|
HC ED LEVEL 1
|
Facility
|
OP
|
$423.47
|
|
|
Service Code
|
CPT 99281
|
| Hospital Charge Code |
1294941
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$75.80 |
| Max. Negotiated Rate |
$393.83 |
| Rate for Payer: Aetna Commercial |
$357.41
|
| Rate for Payer: Aetna Medicare |
$135.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$75.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$131.28
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$243.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$264.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$75.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$155.84
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$149.06
|
| Rate for Payer: Cash Price |
$254.08
|
| Rate for Payer: Cash Price |
$254.08
|
| Rate for Payer: Centivo All Commercial |
$230.37
|
| Rate for Payer: Cigna All Commercial |
$365.45
|
| Rate for Payer: CORVEL All Commercial |
$393.83
|
| Rate for Payer: Coventry All Commercial |
$372.65
|
| Rate for Payer: Encore All Commercial |
$389.80
|
| Rate for Payer: Frontpath All Commercial |
$389.59
|
| Rate for Payer: Humana ChoiceCare |
$365.75
|
| Rate for Payer: Humana Medicare |
$135.51
|
| Rate for Payer: Lucent All Commercial |
$230.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$381.12
|
| Rate for Payer: Managed Health Services Medicaid |
$75.80
|
| Rate for Payer: MDWise Medicaid |
$75.80
|
| Rate for Payer: PHCS All Commercial |
$317.60
|
| Rate for Payer: PHP All Commercial |
$321.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$165.15
|
| Rate for Payer: Sagamore Health Network All Products |
$326.92
|
| Rate for Payer: Signature Care EPO |
$351.48
|
| Rate for Payer: Signature Care PPO |
$372.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$359.95
|
| Rate for Payer: United Healthcare Commercial |
$333.69
|
| Rate for Payer: United Healthcare Medicare |
$135.51
|
|
|
HC ED LEVEL 1
|
Facility
|
IP
|
$423.47
|
|
|
Service Code
|
CPT 99281
|
| Hospital Charge Code |
1294941
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$317.60 |
| Max. Negotiated Rate |
$393.83 |
| Rate for Payer: Aetna Commercial |
$365.88
|
| Rate for Payer: Cash Price |
$254.08
|
| Rate for Payer: Cigna All Commercial |
$365.45
|
| Rate for Payer: CORVEL All Commercial |
$393.83
|
| Rate for Payer: Coventry All Commercial |
$372.65
|
| Rate for Payer: Encore All Commercial |
$389.80
|
| Rate for Payer: Frontpath All Commercial |
$389.59
|
| Rate for Payer: Humana ChoiceCare |
$365.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$381.12
|
| Rate for Payer: PHCS All Commercial |
$317.60
|
| Rate for Payer: PHP All Commercial |
$321.16
|
| Rate for Payer: Sagamore Health Network All Products |
$326.92
|
| Rate for Payer: Signature Care EPO |
$351.48
|
| Rate for Payer: Signature Care PPO |
$372.65
|
| Rate for Payer: United Healthcare Commercial |
$333.69
|
|
|
HC ED LEVEL 2
|
Facility
|
OP
|
$721.87
|
|
|
Service Code
|
CPT 99282
|
| Hospital Charge Code |
1294942
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$75.80 |
| Max. Negotiated Rate |
$671.34 |
| Rate for Payer: Aetna Commercial |
$609.26
|
| Rate for Payer: Aetna Medicare |
$231.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$75.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$223.78
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$414.57
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$451.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$75.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$265.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$254.10
|
| Rate for Payer: Cash Price |
$433.12
|
| Rate for Payer: Cash Price |
$433.12
|
| Rate for Payer: Centivo All Commercial |
$392.70
|
| Rate for Payer: Cigna All Commercial |
$622.97
|
| Rate for Payer: CORVEL All Commercial |
$671.34
|
| Rate for Payer: Coventry All Commercial |
$635.25
|
| Rate for Payer: Encore All Commercial |
$664.48
|
| Rate for Payer: Frontpath All Commercial |
$664.12
|
| Rate for Payer: Humana ChoiceCare |
$623.48
|
| Rate for Payer: Humana Medicare |
$231.00
|
| Rate for Payer: Lucent All Commercial |
$392.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$649.68
|
| Rate for Payer: Managed Health Services Medicaid |
$75.80
|
| Rate for Payer: MDWise Medicaid |
$75.80
|
| Rate for Payer: PHCS All Commercial |
$541.40
|
| Rate for Payer: PHP All Commercial |
$547.47
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$281.53
|
| Rate for Payer: Sagamore Health Network All Products |
$557.28
|
| Rate for Payer: Signature Care EPO |
$599.15
|
| Rate for Payer: Signature Care PPO |
$635.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$613.59
|
| Rate for Payer: United Healthcare Commercial |
$568.83
|
| Rate for Payer: United Healthcare Medicare |
$231.00
|
|
|
HC ED LEVEL 2
|
Facility
|
IP
|
$721.87
|
|
|
Service Code
|
CPT 99282
|
| Hospital Charge Code |
1294942
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$541.40 |
| Max. Negotiated Rate |
$671.34 |
| Rate for Payer: Aetna Commercial |
$623.70
|
| Rate for Payer: Cash Price |
$433.12
|
| Rate for Payer: Cigna All Commercial |
$622.97
|
| Rate for Payer: CORVEL All Commercial |
$671.34
|
| Rate for Payer: Coventry All Commercial |
$635.25
|
| Rate for Payer: Encore All Commercial |
$664.48
|
| Rate for Payer: Frontpath All Commercial |
$664.12
|
| Rate for Payer: Humana ChoiceCare |
$623.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$649.68
|
| Rate for Payer: PHCS All Commercial |
$541.40
|
| Rate for Payer: PHP All Commercial |
$547.47
|
| Rate for Payer: Sagamore Health Network All Products |
$557.28
|
| Rate for Payer: Signature Care EPO |
$599.15
|
| Rate for Payer: Signature Care PPO |
$635.25
|
| Rate for Payer: United Healthcare Commercial |
$568.83
|
|
|
HC ED LEVEL 3
|
Facility
|
OP
|
$1,468.69
|
|
|
Service Code
|
CPT 99283
|
| Hospital Charge Code |
1294943
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$75.80 |
| Max. Negotiated Rate |
$1,365.88 |
| Rate for Payer: Aetna Commercial |
$1,239.57
|
| Rate for Payer: Aetna Medicare |
$469.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$75.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$455.29
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$843.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$918.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$75.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$540.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$516.98
|
| Rate for Payer: Cash Price |
$881.21
|
| Rate for Payer: Cash Price |
$881.21
|
| Rate for Payer: Centivo All Commercial |
$798.97
|
| Rate for Payer: Cigna All Commercial |
$1,267.48
|
| Rate for Payer: CORVEL All Commercial |
$1,365.88
|
| Rate for Payer: Coventry All Commercial |
$1,292.45
|
| Rate for Payer: Encore All Commercial |
$1,351.93
|
| Rate for Payer: Frontpath All Commercial |
$1,351.19
|
| Rate for Payer: Humana ChoiceCare |
$1,268.51
|
| Rate for Payer: Humana Medicare |
$469.98
|
| Rate for Payer: Lucent All Commercial |
$798.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,321.82
|
| Rate for Payer: Managed Health Services Medicaid |
$75.80
|
| Rate for Payer: MDWise Medicaid |
$75.80
|
| Rate for Payer: PHCS All Commercial |
$1,101.52
|
| Rate for Payer: PHP All Commercial |
$1,113.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$572.79
|
| Rate for Payer: Sagamore Health Network All Products |
$1,133.83
|
| Rate for Payer: Signature Care EPO |
$1,219.01
|
| Rate for Payer: Signature Care PPO |
$1,292.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,248.39
|
| Rate for Payer: United Healthcare Commercial |
$1,157.33
|
| Rate for Payer: United Healthcare Medicare |
$469.98
|
|
|
HC ED LEVEL 3
|
Facility
|
IP
|
$1,468.69
|
|
|
Service Code
|
CPT 99283
|
| Hospital Charge Code |
1294943
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,101.52 |
| Max. Negotiated Rate |
$1,365.88 |
| Rate for Payer: Aetna Commercial |
$1,268.95
|
| Rate for Payer: Cash Price |
$881.21
|
| Rate for Payer: Cigna All Commercial |
$1,267.48
|
| Rate for Payer: CORVEL All Commercial |
$1,365.88
|
| Rate for Payer: Coventry All Commercial |
$1,292.45
|
| Rate for Payer: Encore All Commercial |
$1,351.93
|
| Rate for Payer: Frontpath All Commercial |
$1,351.19
|
| Rate for Payer: Humana ChoiceCare |
$1,268.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,321.82
|
| Rate for Payer: PHCS All Commercial |
$1,101.52
|
| Rate for Payer: PHP All Commercial |
$1,113.85
|
| Rate for Payer: Sagamore Health Network All Products |
$1,133.83
|
| Rate for Payer: Signature Care EPO |
$1,219.01
|
| Rate for Payer: Signature Care PPO |
$1,292.45
|
| Rate for Payer: United Healthcare Commercial |
$1,157.33
|
|
|
HC ED LEVEL 4
|
Facility
|
OP
|
$2,234.36
|
|
|
Service Code
|
CPT 99284
|
| Hospital Charge Code |
1294944
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$75.80 |
| Max. Negotiated Rate |
$2,077.95 |
| Rate for Payer: Aetna Commercial |
$1,885.80
|
| Rate for Payer: Aetna Medicare |
$715.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$75.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$692.65
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,283.19
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,396.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$75.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$822.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$786.49
|
| Rate for Payer: Cash Price |
$1,340.62
|
| Rate for Payer: Cash Price |
$1,340.62
|
| Rate for Payer: Centivo All Commercial |
$1,215.49
|
| Rate for Payer: Cigna All Commercial |
$1,928.25
|
| Rate for Payer: CORVEL All Commercial |
$2,077.95
|
| Rate for Payer: Coventry All Commercial |
$1,966.24
|
| Rate for Payer: Encore All Commercial |
$2,056.73
|
| Rate for Payer: Frontpath All Commercial |
$2,055.61
|
| Rate for Payer: Humana ChoiceCare |
$1,929.82
|
| Rate for Payer: Humana Medicare |
$715.00
|
| Rate for Payer: Lucent All Commercial |
$1,215.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,010.92
|
| Rate for Payer: Managed Health Services Medicaid |
$75.80
|
| Rate for Payer: MDWise Medicaid |
$75.80
|
| Rate for Payer: PHCS All Commercial |
$1,675.77
|
| Rate for Payer: PHP All Commercial |
$1,694.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$871.40
|
| Rate for Payer: Sagamore Health Network All Products |
$1,724.93
|
| Rate for Payer: Signature Care EPO |
$1,854.52
|
| Rate for Payer: Signature Care PPO |
$1,966.24
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,899.21
|
| Rate for Payer: United Healthcare Commercial |
$1,760.68
|
| Rate for Payer: United Healthcare Medicare |
$715.00
|
|
|
HC ED LEVEL 4
|
Facility
|
IP
|
$2,234.36
|
|
|
Service Code
|
CPT 99284
|
| Hospital Charge Code |
1294944
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,675.77 |
| Max. Negotiated Rate |
$2,077.95 |
| Rate for Payer: Aetna Commercial |
$1,930.49
|
| Rate for Payer: Cash Price |
$1,340.62
|
| Rate for Payer: Cigna All Commercial |
$1,928.25
|
| Rate for Payer: CORVEL All Commercial |
$2,077.95
|
| Rate for Payer: Coventry All Commercial |
$1,966.24
|
| Rate for Payer: Encore All Commercial |
$2,056.73
|
| Rate for Payer: Frontpath All Commercial |
$2,055.61
|
| Rate for Payer: Humana ChoiceCare |
$1,929.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,010.92
|
| Rate for Payer: PHCS All Commercial |
$1,675.77
|
| Rate for Payer: PHP All Commercial |
$1,694.54
|
| Rate for Payer: Sagamore Health Network All Products |
$1,724.93
|
| Rate for Payer: Signature Care EPO |
$1,854.52
|
| Rate for Payer: Signature Care PPO |
$1,966.24
|
| Rate for Payer: United Healthcare Commercial |
$1,760.68
|
|
|
HC ED LEVEL 5
|
Facility
|
IP
|
$3,371.44
|
|
|
Service Code
|
CPT 99285
|
| Hospital Charge Code |
1299285
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,528.58 |
| Max. Negotiated Rate |
$3,135.44 |
| Rate for Payer: Aetna Commercial |
$2,912.92
|
| Rate for Payer: Cash Price |
$2,022.86
|
| Rate for Payer: Cigna All Commercial |
$2,909.55
|
| Rate for Payer: CORVEL All Commercial |
$3,135.44
|
| Rate for Payer: Coventry All Commercial |
$2,966.87
|
| Rate for Payer: Encore All Commercial |
$3,103.41
|
| Rate for Payer: Frontpath All Commercial |
$3,101.72
|
| Rate for Payer: Humana ChoiceCare |
$2,911.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,034.30
|
| Rate for Payer: PHCS All Commercial |
$2,528.58
|
| Rate for Payer: PHP All Commercial |
$2,556.90
|
| Rate for Payer: Sagamore Health Network All Products |
$2,602.75
|
| Rate for Payer: Signature Care EPO |
$2,798.30
|
| Rate for Payer: Signature Care PPO |
$2,966.87
|
| Rate for Payer: United Healthcare Commercial |
$2,656.69
|
|
|
HC ED LEVEL 5
|
Facility
|
OP
|
$3,371.44
|
|
|
Service Code
|
CPT 99285
|
| Hospital Charge Code |
1299285
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$75.80 |
| Max. Negotiated Rate |
$3,135.44 |
| Rate for Payer: Aetna Commercial |
$2,845.50
|
| Rate for Payer: Aetna Medicare |
$1,078.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$75.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,045.15
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,936.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,107.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$75.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,240.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,186.75
|
| Rate for Payer: Cash Price |
$2,022.86
|
| Rate for Payer: Cash Price |
$2,022.86
|
| Rate for Payer: Centivo All Commercial |
$1,834.06
|
| Rate for Payer: Cigna All Commercial |
$2,909.55
|
| Rate for Payer: CORVEL All Commercial |
$3,135.44
|
| Rate for Payer: Coventry All Commercial |
$2,966.87
|
| Rate for Payer: Encore All Commercial |
$3,103.41
|
| Rate for Payer: Frontpath All Commercial |
$3,101.72
|
| Rate for Payer: Humana ChoiceCare |
$2,911.91
|
| Rate for Payer: Humana Medicare |
$1,078.86
|
| Rate for Payer: Lucent All Commercial |
$1,834.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,034.30
|
| Rate for Payer: Managed Health Services Medicaid |
$75.80
|
| Rate for Payer: MDWise Medicaid |
$75.80
|
| Rate for Payer: PHCS All Commercial |
$2,528.58
|
| Rate for Payer: PHP All Commercial |
$2,556.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,314.86
|
| Rate for Payer: Sagamore Health Network All Products |
$2,602.75
|
| Rate for Payer: Signature Care EPO |
$2,798.30
|
| Rate for Payer: Signature Care PPO |
$2,966.87
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,865.72
|
| Rate for Payer: United Healthcare Commercial |
$2,656.69
|
| Rate for Payer: United Healthcare Medicare |
$1,078.86
|
|
|
HC ED LEVEL 6
|
Facility
|
OP
|
$3,447.60
|
|
|
Service Code
|
CPT 99285
|
| Hospital Charge Code |
1299985
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$75.80 |
| Max. Negotiated Rate |
$3,206.27 |
| Rate for Payer: Aetna Commercial |
$2,909.77
|
| Rate for Payer: Aetna Medicare |
$1,103.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$75.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,068.76
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,979.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,155.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$75.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,268.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,213.56
|
| Rate for Payer: Cash Price |
$2,068.56
|
| Rate for Payer: Cash Price |
$2,068.56
|
| Rate for Payer: Centivo All Commercial |
$1,875.49
|
| Rate for Payer: Cigna All Commercial |
$2,975.28
|
| Rate for Payer: CORVEL All Commercial |
$3,206.27
|
| Rate for Payer: Coventry All Commercial |
$3,033.89
|
| Rate for Payer: Encore All Commercial |
$3,173.52
|
| Rate for Payer: Frontpath All Commercial |
$3,171.79
|
| Rate for Payer: Humana ChoiceCare |
$2,977.69
|
| Rate for Payer: Humana Medicare |
$1,103.23
|
| Rate for Payer: Lucent All Commercial |
$1,875.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,102.84
|
| Rate for Payer: Managed Health Services Medicaid |
$75.80
|
| Rate for Payer: MDWise Medicaid |
$75.80
|
| Rate for Payer: PHCS All Commercial |
$2,585.70
|
| Rate for Payer: PHP All Commercial |
$2,614.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,344.56
|
| Rate for Payer: Sagamore Health Network All Products |
$2,661.55
|
| Rate for Payer: Signature Care EPO |
$2,861.51
|
| Rate for Payer: Signature Care PPO |
$3,033.89
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,930.46
|
| Rate for Payer: United Healthcare Commercial |
$2,716.71
|
| Rate for Payer: United Healthcare Medicare |
$1,103.23
|
|
|
HC ED LEVEL 6
|
Facility
|
IP
|
$3,447.60
|
|
|
Service Code
|
CPT 99285
|
| Hospital Charge Code |
1299985
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,585.70 |
| Max. Negotiated Rate |
$3,206.27 |
| Rate for Payer: Aetna Commercial |
$2,978.73
|
| Rate for Payer: Cash Price |
$2,068.56
|
| Rate for Payer: Cigna All Commercial |
$2,975.28
|
| Rate for Payer: CORVEL All Commercial |
$3,206.27
|
| Rate for Payer: Coventry All Commercial |
$3,033.89
|
| Rate for Payer: Encore All Commercial |
$3,173.52
|
| Rate for Payer: Frontpath All Commercial |
$3,171.79
|
| Rate for Payer: Humana ChoiceCare |
$2,977.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,102.84
|
| Rate for Payer: PHCS All Commercial |
$2,585.70
|
| Rate for Payer: PHP All Commercial |
$2,614.66
|
| Rate for Payer: Sagamore Health Network All Products |
$2,661.55
|
| Rate for Payer: Signature Care EPO |
$2,861.51
|
| Rate for Payer: Signature Care PPO |
$3,033.89
|
| Rate for Payer: United Healthcare Commercial |
$2,716.71
|
|
|
HC ED MAJOR SURG PROC
|
Facility
|
IP
|
$432.91
|
|
| Hospital Charge Code |
1291503
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$324.68 |
| Max. Negotiated Rate |
$402.61 |
| Rate for Payer: Aetna Commercial |
$374.03
|
| Rate for Payer: Cash Price |
$259.75
|
| Rate for Payer: Cigna All Commercial |
$373.60
|
| Rate for Payer: CORVEL All Commercial |
$402.61
|
| Rate for Payer: Coventry All Commercial |
$380.96
|
| Rate for Payer: Encore All Commercial |
$398.49
|
| Rate for Payer: Frontpath All Commercial |
$398.28
|
| Rate for Payer: Humana ChoiceCare |
$373.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$389.62
|
| Rate for Payer: PHCS All Commercial |
$324.68
|
| Rate for Payer: PHP All Commercial |
$328.32
|
| Rate for Payer: Sagamore Health Network All Products |
$334.21
|
| Rate for Payer: Signature Care EPO |
$359.32
|
| Rate for Payer: Signature Care PPO |
$380.96
|
| Rate for Payer: United Healthcare Commercial |
$341.13
|
|
|
HC ED MAJOR SURG PROC
|
Facility
|
OP
|
$432.91
|
|
| Hospital Charge Code |
1291503
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$75.80 |
| Max. Negotiated Rate |
$402.61 |
| Rate for Payer: Aetna Commercial |
$365.38
|
| Rate for Payer: Aetna Medicare |
$138.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$75.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$134.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$248.62
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$270.61
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$75.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$159.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$152.38
|
| Rate for Payer: Cash Price |
$259.75
|
| Rate for Payer: Cash Price |
$259.75
|
| Rate for Payer: Centivo All Commercial |
$235.50
|
| Rate for Payer: Cigna All Commercial |
$373.60
|
| Rate for Payer: CORVEL All Commercial |
$402.61
|
| Rate for Payer: Coventry All Commercial |
$380.96
|
| Rate for Payer: Encore All Commercial |
$398.49
|
| Rate for Payer: Frontpath All Commercial |
$398.28
|
| Rate for Payer: Humana ChoiceCare |
$373.90
|
| Rate for Payer: Humana Medicare |
$138.53
|
| Rate for Payer: Lucent All Commercial |
$235.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$389.62
|
| Rate for Payer: Managed Health Services Medicaid |
$75.80
|
| Rate for Payer: MDWise Medicaid |
$75.80
|
| Rate for Payer: PHCS All Commercial |
$324.68
|
| Rate for Payer: PHP All Commercial |
$328.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$168.83
|
| Rate for Payer: Sagamore Health Network All Products |
$334.21
|
| Rate for Payer: Signature Care EPO |
$359.32
|
| Rate for Payer: Signature Care PPO |
$380.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$367.97
|
| Rate for Payer: United Healthcare Commercial |
$341.13
|
| Rate for Payer: United Healthcare Medicare |
$138.53
|
|
|
HC ED MINOR SURG PROC
|
Facility
|
OP
|
$185.54
|
|
| Hospital Charge Code |
1291501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$57.52 |
| Max. Negotiated Rate |
$172.55 |
| Rate for Payer: Aetna Commercial |
$156.60
|
| Rate for Payer: Aetna Medicare |
$59.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$75.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$57.52
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$106.56
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$115.98
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$75.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$68.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$65.31
|
| Rate for Payer: Cash Price |
$111.32
|
| Rate for Payer: Cash Price |
$111.32
|
| Rate for Payer: Centivo All Commercial |
$100.93
|
| Rate for Payer: Cigna All Commercial |
$160.12
|
| Rate for Payer: CORVEL All Commercial |
$172.55
|
| Rate for Payer: Coventry All Commercial |
$163.28
|
| Rate for Payer: Encore All Commercial |
$170.79
|
| Rate for Payer: Frontpath All Commercial |
$170.70
|
| Rate for Payer: Humana ChoiceCare |
$160.25
|
| Rate for Payer: Humana Medicare |
$59.37
|
| Rate for Payer: Lucent All Commercial |
$100.93
|
| Rate for Payer: Lutheran Preferred All Commercial |
$166.99
|
| Rate for Payer: Managed Health Services Medicaid |
$75.80
|
| Rate for Payer: MDWise Medicaid |
$75.80
|
| Rate for Payer: PHCS All Commercial |
$139.16
|
| Rate for Payer: PHP All Commercial |
$140.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$72.36
|
| Rate for Payer: Sagamore Health Network All Products |
$143.24
|
| Rate for Payer: Signature Care EPO |
$154.00
|
| Rate for Payer: Signature Care PPO |
$163.28
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$157.71
|
| Rate for Payer: United Healthcare Commercial |
$146.21
|
| Rate for Payer: United Healthcare Medicare |
$59.37
|
|
|
HC ED MINOR SURG PROC
|
Facility
|
IP
|
$185.54
|
|
| Hospital Charge Code |
1291501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$139.16 |
| Max. Negotiated Rate |
$172.55 |
| Rate for Payer: Aetna Commercial |
$160.31
|
| Rate for Payer: Cash Price |
$111.32
|
| Rate for Payer: Cigna All Commercial |
$160.12
|
| Rate for Payer: CORVEL All Commercial |
$172.55
|
| Rate for Payer: Coventry All Commercial |
$163.28
|
| Rate for Payer: Encore All Commercial |
$170.79
|
| Rate for Payer: Frontpath All Commercial |
$170.70
|
| Rate for Payer: Humana ChoiceCare |
$160.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$166.99
|
| Rate for Payer: PHCS All Commercial |
$139.16
|
| Rate for Payer: PHP All Commercial |
$140.71
|
| Rate for Payer: Sagamore Health Network All Products |
$143.24
|
| Rate for Payer: Signature Care EPO |
$154.00
|
| Rate for Payer: Signature Care PPO |
$163.28
|
| Rate for Payer: United Healthcare Commercial |
$146.21
|
|
|
HC ED SQ/IM INJECTION
|
Facility
|
IP
|
$106.08
|
|
|
Service Code
|
CPT 96372
|
| Hospital Charge Code |
520372
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$79.56 |
| Max. Negotiated Rate |
$98.65 |
| Rate for Payer: Aetna Commercial |
$91.65
|
| Rate for Payer: Cash Price |
$63.65
|
| Rate for Payer: Cigna All Commercial |
$91.55
|
| Rate for Payer: CORVEL All Commercial |
$98.65
|
| Rate for Payer: Coventry All Commercial |
$93.35
|
| Rate for Payer: Encore All Commercial |
$97.65
|
| Rate for Payer: Frontpath All Commercial |
$97.59
|
| Rate for Payer: Humana ChoiceCare |
$91.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$95.47
|
| Rate for Payer: PHCS All Commercial |
$79.56
|
| Rate for Payer: PHP All Commercial |
$80.45
|
| Rate for Payer: Sagamore Health Network All Products |
$81.89
|
| Rate for Payer: Signature Care EPO |
$88.05
|
| Rate for Payer: Signature Care PPO |
$93.35
|
| Rate for Payer: United Healthcare Commercial |
$83.59
|
|
|
HC ED SQ/IM INJECTION
|
Facility
|
OP
|
$106.08
|
|
|
Service Code
|
CPT 96372
|
| Hospital Charge Code |
520372
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$32.88 |
| Max. Negotiated Rate |
$98.65 |
| Rate for Payer: Aetna Commercial |
$89.53
|
| Rate for Payer: Aetna Medicare |
$33.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$75.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$32.88
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$60.92
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$66.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$75.80
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$39.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$37.34
|
| Rate for Payer: Cash Price |
$63.65
|
| Rate for Payer: Cash Price |
$63.65
|
| Rate for Payer: Centivo All Commercial |
$57.71
|
| Rate for Payer: Cigna All Commercial |
$91.55
|
| Rate for Payer: CORVEL All Commercial |
$98.65
|
| Rate for Payer: Coventry All Commercial |
$93.35
|
| Rate for Payer: Encore All Commercial |
$97.65
|
| Rate for Payer: Frontpath All Commercial |
$97.59
|
| Rate for Payer: Humana ChoiceCare |
$91.62
|
| Rate for Payer: Humana Medicare |
$33.95
|
| Rate for Payer: Lucent All Commercial |
$57.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$95.47
|
| Rate for Payer: Managed Health Services Medicaid |
$75.80
|
| Rate for Payer: MDWise Medicaid |
$75.80
|
| Rate for Payer: PHCS All Commercial |
$79.56
|
| Rate for Payer: PHP All Commercial |
$80.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$41.37
|
| Rate for Payer: Sagamore Health Network All Products |
$81.89
|
| Rate for Payer: Signature Care EPO |
$88.05
|
| Rate for Payer: Signature Care PPO |
$93.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$90.17
|
| Rate for Payer: United Healthcare Commercial |
$83.59
|
| Rate for Payer: United Healthcare Medicare |
$33.95
|
|
|
HC EEG AWAKE & DROWSY
|
Facility
|
OP
|
$1,227.38
|
|
|
Service Code
|
CPT 95816
|
| Hospital Charge Code |
1523383
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$200.10 |
| Max. Negotiated Rate |
$1,141.46 |
| Rate for Payer: Aetna Commercial |
$1,035.91
|
| Rate for Payer: Aetna Medicare |
$392.76
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$200.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$380.49
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$704.88
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$767.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$200.10
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$451.68
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$432.04
|
| Rate for Payer: Cash Price |
$736.43
|
| Rate for Payer: Cash Price |
$736.43
|
| Rate for Payer: Centivo All Commercial |
$667.69
|
| Rate for Payer: Cigna All Commercial |
$1,059.23
|
| Rate for Payer: CORVEL All Commercial |
$1,141.46
|
| Rate for Payer: Coventry All Commercial |
$1,080.09
|
| Rate for Payer: Encore All Commercial |
$1,129.80
|
| Rate for Payer: Frontpath All Commercial |
$1,129.19
|
| Rate for Payer: Humana ChoiceCare |
$1,060.09
|
| Rate for Payer: Humana Medicare |
$392.76
|
| Rate for Payer: Lucent All Commercial |
$667.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,104.64
|
| Rate for Payer: Managed Health Services Medicaid |
$200.10
|
| Rate for Payer: MDWise Medicaid |
$200.10
|
| Rate for Payer: PHCS All Commercial |
$920.53
|
| Rate for Payer: PHP All Commercial |
$930.84
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$478.68
|
| Rate for Payer: Sagamore Health Network All Products |
$947.54
|
| Rate for Payer: Signature Care EPO |
$1,018.73
|
| Rate for Payer: Signature Care PPO |
$1,080.09
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,043.27
|
| Rate for Payer: United Healthcare Commercial |
$967.18
|
| Rate for Payer: United Healthcare Medicare |
$392.76
|
|
|
HC EEG AWAKE & DROWSY
|
Facility
|
IP
|
$1,227.38
|
|
|
Service Code
|
CPT 95816
|
| Hospital Charge Code |
1523383
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$920.53 |
| Max. Negotiated Rate |
$1,141.46 |
| Rate for Payer: Aetna Commercial |
$1,060.46
|
| Rate for Payer: Cash Price |
$736.43
|
| Rate for Payer: Cigna All Commercial |
$1,059.23
|
| Rate for Payer: CORVEL All Commercial |
$1,141.46
|
| Rate for Payer: Coventry All Commercial |
$1,080.09
|
| Rate for Payer: Encore All Commercial |
$1,129.80
|
| Rate for Payer: Frontpath All Commercial |
$1,129.19
|
| Rate for Payer: Humana ChoiceCare |
$1,060.09
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,104.64
|
| Rate for Payer: PHCS All Commercial |
$920.53
|
| Rate for Payer: PHP All Commercial |
$930.84
|
| Rate for Payer: Sagamore Health Network All Products |
$947.54
|
| Rate for Payer: Signature Care EPO |
$1,018.73
|
| Rate for Payer: Signature Care PPO |
$1,080.09
|
| Rate for Payer: United Healthcare Commercial |
$967.18
|
|
|
HC EKG RHYTHM STRIP
|
Facility
|
OP
|
$178.79
|
|
|
Service Code
|
CPT 93041
|
| Hospital Charge Code |
1503826
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$34.97 |
| Max. Negotiated Rate |
$166.27 |
| Rate for Payer: Aetna Commercial |
$150.90
|
| Rate for Payer: Aetna Medicare |
$57.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$34.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$55.42
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$102.68
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$111.76
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$34.97
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$65.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$62.93
|
| Rate for Payer: Cash Price |
$107.27
|
| Rate for Payer: Cash Price |
$107.27
|
| Rate for Payer: Centivo All Commercial |
$97.26
|
| Rate for Payer: Cigna All Commercial |
$154.30
|
| Rate for Payer: CORVEL All Commercial |
$166.27
|
| Rate for Payer: Coventry All Commercial |
$157.34
|
| Rate for Payer: Encore All Commercial |
$164.58
|
| Rate for Payer: Frontpath All Commercial |
$164.49
|
| Rate for Payer: Humana ChoiceCare |
$154.42
|
| Rate for Payer: Humana Medicare |
$57.21
|
| Rate for Payer: Lucent All Commercial |
$97.26
|
| Rate for Payer: Lutheran Preferred All Commercial |
$160.91
|
| Rate for Payer: Managed Health Services Medicaid |
$34.97
|
| Rate for Payer: MDWise Medicaid |
$34.97
|
| Rate for Payer: PHCS All Commercial |
$134.09
|
| Rate for Payer: PHP All Commercial |
$135.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$69.73
|
| Rate for Payer: Sagamore Health Network All Products |
$138.03
|
| Rate for Payer: Signature Care EPO |
$148.40
|
| Rate for Payer: Signature Care PPO |
$157.34
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$151.97
|
| Rate for Payer: United Healthcare Commercial |
$140.89
|
| Rate for Payer: United Healthcare Medicare |
$57.21
|
|
|
HC EKG RHYTHM STRIP
|
Facility
|
IP
|
$178.79
|
|
|
Service Code
|
CPT 93041
|
| Hospital Charge Code |
1503826
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$134.09 |
| Max. Negotiated Rate |
$166.27 |
| Rate for Payer: Aetna Commercial |
$154.47
|
| Rate for Payer: Cash Price |
$107.27
|
| Rate for Payer: Cigna All Commercial |
$154.30
|
| Rate for Payer: CORVEL All Commercial |
$166.27
|
| Rate for Payer: Coventry All Commercial |
$157.34
|
| Rate for Payer: Encore All Commercial |
$164.58
|
| Rate for Payer: Frontpath All Commercial |
$164.49
|
| Rate for Payer: Humana ChoiceCare |
$154.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$160.91
|
| Rate for Payer: PHCS All Commercial |
$134.09
|
| Rate for Payer: PHP All Commercial |
$135.59
|
| Rate for Payer: Sagamore Health Network All Products |
$138.03
|
| Rate for Payer: Signature Care EPO |
$148.40
|
| Rate for Payer: Signature Care PPO |
$157.34
|
| Rate for Payer: United Healthcare Commercial |
$140.89
|
|
|
HC EKG STRESS TEST
|
Facility
|
IP
|
$1,089.44
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
1503935
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$817.08 |
| Max. Negotiated Rate |
$1,013.18 |
| Rate for Payer: Aetna Commercial |
$941.28
|
| Rate for Payer: Cash Price |
$653.66
|
| Rate for Payer: Cigna All Commercial |
$940.19
|
| Rate for Payer: CORVEL All Commercial |
$1,013.18
|
| Rate for Payer: Coventry All Commercial |
$958.71
|
| Rate for Payer: Encore All Commercial |
$1,002.83
|
| Rate for Payer: Frontpath All Commercial |
$1,002.28
|
| Rate for Payer: Humana ChoiceCare |
$940.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$980.50
|
| Rate for Payer: PHCS All Commercial |
$817.08
|
| Rate for Payer: PHP All Commercial |
$826.23
|
| Rate for Payer: Sagamore Health Network All Products |
$841.05
|
| Rate for Payer: Signature Care EPO |
$904.24
|
| Rate for Payer: Signature Care PPO |
$958.71
|
| Rate for Payer: United Healthcare Commercial |
$858.48
|
|
|
HC EKG STRESS TEST
|
Facility
|
OP
|
$1,089.44
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
1503935
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$121.91 |
| Max. Negotiated Rate |
$1,013.18 |
| Rate for Payer: Aetna Commercial |
$919.49
|
| Rate for Payer: Aetna Medicare |
$348.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$121.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$337.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$625.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$681.01
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$121.91
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$400.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$383.48
|
| Rate for Payer: Cash Price |
$653.66
|
| Rate for Payer: Cash Price |
$653.66
|
| Rate for Payer: Centivo All Commercial |
$592.66
|
| Rate for Payer: Cigna All Commercial |
$940.19
|
| Rate for Payer: CORVEL All Commercial |
$1,013.18
|
| Rate for Payer: Coventry All Commercial |
$958.71
|
| Rate for Payer: Encore All Commercial |
$1,002.83
|
| Rate for Payer: Frontpath All Commercial |
$1,002.28
|
| Rate for Payer: Humana ChoiceCare |
$940.95
|
| Rate for Payer: Humana Medicare |
$348.62
|
| Rate for Payer: Lucent All Commercial |
$592.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$980.50
|
| Rate for Payer: Managed Health Services Medicaid |
$121.91
|
| Rate for Payer: MDWise Medicaid |
$121.91
|
| Rate for Payer: PHCS All Commercial |
$817.08
|
| Rate for Payer: PHP All Commercial |
$826.23
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$424.88
|
| Rate for Payer: Sagamore Health Network All Products |
$841.05
|
| Rate for Payer: Signature Care EPO |
$904.24
|
| Rate for Payer: Signature Care PPO |
$958.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$926.02
|
| Rate for Payer: United Healthcare Commercial |
$858.48
|
| Rate for Payer: United Healthcare Medicare |
$348.62
|
|
|
HC ELEC STIM (UNATTENDED)-OT
|
Facility
|
OP
|
$125.36
|
|
|
Service Code
|
CPT G0283 GO
|
| Hospital Charge Code |
1738018
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$38.86 |
| Max. Negotiated Rate |
$116.58 |
| Rate for Payer: Aetna Commercial |
$105.80
|
| Rate for Payer: Aetna Medicare |
$40.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$47.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$38.86
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$71.99
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$78.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$47.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$46.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$44.13
|
| Rate for Payer: Cash Price |
$75.22
|
| Rate for Payer: Cash Price |
$75.22
|
| Rate for Payer: Centivo All Commercial |
$68.20
|
| Rate for Payer: Cigna All Commercial |
$108.19
|
| Rate for Payer: CORVEL All Commercial |
$116.58
|
| Rate for Payer: Coventry All Commercial |
$110.32
|
| Rate for Payer: Encore All Commercial |
$115.39
|
| Rate for Payer: Frontpath All Commercial |
$115.33
|
| Rate for Payer: Humana ChoiceCare |
$108.27
|
| Rate for Payer: Humana Medicare |
$40.12
|
| Rate for Payer: Lucent All Commercial |
$68.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$112.82
|
| Rate for Payer: Managed Health Services Medicaid |
$47.81
|
| Rate for Payer: MDWise Medicaid |
$47.81
|
| Rate for Payer: PHCS All Commercial |
$94.02
|
| Rate for Payer: PHP All Commercial |
$95.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$48.89
|
| Rate for Payer: Sagamore Health Network All Products |
$96.78
|
| Rate for Payer: Signature Care EPO |
$104.05
|
| Rate for Payer: Signature Care PPO |
$110.32
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$106.56
|
| Rate for Payer: United Healthcare Commercial |
$98.78
|
| Rate for Payer: United Healthcare Medicare |
$40.12
|
|
