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Service Code CPT 82952
Hospital Charge Code 63001139
Hospital Revenue Code 300
Min. Negotiated Rate $3.92
Max. Negotiated Rate $32.87
Rate for Payer: Aetna Commercial $29.83
Rate for Payer: Aetna Medicare $11.66
Rate for Payer: Anthem Blue Cross of IN Medicare $11.66
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $16.24
Rate for Payer: Anthem Blue Cross of IN Traditional $16.24
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $3.92
Rate for Payer: CareSource Indiana of IN Just 4 Me $13.41
Rate for Payer: CareSource Indiana of IN Medicare $12.83
Rate for Payer: Cash Price $21.91
Rate for Payer: Cash Price $21.91
Rate for Payer: Centivo All Commercial $18.02
Rate for Payer: Cigna All Commercial $30.50
Rate for Payer: CORVEL All Commercial $32.87
Rate for Payer: Coventry All Commercial $31.10
Rate for Payer: Encore All Commercial $32.53
Rate for Payer: Frontpath All Commercial $32.52
Rate for Payer: Humana ChoiceCare $30.53
Rate for Payer: Humana Medicare $18.02
Rate for Payer: Lucent All Commercial $18.02
Rate for Payer: Lutheran Preferred All Commercial $31.81
Rate for Payer: Managed Health Services Medicaid $3.92
Rate for Payer: MDWise Medicaid $3.92
Rate for Payer: PHCS All Commercial $26.51
Rate for Payer: PHP All Commercial $26.80
Rate for Payer: Plain Church Group Ministry All Commercial $13.78
Rate for Payer: Sagamore Health Network All Products $27.28
Rate for Payer: Signature Care EPO $29.33
Rate for Payer: Signature Care PPO $31.10
Rate for Payer: Three Rivers Preferred All Commercial $30.04
Rate for Payer: United Healthcare Commercial $27.85
Rate for Payer: United Healthcare Medicare $11.66
Service Code CPT 82945
Hospital Charge Code 63001551
Hospital Revenue Code 300
Min. Negotiated Rate $58.41
Max. Negotiated Rate $72.43
Rate for Payer: Aetna Commercial $67.29
Rate for Payer: Cash Price $48.28
Rate for Payer: Cigna All Commercial $67.21
Rate for Payer: CORVEL All Commercial $72.43
Rate for Payer: Coventry All Commercial $68.53
Rate for Payer: Encore All Commercial $71.69
Rate for Payer: Frontpath All Commercial $71.65
Rate for Payer: Humana ChoiceCare $67.26
Rate for Payer: Lutheran Preferred All Commercial $70.09
Rate for Payer: PHCS All Commercial $58.41
Rate for Payer: PHP All Commercial $59.06
Rate for Payer: Sagamore Health Network All Products $60.12
Rate for Payer: Signature Care EPO $64.64
Rate for Payer: Signature Care PPO $68.53
Rate for Payer: United Healthcare Commercial $61.37
Service Code CPT 82945
Hospital Charge Code 63001551
Hospital Revenue Code 300
Min. Negotiated Rate $3.93
Max. Negotiated Rate $72.43
Rate for Payer: Aetna Commercial $65.73
Rate for Payer: Aetna Medicare $25.70
Rate for Payer: Anthem Blue Cross of IN Medicare $25.70
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $44.72
Rate for Payer: Anthem Blue Cross of IN Traditional $48.68
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $3.93
Rate for Payer: CareSource Indiana of IN Just 4 Me $29.55
Rate for Payer: CareSource Indiana of IN Medicare $28.27
Rate for Payer: Cash Price $48.28
Rate for Payer: Cash Price $48.28
Rate for Payer: Centivo All Commercial $39.72
Rate for Payer: Cigna All Commercial $67.21
Rate for Payer: CORVEL All Commercial $72.43
Rate for Payer: Coventry All Commercial $68.53
Rate for Payer: Encore All Commercial $71.69
Rate for Payer: Frontpath All Commercial $71.65
Rate for Payer: Humana ChoiceCare $67.26
Rate for Payer: Humana Medicare $39.72
Rate for Payer: Lucent All Commercial $39.72
Rate for Payer: Lutheran Preferred All Commercial $70.09
Rate for Payer: Managed Health Services Medicaid $3.93
Rate for Payer: MDWise Medicaid $3.93
Rate for Payer: PHCS All Commercial $58.41
Rate for Payer: PHP All Commercial $59.06
Rate for Payer: Plain Church Group Ministry All Commercial $30.37
Rate for Payer: Sagamore Health Network All Products $60.12
Rate for Payer: Signature Care EPO $64.64
Rate for Payer: Signature Care PPO $68.53
Rate for Payer: Three Rivers Preferred All Commercial $66.20
Rate for Payer: United Healthcare Commercial $61.37
Rate for Payer: United Healthcare Medicare $25.70
Service Code CPT 83520
Hospital Charge Code 63001600
Hospital Revenue Code 300
Min. Negotiated Rate $158.75
Max. Negotiated Rate $196.85
Rate for Payer: Aetna Commercial $182.88
Rate for Payer: Cash Price $131.24
Rate for Payer: Cigna All Commercial $182.67
Rate for Payer: CORVEL All Commercial $196.85
Rate for Payer: Coventry All Commercial $186.27
Rate for Payer: Encore All Commercial $194.84
Rate for Payer: Frontpath All Commercial $194.74
Rate for Payer: Humana ChoiceCare $182.82
Rate for Payer: Lutheran Preferred All Commercial $190.50
Rate for Payer: PHCS All Commercial $158.75
Rate for Payer: PHP All Commercial $160.53
Rate for Payer: Sagamore Health Network All Products $163.41
Rate for Payer: Signature Care EPO $175.69
Rate for Payer: Signature Care PPO $186.27
Rate for Payer: United Healthcare Commercial $166.80
Service Code CPT 83520
Hospital Charge Code 63001600
Hospital Revenue Code 300
Min. Negotiated Rate $17.27
Max. Negotiated Rate $196.85
Rate for Payer: Aetna Commercial $178.65
Rate for Payer: Aetna Medicare $69.85
Rate for Payer: Anthem Blue Cross of IN Medicare $69.85
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $121.56
Rate for Payer: Anthem Blue Cross of IN Traditional $132.32
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $17.27
Rate for Payer: CareSource Indiana of IN Just 4 Me $80.33
Rate for Payer: CareSource Indiana of IN Medicare $76.84
Rate for Payer: Cash Price $131.24
Rate for Payer: Cash Price $131.24
Rate for Payer: Centivo All Commercial $107.95
Rate for Payer: Cigna All Commercial $182.67
Rate for Payer: CORVEL All Commercial $196.85
Rate for Payer: Coventry All Commercial $186.27
Rate for Payer: Encore All Commercial $194.84
Rate for Payer: Frontpath All Commercial $194.74
Rate for Payer: Humana ChoiceCare $182.82
Rate for Payer: Humana Medicare $107.95
Rate for Payer: Lucent All Commercial $107.95
Rate for Payer: Lutheran Preferred All Commercial $190.50
Rate for Payer: Managed Health Services Medicaid $17.27
Rate for Payer: MDWise Medicaid $17.27
Rate for Payer: PHCS All Commercial $158.75
Rate for Payer: PHP All Commercial $160.53
Rate for Payer: Plain Church Group Ministry All Commercial $82.55
Rate for Payer: Sagamore Health Network All Products $163.41
Rate for Payer: Signature Care EPO $175.69
Rate for Payer: Signature Care PPO $186.27
Rate for Payer: Three Rivers Preferred All Commercial $179.92
Rate for Payer: United Healthcare Commercial $166.80
Rate for Payer: United Healthcare Medicare $69.85
Service Code CPT 83036
Hospital Charge Code 63001186
Hospital Revenue Code 300
Min. Negotiated Rate $9.71
Max. Negotiated Rate $90.94
Rate for Payer: Aetna Commercial $82.53
Rate for Payer: Aetna Medicare $32.27
Rate for Payer: Anthem Blue Cross of IN Medicare $32.27
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $44.94
Rate for Payer: Anthem Blue Cross of IN Traditional $44.94
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $9.71
Rate for Payer: CareSource Indiana of IN Just 4 Me $37.11
Rate for Payer: CareSource Indiana of IN Medicare $35.50
Rate for Payer: Cash Price $60.63
Rate for Payer: Cash Price $60.63
Rate for Payer: Centivo All Commercial $49.87
Rate for Payer: Cigna All Commercial $84.39
Rate for Payer: CORVEL All Commercial $90.94
Rate for Payer: Coventry All Commercial $86.05
Rate for Payer: Encore All Commercial $90.01
Rate for Payer: Frontpath All Commercial $89.96
Rate for Payer: Humana ChoiceCare $84.46
Rate for Payer: Humana Medicare $49.87
Rate for Payer: Lucent All Commercial $49.87
Rate for Payer: Lutheran Preferred All Commercial $88.01
Rate for Payer: Managed Health Services Medicaid $9.71
Rate for Payer: MDWise Medicaid $9.71
Rate for Payer: PHCS All Commercial $73.34
Rate for Payer: PHP All Commercial $74.16
Rate for Payer: Plain Church Group Ministry All Commercial $38.14
Rate for Payer: Sagamore Health Network All Products $75.49
Rate for Payer: Signature Care EPO $81.16
Rate for Payer: Signature Care PPO $86.05
Rate for Payer: Three Rivers Preferred All Commercial $83.12
Rate for Payer: United Healthcare Commercial $77.06
Rate for Payer: United Healthcare Medicare $32.27
Service Code CPT 83036
Hospital Charge Code 63001186
Hospital Revenue Code 300
Min. Negotiated Rate $73.34
Max. Negotiated Rate $90.94
Rate for Payer: Aetna Commercial $84.49
Rate for Payer: Cash Price $60.63
Rate for Payer: Cigna All Commercial $84.39
Rate for Payer: CORVEL All Commercial $90.94
Rate for Payer: Coventry All Commercial $86.05
Rate for Payer: Encore All Commercial $90.01
Rate for Payer: Frontpath All Commercial $89.96
Rate for Payer: Humana ChoiceCare $84.46
Rate for Payer: Lutheran Preferred All Commercial $88.01
Rate for Payer: PHCS All Commercial $73.34
Rate for Payer: PHP All Commercial $74.16
Rate for Payer: Sagamore Health Network All Products $75.49
Rate for Payer: Signature Care EPO $81.16
Rate for Payer: Signature Care PPO $86.05
Rate for Payer: United Healthcare Commercial $77.06
Service Code CPT 83516
Hospital Charge Code 63044045
Hospital Revenue Code 300
Min. Negotiated Rate $11.53
Max. Negotiated Rate $60.47
Rate for Payer: Aetna Commercial $54.88
Rate for Payer: Aetna Medicare $21.46
Rate for Payer: Anthem Blue Cross of IN Medicare $21.46
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $29.89
Rate for Payer: Anthem Blue Cross of IN Traditional $29.89
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $11.53
Rate for Payer: CareSource Indiana of IN Just 4 Me $24.68
Rate for Payer: CareSource Indiana of IN Medicare $23.60
Rate for Payer: Cash Price $40.32
Rate for Payer: Cash Price $40.32
Rate for Payer: Centivo All Commercial $33.16
Rate for Payer: Cigna All Commercial $56.12
Rate for Payer: CORVEL All Commercial $60.47
Rate for Payer: Coventry All Commercial $57.22
Rate for Payer: Encore All Commercial $59.86
Rate for Payer: Frontpath All Commercial $59.82
Rate for Payer: Humana ChoiceCare $56.16
Rate for Payer: Humana Medicare $33.16
Rate for Payer: Lucent All Commercial $33.16
Rate for Payer: Lutheran Preferred All Commercial $58.52
Rate for Payer: Managed Health Services Medicaid $11.53
Rate for Payer: MDWise Medicaid $11.53
Rate for Payer: PHCS All Commercial $48.77
Rate for Payer: PHP All Commercial $49.31
Rate for Payer: Plain Church Group Ministry All Commercial $25.36
Rate for Payer: Sagamore Health Network All Products $50.20
Rate for Payer: Signature Care EPO $53.97
Rate for Payer: Signature Care PPO $57.22
Rate for Payer: Three Rivers Preferred All Commercial $55.27
Rate for Payer: United Healthcare Commercial $51.24
Rate for Payer: United Healthcare Medicare $21.46
Service Code CPT 83516
Hospital Charge Code 63044045
Hospital Revenue Code 300
Min. Negotiated Rate $48.77
Max. Negotiated Rate $60.47
Rate for Payer: Aetna Commercial $56.18
Rate for Payer: Cash Price $40.32
Rate for Payer: Cigna All Commercial $56.12
Rate for Payer: CORVEL All Commercial $60.47
Rate for Payer: Coventry All Commercial $57.22
Rate for Payer: Encore All Commercial $59.86
Rate for Payer: Frontpath All Commercial $59.82
Rate for Payer: Humana ChoiceCare $56.16
Rate for Payer: Lutheran Preferred All Commercial $58.52
Rate for Payer: PHCS All Commercial $48.77
Rate for Payer: PHP All Commercial $49.31
Rate for Payer: Sagamore Health Network All Products $50.20
Rate for Payer: Signature Care EPO $53.97
Rate for Payer: Signature Care PPO $57.22
Rate for Payer: United Healthcare Commercial $51.24
Service Code CPT 83516
Hospital Charge Code 63044046
Hospital Revenue Code 300
Min. Negotiated Rate $11.53
Max. Negotiated Rate $60.47
Rate for Payer: Aetna Commercial $54.88
Rate for Payer: Aetna Medicare $21.46
Rate for Payer: Anthem Blue Cross of IN Medicare $21.46
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $29.89
Rate for Payer: Anthem Blue Cross of IN Traditional $29.89
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $11.53
Rate for Payer: CareSource Indiana of IN Just 4 Me $24.68
Rate for Payer: CareSource Indiana of IN Medicare $23.60
Rate for Payer: Cash Price $40.32
Rate for Payer: Cash Price $40.32
Rate for Payer: Centivo All Commercial $33.16
Rate for Payer: Cigna All Commercial $56.12
Rate for Payer: CORVEL All Commercial $60.47
Rate for Payer: Coventry All Commercial $57.22
Rate for Payer: Encore All Commercial $59.86
Rate for Payer: Frontpath All Commercial $59.82
Rate for Payer: Humana ChoiceCare $56.16
Rate for Payer: Humana Medicare $33.16
Rate for Payer: Lucent All Commercial $33.16
Rate for Payer: Lutheran Preferred All Commercial $58.52
Rate for Payer: Managed Health Services Medicaid $11.53
Rate for Payer: MDWise Medicaid $11.53
Rate for Payer: PHCS All Commercial $48.77
Rate for Payer: PHP All Commercial $49.31
Rate for Payer: Plain Church Group Ministry All Commercial $25.36
Rate for Payer: Sagamore Health Network All Products $50.20
Rate for Payer: Signature Care EPO $53.97
Rate for Payer: Signature Care PPO $57.22
Rate for Payer: Three Rivers Preferred All Commercial $55.27
Rate for Payer: United Healthcare Commercial $51.24
Rate for Payer: United Healthcare Medicare $21.46
Service Code CPT 83516
Hospital Charge Code 63044046
Hospital Revenue Code 300
Min. Negotiated Rate $48.77
Max. Negotiated Rate $60.47
Rate for Payer: Aetna Commercial $56.18
Rate for Payer: Cash Price $40.32
Rate for Payer: Cigna All Commercial $56.12
Rate for Payer: CORVEL All Commercial $60.47
Rate for Payer: Coventry All Commercial $57.22
Rate for Payer: Encore All Commercial $59.86
Rate for Payer: Frontpath All Commercial $59.82
Rate for Payer: Humana ChoiceCare $56.16
Rate for Payer: Lutheran Preferred All Commercial $58.52
Rate for Payer: PHCS All Commercial $48.77
Rate for Payer: PHP All Commercial $49.31
Rate for Payer: Sagamore Health Network All Products $50.20
Rate for Payer: Signature Care EPO $53.97
Rate for Payer: Signature Care PPO $57.22
Rate for Payer: United Healthcare Commercial $51.24
Hospital Charge Code 41601061
Hospital Revenue Code 270
Min. Negotiated Rate $31.29
Max. Negotiated Rate $96.84
Rate for Payer: Aetna Commercial $80.02
Rate for Payer: Aetna Medicare $31.29
Rate for Payer: Anthem Blue Cross of IN Medicare $31.29
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $54.45
Rate for Payer: Anthem Blue Cross of IN Traditional $59.27
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $96.84
Rate for Payer: CareSource Indiana of IN Just 4 Me $35.98
Rate for Payer: CareSource Indiana of IN Medicare $34.42
Rate for Payer: Cash Price $58.78
Rate for Payer: Cash Price $58.78
Rate for Payer: Centivo All Commercial $48.35
Rate for Payer: Cigna All Commercial $81.82
Rate for Payer: CORVEL All Commercial $88.17
Rate for Payer: Coventry All Commercial $83.43
Rate for Payer: Encore All Commercial $87.27
Rate for Payer: Frontpath All Commercial $87.23
Rate for Payer: Humana ChoiceCare $81.89
Rate for Payer: Humana Medicare $48.35
Rate for Payer: Lucent All Commercial $48.35
Rate for Payer: Lutheran Preferred All Commercial $85.33
Rate for Payer: Managed Health Services Medicaid $96.84
Rate for Payer: MDWise Medicaid $96.84
Rate for Payer: PHCS All Commercial $71.11
Rate for Payer: PHP All Commercial $71.90
Rate for Payer: Plain Church Group Ministry All Commercial $36.98
Rate for Payer: Sagamore Health Network All Products $73.19
Rate for Payer: Signature Care EPO $78.69
Rate for Payer: Signature Care PPO $83.43
Rate for Payer: Three Rivers Preferred All Commercial $80.59
Rate for Payer: United Healthcare Commercial $74.71
Rate for Payer: United Healthcare Medicare $31.29
Hospital Charge Code 41601061
Hospital Revenue Code 270
Min. Negotiated Rate $71.11
Max. Negotiated Rate $88.17
Rate for Payer: Aetna Commercial $81.92
Rate for Payer: Cash Price $58.78
Rate for Payer: Cigna All Commercial $81.82
Rate for Payer: CORVEL All Commercial $88.17
Rate for Payer: Coventry All Commercial $83.43
Rate for Payer: Encore All Commercial $87.27
Rate for Payer: Frontpath All Commercial $87.23
Rate for Payer: Humana ChoiceCare $81.89
Rate for Payer: Lutheran Preferred All Commercial $85.33
Rate for Payer: PHCS All Commercial $71.11
Rate for Payer: PHP All Commercial $71.90
Rate for Payer: Sagamore Health Network All Products $73.19
Rate for Payer: Signature Care EPO $78.69
Rate for Payer: Signature Care PPO $83.43
Rate for Payer: United Healthcare Commercial $74.71
Hospital Charge Code 41601063
Hospital Revenue Code 270
Min. Negotiated Rate $52.85
Max. Negotiated Rate $65.54
Rate for Payer: Aetna Commercial $60.89
Rate for Payer: Cash Price $43.69
Rate for Payer: Cigna All Commercial $60.82
Rate for Payer: CORVEL All Commercial $65.54
Rate for Payer: Coventry All Commercial $62.01
Rate for Payer: Encore All Commercial $64.87
Rate for Payer: Frontpath All Commercial $64.83
Rate for Payer: Humana ChoiceCare $60.86
Rate for Payer: Lutheran Preferred All Commercial $63.42
Rate for Payer: PHCS All Commercial $52.85
Rate for Payer: PHP All Commercial $53.44
Rate for Payer: Sagamore Health Network All Products $54.40
Rate for Payer: Signature Care EPO $58.49
Rate for Payer: Signature Care PPO $62.01
Rate for Payer: United Healthcare Commercial $55.53
Hospital Charge Code 41601063
Hospital Revenue Code 270
Min. Negotiated Rate $23.26
Max. Negotiated Rate $96.84
Rate for Payer: Aetna Commercial $59.48
Rate for Payer: Aetna Medicare $23.26
Rate for Payer: Anthem Blue Cross of IN Medicare $23.26
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $40.47
Rate for Payer: Anthem Blue Cross of IN Traditional $44.05
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $96.84
Rate for Payer: CareSource Indiana of IN Just 4 Me $26.74
Rate for Payer: CareSource Indiana of IN Medicare $25.58
Rate for Payer: Cash Price $43.69
Rate for Payer: Cash Price $43.69
Rate for Payer: Centivo All Commercial $35.94
Rate for Payer: Cigna All Commercial $60.82
Rate for Payer: CORVEL All Commercial $65.54
Rate for Payer: Coventry All Commercial $62.01
Rate for Payer: Encore All Commercial $64.87
Rate for Payer: Frontpath All Commercial $64.83
Rate for Payer: Humana ChoiceCare $60.86
Rate for Payer: Humana Medicare $35.94
Rate for Payer: Lucent All Commercial $35.94
Rate for Payer: Lutheran Preferred All Commercial $63.42
Rate for Payer: Managed Health Services Medicaid $96.84
Rate for Payer: MDWise Medicaid $96.84
Rate for Payer: PHCS All Commercial $52.85
Rate for Payer: PHP All Commercial $53.44
Rate for Payer: Plain Church Group Ministry All Commercial $27.48
Rate for Payer: Sagamore Health Network All Products $54.40
Rate for Payer: Signature Care EPO $58.49
Rate for Payer: Signature Care PPO $62.01
Rate for Payer: Three Rivers Preferred All Commercial $59.90
Rate for Payer: United Healthcare Commercial $55.53
Rate for Payer: United Healthcare Medicare $23.26
Service Code CPT C1762
Hospital Charge Code 41608115
Hospital Revenue Code 278
Min. Negotiated Rate $4,050.00
Max. Negotiated Rate $5,022.00
Rate for Payer: Aetna Commercial $4,665.60
Rate for Payer: Cash Price $3,348.00
Rate for Payer: Cigna All Commercial $4,660.20
Rate for Payer: CORVEL All Commercial $5,022.00
Rate for Payer: Coventry All Commercial $4,752.00
Rate for Payer: Encore All Commercial $4,970.70
Rate for Payer: Frontpath All Commercial $4,968.00
Rate for Payer: Humana ChoiceCare $4,663.98
Rate for Payer: Lutheran Preferred All Commercial $4,860.00
Rate for Payer: PHCS All Commercial $4,050.00
Rate for Payer: PHP All Commercial $4,095.36
Rate for Payer: Sagamore Health Network All Products $4,168.80
Rate for Payer: Signature Care EPO $4,482.00
Rate for Payer: Signature Care PPO $4,752.00
Rate for Payer: United Healthcare Commercial $4,255.20
Service Code CPT C1762
Hospital Charge Code 41608115
Hospital Revenue Code 278
Min. Negotiated Rate $524.16
Max. Negotiated Rate $5,022.00
Rate for Payer: Aetna Commercial $4,557.60
Rate for Payer: Aetna Medicare $1,782.00
Rate for Payer: Anthem Blue Cross of IN Medicare $1,782.00
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $3,101.22
Rate for Payer: Anthem Blue Cross of IN Traditional $3,375.54
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $2,049.30
Rate for Payer: CareSource Indiana of IN Medicare $1,960.20
Rate for Payer: Cash Price $3,348.00
Rate for Payer: Cash Price $3,348.00
Rate for Payer: Centivo All Commercial $2,754.00
Rate for Payer: Cigna All Commercial $4,660.20
Rate for Payer: CORVEL All Commercial $5,022.00
Rate for Payer: Coventry All Commercial $4,752.00
Rate for Payer: Encore All Commercial $4,970.70
Rate for Payer: Frontpath All Commercial $4,968.00
Rate for Payer: Humana ChoiceCare $4,663.98
Rate for Payer: Humana Medicare $2,754.00
Rate for Payer: Lucent All Commercial $2,754.00
Rate for Payer: Lutheran Preferred All Commercial $4,860.00
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $4,050.00
Rate for Payer: PHP All Commercial $4,095.36
Rate for Payer: Plain Church Group Ministry All Commercial $2,106.00
Rate for Payer: Sagamore Health Network All Products $4,168.80
Rate for Payer: Signature Care EPO $4,482.00
Rate for Payer: Signature Care PPO $4,752.00
Rate for Payer: Three Rivers Preferred All Commercial $4,590.00
Rate for Payer: United Healthcare Commercial $4,255.20
Rate for Payer: United Healthcare Medicare $1,782.00
Service Code CPT 87205
Hospital Charge Code 63001077
Hospital Revenue Code 300
Min. Negotiated Rate $75.55
Max. Negotiated Rate $93.68
Rate for Payer: Aetna Commercial $87.04
Rate for Payer: Cash Price $62.46
Rate for Payer: Cigna All Commercial $86.93
Rate for Payer: CORVEL All Commercial $93.68
Rate for Payer: Coventry All Commercial $88.65
Rate for Payer: Encore All Commercial $92.73
Rate for Payer: Frontpath All Commercial $92.68
Rate for Payer: Humana ChoiceCare $87.00
Rate for Payer: Lutheran Preferred All Commercial $90.66
Rate for Payer: PHCS All Commercial $75.55
Rate for Payer: PHP All Commercial $76.40
Rate for Payer: Sagamore Health Network All Products $77.77
Rate for Payer: Signature Care EPO $83.61
Rate for Payer: Signature Care PPO $88.65
Rate for Payer: United Healthcare Commercial $79.38
Service Code CPT 87205
Hospital Charge Code 63001077
Hospital Revenue Code 300
Min. Negotiated Rate $4.27
Max. Negotiated Rate $93.68
Rate for Payer: Aetna Commercial $85.02
Rate for Payer: Aetna Medicare $33.24
Rate for Payer: Anthem Blue Cross of IN Medicare $33.24
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $46.30
Rate for Payer: Anthem Blue Cross of IN Traditional $46.30
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $4.27
Rate for Payer: CareSource Indiana of IN Just 4 Me $38.23
Rate for Payer: CareSource Indiana of IN Medicare $36.57
Rate for Payer: Cash Price $62.46
Rate for Payer: Cash Price $62.46
Rate for Payer: Centivo All Commercial $51.37
Rate for Payer: Cigna All Commercial $86.93
Rate for Payer: CORVEL All Commercial $93.68
Rate for Payer: Coventry All Commercial $88.65
Rate for Payer: Encore All Commercial $92.73
Rate for Payer: Frontpath All Commercial $92.68
Rate for Payer: Humana ChoiceCare $87.00
Rate for Payer: Humana Medicare $51.37
Rate for Payer: Lucent All Commercial $51.37
Rate for Payer: Lutheran Preferred All Commercial $90.66
Rate for Payer: Managed Health Services Medicaid $4.27
Rate for Payer: MDWise Medicaid $4.27
Rate for Payer: PHCS All Commercial $75.55
Rate for Payer: PHP All Commercial $76.40
Rate for Payer: Plain Church Group Ministry All Commercial $39.29
Rate for Payer: Sagamore Health Network All Products $77.77
Rate for Payer: Signature Care EPO $83.61
Rate for Payer: Signature Care PPO $88.65
Rate for Payer: Three Rivers Preferred All Commercial $85.62
Rate for Payer: United Healthcare Commercial $79.38
Rate for Payer: United Healthcare Medicare $33.24
Service Code CPT P9050
Hospital Charge Code 01375320
Hospital Revenue Code 390
Min. Negotiated Rate $278.73
Max. Negotiated Rate $3,277.49
Rate for Payer: Aetna Commercial $2,974.41
Rate for Payer: Aetna Medicare $1,162.98
Rate for Payer: Anthem Blue Cross of IN Medicare $1,162.98
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $2,023.94
Rate for Payer: Anthem Blue Cross of IN Traditional $2,202.97
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $278.73
Rate for Payer: CareSource Indiana of IN Just 4 Me $1,337.43
Rate for Payer: CareSource Indiana of IN Medicare $1,279.28
Rate for Payer: Cash Price $2,184.99
Rate for Payer: Cash Price $2,184.99
Rate for Payer: Centivo All Commercial $1,797.33
Rate for Payer: Cigna All Commercial $3,041.37
Rate for Payer: CORVEL All Commercial $3,277.49
Rate for Payer: Coventry All Commercial $3,101.28
Rate for Payer: Encore All Commercial $3,244.01
Rate for Payer: Frontpath All Commercial $3,242.25
Rate for Payer: Humana ChoiceCare $3,043.84
Rate for Payer: Humana Medicare $1,797.33
Rate for Payer: Lucent All Commercial $1,797.33
Rate for Payer: Lutheran Preferred All Commercial $3,171.76
Rate for Payer: Managed Health Services Medicaid $278.73
Rate for Payer: MDWise Medicaid $278.73
Rate for Payer: PHCS All Commercial $2,643.14
Rate for Payer: PHP All Commercial $2,672.74
Rate for Payer: Plain Church Group Ministry All Commercial $1,374.43
Rate for Payer: Sagamore Health Network All Products $2,720.67
Rate for Payer: Signature Care EPO $2,925.07
Rate for Payer: Signature Care PPO $3,101.28
Rate for Payer: Three Rivers Preferred All Commercial $2,995.55
Rate for Payer: United Healthcare Commercial $2,777.06
Rate for Payer: United Healthcare Medicare $1,162.98
Service Code CPT P9050
Hospital Charge Code 01375320
Hospital Revenue Code 390
Min. Negotiated Rate $2,643.14
Max. Negotiated Rate $3,277.49
Rate for Payer: Aetna Commercial $3,044.89
Rate for Payer: Cash Price $2,184.99
Rate for Payer: Cigna All Commercial $3,041.37
Rate for Payer: CORVEL All Commercial $3,277.49
Rate for Payer: Coventry All Commercial $3,101.28
Rate for Payer: Encore All Commercial $3,244.01
Rate for Payer: Frontpath All Commercial $3,242.25
Rate for Payer: Humana ChoiceCare $3,043.84
Rate for Payer: Lutheran Preferred All Commercial $3,171.76
Rate for Payer: PHCS All Commercial $2,643.14
Rate for Payer: PHP All Commercial $2,672.74
Rate for Payer: Sagamore Health Network All Products $2,720.67
Rate for Payer: Signature Care EPO $2,925.07
Rate for Payer: Signature Care PPO $3,101.28
Rate for Payer: United Healthcare Commercial $2,777.06
Hospital Charge Code 41602274
Hospital Revenue Code 272
Min. Negotiated Rate $121.68
Max. Negotiated Rate $1,003.33
Rate for Payer: Aetna Commercial $910.55
Rate for Payer: Aetna Medicare $356.02
Rate for Payer: Anthem Blue Cross of IN Medicare $356.02
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $619.58
Rate for Payer: Anthem Blue Cross of IN Traditional $674.39
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $121.68
Rate for Payer: CareSource Indiana of IN Just 4 Me $409.42
Rate for Payer: CareSource Indiana of IN Medicare $391.62
Rate for Payer: Cash Price $668.89
Rate for Payer: Cash Price $668.89
Rate for Payer: Centivo All Commercial $550.21
Rate for Payer: Cigna All Commercial $931.05
Rate for Payer: CORVEL All Commercial $1,003.33
Rate for Payer: Coventry All Commercial $949.39
Rate for Payer: Encore All Commercial $993.08
Rate for Payer: Frontpath All Commercial $992.54
Rate for Payer: Humana ChoiceCare $931.80
Rate for Payer: Humana Medicare $550.21
Rate for Payer: Lucent All Commercial $550.21
Rate for Payer: Lutheran Preferred All Commercial $970.96
Rate for Payer: Managed Health Services Medicaid $121.68
Rate for Payer: MDWise Medicaid $121.68
Rate for Payer: PHCS All Commercial $809.14
Rate for Payer: PHP All Commercial $818.20
Rate for Payer: Plain Church Group Ministry All Commercial $420.75
Rate for Payer: Sagamore Health Network All Products $832.87
Rate for Payer: Signature Care EPO $895.45
Rate for Payer: Signature Care PPO $949.39
Rate for Payer: Three Rivers Preferred All Commercial $917.02
Rate for Payer: United Healthcare Commercial $850.13
Rate for Payer: United Healthcare Medicare $356.02
Hospital Charge Code 41602274
Hospital Revenue Code 272
Min. Negotiated Rate $809.14
Max. Negotiated Rate $1,003.33
Rate for Payer: Aetna Commercial $932.13
Rate for Payer: Cash Price $668.89
Rate for Payer: Cigna All Commercial $931.05
Rate for Payer: CORVEL All Commercial $1,003.33
Rate for Payer: Coventry All Commercial $949.39
Rate for Payer: Encore All Commercial $993.08
Rate for Payer: Frontpath All Commercial $992.54
Rate for Payer: Humana ChoiceCare $931.80
Rate for Payer: Lutheran Preferred All Commercial $970.96
Rate for Payer: PHCS All Commercial $809.14
Rate for Payer: PHP All Commercial $818.20
Rate for Payer: Sagamore Health Network All Products $832.87
Rate for Payer: Signature Care EPO $895.45
Rate for Payer: Signature Care PPO $949.39
Rate for Payer: United Healthcare Commercial $850.13
Hospital Charge Code 41606950
Hospital Revenue Code 272
Min. Negotiated Rate $1,631.25
Max. Negotiated Rate $2,022.75
Rate for Payer: Aetna Commercial $1,879.20
Rate for Payer: Cash Price $1,348.50
Rate for Payer: Cigna All Commercial $1,877.02
Rate for Payer: CORVEL All Commercial $2,022.75
Rate for Payer: Coventry All Commercial $1,914.00
Rate for Payer: Encore All Commercial $2,002.09
Rate for Payer: Frontpath All Commercial $2,001.00
Rate for Payer: Humana ChoiceCare $1,878.55
Rate for Payer: Lutheran Preferred All Commercial $1,957.50
Rate for Payer: PHCS All Commercial $1,631.25
Rate for Payer: PHP All Commercial $1,649.52
Rate for Payer: Sagamore Health Network All Products $1,679.10
Rate for Payer: Signature Care EPO $1,805.25
Rate for Payer: Signature Care PPO $1,914.00
Rate for Payer: United Healthcare Commercial $1,713.90
Hospital Charge Code 41606950
Hospital Revenue Code 272
Min. Negotiated Rate $121.68
Max. Negotiated Rate $2,022.75
Rate for Payer: Aetna Commercial $1,835.70
Rate for Payer: Aetna Medicare $717.75
Rate for Payer: Anthem Blue Cross of IN Medicare $717.75
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $1,249.10
Rate for Payer: Anthem Blue Cross of IN Traditional $1,359.59
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $121.68
Rate for Payer: CareSource Indiana of IN Just 4 Me $825.41
Rate for Payer: CareSource Indiana of IN Medicare $789.52
Rate for Payer: Cash Price $1,348.50
Rate for Payer: Cash Price $1,348.50
Rate for Payer: Centivo All Commercial $1,109.25
Rate for Payer: Cigna All Commercial $1,877.02
Rate for Payer: CORVEL All Commercial $2,022.75
Rate for Payer: Coventry All Commercial $1,914.00
Rate for Payer: Encore All Commercial $2,002.09
Rate for Payer: Frontpath All Commercial $2,001.00
Rate for Payer: Humana ChoiceCare $1,878.55
Rate for Payer: Humana Medicare $1,109.25
Rate for Payer: Lucent All Commercial $1,109.25
Rate for Payer: Lutheran Preferred All Commercial $1,957.50
Rate for Payer: Managed Health Services Medicaid $121.68
Rate for Payer: MDWise Medicaid $121.68
Rate for Payer: PHCS All Commercial $1,631.25
Rate for Payer: PHP All Commercial $1,649.52
Rate for Payer: Plain Church Group Ministry All Commercial $848.25
Rate for Payer: Sagamore Health Network All Products $1,679.10
Rate for Payer: Signature Care EPO $1,805.25
Rate for Payer: Signature Care PPO $1,914.00
Rate for Payer: Three Rivers Preferred All Commercial $1,848.75
Rate for Payer: United Healthcare Commercial $1,713.90
Rate for Payer: United Healthcare Medicare $717.75