|
HC ICD DC FORT ASS DR 40 DF4 CONN
|
Facility
OP
|
$41,534.64
|
|
|
Service Code
|
CPT C1721
|
| Hospital Charge Code |
41607554
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$38,627.22 |
| Rate for Payer: Aetna Commercial |
$35,055.24
|
| Rate for Payer: Aetna Medicare |
$13,706.43
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$13,706.43
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$23,853.34
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$25,963.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$15,762.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$15,077.07
|
| Rate for Payer: Cash Price |
$25,751.48
|
| Rate for Payer: Cash Price |
$25,751.48
|
| Rate for Payer: Centivo All Commercial |
$21,182.67
|
| Rate for Payer: Cigna All Commercial |
$35,844.39
|
| Rate for Payer: CORVEL All Commercial |
$38,627.22
|
| Rate for Payer: Coventry All Commercial |
$36,550.48
|
| Rate for Payer: Encore All Commercial |
$38,232.64
|
| Rate for Payer: Frontpath All Commercial |
$38,211.87
|
| Rate for Payer: Humana ChoiceCare |
$35,873.47
|
| Rate for Payer: Humana Medicare |
$21,182.67
|
| Rate for Payer: Lucent All Commercial |
$21,182.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$37,381.18
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$31,150.98
|
| Rate for Payer: PHP All Commercial |
$31,499.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$16,198.51
|
| Rate for Payer: Sagamore Health Network All Products |
$32,064.74
|
| Rate for Payer: Signature Care EPO |
$34,473.75
|
| Rate for Payer: Signature Care PPO |
$36,550.48
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$35,304.44
|
| Rate for Payer: United Healthcare Commercial |
$32,729.30
|
| Rate for Payer: United Healthcare Medicare |
$13,706.43
|
|
|
HC ICD DC GALLANT DR
|
Facility
OP
|
$46,732.14
|
|
|
Service Code
|
CPT C1721
|
| Hospital Charge Code |
41607552
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$43,460.89 |
| Rate for Payer: Aetna Commercial |
$39,441.93
|
| Rate for Payer: Aetna Medicare |
$15,421.61
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$15,421.61
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$26,838.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$29,212.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$17,734.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$16,963.77
|
| Rate for Payer: Cash Price |
$28,973.93
|
| Rate for Payer: Cash Price |
$28,973.93
|
| Rate for Payer: Centivo All Commercial |
$23,833.39
|
| Rate for Payer: Cigna All Commercial |
$40,329.84
|
| Rate for Payer: CORVEL All Commercial |
$43,460.89
|
| Rate for Payer: Coventry All Commercial |
$41,124.28
|
| Rate for Payer: Encore All Commercial |
$43,016.93
|
| Rate for Payer: Frontpath All Commercial |
$42,993.57
|
| Rate for Payer: Humana ChoiceCare |
$40,362.55
|
| Rate for Payer: Humana Medicare |
$23,833.39
|
| Rate for Payer: Lucent All Commercial |
$23,833.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$42,058.93
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$35,049.10
|
| Rate for Payer: PHP All Commercial |
$35,441.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$18,225.53
|
| Rate for Payer: Sagamore Health Network All Products |
$36,077.21
|
| Rate for Payer: Signature Care EPO |
$38,787.68
|
| Rate for Payer: Signature Care PPO |
$41,124.28
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$39,722.32
|
| Rate for Payer: United Healthcare Commercial |
$36,824.93
|
| Rate for Payer: United Healthcare Medicare |
$15,421.61
|
|
|
HC ICD DC GALLANT DR
|
Facility
IP
|
$46,732.14
|
|
|
Service Code
|
CPT C1721
|
| Hospital Charge Code |
41607552
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$35,049.10 |
| Max. Negotiated Rate |
$43,460.89 |
| Rate for Payer: Aetna Commercial |
$40,376.57
|
| Rate for Payer: Cash Price |
$28,973.93
|
| Rate for Payer: Cigna All Commercial |
$40,329.84
|
| Rate for Payer: CORVEL All Commercial |
$43,460.89
|
| Rate for Payer: Coventry All Commercial |
$41,124.28
|
| Rate for Payer: Encore All Commercial |
$43,016.93
|
| Rate for Payer: Frontpath All Commercial |
$42,993.57
|
| Rate for Payer: Humana ChoiceCare |
$40,362.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$42,058.93
|
| Rate for Payer: PHCS All Commercial |
$35,049.10
|
| Rate for Payer: PHP All Commercial |
$35,441.65
|
| Rate for Payer: Sagamore Health Network All Products |
$36,077.21
|
| Rate for Payer: Signature Care EPO |
$38,787.68
|
| Rate for Payer: Signature Care PPO |
$41,124.28
|
| Rate for Payer: United Healthcare Commercial |
$36,824.93
|
|
|
HC ICD DC MOMENTUM EL DR
|
Facility
OP
|
$52,185.00
|
|
|
Service Code
|
CPT C1721
|
| Hospital Charge Code |
41607205
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$48,532.05 |
| Rate for Payer: Aetna Commercial |
$44,044.14
|
| Rate for Payer: Aetna Medicare |
$17,221.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$17,221.05
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$29,969.85
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$32,620.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$19,804.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$18,943.16
|
| Rate for Payer: Cash Price |
$32,354.70
|
| Rate for Payer: Cash Price |
$32,354.70
|
| Rate for Payer: Centivo All Commercial |
$26,614.35
|
| Rate for Payer: Cigna All Commercial |
$45,035.66
|
| Rate for Payer: CORVEL All Commercial |
$48,532.05
|
| Rate for Payer: Coventry All Commercial |
$45,922.80
|
| Rate for Payer: Encore All Commercial |
$48,036.29
|
| Rate for Payer: Frontpath All Commercial |
$48,010.20
|
| Rate for Payer: Humana ChoiceCare |
$45,072.18
|
| Rate for Payer: Humana Medicare |
$26,614.35
|
| Rate for Payer: Lucent All Commercial |
$26,614.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$46,966.50
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$39,138.75
|
| Rate for Payer: PHP All Commercial |
$39,577.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$20,352.15
|
| Rate for Payer: Sagamore Health Network All Products |
$40,286.82
|
| Rate for Payer: Signature Care EPO |
$43,313.55
|
| Rate for Payer: Signature Care PPO |
$45,922.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$44,357.25
|
| Rate for Payer: United Healthcare Commercial |
$41,121.78
|
| Rate for Payer: United Healthcare Medicare |
$17,221.05
|
|
|
HC ICD DC MOMENTUM EL DR
|
Facility
IP
|
$52,185.00
|
|
|
Service Code
|
CPT C1721
|
| Hospital Charge Code |
41607205
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$39,138.75 |
| Max. Negotiated Rate |
$48,532.05 |
| Rate for Payer: Aetna Commercial |
$45,087.84
|
| Rate for Payer: Cash Price |
$32,354.70
|
| Rate for Payer: Cigna All Commercial |
$45,035.66
|
| Rate for Payer: CORVEL All Commercial |
$48,532.05
|
| Rate for Payer: Coventry All Commercial |
$45,922.80
|
| Rate for Payer: Encore All Commercial |
$48,036.29
|
| Rate for Payer: Frontpath All Commercial |
$48,010.20
|
| Rate for Payer: Humana ChoiceCare |
$45,072.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$46,966.50
|
| Rate for Payer: PHCS All Commercial |
$39,138.75
|
| Rate for Payer: PHP All Commercial |
$39,577.10
|
| Rate for Payer: Sagamore Health Network All Products |
$40,286.82
|
| Rate for Payer: Signature Care EPO |
$43,313.55
|
| Rate for Payer: Signature Care PPO |
$45,922.80
|
| Rate for Payer: United Healthcare Commercial |
$41,121.78
|
|
|
HC ICD DC PERCIVA DR
|
Facility
OP
|
$52,185.00
|
|
|
Service Code
|
CPT C1721
|
| Hospital Charge Code |
41607207
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$48,532.05 |
| Rate for Payer: Aetna Commercial |
$44,044.14
|
| Rate for Payer: Aetna Medicare |
$17,221.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$17,221.05
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$29,969.85
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$32,620.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$19,804.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$18,943.16
|
| Rate for Payer: Cash Price |
$32,354.70
|
| Rate for Payer: Cash Price |
$32,354.70
|
| Rate for Payer: Centivo All Commercial |
$26,614.35
|
| Rate for Payer: Cigna All Commercial |
$45,035.66
|
| Rate for Payer: CORVEL All Commercial |
$48,532.05
|
| Rate for Payer: Coventry All Commercial |
$45,922.80
|
| Rate for Payer: Encore All Commercial |
$48,036.29
|
| Rate for Payer: Frontpath All Commercial |
$48,010.20
|
| Rate for Payer: Humana ChoiceCare |
$45,072.18
|
| Rate for Payer: Humana Medicare |
$26,614.35
|
| Rate for Payer: Lucent All Commercial |
$26,614.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$46,966.50
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$39,138.75
|
| Rate for Payer: PHP All Commercial |
$39,577.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$20,352.15
|
| Rate for Payer: Sagamore Health Network All Products |
$40,286.82
|
| Rate for Payer: Signature Care EPO |
$43,313.55
|
| Rate for Payer: Signature Care PPO |
$45,922.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$44,357.25
|
| Rate for Payer: United Healthcare Commercial |
$41,121.78
|
| Rate for Payer: United Healthcare Medicare |
$17,221.05
|
|
|
HC ICD DC PERCIVA DR
|
Facility
IP
|
$52,185.00
|
|
|
Service Code
|
CPT C1721
|
| Hospital Charge Code |
41607207
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$39,138.75 |
| Max. Negotiated Rate |
$48,532.05 |
| Rate for Payer: Aetna Commercial |
$45,087.84
|
| Rate for Payer: Cash Price |
$32,354.70
|
| Rate for Payer: Cigna All Commercial |
$45,035.66
|
| Rate for Payer: CORVEL All Commercial |
$48,532.05
|
| Rate for Payer: Coventry All Commercial |
$45,922.80
|
| Rate for Payer: Encore All Commercial |
$48,036.29
|
| Rate for Payer: Frontpath All Commercial |
$48,010.20
|
| Rate for Payer: Humana ChoiceCare |
$45,072.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$46,966.50
|
| Rate for Payer: PHCS All Commercial |
$39,138.75
|
| Rate for Payer: PHP All Commercial |
$39,577.10
|
| Rate for Payer: Sagamore Health Network All Products |
$40,286.82
|
| Rate for Payer: Signature Care EPO |
$43,313.55
|
| Rate for Payer: Signature Care PPO |
$45,922.80
|
| Rate for Payer: United Healthcare Commercial |
$41,121.78
|
|
|
HC ICD DC PERCIVA DR DF4
|
Facility
OP
|
$52,185.00
|
|
|
Service Code
|
CPT C1721
|
| Hospital Charge Code |
41607206
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$48,532.05 |
| Rate for Payer: Aetna Commercial |
$44,044.14
|
| Rate for Payer: Aetna Medicare |
$17,221.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$17,221.05
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$29,969.85
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$32,620.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$19,804.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$18,943.16
|
| Rate for Payer: Cash Price |
$32,354.70
|
| Rate for Payer: Cash Price |
$32,354.70
|
| Rate for Payer: Centivo All Commercial |
$26,614.35
|
| Rate for Payer: Cigna All Commercial |
$45,035.66
|
| Rate for Payer: CORVEL All Commercial |
$48,532.05
|
| Rate for Payer: Coventry All Commercial |
$45,922.80
|
| Rate for Payer: Encore All Commercial |
$48,036.29
|
| Rate for Payer: Frontpath All Commercial |
$48,010.20
|
| Rate for Payer: Humana ChoiceCare |
$45,072.18
|
| Rate for Payer: Humana Medicare |
$26,614.35
|
| Rate for Payer: Lucent All Commercial |
$26,614.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$46,966.50
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$39,138.75
|
| Rate for Payer: PHP All Commercial |
$39,577.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$20,352.15
|
| Rate for Payer: Sagamore Health Network All Products |
$40,286.82
|
| Rate for Payer: Signature Care EPO |
$43,313.55
|
| Rate for Payer: Signature Care PPO |
$45,922.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$44,357.25
|
| Rate for Payer: United Healthcare Commercial |
$41,121.78
|
| Rate for Payer: United Healthcare Medicare |
$17,221.05
|
|
|
HC ICD DC PERCIVA DR DF4
|
Facility
IP
|
$52,185.00
|
|
|
Service Code
|
CPT C1721
|
| Hospital Charge Code |
41607206
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$39,138.75 |
| Max. Negotiated Rate |
$48,532.05 |
| Rate for Payer: Aetna Commercial |
$45,087.84
|
| Rate for Payer: Cash Price |
$32,354.70
|
| Rate for Payer: Cigna All Commercial |
$45,035.66
|
| Rate for Payer: CORVEL All Commercial |
$48,532.05
|
| Rate for Payer: Coventry All Commercial |
$45,922.80
|
| Rate for Payer: Encore All Commercial |
$48,036.29
|
| Rate for Payer: Frontpath All Commercial |
$48,010.20
|
| Rate for Payer: Humana ChoiceCare |
$45,072.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$46,966.50
|
| Rate for Payer: PHCS All Commercial |
$39,138.75
|
| Rate for Payer: PHP All Commercial |
$39,577.10
|
| Rate for Payer: Sagamore Health Network All Products |
$40,286.82
|
| Rate for Payer: Signature Care EPO |
$43,313.55
|
| Rate for Payer: Signature Care PPO |
$45,922.80
|
| Rate for Payer: United Healthcare Commercial |
$41,121.78
|
|
|
HC ICD DC VIGILANT EL DR DF4
|
Facility
OP
|
$52,185.00
|
|
|
Service Code
|
CPT C1721
|
| Hospital Charge Code |
41607204
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$48,532.05 |
| Rate for Payer: Aetna Commercial |
$44,044.14
|
| Rate for Payer: Aetna Medicare |
$17,221.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$17,221.05
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$29,969.85
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$32,620.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$19,804.21
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$18,943.16
|
| Rate for Payer: Cash Price |
$32,354.70
|
| Rate for Payer: Cash Price |
$32,354.70
|
| Rate for Payer: Centivo All Commercial |
$26,614.35
|
| Rate for Payer: Cigna All Commercial |
$45,035.66
|
| Rate for Payer: CORVEL All Commercial |
$48,532.05
|
| Rate for Payer: Coventry All Commercial |
$45,922.80
|
| Rate for Payer: Encore All Commercial |
$48,036.29
|
| Rate for Payer: Frontpath All Commercial |
$48,010.20
|
| Rate for Payer: Humana ChoiceCare |
$45,072.18
|
| Rate for Payer: Humana Medicare |
$26,614.35
|
| Rate for Payer: Lucent All Commercial |
$26,614.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$46,966.50
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$39,138.75
|
| Rate for Payer: PHP All Commercial |
$39,577.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$20,352.15
|
| Rate for Payer: Sagamore Health Network All Products |
$40,286.82
|
| Rate for Payer: Signature Care EPO |
$43,313.55
|
| Rate for Payer: Signature Care PPO |
$45,922.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$44,357.25
|
| Rate for Payer: United Healthcare Commercial |
$41,121.78
|
| Rate for Payer: United Healthcare Medicare |
$17,221.05
|
|
|
HC ICD DC VIGILANT EL DR DF4
|
Facility
IP
|
$52,185.00
|
|
|
Service Code
|
CPT C1721
|
| Hospital Charge Code |
41607204
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$39,138.75 |
| Max. Negotiated Rate |
$48,532.05 |
| Rate for Payer: Aetna Commercial |
$45,087.84
|
| Rate for Payer: Cash Price |
$32,354.70
|
| Rate for Payer: Cigna All Commercial |
$45,035.66
|
| Rate for Payer: CORVEL All Commercial |
$48,532.05
|
| Rate for Payer: Coventry All Commercial |
$45,922.80
|
| Rate for Payer: Encore All Commercial |
$48,036.29
|
| Rate for Payer: Frontpath All Commercial |
$48,010.20
|
| Rate for Payer: Humana ChoiceCare |
$45,072.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$46,966.50
|
| Rate for Payer: PHCS All Commercial |
$39,138.75
|
| Rate for Payer: PHP All Commercial |
$39,577.10
|
| Rate for Payer: Sagamore Health Network All Products |
$40,286.82
|
| Rate for Payer: Signature Care EPO |
$43,313.55
|
| Rate for Payer: Signature Care PPO |
$45,922.80
|
| Rate for Payer: United Healthcare Commercial |
$41,121.78
|
|
|
HC ICD SC DYNAGEN EL VR
|
Facility
OP
|
$42,997.50
|
|
|
Service Code
|
CPT C1722
|
| Hospital Charge Code |
41607217
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$39,987.68 |
| Rate for Payer: Aetna Commercial |
$36,289.89
|
| Rate for Payer: Aetna Medicare |
$14,189.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$14,189.18
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$24,693.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$26,877.74
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$16,317.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$15,608.09
|
| Rate for Payer: Cash Price |
$26,658.45
|
| Rate for Payer: Cash Price |
$26,658.45
|
| Rate for Payer: Centivo All Commercial |
$21,928.72
|
| Rate for Payer: Cigna All Commercial |
$37,106.84
|
| Rate for Payer: CORVEL All Commercial |
$39,987.68
|
| Rate for Payer: Coventry All Commercial |
$37,837.80
|
| Rate for Payer: Encore All Commercial |
$39,579.20
|
| Rate for Payer: Frontpath All Commercial |
$39,557.70
|
| Rate for Payer: Humana ChoiceCare |
$37,136.94
|
| Rate for Payer: Humana Medicare |
$21,928.72
|
| Rate for Payer: Lucent All Commercial |
$21,928.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$38,697.75
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$32,248.12
|
| Rate for Payer: PHP All Commercial |
$32,609.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$16,769.02
|
| Rate for Payer: Sagamore Health Network All Products |
$33,194.07
|
| Rate for Payer: Signature Care EPO |
$35,687.92
|
| Rate for Payer: Signature Care PPO |
$37,837.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$36,547.88
|
| Rate for Payer: United Healthcare Commercial |
$33,882.03
|
| Rate for Payer: United Healthcare Medicare |
$14,189.18
|
|
|
HC ICD SC DYNAGEN EL VR
|
Facility
IP
|
$42,997.50
|
|
|
Service Code
|
CPT C1722
|
| Hospital Charge Code |
41607217
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$32,248.12 |
| Max. Negotiated Rate |
$39,987.68 |
| Rate for Payer: Aetna Commercial |
$37,149.84
|
| Rate for Payer: Cash Price |
$26,658.45
|
| Rate for Payer: Cigna All Commercial |
$37,106.84
|
| Rate for Payer: CORVEL All Commercial |
$39,987.68
|
| Rate for Payer: Coventry All Commercial |
$37,837.80
|
| Rate for Payer: Encore All Commercial |
$39,579.20
|
| Rate for Payer: Frontpath All Commercial |
$39,557.70
|
| Rate for Payer: Humana ChoiceCare |
$37,136.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$38,697.75
|
| Rate for Payer: PHCS All Commercial |
$32,248.12
|
| Rate for Payer: PHP All Commercial |
$32,609.30
|
| Rate for Payer: Sagamore Health Network All Products |
$33,194.07
|
| Rate for Payer: Signature Care EPO |
$35,687.92
|
| Rate for Payer: Signature Care PPO |
$37,837.80
|
| Rate for Payer: United Healthcare Commercial |
$33,882.03
|
|
|
HC ICD SC DYNAGEN EL VR DF4
|
Facility
IP
|
$42,997.50
|
|
|
Service Code
|
CPT C1722
|
| Hospital Charge Code |
41607216
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$32,248.12 |
| Max. Negotiated Rate |
$39,987.68 |
| Rate for Payer: Aetna Commercial |
$37,149.84
|
| Rate for Payer: Cash Price |
$26,658.45
|
| Rate for Payer: Cigna All Commercial |
$37,106.84
|
| Rate for Payer: CORVEL All Commercial |
$39,987.68
|
| Rate for Payer: Coventry All Commercial |
$37,837.80
|
| Rate for Payer: Encore All Commercial |
$39,579.20
|
| Rate for Payer: Frontpath All Commercial |
$39,557.70
|
| Rate for Payer: Humana ChoiceCare |
$37,136.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$38,697.75
|
| Rate for Payer: PHCS All Commercial |
$32,248.12
|
| Rate for Payer: PHP All Commercial |
$32,609.30
|
| Rate for Payer: Sagamore Health Network All Products |
$33,194.07
|
| Rate for Payer: Signature Care EPO |
$35,687.92
|
| Rate for Payer: Signature Care PPO |
$37,837.80
|
| Rate for Payer: United Healthcare Commercial |
$33,882.03
|
|
|
HC ICD SC DYNAGEN EL VR DF4
|
Facility
OP
|
$42,997.50
|
|
|
Service Code
|
CPT C1722
|
| Hospital Charge Code |
41607216
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$39,987.68 |
| Rate for Payer: Aetna Commercial |
$36,289.89
|
| Rate for Payer: Aetna Medicare |
$14,189.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$14,189.18
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$24,693.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$26,877.74
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$16,317.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$15,608.09
|
| Rate for Payer: Cash Price |
$26,658.45
|
| Rate for Payer: Cash Price |
$26,658.45
|
| Rate for Payer: Centivo All Commercial |
$21,928.72
|
| Rate for Payer: Cigna All Commercial |
$37,106.84
|
| Rate for Payer: CORVEL All Commercial |
$39,987.68
|
| Rate for Payer: Coventry All Commercial |
$37,837.80
|
| Rate for Payer: Encore All Commercial |
$39,579.20
|
| Rate for Payer: Frontpath All Commercial |
$39,557.70
|
| Rate for Payer: Humana ChoiceCare |
$37,136.94
|
| Rate for Payer: Humana Medicare |
$21,928.72
|
| Rate for Payer: Lucent All Commercial |
$21,928.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$38,697.75
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$32,248.12
|
| Rate for Payer: PHP All Commercial |
$32,609.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$16,769.02
|
| Rate for Payer: Sagamore Health Network All Products |
$33,194.07
|
| Rate for Payer: Signature Care EPO |
$35,687.92
|
| Rate for Payer: Signature Care PPO |
$37,837.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$36,547.88
|
| Rate for Payer: United Healthcare Commercial |
$33,882.03
|
| Rate for Payer: United Healthcare Medicare |
$14,189.18
|
|
|
HC ICD SC DYNAGEN MINI VR
|
Facility
IP
|
$42,997.50
|
|
|
Service Code
|
CPT C1722
|
| Hospital Charge Code |
41607219
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$32,248.12 |
| Max. Negotiated Rate |
$39,987.68 |
| Rate for Payer: Aetna Commercial |
$37,149.84
|
| Rate for Payer: Cash Price |
$26,658.45
|
| Rate for Payer: Cigna All Commercial |
$37,106.84
|
| Rate for Payer: CORVEL All Commercial |
$39,987.68
|
| Rate for Payer: Coventry All Commercial |
$37,837.80
|
| Rate for Payer: Encore All Commercial |
$39,579.20
|
| Rate for Payer: Frontpath All Commercial |
$39,557.70
|
| Rate for Payer: Humana ChoiceCare |
$37,136.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$38,697.75
|
| Rate for Payer: PHCS All Commercial |
$32,248.12
|
| Rate for Payer: PHP All Commercial |
$32,609.30
|
| Rate for Payer: Sagamore Health Network All Products |
$33,194.07
|
| Rate for Payer: Signature Care EPO |
$35,687.92
|
| Rate for Payer: Signature Care PPO |
$37,837.80
|
| Rate for Payer: United Healthcare Commercial |
$33,882.03
|
|
|
HC ICD SC DYNAGEN MINI VR
|
Facility
OP
|
$42,997.50
|
|
|
Service Code
|
CPT C1722
|
| Hospital Charge Code |
41607219
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$39,987.68 |
| Rate for Payer: Aetna Commercial |
$36,289.89
|
| Rate for Payer: Aetna Medicare |
$14,189.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$14,189.18
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$24,693.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$26,877.74
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$16,317.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$15,608.09
|
| Rate for Payer: Cash Price |
$26,658.45
|
| Rate for Payer: Cash Price |
$26,658.45
|
| Rate for Payer: Centivo All Commercial |
$21,928.72
|
| Rate for Payer: Cigna All Commercial |
$37,106.84
|
| Rate for Payer: CORVEL All Commercial |
$39,987.68
|
| Rate for Payer: Coventry All Commercial |
$37,837.80
|
| Rate for Payer: Encore All Commercial |
$39,579.20
|
| Rate for Payer: Frontpath All Commercial |
$39,557.70
|
| Rate for Payer: Humana ChoiceCare |
$37,136.94
|
| Rate for Payer: Humana Medicare |
$21,928.72
|
| Rate for Payer: Lucent All Commercial |
$21,928.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$38,697.75
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$32,248.12
|
| Rate for Payer: PHP All Commercial |
$32,609.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$16,769.02
|
| Rate for Payer: Sagamore Health Network All Products |
$33,194.07
|
| Rate for Payer: Signature Care EPO |
$35,687.92
|
| Rate for Payer: Signature Care PPO |
$37,837.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$36,547.88
|
| Rate for Payer: United Healthcare Commercial |
$33,882.03
|
| Rate for Payer: United Healthcare Medicare |
$14,189.18
|
|
|
HC ICD SC DYNAGEN MINI VR DF4
|
Facility
IP
|
$42,997.50
|
|
|
Service Code
|
CPT C1722
|
| Hospital Charge Code |
41607218
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$32,248.12 |
| Max. Negotiated Rate |
$39,987.68 |
| Rate for Payer: Aetna Commercial |
$37,149.84
|
| Rate for Payer: Cash Price |
$26,658.45
|
| Rate for Payer: Cigna All Commercial |
$37,106.84
|
| Rate for Payer: CORVEL All Commercial |
$39,987.68
|
| Rate for Payer: Coventry All Commercial |
$37,837.80
|
| Rate for Payer: Encore All Commercial |
$39,579.20
|
| Rate for Payer: Frontpath All Commercial |
$39,557.70
|
| Rate for Payer: Humana ChoiceCare |
$37,136.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$38,697.75
|
| Rate for Payer: PHCS All Commercial |
$32,248.12
|
| Rate for Payer: PHP All Commercial |
$32,609.30
|
| Rate for Payer: Sagamore Health Network All Products |
$33,194.07
|
| Rate for Payer: Signature Care EPO |
$35,687.92
|
| Rate for Payer: Signature Care PPO |
$37,837.80
|
| Rate for Payer: United Healthcare Commercial |
$33,882.03
|
|
|
HC ICD SC DYNAGEN MINI VR DF4
|
Facility
OP
|
$42,997.50
|
|
|
Service Code
|
CPT C1722
|
| Hospital Charge Code |
41607218
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$39,987.68 |
| Rate for Payer: Aetna Commercial |
$36,289.89
|
| Rate for Payer: Aetna Medicare |
$14,189.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$14,189.18
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$24,693.46
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$26,877.74
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$16,317.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$15,608.09
|
| Rate for Payer: Cash Price |
$26,658.45
|
| Rate for Payer: Cash Price |
$26,658.45
|
| Rate for Payer: Centivo All Commercial |
$21,928.72
|
| Rate for Payer: Cigna All Commercial |
$37,106.84
|
| Rate for Payer: CORVEL All Commercial |
$39,987.68
|
| Rate for Payer: Coventry All Commercial |
$37,837.80
|
| Rate for Payer: Encore All Commercial |
$39,579.20
|
| Rate for Payer: Frontpath All Commercial |
$39,557.70
|
| Rate for Payer: Humana ChoiceCare |
$37,136.94
|
| Rate for Payer: Humana Medicare |
$21,928.72
|
| Rate for Payer: Lucent All Commercial |
$21,928.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$38,697.75
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$32,248.12
|
| Rate for Payer: PHP All Commercial |
$32,609.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$16,769.02
|
| Rate for Payer: Sagamore Health Network All Products |
$33,194.07
|
| Rate for Payer: Signature Care EPO |
$35,687.92
|
| Rate for Payer: Signature Care PPO |
$37,837.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$36,547.88
|
| Rate for Payer: United Healthcare Commercial |
$33,882.03
|
| Rate for Payer: United Healthcare Medicare |
$14,189.18
|
|
|
HC ICD SC ELLI MRI VR 36 DF4 CONN
|
Facility
OP
|
$34,730.64
|
|
|
Service Code
|
CPT C1722
|
| Hospital Charge Code |
41607562
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$32,299.50 |
| Rate for Payer: Aetna Commercial |
$29,312.66
|
| Rate for Payer: Aetna Medicare |
$11,461.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$11,461.11
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$19,945.81
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$21,710.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$13,180.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$12,607.22
|
| Rate for Payer: Cash Price |
$21,533.00
|
| Rate for Payer: Cash Price |
$21,533.00
|
| Rate for Payer: Centivo All Commercial |
$17,712.63
|
| Rate for Payer: Cigna All Commercial |
$29,972.54
|
| Rate for Payer: CORVEL All Commercial |
$32,299.50
|
| Rate for Payer: Coventry All Commercial |
$30,562.96
|
| Rate for Payer: Encore All Commercial |
$31,969.55
|
| Rate for Payer: Frontpath All Commercial |
$31,952.19
|
| Rate for Payer: Humana ChoiceCare |
$29,996.85
|
| Rate for Payer: Humana Medicare |
$17,712.63
|
| Rate for Payer: Lucent All Commercial |
$17,712.63
|
| Rate for Payer: Lutheran Preferred All Commercial |
$31,257.58
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$26,047.98
|
| Rate for Payer: PHP All Commercial |
$26,339.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$13,544.95
|
| Rate for Payer: Sagamore Health Network All Products |
$26,812.05
|
| Rate for Payer: Signature Care EPO |
$28,826.43
|
| Rate for Payer: Signature Care PPO |
$30,562.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$29,521.04
|
| Rate for Payer: United Healthcare Commercial |
$27,367.74
|
| Rate for Payer: United Healthcare Medicare |
$11,461.11
|
|
|
HC ICD SC ELLI MRI VR 36 DF4 CONN
|
Facility
IP
|
$34,730.64
|
|
|
Service Code
|
CPT C1722
|
| Hospital Charge Code |
41607562
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$26,047.98 |
| Max. Negotiated Rate |
$32,299.50 |
| Rate for Payer: Aetna Commercial |
$30,007.27
|
| Rate for Payer: Cash Price |
$21,533.00
|
| Rate for Payer: Cigna All Commercial |
$29,972.54
|
| Rate for Payer: CORVEL All Commercial |
$32,299.50
|
| Rate for Payer: Coventry All Commercial |
$30,562.96
|
| Rate for Payer: Encore All Commercial |
$31,969.55
|
| Rate for Payer: Frontpath All Commercial |
$31,952.19
|
| Rate for Payer: Humana ChoiceCare |
$29,996.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$31,257.58
|
| Rate for Payer: PHCS All Commercial |
$26,047.98
|
| Rate for Payer: PHP All Commercial |
$26,339.72
|
| Rate for Payer: Sagamore Health Network All Products |
$26,812.05
|
| Rate for Payer: Signature Care EPO |
$28,826.43
|
| Rate for Payer: Signature Care PPO |
$30,562.96
|
| Rate for Payer: United Healthcare Commercial |
$27,367.74
|
|
|
HC ICD SC ELLI VR 36
|
Facility
IP
|
$34,730.64
|
|
|
Service Code
|
CPT C1722
|
| Hospital Charge Code |
41607561
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$26,047.98 |
| Max. Negotiated Rate |
$32,299.50 |
| Rate for Payer: Aetna Commercial |
$30,007.27
|
| Rate for Payer: Cash Price |
$21,533.00
|
| Rate for Payer: Cigna All Commercial |
$29,972.54
|
| Rate for Payer: CORVEL All Commercial |
$32,299.50
|
| Rate for Payer: Coventry All Commercial |
$30,562.96
|
| Rate for Payer: Encore All Commercial |
$31,969.55
|
| Rate for Payer: Frontpath All Commercial |
$31,952.19
|
| Rate for Payer: Humana ChoiceCare |
$29,996.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$31,257.58
|
| Rate for Payer: PHCS All Commercial |
$26,047.98
|
| Rate for Payer: PHP All Commercial |
$26,339.72
|
| Rate for Payer: Sagamore Health Network All Products |
$26,812.05
|
| Rate for Payer: Signature Care EPO |
$28,826.43
|
| Rate for Payer: Signature Care PPO |
$30,562.96
|
| Rate for Payer: United Healthcare Commercial |
$27,367.74
|
|
|
HC ICD SC ELLI VR 36
|
Facility
OP
|
$34,730.64
|
|
|
Service Code
|
CPT C1722
|
| Hospital Charge Code |
41607561
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$32,299.50 |
| Rate for Payer: Aetna Commercial |
$29,312.66
|
| Rate for Payer: Aetna Medicare |
$11,461.11
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$11,461.11
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$19,945.81
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$21,710.12
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$13,180.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$12,607.22
|
| Rate for Payer: Cash Price |
$21,533.00
|
| Rate for Payer: Cash Price |
$21,533.00
|
| Rate for Payer: Centivo All Commercial |
$17,712.63
|
| Rate for Payer: Cigna All Commercial |
$29,972.54
|
| Rate for Payer: CORVEL All Commercial |
$32,299.50
|
| Rate for Payer: Coventry All Commercial |
$30,562.96
|
| Rate for Payer: Encore All Commercial |
$31,969.55
|
| Rate for Payer: Frontpath All Commercial |
$31,952.19
|
| Rate for Payer: Humana ChoiceCare |
$29,996.85
|
| Rate for Payer: Humana Medicare |
$17,712.63
|
| Rate for Payer: Lucent All Commercial |
$17,712.63
|
| Rate for Payer: Lutheran Preferred All Commercial |
$31,257.58
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$26,047.98
|
| Rate for Payer: PHP All Commercial |
$26,339.72
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$13,544.95
|
| Rate for Payer: Sagamore Health Network All Products |
$26,812.05
|
| Rate for Payer: Signature Care EPO |
$28,826.43
|
| Rate for Payer: Signature Care PPO |
$30,562.96
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$29,521.04
|
| Rate for Payer: United Healthcare Commercial |
$27,367.74
|
| Rate for Payer: United Healthcare Medicare |
$11,461.11
|
|
|
HC ICD SC ENTRANT VR
|
Facility
IP
|
$37,800.00
|
|
|
Service Code
|
CPT C1722
|
| Hospital Charge Code |
41607557
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$28,350.00 |
| Max. Negotiated Rate |
$35,154.00 |
| Rate for Payer: Aetna Commercial |
$32,659.20
|
| Rate for Payer: Cash Price |
$23,436.00
|
| Rate for Payer: Cigna All Commercial |
$32,621.40
|
| Rate for Payer: CORVEL All Commercial |
$35,154.00
|
| Rate for Payer: Coventry All Commercial |
$33,264.00
|
| Rate for Payer: Encore All Commercial |
$34,794.90
|
| Rate for Payer: Frontpath All Commercial |
$34,776.00
|
| Rate for Payer: Humana ChoiceCare |
$32,647.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$34,020.00
|
| Rate for Payer: PHCS All Commercial |
$28,350.00
|
| Rate for Payer: PHP All Commercial |
$28,667.52
|
| Rate for Payer: Sagamore Health Network All Products |
$29,181.60
|
| Rate for Payer: Signature Care EPO |
$31,374.00
|
| Rate for Payer: Signature Care PPO |
$33,264.00
|
| Rate for Payer: United Healthcare Commercial |
$29,786.40
|
|
|
HC ICD SC ENTRANT VR
|
Facility
OP
|
$37,800.00
|
|
|
Service Code
|
CPT C1722
|
| Hospital Charge Code |
41607557
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$35,154.00 |
| Rate for Payer: Aetna Commercial |
$31,903.20
|
| Rate for Payer: Aetna Medicare |
$12,474.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$12,474.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$21,708.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$23,628.78
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$14,345.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$13,721.40
|
| Rate for Payer: Cash Price |
$23,436.00
|
| Rate for Payer: Cash Price |
$23,436.00
|
| Rate for Payer: Centivo All Commercial |
$19,278.00
|
| Rate for Payer: Cigna All Commercial |
$32,621.40
|
| Rate for Payer: CORVEL All Commercial |
$35,154.00
|
| Rate for Payer: Coventry All Commercial |
$33,264.00
|
| Rate for Payer: Encore All Commercial |
$34,794.90
|
| Rate for Payer: Frontpath All Commercial |
$34,776.00
|
| Rate for Payer: Humana ChoiceCare |
$32,647.86
|
| Rate for Payer: Humana Medicare |
$19,278.00
|
| Rate for Payer: Lucent All Commercial |
$19,278.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$34,020.00
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$28,350.00
|
| Rate for Payer: PHP All Commercial |
$28,667.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$14,742.00
|
| Rate for Payer: Sagamore Health Network All Products |
$29,181.60
|
| Rate for Payer: Signature Care EPO |
$31,374.00
|
| Rate for Payer: Signature Care PPO |
$33,264.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$32,130.00
|
| Rate for Payer: United Healthcare Commercial |
$29,786.40
|
| Rate for Payer: United Healthcare Medicare |
$12,474.00
|
|
