payer: Signature Care EPO |
$368.90
|
| Rate for Payer: Signature Care PPO |
$391.12
|
| Rate for Payer: United Healthcare Commercial |
$350.23
|
|
|
HC EVALUATE SPEECH PRODUCTION 30 MIN
|
Facility
OP
|
$444.45
|
|
|
Service Code
|
CPT 92522 GN
|
| Hospital Charge Code |
01744522
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$146.67 |
| Max. Negotiated Rate |
$413.34 |
| Rate for Payer: Aetna Commercial |
$375.12
|
| Rate for Payer: Aetna Medicare |
$146.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$146.67
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$255.25
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$277.83
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$168.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$161.34
|
| Rate for Payer: Cash Price |
$275.56
|
| Rate for Payer: Centivo All Commercial |
$226.67
|
| Rate for Payer: Cigna All Commercial |
$383.56
|
| Rate for Payer: CORVEL All Commercial |
$413.34
|
| Rate for Payer: Coventry All Commercial |
$391.12
|
| Rate for Payer: Encore All Commercial |
$409.12
|
| Rate for Payer: Frontpath All Commercial |
$408.90
|
| Rate for Payer: Humana ChoiceCare |
$383.88
|
| Rate for Payer: Humana Medicare |
$226.67
|
| Rate for Payer: Lucent All Commercial |
$226.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$400.01
|
| Rate for Payer: PHCS All Commercial |
$333.34
|
| Rate for Payer: PHP All Commercial |
$337.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$173.34
|
| Rate for Payer: Sagamore Health Network All Products |
$343.12
|
| Rate for Payer: Signature Care EPO |
$368.90
|
| Rate for Payer: Signature Care PPO |
$391.12
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$377.79
|
| Rate for Payer: United Healthcare Commercial |
$350.23
|
| Rate for Payer: United Healthcare Medicare |
$146.67
|
|
|
HC EVALUATE SPEECH PRODUCTION 45 MIN
|
Facility
OP
|
$449.08
|
|
|
Service Code
|
CPT 92522 GN
|
| Hospital Charge Code |
01745522
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$148.19 |
| Max. Negotiated Rate |
$417.64 |
| Rate for Payer: Aetna Commercial |
$379.02
|
| Rate for Payer: Aetna Medicare |
$148.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$148.19
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$257.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$280.72
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$170.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$163.01
|
| Rate for Payer: Cash Price |
$278.43
|
| Rate for Payer: Centivo All Commercial |
$229.03
|
| Rate for Payer: Cigna All Commercial |
$387.55
|
| Rate for Payer: CORVEL All Commercial |
$417.64
|
| Rate for Payer: Coventry All Commercial |
$395.19
|
| Rate for Payer: Encore All Commercial |
$413.37
|
| Rate for Payer: Frontpath All Commercial |
$413.15
|
| Rate for Payer: Humana ChoiceCare |
$387.87
|
| Rate for Payer: Humana Medicare |
$229.03
|
| Rate for Payer: Lucent All Commercial |
$229.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$404.17
|
| Rate for Payer: PHCS All Commercial |
$336.81
|
| Rate for Payer: PHP All Commercial |
$340.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$175.14
|
| Rate for Payer: Sagamore Health Network All Products |
$346.69
|
| Rate for Payer: Signature Care EPO |
$372.73
|
| Rate for Payer: Signature Care PPO |
$395.19
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$381.71
|
| Rate for Payer: United Healthcare Commercial |
$353.87
|
| Rate for Payer: United Healthcare Medicare |
$148.19
|
|
|
HC EVALUATE SPEECH PRODUCTION 45 MIN
|
Facility
IP
|
$449.08
|
|
|
Service Code
|
CPT 92522 GN
|
| Hospital Charge Code |
01745522
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$336.81 |
| Max. Negotiated Rate |
$417.64 |
| Rate for Payer: Aetna Commercial |
$388.00
|
| Rate for Payer: Cash Price |
$278.43
|
| Rate for Payer: Cigna All Commercial |
$387.55
|
| Rate for Payer: CORVEL All Commercial |
$417.64
|
| Rate for Payer: Coventry All Commercial |
$395.19
|
| Rate for Payer: Encore All Commercial |
$413.37
|
| Rate for Payer: Frontpath All Commercial |
$413.15
|
| Rate for Payer: Humana ChoiceCare |
$387.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$404.17
|
| Rate for Payer: PHCS All Commercial |
$336.81
|
| Rate for Payer: PHP All Commercial |
$340.58
|
| Rate for Payer: Sagamore Health Network All Products |
$346.69
|
| Rate for Payer: Signature Care EPO |
$372.73
|
| Rate for Payer: Signature Care PPO |
$395.19
|
| Rate for Payer: United Healthcare Commercial |
$353.87
|
|
|
HC EVALUATE SPEECH PRODUCTION 60 MIN
|
Facility
OP
|
$444.45
|
|
|
Service Code
|
CPT 92522 GN
|
| Hospital Charge Code |
01742522
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$146.67 |
| Max. Negotiated Rate |
$413.34 |
| Rate for Payer: Aetna Commercial |
$375.12
|
| Rate for Payer: Aetna Medicare |
$146.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$146.67
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$255.25
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$277.83
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$168.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$161.34
|
| Rate for Payer: Cash Price |
$275.56
|
| Rate for Payer: Centivo All Commercial |
$226.67
|
| Rate for Payer: Cigna All Commercial |
$383.56
|
| Rate for Payer: CORVEL All Commercial |
$413.34
|
| Rate for Payer: Coventry All Commercial |
$391.12
|
| Rate for Payer: Encore All Commercial |
$409.12
|
| Rate for Payer: Frontpath All Commercial |
$408.90
|
| Rate for Payer: Humana ChoiceCare |
$383.88
|
| Rate for Payer: Humana Medicare |
$226.67
|
| Rate for Payer: Lucent All Commercial |
$226.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$400.01
|
| Rate for Payer: PHCS All Commercial |
$333.34
|
| Rate for Payer: PHP All Commercial |
$337.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$173.34
|
| Rate for Payer: Sagamore Health Network All Products |
$343.12
|
| Rate for Payer: Signature Care EPO |
$368.90
|
| Rate for Payer: Signature Care PPO |
$391.12
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$377.79
|
| Rate for Payer: United Healthcare Commercial |
$350.23
|
| Rate for Payer: United Healthcare Medicare |
$146.67
|
|
|
HC EVALUATE SPEECH PRODUCTION 60 MIN
|
Facility
IP
|
$444.45
|
|
|
Service Code
|
CPT 92522 GN
|
| Hospital Charge Code |
01742522
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$333.34 |
| Max. Negotiated Rate |
$413.34 |
| Rate for Payer: Aetna Commercial |
$384.01
|
| Rate for Payer: Cash Price |
$275.56
|
| Rate for Payer: Cigna All Commercial |
$383.56
|
| Rate for Payer: CORVEL All Commercial |
$413.34
|
| Rate for Payer: Coventry All Commercial |
$391.12
|
| Rate for Payer: Encore All Commercial |
$409.12
|
| Rate for Payer: Frontpath All Commercial |
$408.90
|
| Rate for Payer: Humana ChoiceCare |
$383.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$400.01
|
| Rate for Payer: PHCS All Commercial |
$333.34
|
| Rate for Payer: PHP All Commercial |
$337.07
|
| Rate for Payer: Sagamore Health Network All Products |
$343.12
|
| Rate for Payer: Signature Care EPO |
$368.90
|
| Rate for Payer: Signature Care PPO |
$391.12
|
| Rate for Payer: United Healthcare Commercial |
$350.23
|
|
|
HC EVALUATE SPEECH PRODUCTION - SP
|
Facility
IP
|
$449.08
|
|
|
Service Code
|
CPT 92522 GN
|
| Hospital Charge Code |
01749072
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$336.81 |
| Max. Negotiated Rate |
$417.64 |
| Rate for Payer: Aetna Commercial |
$388.00
|
| Rate for Payer: Cash Price |
$278.43
|
| Rate for Payer: Cigna All Commercial |
$387.55
|
| Rate for Payer: CORVEL All Commercial |
$417.64
|
| Rate for Payer: Coventry All Commercial |
$395.19
|
| Rate for Payer: Encore All Commercial |
$413.37
|
| Rate for Payer: Frontpath All Commercial |
$413.15
|
| Rate for Payer: Humana ChoiceCare |
$387.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$404.17
|
| Rate for Payer: PHCS All Commercial |
$336.81
|
| Rate for Payer: PHP All Commercial |
$340.58
|
| Rate for Payer: Sagamore Health Network All Products |
$346.69
|
| Rate for Payer: Signature Care EPO |
$372.73
|
| Rate for Payer: Signature Care PPO |
$395.19
|
| Rate for Payer: United Healthcare Commercial |
$353.87
|
|
|
HC EVALUATE SPEECH PRODUCTION - SP
|
Facility
OP
|
$449.08
|
|
|
Service Code
|
CPT 92522 GN
|
| Hospital Charge Code |
01749072
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$148.19 |
| Max. Negotiated Rate |
$417.64 |
| Rate for Payer: Aetna Commercial |
$379.02
|
| Rate for Payer: Aetna Medicare |
$148.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$148.19
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$257.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$280.72
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$170.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$163.01
|
| Rate for Payer: Cash Price |
$278.43
|
| Rate for Payer: Centivo All Commercial |
$229.03
|
| Rate for Payer: Cigna All Commercial |
$387.55
|
| Rate for Payer: CORVEL All Commercial |
$417.64
|
| Rate for Payer: Coventry All Commercial |
$395.19
|
| Rate for Payer: Encore All Commercial |
$413.37
|
| Rate for Payer: Frontpath All Commercial |
$413.15
|
| Rate for Payer: Humana ChoiceCare |
$387.87
|
| Rate for Payer: Humana Medicare |
$229.03
|
| Rate for Payer: Lucent All Commercial |
$229.03
|
| Rate for Payer: Lutheran Preferred All Commercial |
$404.17
|
| Rate for Payer: PHCS All Commercial |
$336.81
|
| Rate for Payer: PHP All Commercial |
$340.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$175.14
|
| Rate for Payer: Sagamore Health Network All Products |
$346.69
|
| Rate for Payer: Signature Care EPO |
$372.73
|
| Rate for Payer: Signature Care PPO |
$395.19
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$381.71
|
| Rate for Payer: United Healthcare Commercial |
$353.87
|
| Rate for Payer: United Healthcare Medicare |
$148.19
|
|
|
HC EVALUATION OF SPEECH FLUENCY 15 MIN
|
Facility
OP
|
$462.23
|
|
|
Service Code
|
CPT 92521 GN
|
| Hospital Charge Code |
01743521
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$152.54 |
| Max. Negotiated Rate |
$429.88 |
| Rate for Payer: Aetna Commercial |
$390.12
|
| Rate for Payer: Aetna Medicare |
$152.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$152.54
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$265.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$288.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$175.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$167.79
|
| Rate for Payer: Cash Price |
$286.59
|
| Rate for Payer: Centivo All Commercial |
$235.74
|
| Rate for Payer: Cigna All Commercial |
$398.91
|
| Rate for Payer: CORVEL All Commercial |
$429.88
|
| Rate for Payer: Coventry All Commercial |
$406.77
|
| Rate for Payer: Encore All Commercial |
$425.49
|
| Rate for Payer: Frontpath All Commercial |
$425.25
|
| Rate for Payer: Humana ChoiceCare |
$399.23
|
| Rate for Payer: Humana Medicare |
$235.74
|
| Rate for Payer: Lucent All Commercial |
$235.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$416.01
|
| Rate for Payer: PHCS All Commercial |
$346.68
|
| Rate for Payer: PHP All Commercial |
$350.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$180.27
|
| Rate for Payer: Sagamore Health Network All Products |
$356.84
|
| Rate for Payer: Signature Care EPO |
$383.65
|
| Rate for Payer: Signature Care PPO |
$406.77
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$392.90
|
| Rate for Payer: United Healthcare Commercial |
$364.24
|
| Rate for Payer: United Healthcare Medicare |
$152.54
|
|
|
HC EVALUATION OF SPEECH FLUENCY 15 MIN
|
Facility
IP
|
$462.23
|
|
|
Service Code
|
CPT 92521 GN
|
| Hospital Charge Code |
01743521
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$346.68 |
| Max. Negotiated Rate |
$429.88 |
| Rate for Payer: Aetna Commercial |
$399.37
|
| Rate for Payer: Cash Price |
$286.59
|
| Rate for Payer: Cigna All Commercial |
$398.91
|
| Rate for Payer: CORVEL All Commercial |
$429.88
|
| Rate for Payer: Coventry All Commercial |
$406.77
|
| Rate for Payer: Encore All Commercial |
$425.49
|
| Rate for Payer: Frontpath All Commercial |
$425.25
|
| Rate for Payer: Humana ChoiceCare |
$399.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$416.01
|
| Rate for Payer: PHCS All Commercial |
$346.68
|
| Rate for Payer: PHP All Commercial |
$350.56
|
| Rate for Payer: Sagamore Health Network All Products |
$356.84
|
| Rate for Payer: Signature Care EPO |
$383.65
|
| Rate for Payer: Signature Care PPO |
$406.77
|
| Rate for Payer: United Healthcare Commercial |
$364.24
|
|
|
HC EVALUATION OF SPEECH FLUENCY 30 MIN
|
Facility
OP
|
$462.23
|
|
|
Service Code
|
CPT 92521 GN
|
| Hospital Charge Code |
01744521
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$152.54 |
| Max. Negotiated Rate |
$429.88 |
| Rate for Payer: Aetna Commercial |
$390.12
|
| Rate for Payer: Aetna Medicare |
$152.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$152.54
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$265.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$288.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$175.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$167.79
|
| Rate for Payer: Cash Price |
$286.59
|
| Rate for Payer: Centivo All Commercial |
$235.74
|
| Rate for Payer: Cigna All Commercial |
$398.91
|
| Rate for Payer: CORVEL All Commercial |
$429.88
|
| Rate for Payer: Coventry All Commercial |
$406.77
|
| Rate for Payer: Encore All Commercial |
$425.49
|
| Rate for Payer: Frontpath All Commercial |
$425.25
|
| Rate for Payer: Humana ChoiceCare |
$399.23
|
| Rate for Payer: Humana Medicare |
$235.74
|
| Rate for Payer: Lucent All Commercial |
$235.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$416.01
|
| Rate for Payer: PHCS All Commercial |
$346.68
|
| Rate for Payer: PHP All Commercial |
$350.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$180.27
|
| Rate for Payer: Sagamore Health Network All Products |
$356.84
|
| Rate for Payer: Signature Care EPO |
$383.65
|
| Rate for Payer: Signature Care PPO |
$406.77
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$392.90
|
| Rate for Payer: United Healthcare Commercial |
$364.24
|
| Rate for Payer: United Healthcare Medicare |
$152.54
|
|
|
HC EVALUATION OF SPEECH FLUENCY 30 MIN
|
Facility
IP
|
$462.23
|
|
|
Service Code
|
CPT 92521 GN
|
| Hospital Charge Code |
01744521
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$346.68 |
| Max. Negotiated Rate |
$429.88 |
| Rate for Payer: Aetna Commercial |
$399.37
|
| Rate for Payer: Cash Price |
$286.59
|
| Rate for Payer: Cigna All Commercial |
$398.91
|
| Rate for Payer: CORVEL All Commercial |
$429.88
|
| Rate for Payer: Coventry All Commercial |
$406.77
|
| Rate for Payer: Encore All Commercial |
$425.49
|
| Rate for Payer: Frontpath All Commercial |
$425.25
|
| Rate for Payer: Humana ChoiceCare |
$399.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$416.01
|
| Rate for Payer: PHCS All Commercial |
$346.68
|
| Rate for Payer: PHP All Commercial |
$350.56
|
| Rate for Payer: Sagamore Health Network All Products |
$356.84
|
| Rate for Payer: Signature Care EPO |
$383.65
|
| Rate for Payer: Signature Care PPO |
$406.77
|
| Rate for Payer: United Healthcare Commercial |
$364.24
|
|
|
HC EVALUATION OF SPEECH FLUENCY 45 MIN
|
Facility
OP
|
$462.23
|
|
|
Service Code
|
CPT 92521 GN
|
| Hospital Charge Code |
01745521
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$152.54 |
| Max. Negotiated Rate |
$429.88 |
| Rate for Payer: Aetna Commercial |
$390.12
|
| Rate for Payer: Aetna Medicare |
$152.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$152.54
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$265.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$288.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$175.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$167.79
|
| Rate for Payer: Cash Price |
$286.59
|
| Rate for Payer: Centivo All Commercial |
$235.74
|
| Rate for Payer: Cigna All Commercial |
$398.91
|
| Rate for Payer: CORVEL All Commercial |
$429.88
|
| Rate for Payer: Coventry All Commercial |
$406.77
|
| Rate for Payer: Encore All Commercial |
$425.49
|
| Rate for Payer: Frontpath All Commercial |
$425.25
|
| Rate for Payer: Humana ChoiceCare |
$399.23
|
| Rate for Payer: Humana Medicare |
$235.74
|
| Rate for Payer: Lucent All Commercial |
$235.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$416.01
|
| Rate for Payer: PHCS All Commercial |
$346.68
|
| Rate for Payer: PHP All Commercial |
$350.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$180.27
|
| Rate for Payer: Sagamore Health Network All Products |
$356.84
|
| Rate for Payer: Signature Care EPO |
$383.65
|
| Rate for Payer: Signature Care PPO |
$406.77
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$392.90
|
| Rate for Payer: United Healthcare Commercial |
$364.24
|
| Rate for Payer: United Healthcare Medicare |
$152.54
|
|
|
HC EVALUATION OF SPEECH FLUENCY 45 MIN
|
Facility
IP
|
$462.23
|
|
|
Service Code
|
CPT 92521 GN
|
| Hospital Charge Code |
01745521
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$346.68 |
| Max. Negotiated Rate |
$429.88 |
| Rate for Payer: Aetna Commercial |
$399.37
|
| Rate for Payer: Cash Price |
$286.59
|
| Rate for Payer: Cigna All Commercial |
$398.91
|
| Rate for Payer: CORVEL All Commercial |
$429.88
|
| Rate for Payer: Coventry All Commercial |
$406.77
|
| Rate for Payer: Encore All Commercial |
$425.49
|
| Rate for Payer: Frontpath All Commercial |
$425.25
|
| Rate for Payer: Humana ChoiceCare |
$399.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$416.01
|
| Rate for Payer: PHCS All Commercial |
$346.68
|
| Rate for Payer: PHP All Commercial |
$350.56
|
| Rate for Payer: Sagamore Health Network All Products |
$356.84
|
| Rate for Payer: Signature Care EPO |
$383.65
|
| Rate for Payer: Signature Care PPO |
$406.77
|
| Rate for Payer: United Healthcare Commercial |
$364.24
|
|
