|
HC GCATH 9F ACU PRO 45CM CSEH
|
Facility
OP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607318
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,566.68
|
| Rate for Payer: Aetna Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,066.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,160.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$704.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$673.82
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Centivo All Commercial |
$946.69
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Humana Medicare |
$946.69
|
| Rate for Payer: Lucent All Commercial |
$946.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$723.94
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,577.81
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
| Rate for Payer: United Healthcare Medicare |
$612.56
|
|
|
HC GCATH 9F ACU PRO 45CM CSEH R
|
Facility
OP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607322
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,566.68
|
| Rate for Payer: Aetna Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,066.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,160.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$704.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$673.82
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Centivo All Commercial |
$946.69
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Humana Medicare |
$946.69
|
| Rate for Payer: Lucent All Commercial |
$946.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$723.94
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,577.81
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
| Rate for Payer: United Healthcare Medicare |
$612.56
|
|
|
HC GCATH 9F ACU PRO 45CM CSEH R
|
Facility
IP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607322
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,392.19 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,603.80
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
|
|
HC GCATH 9F ACU PRO 45CM CSEH STR
|
Facility
OP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607320
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,566.68
|
| Rate for Payer: Aetna Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,066.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,160.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$704.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$673.82
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Centivo All Commercial |
$946.69
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Humana Medicare |
$946.69
|
| Rate for Payer: Lucent All Commercial |
$946.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$723.94
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,577.81
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
| Rate for Payer: United Healthcare Medicare |
$612.56
|
|
|
HC GCATH 9F ACU PRO 45CM CSEH STR
|
Facility
IP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607320
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,392.19 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,603.80
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
|
|
HC GCATH 9F ACU PRO 45CM CSH
|
Facility
OP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607328
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,566.68
|
| Rate for Payer: Aetna Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,066.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,160.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$704.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$673.82
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Centivo All Commercial |
$946.69
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Humana Medicare |
$946.69
|
| Rate for Payer: Lucent All Commercial |
$946.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$723.94
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,577.81
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
| Rate for Payer: United Healthcare Medicare |
$612.56
|
|
|
HC GCATH 9F ACU PRO 45CM CSH
|
Facility
IP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607328
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,392.19 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,603.80
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
|
|
HC GCATH 9F ACU PRO 45CM CSMP
|
Facility
OP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607326
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,566.68
|
| Rate for Payer: Aetna Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,066.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,160.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$704.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$673.82
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Centivo All Commercial |
$946.69
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Humana Medicare |
$946.69
|
| Rate for Payer: Lucent All Commercial |
$946.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$723.94
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,577.81
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
| Rate for Payer: United Healthcare Medicare |
$612.56
|
|
|
HC GCATH 9F ACU PRO 45CM CSMP
|
Facility
IP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607326
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,392.19 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,603.80
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
|
|
HC GCATH 9F ACU PRO 45CM CSST
|
Facility
IP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607332
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,392.19 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,603.80
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
|
|
HC GCATH 9F ACU PRO 45CM CSST
|
Facility
OP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607332
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,566.68
|
| Rate for Payer: Aetna Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,066.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,160.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$704.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$673.82
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Centivo All Commercial |
$946.69
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Humana Medicare |
$946.69
|
| Rate for Payer: Lucent All Commercial |
$946.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$723.94
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,577.81
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
| Rate for Payer: United Healthcare Medicare |
$612.56
|
|
|
HC GCATH 9F ACU PRO 45CM CSW
|
Facility
IP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,392.19 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,603.80
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
|
|
HC GCATH 9F ACU PRO 45CM CSW
|
Facility
OP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,566.68
|
| Rate for Payer: Aetna Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,066.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,160.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$704.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$673.82
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Centivo All Commercial |
$946.69
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Humana Medicare |
$946.69
|
| Rate for Payer: Lucent All Commercial |
$946.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$723.94
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,577.81
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
| Rate for Payer: United Healthcare Medicare |
$612.56
|
|
|
HC GCATH 9F ACU PRO 54CM CSA6
|
Facility
IP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607329
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,392.19 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,603.80
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
|
|
HC GCATH 9F ACU PRO 54CM CSA6
|
Facility
OP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607329
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,566.68
|
| Rate for Payer: Aetna Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,066.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,160.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$704.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$673.82
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Centivo All Commercial |
$946.69
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Humana Medicare |
$946.69
|
| Rate for Payer: Lucent All Commercial |
$946.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$723.94
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,577.81
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
| Rate for Payer: United Healthcare Medicare |
$612.56
|
|
|
HC GCATH 9F ACU PRO 54CM CSEH
|
Facility
IP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607317
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,392.19 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,603.80
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
|
|
HC GCATH 9F ACU PRO 54CM CSEH
|
Facility
OP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607317
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,566.68
|
| Rate for Payer: Aetna Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,066.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,160.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$704.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$673.82
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Centivo All Commercial |
$946.69
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Humana Medicare |
$946.69
|
| Rate for Payer: Lucent All Commercial |
$946.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$723.94
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,577.81
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
| Rate for Payer: United Healthcare Medicare |
$612.56
|
|
|
HC GCATH 9F ACU PRO 54CM CSEH R
|
Facility
OP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607321
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,566.68
|
| Rate for Payer: Aetna Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,066.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,160.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$704.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$673.82
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Centivo All Commercial |
$946.69
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Humana Medicare |
$946.69
|
| Rate for Payer: Lucent All Commercial |
$946.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$723.94
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,577.81
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
| Rate for Payer: United Healthcare Medicare |
$612.56
|
|
|
HC GCATH 9F ACU PRO 54CM CSEH R
|
Facility
IP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607321
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,392.19 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,603.80
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
|
|
HC GCATH 9F ACU PRO 54CM CSEH STR
|
Facility
OP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607319
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,566.68
|
| Rate for Payer: Aetna Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,066.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,160.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$704.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$673.82
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Centivo All Commercial |
$946.69
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Humana Medicare |
$946.69
|
| Rate for Payer: Lucent All Commercial |
$946.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$723.94
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,577.81
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
| Rate for Payer: United Healthcare Medicare |
$612.56
|
|
|
HC GCATH 9F ACU PRO 54CM CSEH STR
|
Facility
IP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607319
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,392.19 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,603.80
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
|
|
HC GCATH 9F ACU PRO 54CM CSH
|
Facility
IP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607327
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,392.19 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,603.80
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
|
|
HC GCATH 9F ACU PRO 54CM CSH
|
Facility
OP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607327
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,566.68
|
| Rate for Payer: Aetna Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,066.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,160.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$704.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$673.82
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Centivo All Commercial |
$946.69
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Humana Medicare |
$946.69
|
| Rate for Payer: Lucent All Commercial |
$946.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$723.94
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,577.81
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
| Rate for Payer: United Healthcare Medicare |
$612.56
|
|
|
HC GCATH 9F ACU PRO 54CM CSMP
|
Facility
IP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607325
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,392.19 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,603.80
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
|
|
HC GCATH 9F ACU PRO 54CM CSMP
|
Facility
OP
|
$1,856.25
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
41607325
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,726.31 |
| Rate for Payer: Aetna Commercial |
$1,566.68
|
| Rate for Payer: Aetna Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$612.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,066.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,160.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$704.45
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$673.82
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Cash Price |
$1,150.88
|
| Rate for Payer: Centivo All Commercial |
$946.69
|
| Rate for Payer: Cigna All Commercial |
$1,601.94
|
| Rate for Payer: CORVEL All Commercial |
$1,726.31
|
| Rate for Payer: Coventry All Commercial |
$1,633.50
|
| Rate for Payer: Encore All Commercial |
$1,708.68
|
| Rate for Payer: Frontpath All Commercial |
$1,707.75
|
| Rate for Payer: Humana ChoiceCare |
$1,603.24
|
| Rate for Payer: Humana Medicare |
$946.69
|
| Rate for Payer: Lucent All Commercial |
$946.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,670.62
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,392.19
|
| Rate for Payer: PHP All Commercial |
$1,407.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$723.94
|
| Rate for Payer: Sagamore Health Network All Products |
$1,433.02
|
| Rate for Payer: Signature Care EPO |
$1,540.69
|
| Rate for Payer: Signature Care PPO |
$1,633.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,577.81
|
| Rate for Payer: United Healthcare Commercial |
$1,462.72
|
| Rate for Payer: United Healthcare Medicare |
$612.56
|
|
