|
HC I2B INS KIT 5MS
|
Facility
IP
|
$3,322.80
|
|
| Hospital Charge Code |
41607911
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,492.10 |
| Max. Negotiated Rate |
$3,090.20 |
| Rate for Payer: Aetna Commercial |
$2,870.90
|
| Rate for Payer: Cash Price |
$2,060.14
|
| Rate for Payer: Cigna All Commercial |
$2,867.58
|
| Rate for Payer: CORVEL All Commercial |
$3,090.20
|
| Rate for Payer: Coventry All Commercial |
$2,924.06
|
| Rate for Payer: Encore All Commercial |
$3,058.64
|
| Rate for Payer: Frontpath All Commercial |
$3,056.98
|
| Rate for Payer: Humana ChoiceCare |
$2,869.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,990.52
|
| Rate for Payer: PHCS All Commercial |
$2,492.10
|
| Rate for Payer: PHP All Commercial |
$2,520.01
|
| Rate for Payer: Sagamore Health Network All Products |
$2,565.20
|
| Rate for Payer: Signature Care EPO |
$2,757.92
|
| Rate for Payer: Signature Care PPO |
$2,924.06
|
| Rate for Payer: United Healthcare Commercial |
$2,618.37
|
|
|
HC I2B INS KIT 5MS
|
Facility
OP
|
$3,322.80
|
|
| Hospital Charge Code |
41607911
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$3,090.20 |
| Rate for Payer: Aetna Commercial |
$2,804.44
|
| Rate for Payer: Aetna Medicare |
$1,096.52
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,096.52
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,908.28
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,077.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,261.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,206.18
|
| Rate for Payer: Cash Price |
$2,060.14
|
| Rate for Payer: Cash Price |
$2,060.14
|
| Rate for Payer: Centivo All Commercial |
$1,694.63
|
| Rate for Payer: Cigna All Commercial |
$2,867.58
|
| Rate for Payer: CORVEL All Commercial |
$3,090.20
|
| Rate for Payer: Coventry All Commercial |
$2,924.06
|
| Rate for Payer: Encore All Commercial |
$3,058.64
|
| Rate for Payer: Frontpath All Commercial |
$3,056.98
|
| Rate for Payer: Humana ChoiceCare |
$2,869.90
|
| Rate for Payer: Humana Medicare |
$1,694.63
|
| Rate for Payer: Lucent All Commercial |
$1,694.63
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,990.52
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$2,492.10
|
| Rate for Payer: PHP All Commercial |
$2,520.01
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,295.89
|
| Rate for Payer: Sagamore Health Network All Products |
$2,565.20
|
| Rate for Payer: Signature Care EPO |
$2,757.92
|
| Rate for Payer: Signature Care PPO |
$2,924.06
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,824.38
|
| Rate for Payer: United Healthcare Commercial |
$2,618.37
|
| Rate for Payer: United Healthcare Medicare |
$1,096.52
|
|
|
HC I2B PLATE 6-H LAT NK R
|
Facility
IP
|
$9,057.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607910
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,793.20 |
| Max. Negotiated Rate |
$8,423.57 |
| Rate for Payer: Aetna Commercial |
$7,825.77
|
| Rate for Payer: Cash Price |
$5,615.71
|
| Rate for Payer: Cigna All Commercial |
$7,816.71
|
| Rate for Payer: CORVEL All Commercial |
$8,423.57
|
| Rate for Payer: Coventry All Commercial |
$7,970.69
|
| Rate for Payer: Encore All Commercial |
$8,337.52
|
| Rate for Payer: Frontpath All Commercial |
$8,332.99
|
| Rate for Payer: Humana ChoiceCare |
$7,823.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,151.84
|
| Rate for Payer: PHCS All Commercial |
$6,793.20
|
| Rate for Payer: PHP All Commercial |
$6,869.28
|
| Rate for Payer: Sagamore Health Network All Products |
$6,992.47
|
| Rate for Payer: Signature Care EPO |
$7,517.81
|
| Rate for Payer: Signature Care PPO |
$7,970.69
|
| Rate for Payer: United Healthcare Commercial |
$7,137.39
|
|
|
HC I2B PLATE 6-H LAT NK R
|
Facility
OP
|
$9,057.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607910
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$8,423.57 |
| Rate for Payer: Aetna Commercial |
$7,644.61
|
| Rate for Payer: Aetna Medicare |
$2,989.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,989.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$5,201.78
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,661.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,437.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,287.91
|
| Rate for Payer: Cash Price |
$5,615.71
|
| Rate for Payer: Cash Price |
$5,615.71
|
| Rate for Payer: Centivo All Commercial |
$4,619.38
|
| Rate for Payer: Cigna All Commercial |
$7,816.71
|
| Rate for Payer: CORVEL All Commercial |
$8,423.57
|
| Rate for Payer: Coventry All Commercial |
$7,970.69
|
| Rate for Payer: Encore All Commercial |
$8,337.52
|
| Rate for Payer: Frontpath All Commercial |
$8,332.99
|
| Rate for Payer: Humana ChoiceCare |
$7,823.05
|
| Rate for Payer: Humana Medicare |
$4,619.38
|
| Rate for Payer: Lucent All Commercial |
$4,619.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,151.84
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,793.20
|
| Rate for Payer: PHP All Commercial |
$6,869.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,532.46
|
| Rate for Payer: Sagamore Health Network All Products |
$6,992.47
|
| Rate for Payer: Signature Care EPO |
$7,517.81
|
| Rate for Payer: Signature Care PPO |
$7,970.69
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,698.96
|
| Rate for Payer: United Healthcare Commercial |
$7,137.39
|
| Rate for Payer: United Healthcare Medicare |
$2,989.01
|
|
|
HC I2B PLATE 8-H LAT NK L
|
Facility
IP
|
$8,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608259
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,412.50 |
| Max. Negotiated Rate |
$7,951.50 |
| Rate for Payer: Aetna Commercial |
$7,387.20
|
| Rate for Payer: Cash Price |
$5,301.00
|
| Rate for Payer: Cigna All Commercial |
$7,378.65
|
| Rate for Payer: CORVEL All Commercial |
$7,951.50
|
| Rate for Payer: Coventry All Commercial |
$7,524.00
|
| Rate for Payer: Encore All Commercial |
$7,870.28
|
| Rate for Payer: Frontpath All Commercial |
$7,866.00
|
| Rate for Payer: Humana ChoiceCare |
$7,384.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,695.00
|
| Rate for Payer: PHCS All Commercial |
$6,412.50
|
| Rate for Payer: PHP All Commercial |
$6,484.32
|
| Rate for Payer: Sagamore Health Network All Products |
$6,600.60
|
| Rate for Payer: Signature Care EPO |
$7,096.50
|
| Rate for Payer: Signature Care PPO |
$7,524.00
|
| Rate for Payer: United Healthcare Commercial |
$6,737.40
|
|
|
HC I2B PLATE 8-H LAT NK L
|
Facility
OP
|
$8,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608259
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,951.50 |
| Rate for Payer: Aetna Commercial |
$7,216.20
|
| Rate for Payer: Aetna Medicare |
$2,821.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,821.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,910.26
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,344.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,244.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,103.65
|
| Rate for Payer: Cash Price |
$5,301.00
|
| Rate for Payer: Cash Price |
$5,301.00
|
| Rate for Payer: Centivo All Commercial |
$4,360.50
|
| Rate for Payer: Cigna All Commercial |
$7,378.65
|
| Rate for Payer: CORVEL All Commercial |
$7,951.50
|
| Rate for Payer: Coventry All Commercial |
$7,524.00
|
| Rate for Payer: Encore All Commercial |
$7,870.28
|
| Rate for Payer: Frontpath All Commercial |
$7,866.00
|
| Rate for Payer: Humana ChoiceCare |
$7,384.64
|
| Rate for Payer: Humana Medicare |
$4,360.50
|
| Rate for Payer: Lucent All Commercial |
$4,360.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,695.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,412.50
|
| Rate for Payer: PHP All Commercial |
$6,484.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,334.50
|
| Rate for Payer: Sagamore Health Network All Products |
$6,600.60
|
| Rate for Payer: Signature Care EPO |
$7,096.50
|
| Rate for Payer: Signature Care PPO |
$7,524.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,267.50
|
| Rate for Payer: United Healthcare Commercial |
$6,737.40
|
| Rate for Payer: United Healthcare Medicare |
$2,821.50
|
|
|
HC I2B RTS 1ST MPJ GROM 1
|
Facility
IP
|
$9,054.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607042
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,790.50 |
| Max. Negotiated Rate |
$8,420.22 |
| Rate for Payer: Aetna Commercial |
$7,822.66
|
| Rate for Payer: Cash Price |
$5,613.48
|
| Rate for Payer: Cigna All Commercial |
$7,813.60
|
| Rate for Payer: CORVEL All Commercial |
$8,420.22
|
| Rate for Payer: Coventry All Commercial |
$7,967.52
|
| Rate for Payer: Encore All Commercial |
$8,334.21
|
| Rate for Payer: Frontpath All Commercial |
$8,329.68
|
| Rate for Payer: Humana ChoiceCare |
$7,819.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,148.60
|
| Rate for Payer: PHCS All Commercial |
$6,790.50
|
| Rate for Payer: PHP All Commercial |
$6,866.55
|
| Rate for Payer: Sagamore Health Network All Products |
$6,989.69
|
| Rate for Payer: Signature Care EPO |
$7,514.82
|
| Rate for Payer: Signature Care PPO |
$7,967.52
|
| Rate for Payer: United Healthcare Commercial |
$7,134.55
|
|
|
HC I2B RTS 1ST MPJ GROM 1
|
Facility
OP
|
$9,054.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607042
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$8,420.22 |
| Rate for Payer: Aetna Commercial |
$7,641.58
|
| Rate for Payer: Aetna Medicare |
$2,987.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,987.82
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$5,199.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,659.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,435.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,286.60
|
| Rate for Payer: Cash Price |
$5,613.48
|
| Rate for Payer: Cash Price |
$5,613.48
|
| Rate for Payer: Centivo All Commercial |
$4,617.54
|
| Rate for Payer: Cigna All Commercial |
$7,813.60
|
| Rate for Payer: CORVEL All Commercial |
$8,420.22
|
| Rate for Payer: Coventry All Commercial |
$7,967.52
|
| Rate for Payer: Encore All Commercial |
$8,334.21
|
| Rate for Payer: Frontpath All Commercial |
$8,329.68
|
| Rate for Payer: Humana ChoiceCare |
$7,819.94
|
| Rate for Payer: Humana Medicare |
$4,617.54
|
| Rate for Payer: Lucent All Commercial |
$4,617.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,148.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,790.50
|
| Rate for Payer: PHP All Commercial |
$6,866.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,531.06
|
| Rate for Payer: Sagamore Health Network All Products |
$6,989.69
|
| Rate for Payer: Signature Care EPO |
$7,514.82
|
| Rate for Payer: Signature Care PPO |
$7,967.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,695.90
|
| Rate for Payer: United Healthcare Commercial |
$7,134.55
|
| Rate for Payer: United Healthcare Medicare |
$2,987.82
|
|
|
HC I2B RTS 1ST MPJ GROM3
|
Facility
OP
|
$9,054.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606646
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$8,420.22 |
| Rate for Payer: Aetna Commercial |
$7,641.58
|
| Rate for Payer: Aetna Medicare |
$2,987.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,987.82
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$5,199.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,659.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,435.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,286.60
|
| Rate for Payer: Cash Price |
$5,613.48
|
| Rate for Payer: Cash Price |
$5,613.48
|
| Rate for Payer: Centivo All Commercial |
$4,617.54
|
| Rate for Payer: Cigna All Commercial |
$7,813.60
|
| Rate for Payer: CORVEL All Commercial |
$8,420.22
|
| Rate for Payer: Coventry All Commercial |
$7,967.52
|
| Rate for Payer: Encore All Commercial |
$8,334.21
|
| Rate for Payer: Frontpath All Commercial |
$8,329.68
|
| Rate for Payer: Humana ChoiceCare |
$7,819.94
|
| Rate for Payer: Humana Medicare |
$4,617.54
|
| Rate for Payer: Lucent All Commercial |
$4,617.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,148.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,790.50
|
| Rate for Payer: PHP All Commercial |
$6,866.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,531.06
|
| Rate for Payer: Sagamore Health Network All Products |
$6,989.69
|
| Rate for Payer: Signature Care EPO |
$7,514.82
|
| Rate for Payer: Signature Care PPO |
$7,967.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,695.90
|
| Rate for Payer: United Healthcare Commercial |
$7,134.55
|
| Rate for Payer: United Healthcare Medicare |
$2,987.82
|
|
|
HC I2B RTS 1ST MPJ GROM3
|
Facility
IP
|
$9,054.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606646
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,790.50 |
| Max. Negotiated Rate |
$8,420.22 |
| Rate for Payer: Aetna Commercial |
$7,822.66
|
| Rate for Payer: Cash Price |
$5,613.48
|
| Rate for Payer: Cigna All Commercial |
$7,813.60
|
| Rate for Payer: CORVEL All Commercial |
$8,420.22
|
| Rate for Payer: Coventry All Commercial |
$7,967.52
|
| Rate for Payer: Encore All Commercial |
$8,334.21
|
| Rate for Payer: Frontpath All Commercial |
$8,329.68
|
| Rate for Payer: Humana ChoiceCare |
$7,819.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,148.60
|
| Rate for Payer: PHCS All Commercial |
$6,790.50
|
| Rate for Payer: PHP All Commercial |
$6,866.55
|
| Rate for Payer: Sagamore Health Network All Products |
$6,989.69
|
| Rate for Payer: Signature Care EPO |
$7,514.82
|
| Rate for Payer: Signature Care PPO |
$7,967.52
|
| Rate for Payer: United Healthcare Commercial |
$7,134.55
|
|
|
HC I2B RTS 1ST MPJ GROM 4
|
Facility
OP
|
$9,054.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604938
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$8,420.22 |
| Rate for Payer: Aetna Commercial |
$7,641.58
|
| Rate for Payer: Aetna Medicare |
$2,987.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,987.82
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$5,199.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,659.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,435.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,286.60
|
| Rate for Payer: Cash Price |
$5,613.48
|
| Rate for Payer: Cash Price |
$5,613.48
|
| Rate for Payer: Centivo All Commercial |
$4,617.54
|
| Rate for Payer: Cigna All Commercial |
$7,813.60
|
| Rate for Payer: CORVEL All Commercial |
$8,420.22
|
| Rate for Payer: Coventry All Commercial |
$7,967.52
|
| Rate for Payer: Encore All Commercial |
$8,334.21
|
| Rate for Payer: Frontpath All Commercial |
$8,329.68
|
| Rate for Payer: Humana ChoiceCare |
$7,819.94
|
| Rate for Payer: Humana Medicare |
$4,617.54
|
| Rate for Payer: Lucent All Commercial |
$4,617.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,148.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,790.50
|
| Rate for Payer: PHP All Commercial |
$6,866.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,531.06
|
| Rate for Payer: Sagamore Health Network All Products |
$6,989.69
|
| Rate for Payer: Signature Care EPO |
$7,514.82
|
| Rate for Payer: Signature Care PPO |
$7,967.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,695.90
|
| Rate for Payer: United Healthcare Commercial |
$7,134.55
|
| Rate for Payer: United Healthcare Medicare |
$2,987.82
|
|
|
HC I2B RTS 1ST MPJ GROM 4
|
Facility
IP
|
$9,054.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604938
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,790.50 |
| Max. Negotiated Rate |
$8,420.22 |
| Rate for Payer: Aetna Commercial |
$7,822.66
|
| Rate for Payer: Cash Price |
$5,613.48
|
| Rate for Payer: Cigna All Commercial |
$7,813.60
|
| Rate for Payer: CORVEL All Commercial |
$8,420.22
|
| Rate for Payer: Coventry All Commercial |
$7,967.52
|
| Rate for Payer: Encore All Commercial |
$8,334.21
|
| Rate for Payer: Frontpath All Commercial |
$8,329.68
|
| Rate for Payer: Humana ChoiceCare |
$7,819.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,148.60
|
| Rate for Payer: PHCS All Commercial |
$6,790.50
|
| Rate for Payer: PHP All Commercial |
$6,866.55
|
| Rate for Payer: Sagamore Health Network All Products |
$6,989.69
|
| Rate for Payer: Signature Care EPO |
$7,514.82
|
| Rate for Payer: Signature Care PPO |
$7,967.52
|
| Rate for Payer: United Healthcare Commercial |
$7,134.55
|
|
|
HC I2B RTS 1ST MPJ GROM 4
|
Facility
OP
|
$9,054.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604375
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$8,420.22 |
| Rate for Payer: Aetna Commercial |
$7,641.58
|
| Rate for Payer: Aetna Medicare |
$2,987.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,987.82
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$5,199.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,659.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,435.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,286.60
|
| Rate for Payer: Cash Price |
$5,613.48
|
| Rate for Payer: Cash Price |
$5,613.48
|
| Rate for Payer: Centivo All Commercial |
$4,617.54
|
| Rate for Payer: Cigna All Commercial |
$7,813.60
|
| Rate for Payer: CORVEL All Commercial |
$8,420.22
|
| Rate for Payer: Coventry All Commercial |
$7,967.52
|
| Rate for Payer: Encore All Commercial |
$8,334.21
|
| Rate for Payer: Frontpath All Commercial |
$8,329.68
|
| Rate for Payer: Humana ChoiceCare |
$7,819.94
|
| Rate for Payer: Humana Medicare |
$4,617.54
|
| Rate for Payer: Lucent All Commercial |
$4,617.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,148.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,790.50
|
| Rate for Payer: PHP All Commercial |
$6,866.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,531.06
|
| Rate for Payer: Sagamore Health Network All Products |
$6,989.69
|
| Rate for Payer: Signature Care EPO |
$7,514.82
|
| Rate for Payer: Signature Care PPO |
$7,967.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,695.90
|
| Rate for Payer: United Healthcare Commercial |
$7,134.55
|
| Rate for Payer: United Healthcare Medicare |
$2,987.82
|
|
|
HC I2B RTS 1ST MPJ GROM 4
|
Facility
IP
|
$9,054.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41604375
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,790.50 |
| Max. Negotiated Rate |
$8,420.22 |
| Rate for Payer: Aetna Commercial |
$7,822.66
|
| Rate for Payer: Cash Price |
$5,613.48
|
| Rate for Payer: Cigna All Commercial |
$7,813.60
|
| Rate for Payer: CORVEL All Commercial |
$8,420.22
|
| Rate for Payer: Coventry All Commercial |
$7,967.52
|
| Rate for Payer: Encore All Commercial |
$8,334.21
|
| Rate for Payer: Frontpath All Commercial |
$8,329.68
|
| Rate for Payer: Humana ChoiceCare |
$7,819.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,148.60
|
| Rate for Payer: PHCS All Commercial |
$6,790.50
|
| Rate for Payer: PHP All Commercial |
$6,866.55
|
| Rate for Payer: Sagamore Health Network All Products |
$6,989.69
|
| Rate for Payer: Signature Care EPO |
$7,514.82
|
| Rate for Payer: Signature Care PPO |
$7,967.52
|
| Rate for Payer: United Healthcare Commercial |
$7,134.55
|
|
|
HC I2B RTS INS 1-2
|
Facility
OP
|
$1,962.00
|
|
| Hospital Charge Code |
41604937
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,824.66 |
| Rate for Payer: Aetna Commercial |
$1,655.93
|
| Rate for Payer: Aetna Medicare |
$647.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$647.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,126.78
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,226.45
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$744.58
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$712.21
|
| Rate for Payer: Cash Price |
$1,216.44
|
| Rate for Payer: Cash Price |
$1,216.44
|
| Rate for Payer: Centivo All Commercial |
$1,000.62
|
| Rate for Payer: Cigna All Commercial |
$1,693.21
|
| Rate for Payer: CORVEL All Commercial |
$1,824.66
|
| Rate for Payer: Coventry All Commercial |
$1,726.56
|
| Rate for Payer: Encore All Commercial |
$1,806.02
|
| Rate for Payer: Frontpath All Commercial |
$1,805.04
|
| Rate for Payer: Humana ChoiceCare |
$1,694.58
|
| Rate for Payer: Humana Medicare |
$1,000.62
|
| Rate for Payer: Lucent All Commercial |
$1,000.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,765.80
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,471.50
|
| Rate for Payer: PHP All Commercial |
$1,487.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$765.18
|
| Rate for Payer: Sagamore Health Network All Products |
$1,514.66
|
| Rate for Payer: Signature Care EPO |
$1,628.46
|
| Rate for Payer: Signature Care PPO |
$1,726.56
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,667.70
|
| Rate for Payer: United Healthcare Commercial |
$1,546.06
|
| Rate for Payer: United Healthcare Medicare |
$647.46
|
|
|
HC I2B RTS INS 1-2
|
Facility
IP
|
$1,962.00
|
|
| Hospital Charge Code |
41604937
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,471.50 |
| Max. Negotiated Rate |
$1,824.66 |
| Rate for Payer: Aetna Commercial |
$1,695.17
|
| Rate for Payer: Cash Price |
$1,216.44
|
| Rate for Payer: Cigna All Commercial |
$1,693.21
|
| Rate for Payer: CORVEL All Commercial |
$1,824.66
|
| Rate for Payer: Coventry All Commercial |
$1,726.56
|
| Rate for Payer: Encore All Commercial |
$1,806.02
|
| Rate for Payer: Frontpath All Commercial |
$1,805.04
|
| Rate for Payer: Humana ChoiceCare |
$1,694.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,765.80
|
| Rate for Payer: PHCS All Commercial |
$1,471.50
|
| Rate for Payer: PHP All Commercial |
$1,487.98
|
| Rate for Payer: Sagamore Health Network All Products |
$1,514.66
|
| Rate for Payer: Signature Care EPO |
$1,628.46
|
| Rate for Payer: Signature Care PPO |
$1,726.56
|
| Rate for Payer: United Healthcare Commercial |
$1,546.06
|
|
|
HC I2B RTS INS 3-4
|
Facility
IP
|
$1,962.00
|
|
| Hospital Charge Code |
41604376
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,471.50 |
| Max. Negotiated Rate |
$1,824.66 |
| Rate for Payer: Aetna Commercial |
$1,695.17
|
| Rate for Payer: Cash Price |
$1,216.44
|
| Rate for Payer: Cigna All Commercial |
$1,693.21
|
| Rate for Payer: CORVEL All Commercial |
$1,824.66
|
| Rate for Payer: Coventry All Commercial |
$1,726.56
|
| Rate for Payer: Encore All Commercial |
$1,806.02
|
| Rate for Payer: Frontpath All Commercial |
$1,805.04
|
| Rate for Payer: Humana ChoiceCare |
$1,694.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,765.80
|
| Rate for Payer: PHCS All Commercial |
$1,471.50
|
| Rate for Payer: PHP All Commercial |
$1,487.98
|
| Rate for Payer: Sagamore Health Network All Products |
$1,514.66
|
| Rate for Payer: Signature Care EPO |
$1,628.46
|
| Rate for Payer: Signature Care PPO |
$1,726.56
|
| Rate for Payer: United Healthcare Commercial |
$1,546.06
|
|
|
HC I2B RTS INS 3-4
|
Facility
OP
|
$1,962.00
|
|
| Hospital Charge Code |
41604376
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,824.66 |
| Rate for Payer: Aetna Commercial |
$1,655.93
|
| Rate for Payer: Aetna Medicare |
$647.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$647.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,126.78
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,226.45
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$744.58
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$712.21
|
| Rate for Payer: Cash Price |
$1,216.44
|
| Rate for Payer: Cash Price |
$1,216.44
|
| Rate for Payer: Centivo All Commercial |
$1,000.62
|
| Rate for Payer: Cigna All Commercial |
$1,693.21
|
| Rate for Payer: CORVEL All Commercial |
$1,824.66
|
| Rate for Payer: Coventry All Commercial |
$1,726.56
|
| Rate for Payer: Encore All Commercial |
$1,806.02
|
| Rate for Payer: Frontpath All Commercial |
$1,805.04
|
| Rate for Payer: Humana ChoiceCare |
$1,694.58
|
| Rate for Payer: Humana Medicare |
$1,000.62
|
| Rate for Payer: Lucent All Commercial |
$1,000.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,765.80
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,471.50
|
| Rate for Payer: PHP All Commercial |
$1,487.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$765.18
|
| Rate for Payer: Sagamore Health Network All Products |
$1,514.66
|
| Rate for Payer: Signature Care EPO |
$1,628.46
|
| Rate for Payer: Signature Care PPO |
$1,726.56
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,667.70
|
| Rate for Payer: United Healthcare Commercial |
$1,546.06
|
| Rate for Payer: United Healthcare Medicare |
$647.46
|
|
|
HC I2B RTS INS LESSER MTP
|
Facility
IP
|
$2,475.00
|
|
| Hospital Charge Code |
41606960
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,856.25 |
| Max. Negotiated Rate |
$2,301.75 |
| Rate for Payer: Aetna Commercial |
$2,138.40
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Cigna All Commercial |
$2,135.92
|
| Rate for Payer: CORVEL All Commercial |
$2,301.75
|
| Rate for Payer: Coventry All Commercial |
$2,178.00
|
| Rate for Payer: Encore All Commercial |
$2,278.24
|
| Rate for Payer: Frontpath All Commercial |
$2,277.00
|
| Rate for Payer: Humana ChoiceCare |
$2,137.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,227.50
|
| Rate for Payer: PHCS All Commercial |
$1,856.25
|
| Rate for Payer: PHP All Commercial |
$1,877.04
|
| Rate for Payer: Sagamore Health Network All Products |
$1,910.70
|
| Rate for Payer: Signature Care EPO |
$2,054.25
|
| Rate for Payer: Signature Care PPO |
$2,178.00
|
| Rate for Payer: United Healthcare Commercial |
$1,950.30
|
|
|
HC I2B RTS INS LESSER MTP
|
Facility
OP
|
$2,475.00
|
|
| Hospital Charge Code |
41606960
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$2,301.75 |
| Rate for Payer: Aetna Commercial |
$2,088.90
|
| Rate for Payer: Aetna Medicare |
$816.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$816.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,421.39
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,547.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$939.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$898.42
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Cash Price |
$1,534.50
|
| Rate for Payer: Centivo All Commercial |
$1,262.25
|
| Rate for Payer: Cigna All Commercial |
$2,135.92
|
| Rate for Payer: CORVEL All Commercial |
$2,301.75
|
| Rate for Payer: Coventry All Commercial |
$2,178.00
|
| Rate for Payer: Encore All Commercial |
$2,278.24
|
| Rate for Payer: Frontpath All Commercial |
$2,277.00
|
| Rate for Payer: Humana ChoiceCare |
$2,137.66
|
| Rate for Payer: Humana Medicare |
$1,262.25
|
| Rate for Payer: Lucent All Commercial |
$1,262.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,227.50
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,856.25
|
| Rate for Payer: PHP All Commercial |
$1,877.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$965.25
|
| Rate for Payer: Sagamore Health Network All Products |
$1,910.70
|
| Rate for Payer: Signature Care EPO |
$2,054.25
|
| Rate for Payer: Signature Care PPO |
$2,178.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,103.75
|
| Rate for Payer: United Healthcare Commercial |
$1,950.30
|
| Rate for Payer: United Healthcare Medicare |
$816.75
|
|
|
HC I2B RTS LESSER MTP 3
|
Facility
OP
|
$8,449.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606961
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,857.76 |
| Rate for Payer: Aetna Commercial |
$7,131.12
|
| Rate for Payer: Aetna Medicare |
$2,788.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,788.24
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,852.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,281.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,206.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,067.06
|
| Rate for Payer: Cash Price |
$5,238.50
|
| Rate for Payer: Cash Price |
$5,238.50
|
| Rate for Payer: Centivo All Commercial |
$4,309.09
|
| Rate for Payer: Cigna All Commercial |
$7,291.66
|
| Rate for Payer: CORVEL All Commercial |
$7,857.76
|
| Rate for Payer: Coventry All Commercial |
$7,435.30
|
| Rate for Payer: Encore All Commercial |
$7,777.49
|
| Rate for Payer: Frontpath All Commercial |
$7,773.26
|
| Rate for Payer: Humana ChoiceCare |
$7,297.57
|
| Rate for Payer: Humana Medicare |
$4,309.09
|
| Rate for Payer: Lucent All Commercial |
$4,309.09
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,604.28
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,336.90
|
| Rate for Payer: PHP All Commercial |
$6,407.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,295.19
|
| Rate for Payer: Sagamore Health Network All Products |
$6,522.78
|
| Rate for Payer: Signature Care EPO |
$7,012.84
|
| Rate for Payer: Signature Care PPO |
$7,435.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,181.82
|
| Rate for Payer: United Healthcare Commercial |
$6,657.97
|
| Rate for Payer: United Healthcare Medicare |
$2,788.24
|
|
|
HC I2B RTS LESSER MTP 3
|
Facility
IP
|
$8,449.20
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606961
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,336.90 |
| Max. Negotiated Rate |
$7,857.76 |
| Rate for Payer: Aetna Commercial |
$7,300.11
|
| Rate for Payer: Cash Price |
$5,238.50
|
| Rate for Payer: Cigna All Commercial |
$7,291.66
|
| Rate for Payer: CORVEL All Commercial |
$7,857.76
|
| Rate for Payer: Coventry All Commercial |
$7,435.30
|
| Rate for Payer: Encore All Commercial |
$7,777.49
|
| Rate for Payer: Frontpath All Commercial |
$7,773.26
|
| Rate for Payer: Humana ChoiceCare |
$7,297.57
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,604.28
|
| Rate for Payer: PHCS All Commercial |
$6,336.90
|
| Rate for Payer: PHP All Commercial |
$6,407.87
|
| Rate for Payer: Sagamore Health Network All Products |
$6,522.78
|
| Rate for Payer: Signature Care EPO |
$7,012.84
|
| Rate for Payer: Signature Care PPO |
$7,435.30
|
| Rate for Payer: United Healthcare Commercial |
$6,657.97
|
|
|
HC I2B SCREW 2.4X10 LOCK
|
Facility
IP
|
$1,690.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607883
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,267.50 |
| Max. Negotiated Rate |
$1,571.70 |
| Rate for Payer: Aetna Commercial |
$1,460.16
|
| Rate for Payer: Cash Price |
$1,047.80
|
| Rate for Payer: Cigna All Commercial |
$1,458.47
|
| Rate for Payer: CORVEL All Commercial |
$1,571.70
|
| Rate for Payer: Coventry All Commercial |
$1,487.20
|
| Rate for Payer: Encore All Commercial |
$1,555.64
|
| Rate for Payer: Frontpath All Commercial |
$1,554.80
|
| Rate for Payer: Humana ChoiceCare |
$1,459.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,521.00
|
| Rate for Payer: PHCS All Commercial |
$1,267.50
|
| Rate for Payer: PHP All Commercial |
$1,281.70
|
| Rate for Payer: Sagamore Health Network All Products |
$1,304.68
|
| Rate for Payer: Signature Care EPO |
$1,402.70
|
| Rate for Payer: Signature Care PPO |
$1,487.20
|
| Rate for Payer: United Healthcare Commercial |
$1,331.72
|
|
|
HC I2B SCREW 2.4X10 LOCK
|
Facility
OP
|
$1,690.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607883
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,571.70 |
| Rate for Payer: Aetna Commercial |
$1,426.36
|
| Rate for Payer: Aetna Medicare |
$557.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$557.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$970.57
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,056.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$641.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$613.47
|
| Rate for Payer: Cash Price |
$1,047.80
|
| Rate for Payer: Cash Price |
$1,047.80
|
| Rate for Payer: Centivo All Commercial |
$861.90
|
| Rate for Payer: Cigna All Commercial |
$1,458.47
|
| Rate for Payer: CORVEL All Commercial |
$1,571.70
|
| Rate for Payer: Coventry All Commercial |
$1,487.20
|
| Rate for Payer: Encore All Commercial |
$1,555.64
|
| Rate for Payer: Frontpath All Commercial |
$1,554.80
|
| Rate for Payer: Humana ChoiceCare |
$1,459.65
|
| Rate for Payer: Humana Medicare |
$861.90
|
| Rate for Payer: Lucent All Commercial |
$861.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,521.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,267.50
|
| Rate for Payer: PHP All Commercial |
$1,281.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$659.10
|
| Rate for Payer: Sagamore Health Network All Products |
$1,304.68
|
| Rate for Payer: Signature Care EPO |
$1,402.70
|
| Rate for Payer: Signature Care PPO |
$1,487.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,436.50
|
| Rate for Payer: United Healthcare Commercial |
$1,331.72
|
| Rate for Payer: United Healthcare Medicare |
$557.70
|
|
|
HC I2B SCREW 2.4X10 NON LOCK
|
Facility
IP
|
$1,330.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607884
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$997.50 |
| Max. Negotiated Rate |
$1,236.90 |
| Rate for Payer: Aetna Commercial |
$1,149.12
|
| Rate for Payer: Cash Price |
$824.60
|
| Rate for Payer: Cigna All Commercial |
$1,147.79
|
| Rate for Payer: CORVEL All Commercial |
$1,236.90
|
| Rate for Payer: Coventry All Commercial |
$1,170.40
|
| Rate for Payer: Encore All Commercial |
$1,224.26
|
| Rate for Payer: Frontpath All Commercial |
$1,223.60
|
| Rate for Payer: Humana ChoiceCare |
$1,148.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,197.00
|
| Rate for Payer: PHCS All Commercial |
$997.50
|
| Rate for Payer: PHP All Commercial |
$1,008.67
|
| Rate for Payer: Sagamore Health Network All Products |
$1,026.76
|
| Rate for Payer: Signature Care EPO |
$1,103.90
|
| Rate for Payer: Signature Care PPO |
$1,170.40
|
| Rate for Payer: United Healthcare Commercial |
$1,048.04
|
|
