|
HC GLIADIN IGA
|
Facility
|
OP
|
$130.86
|
|
|
Service Code
|
CPT 86258
|
| Hospital Charge Code |
63001581
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.05 |
| Max. Negotiated Rate |
$121.70 |
| Rate for Payer: Aetna Commercial |
$110.45
|
| Rate for Payer: Aetna Medicare |
$41.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$12.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$40.57
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$60.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$60.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$12.05
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$48.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$46.06
|
| Rate for Payer: Cash Price |
$78.52
|
| Rate for Payer: Cash Price |
$78.52
|
| Rate for Payer: Centivo All Commercial |
$71.19
|
| Rate for Payer: Cigna All Commercial |
$112.93
|
| Rate for Payer: CORVEL All Commercial |
$121.70
|
| Rate for Payer: Coventry All Commercial |
$115.16
|
| Rate for Payer: Encore All Commercial |
$120.46
|
| Rate for Payer: Frontpath All Commercial |
$120.39
|
| Rate for Payer: Humana ChoiceCare |
$113.02
|
| Rate for Payer: Humana Medicare |
$41.88
|
| Rate for Payer: Lucent All Commercial |
$71.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$117.77
|
| Rate for Payer: Managed Health Services Medicaid |
$12.05
|
| Rate for Payer: MDWise Medicaid |
$12.05
|
| Rate for Payer: PHCS All Commercial |
$98.14
|
| Rate for Payer: PHP All Commercial |
$99.24
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$51.04
|
| Rate for Payer: Sagamore Health Network All Products |
$101.02
|
| Rate for Payer: Signature Care EPO |
$108.61
|
| Rate for Payer: Signature Care PPO |
$115.16
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$111.23
|
| Rate for Payer: United Healthcare Commercial |
$103.12
|
| Rate for Payer: United Healthcare Medicare |
$41.88
|
|
|
HC GLIADIN IGG
|
Facility
|
IP
|
$130.86
|
|
|
Service Code
|
CPT 86258
|
| Hospital Charge Code |
63001582
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$98.14 |
| Max. Negotiated Rate |
$121.70 |
| Rate for Payer: Aetna Commercial |
$113.06
|
| Rate for Payer: Cash Price |
$78.52
|
| Rate for Payer: Cigna All Commercial |
$112.93
|
| Rate for Payer: CORVEL All Commercial |
$121.70
|
| Rate for Payer: Coventry All Commercial |
$115.16
|
| Rate for Payer: Encore All Commercial |
$120.46
|
| Rate for Payer: Frontpath All Commercial |
$120.39
|
| Rate for Payer: Humana ChoiceCare |
$113.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$117.77
|
| Rate for Payer: PHCS All Commercial |
$98.14
|
| Rate for Payer: PHP All Commercial |
$99.24
|
| Rate for Payer: Sagamore Health Network All Products |
$101.02
|
| Rate for Payer: Signature Care EPO |
$108.61
|
| Rate for Payer: Signature Care PPO |
$115.16
|
| Rate for Payer: United Healthcare Commercial |
$103.12
|
|
|
HC GLIADIN IGG
|
Facility
|
OP
|
$130.86
|
|
|
Service Code
|
CPT 86258
|
| Hospital Charge Code |
63001582
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.05 |
| Max. Negotiated Rate |
$121.70 |
| Rate for Payer: Aetna Commercial |
$110.45
|
| Rate for Payer: Aetna Medicare |
$41.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$12.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$40.57
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$60.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$60.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$12.05
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$48.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$46.06
|
| Rate for Payer: Cash Price |
$78.52
|
| Rate for Payer: Cash Price |
$78.52
|
| Rate for Payer: Centivo All Commercial |
$71.19
|
| Rate for Payer: Cigna All Commercial |
$112.93
|
| Rate for Payer: CORVEL All Commercial |
$121.70
|
| Rate for Payer: Coventry All Commercial |
$115.16
|
| Rate for Payer: Encore All Commercial |
$120.46
|
| Rate for Payer: Frontpath All Commercial |
$120.39
|
| Rate for Payer: Humana ChoiceCare |
$113.02
|
| Rate for Payer: Humana Medicare |
$41.88
|
| Rate for Payer: Lucent All Commercial |
$71.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$117.77
|
| Rate for Payer: Managed Health Services Medicaid |
$12.05
|
| Rate for Payer: MDWise Medicaid |
$12.05
|
| Rate for Payer: PHCS All Commercial |
$98.14
|
| Rate for Payer: PHP All Commercial |
$99.24
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$51.04
|
| Rate for Payer: Sagamore Health Network All Products |
$101.02
|
| Rate for Payer: Signature Care EPO |
$108.61
|
| Rate for Payer: Signature Care PPO |
$115.16
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$111.23
|
| Rate for Payer: United Healthcare Commercial |
$103.12
|
| Rate for Payer: United Healthcare Medicare |
$41.88
|
|
|
HC GLIDESCOPE VIDEO LOPRO S2
|
Facility
|
IP
|
$334.88
|
|
| Hospital Charge Code |
41607723
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$251.16 |
| Max. Negotiated Rate |
$311.44 |
| Rate for Payer: Aetna Commercial |
$289.34
|
| Rate for Payer: Cash Price |
$200.93
|
| Rate for Payer: Cigna All Commercial |
$289.00
|
| Rate for Payer: CORVEL All Commercial |
$311.44
|
| Rate for Payer: Coventry All Commercial |
$294.69
|
| Rate for Payer: Encore All Commercial |
$308.26
|
| Rate for Payer: Frontpath All Commercial |
$308.09
|
| Rate for Payer: Humana ChoiceCare |
$289.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$301.39
|
| Rate for Payer: PHCS All Commercial |
$251.16
|
| Rate for Payer: PHP All Commercial |
$253.97
|
| Rate for Payer: Sagamore Health Network All Products |
$258.53
|
| Rate for Payer: Signature Care EPO |
$277.95
|
| Rate for Payer: Signature Care PPO |
$294.69
|
| Rate for Payer: United Healthcare Commercial |
$263.89
|
|
|
HC GLIDESCOPE VIDEO LOPRO S2
|
Facility
|
OP
|
$334.88
|
|
| Hospital Charge Code |
41607723
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$311.44 |
| Rate for Payer: Aetna Commercial |
$282.64
|
| Rate for Payer: Aetna Medicare |
$107.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$103.81
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$192.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$209.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$123.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$117.88
|
| Rate for Payer: Cash Price |
$200.93
|
| Rate for Payer: Cash Price |
$200.93
|
| Rate for Payer: Centivo All Commercial |
$182.17
|
| Rate for Payer: Cigna All Commercial |
$289.00
|
| Rate for Payer: CORVEL All Commercial |
$311.44
|
| Rate for Payer: Coventry All Commercial |
$294.69
|
| Rate for Payer: Encore All Commercial |
$308.26
|
| Rate for Payer: Frontpath All Commercial |
$308.09
|
| Rate for Payer: Humana ChoiceCare |
$289.24
|
| Rate for Payer: Humana Medicare |
$107.16
|
| Rate for Payer: Lucent All Commercial |
$182.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$301.39
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$251.16
|
| Rate for Payer: PHP All Commercial |
$253.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$130.60
|
| Rate for Payer: Sagamore Health Network All Products |
$258.53
|
| Rate for Payer: Signature Care EPO |
$277.95
|
| Rate for Payer: Signature Care PPO |
$294.69
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$284.65
|
| Rate for Payer: United Healthcare Commercial |
$263.89
|
| Rate for Payer: United Healthcare Medicare |
$107.16
|
|
|
HC GLUCOSE 24U
|
Facility
|
IP
|
$77.88
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
63001550
|
|
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 |
$46.73
|
| 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
|
|
|
HC GLUCOSE 24U
|
Facility
|
OP
|
$77.88
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
63001550
|
|
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 |
$24.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$3.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$24.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$35.79
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$35.79
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$3.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$28.66
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$27.41
|
| Rate for Payer: Cash Price |
$46.73
|
| Rate for Payer: Cash Price |
$46.73
|
| Rate for Payer: Centivo All Commercial |
$42.37
|
| 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 |
$24.92
|
| Rate for Payer: Lucent All Commercial |
$42.37
|
| 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 |
$24.92
|
|
|
HC GLUCOSE BF
|
Facility
|
IP
|
$113.88
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
63001181
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$85.41 |
| Max. Negotiated Rate |
$105.91 |
| Rate for Payer: Aetna Commercial |
$98.39
|
| Rate for Payer: Cash Price |
$68.33
|
| Rate for Payer: Cigna All Commercial |
$98.28
|
| Rate for Payer: CORVEL All Commercial |
$105.91
|
| Rate for Payer: Coventry All Commercial |
$100.21
|
| Rate for Payer: Encore All Commercial |
$104.83
|
| Rate for Payer: Frontpath All Commercial |
$104.77
|
| Rate for Payer: Humana ChoiceCare |
$98.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$102.49
|
| Rate for Payer: PHCS All Commercial |
$85.41
|
| Rate for Payer: PHP All Commercial |
$86.37
|
| Rate for Payer: Sagamore Health Network All Products |
$87.92
|
| Rate for Payer: Signature Care EPO |
$94.52
|
| Rate for Payer: Signature Care PPO |
$100.21
|
| Rate for Payer: United Healthcare Commercial |
$89.74
|
|
|
HC GLUCOSE BF
|
Facility
|
OP
|
$113.88
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
63001181
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$105.91 |
| Rate for Payer: Aetna Commercial |
$96.11
|
| Rate for Payer: Aetna Medicare |
$36.44
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$3.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$35.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$52.34
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$52.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$3.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$41.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$40.09
|
| Rate for Payer: Cash Price |
$68.33
|
| Rate for Payer: Cash Price |
$68.33
|
| Rate for Payer: Centivo All Commercial |
$61.95
|
| Rate for Payer: Cigna All Commercial |
$98.28
|
| Rate for Payer: CORVEL All Commercial |
$105.91
|
| Rate for Payer: Coventry All Commercial |
$100.21
|
| Rate for Payer: Encore All Commercial |
$104.83
|
| Rate for Payer: Frontpath All Commercial |
$104.77
|
| Rate for Payer: Humana ChoiceCare |
$98.36
|
| Rate for Payer: Humana Medicare |
$36.44
|
| Rate for Payer: Lucent All Commercial |
$61.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$102.49
|
| Rate for Payer: Managed Health Services Medicaid |
$3.93
|
| Rate for Payer: MDWise Medicaid |
$3.93
|
| Rate for Payer: PHCS All Commercial |
$85.41
|
| Rate for Payer: PHP All Commercial |
$86.37
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$44.41
|
| Rate for Payer: Sagamore Health Network All Products |
$87.92
|
| Rate for Payer: Signature Care EPO |
$94.52
|
| Rate for Payer: Signature Care PPO |
$100.21
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$96.80
|
| Rate for Payer: United Healthcare Commercial |
$89.74
|
| Rate for Payer: United Healthcare Medicare |
$36.44
|
|
|
HC GLUCOSE BLOOD
|
Facility
|
IP
|
$44.88
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
63001095
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.66 |
| Max. Negotiated Rate |
$41.74 |
| Rate for Payer: Aetna Commercial |
$38.78
|
| Rate for Payer: Cash Price |
$26.93
|
| Rate for Payer: Cigna All Commercial |
$38.73
|
| Rate for Payer: CORVEL All Commercial |
$41.74
|
| Rate for Payer: Coventry All Commercial |
$39.49
|
| Rate for Payer: Encore All Commercial |
$41.31
|
| Rate for Payer: Frontpath All Commercial |
$41.29
|
| Rate for Payer: Humana ChoiceCare |
$38.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$40.39
|
| Rate for Payer: PHCS All Commercial |
$33.66
|
| Rate for Payer: PHP All Commercial |
$34.04
|
| Rate for Payer: Sagamore Health Network All Products |
$34.65
|
| Rate for Payer: Signature Care EPO |
$37.25
|
| Rate for Payer: Signature Care PPO |
$39.49
|
| Rate for Payer: United Healthcare Commercial |
$35.37
|
|
|
HC GLUCOSE BLOOD
|
Facility
|
OP
|
$44.88
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
63001095
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$41.74 |
| Rate for Payer: Aetna Commercial |
$37.88
|
| Rate for Payer: Aetna Medicare |
$14.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$3.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$13.91
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$20.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$20.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$3.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$16.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$15.80
|
| Rate for Payer: Cash Price |
$26.93
|
| Rate for Payer: Cash Price |
$26.93
|
| Rate for Payer: Centivo All Commercial |
$24.41
|
| Rate for Payer: Cigna All Commercial |
$38.73
|
| Rate for Payer: CORVEL All Commercial |
$41.74
|
| Rate for Payer: Coventry All Commercial |
$39.49
|
| Rate for Payer: Encore All Commercial |
$41.31
|
| Rate for Payer: Frontpath All Commercial |
$41.29
|
| Rate for Payer: Humana ChoiceCare |
$38.76
|
| Rate for Payer: Humana Medicare |
$14.36
|
| Rate for Payer: Lucent All Commercial |
$24.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$40.39
|
| Rate for Payer: Managed Health Services Medicaid |
$3.93
|
| Rate for Payer: MDWise Medicaid |
$3.93
|
| Rate for Payer: PHCS All Commercial |
$33.66
|
| Rate for Payer: PHP All Commercial |
$34.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$17.50
|
| Rate for Payer: Sagamore Health Network All Products |
$34.65
|
| Rate for Payer: Signature Care EPO |
$37.25
|
| Rate for Payer: Signature Care PPO |
$39.49
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$38.15
|
| Rate for Payer: United Healthcare Commercial |
$35.37
|
| Rate for Payer: United Healthcare Medicare |
$14.36
|
|
|
HC GLUCOSE POST DOSE
|
Facility
|
IP
|
$71.81
|
|
|
Service Code
|
CPT 82950
|
| Hospital Charge Code |
63001134
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$53.86 |
| Max. Negotiated Rate |
$66.78 |
| Rate for Payer: Aetna Commercial |
$62.04
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cigna All Commercial |
$61.97
|
| Rate for Payer: CORVEL All Commercial |
$66.78
|
| Rate for Payer: Coventry All Commercial |
$63.19
|
| Rate for Payer: Encore All Commercial |
$66.10
|
| Rate for Payer: Frontpath All Commercial |
$66.07
|
| Rate for Payer: Humana ChoiceCare |
$62.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$64.63
|
| Rate for Payer: PHCS All Commercial |
$53.86
|
| Rate for Payer: PHP All Commercial |
$54.46
|
| Rate for Payer: Sagamore Health Network All Products |
$55.44
|
| Rate for Payer: Signature Care EPO |
$59.60
|
| Rate for Payer: Signature Care PPO |
$63.19
|
| Rate for Payer: United Healthcare Commercial |
$56.59
|
|
|
HC GLUCOSE POST DOSE
|
Facility
|
OP
|
$71.81
|
|
|
Service Code
|
CPT 82950
|
| Hospital Charge Code |
63001134
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.75 |
| Max. Negotiated Rate |
$66.78 |
| Rate for Payer: Aetna Commercial |
$60.61
|
| Rate for Payer: Aetna Medicare |
$22.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$4.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$22.26
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$33.00
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$33.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$4.75
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$26.43
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$25.28
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Centivo All Commercial |
$39.06
|
| Rate for Payer: Cigna All Commercial |
$61.97
|
| Rate for Payer: CORVEL All Commercial |
$66.78
|
| Rate for Payer: Coventry All Commercial |
$63.19
|
| Rate for Payer: Encore All Commercial |
$66.10
|
| Rate for Payer: Frontpath All Commercial |
$66.07
|
| Rate for Payer: Humana ChoiceCare |
$62.02
|
| Rate for Payer: Humana Medicare |
$22.98
|
| Rate for Payer: Lucent All Commercial |
$39.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$64.63
|
| Rate for Payer: Managed Health Services Medicaid |
$4.75
|
| Rate for Payer: MDWise Medicaid |
$4.75
|
| Rate for Payer: PHCS All Commercial |
$53.86
|
| Rate for Payer: PHP All Commercial |
$54.46
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$28.01
|
| Rate for Payer: Sagamore Health Network All Products |
$55.44
|
| Rate for Payer: Signature Care EPO |
$59.60
|
| Rate for Payer: Signature Care PPO |
$63.19
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$61.04
|
| Rate for Payer: United Healthcare Commercial |
$56.59
|
| Rate for Payer: United Healthcare Medicare |
$22.98
|
|
|
HC GLUCOSE TOLER 2HR
|
Facility
|
OP
|
$35.34
|
|
|
Service Code
|
CPT 82952
|
| Hospital Charge Code |
63001136
|
|
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 |
$11.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$3.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$10.96
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$16.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$16.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$3.92
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$13.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$12.44
|
| Rate for Payer: Cash Price |
$21.20
|
| Rate for Payer: Cash Price |
$21.20
|
| Rate for Payer: Centivo All Commercial |
$19.22
|
| 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 |
$32.51
|
| Rate for Payer: Humana ChoiceCare |
$30.52
|
| Rate for Payer: Humana Medicare |
$11.31
|
| Rate for Payer: Lucent All Commercial |
$19.22
|
| 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 |
$26.50
|
| 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 |
$11.31
|
|
|
HC GLUCOSE TOLER 2HR
|
Facility
|
IP
|
$35.34
|
|
|
Service Code
|
CPT 82952
|
| Hospital Charge Code |
63001136
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$26.50 |
| Max. Negotiated Rate |
$32.87 |
| Rate for Payer: Aetna Commercial |
$30.53
|
| Rate for Payer: Cash Price |
$21.20
|
| 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 |
$32.51
|
| Rate for Payer: Humana ChoiceCare |
$30.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$31.81
|
| Rate for Payer: PHCS All Commercial |
$26.50
|
| Rate for Payer: PHP All Commercial |
$26.80
|
| 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: United Healthcare Commercial |
$27.85
|
|
|
HC GLUCOSE TOLER 3HR
|
Facility
|
OP
|
$35.34
|
|
|
Service Code
|
CPT 82952
|
| Hospital Charge Code |
63001137
|
|
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 |
$11.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$3.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$10.96
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$16.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$16.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$3.92
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$13.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$12.44
|
| Rate for Payer: Cash Price |
$21.20
|
| Rate for Payer: Cash Price |
$21.20
|
| Rate for Payer: Centivo All Commercial |
$19.22
|
| 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 |
$32.51
|
| Rate for Payer: Humana ChoiceCare |
$30.52
|
| Rate for Payer: Humana Medicare |
$11.31
|
| Rate for Payer: Lucent All Commercial |
$19.22
|
| 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 |
$26.50
|
| 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 |
$11.31
|
|
|
HC GLUCOSE TOLER 3HR
|
Facility
|
IP
|
$35.34
|
|
|
Service Code
|
CPT 82952
|
| Hospital Charge Code |
63001137
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$26.50 |
| Max. Negotiated Rate |
$32.87 |
| Rate for Payer: Aetna Commercial |
$30.53
|
| Rate for Payer: Cash Price |
$21.20
|
| 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 |
$32.51
|
| Rate for Payer: Humana ChoiceCare |
$30.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$31.81
|
| Rate for Payer: PHCS All Commercial |
$26.50
|
| Rate for Payer: PHP All Commercial |
$26.80
|
| 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: United Healthcare Commercial |
$27.85
|
|
|
HC GLUCOSE TOLERANCE 5HR SPE
|
Facility
|
IP
|
$35.34
|
|
|
Service Code
|
CPT 82952
|
| Hospital Charge Code |
63001139
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$26.50 |
| Max. Negotiated Rate |
$32.87 |
| Rate for Payer: Aetna Commercial |
$30.53
|
| Rate for Payer: Cash Price |
$21.20
|
| 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 |
$32.51
|
| Rate for Payer: Humana ChoiceCare |
$30.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$31.81
|
| Rate for Payer: PHCS All Commercial |
$26.50
|
| Rate for Payer: PHP All Commercial |
$26.80
|
| 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: United Healthcare Commercial |
$27.85
|
|
|
HC GLUCOSE TOLERANCE 5HR SPE
|
Facility
|
OP
|
$35.34
|
|
|
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 |
$11.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$3.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$10.96
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$16.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$16.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$3.92
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$13.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$12.44
|
| Rate for Payer: Cash Price |
$21.20
|
| Rate for Payer: Cash Price |
$21.20
|
| Rate for Payer: Centivo All Commercial |
$19.22
|
| 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 |
$32.51
|
| Rate for Payer: Humana ChoiceCare |
$30.52
|
| Rate for Payer: Humana Medicare |
$11.31
|
| Rate for Payer: Lucent All Commercial |
$19.22
|
| 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 |
$26.50
|
| 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 |
$11.31
|
|
|
HC GLUTAMIC ACID DECARBOXLA
|
Facility
|
IP
|
$211.67
|
|
|
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 |
$127.00
|
| 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
|
|
|
HC GLUTAMIC ACID DECARBOXLA
|
Facility
|
OP
|
$211.67
|
|
|
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 |
$67.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$17.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$65.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$97.28
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$97.28
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$17.27
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$77.89
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$74.51
|
| Rate for Payer: Cash Price |
$127.00
|
| Rate for Payer: Cash Price |
$127.00
|
| Rate for Payer: Centivo All Commercial |
$115.15
|
| 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 |
$67.73
|
| Rate for Payer: Lucent All Commercial |
$115.15
|
| 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 |
$67.73
|
|
|
HC GLYCOSYLATED HEMOGLOBIN A1C
|
Facility
|
IP
|
$97.79
|
|
|
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 |
$58.67
|
| Rate for Payer: Cigna All Commercial |
$84.39
|
| Rate for Payer: CORVEL All Commercial |
$90.94
|
| Rate for Payer: Coventry All Commercial |
$86.06
|
| Rate for Payer: Encore All Commercial |
$90.02
|
| Rate for Payer: Frontpath All Commercial |
$89.97
|
| 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 |
$81.17
|
| Rate for Payer: Signature Care PPO |
$86.06
|
| Rate for Payer: United Healthcare Commercial |
$77.06
|
|
|
HC GLYCOSYLATED HEMOGLOBIN A1C
|
Facility
|
OP
|
$97.79
|
|
|
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 |
$31.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$9.71
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$30.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$44.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$44.94
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$9.71
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$35.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$34.42
|
| Rate for Payer: Cash Price |
$58.67
|
| Rate for Payer: Cash Price |
$58.67
|
| Rate for Payer: Centivo All Commercial |
$53.20
|
| Rate for Payer: Cigna All Commercial |
$84.39
|
| Rate for Payer: CORVEL All Commercial |
$90.94
|
| Rate for Payer: Coventry All Commercial |
$86.06
|
| Rate for Payer: Encore All Commercial |
$90.02
|
| Rate for Payer: Frontpath All Commercial |
$89.97
|
| Rate for Payer: Humana ChoiceCare |
$84.46
|
| Rate for Payer: Humana Medicare |
$31.29
|
| Rate for Payer: Lucent All Commercial |
$53.20
|
| 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 |
$81.17
|
| Rate for Payer: Signature Care PPO |
$86.06
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$83.12
|
| Rate for Payer: United Healthcare Commercial |
$77.06
|
| Rate for Payer: United Healthcare Medicare |
$31.29
|
|
|
HC GM1 ANTIBODY, IGG & IGM
|
Facility
|
OP
|
$65.03
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
63044045
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.53 |
| Max. Negotiated Rate |
$60.48 |
| Rate for Payer: Aetna Commercial |
$54.89
|
| Rate for Payer: Aetna Medicare |
$20.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$11.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$20.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$29.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$29.89
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$11.53
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$23.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$22.89
|
| Rate for Payer: Cash Price |
$39.02
|
| Rate for Payer: Cash Price |
$39.02
|
| Rate for Payer: Centivo All Commercial |
$35.38
|
| Rate for Payer: Cigna All Commercial |
$56.12
|
| Rate for Payer: CORVEL All Commercial |
$60.48
|
| Rate for Payer: Coventry All Commercial |
$57.23
|
| Rate for Payer: Encore All Commercial |
$59.86
|
| Rate for Payer: Frontpath All Commercial |
$59.83
|
| Rate for Payer: Humana ChoiceCare |
$56.17
|
| Rate for Payer: Humana Medicare |
$20.81
|
| Rate for Payer: Lucent All Commercial |
$35.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$58.53
|
| 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 |
$49.32
|
| 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 |
$57.23
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$55.28
|
| Rate for Payer: United Healthcare Commercial |
$51.24
|
| Rate for Payer: United Healthcare Medicare |
$20.81
|
|
|
HC GM1 ANTIBODY, IGG & IGM
|
Facility
|
IP
|
$65.03
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
63044045
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$48.77 |
| Max. Negotiated Rate |
$60.48 |
| Rate for Payer: Aetna Commercial |
$56.19
|
| Rate for Payer: Cash Price |
$39.02
|
| Rate for Payer: Cigna All Commercial |
$56.12
|
| Rate for Payer: CORVEL All Commercial |
$60.48
|
| Rate for Payer: Coventry All Commercial |
$57.23
|
| Rate for Payer: Encore All Commercial |
$59.86
|
| Rate for Payer: Frontpath All Commercial |
$59.83
|
| Rate for Payer: Humana ChoiceCare |
$56.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$58.53
|
| Rate for Payer: PHCS All Commercial |
$48.77
|
| Rate for Payer: PHP All Commercial |
$49.32
|
| Rate for Payer: Sagamore Health Network All Products |
$50.20
|
| Rate for Payer: Signature Care EPO |
$53.97
|
| Rate for Payer: Signature Care PPO |
$57.23
|
| Rate for Payer: United Healthcare Commercial |
$51.24
|
|
