|
HC GRAFT SEMI TEND 0.65X22
|
Facility
|
IP
|
$5,400.00
|
|
|
Service Code
|
CPT C1762
|
| Hospital Charge Code |
41608115
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,050.00 |
| Max. Negotiated Rate |
$5,022.00 |
| Rate for Payer: Aetna Commercial |
$4,665.60
|
| Rate for Payer: Cash Price |
$3,240.00
|
| Rate for Payer: Cigna All Commercial |
$4,660.20
|
| Rate for Payer: CORVEL All Commercial |
$5,022.00
|
| Rate for Payer: Coventry All Commercial |
$4,752.00
|
| Rate for Payer: Encore All Commercial |
$4,970.70
|
| Rate for Payer: Frontpath All Commercial |
$4,968.00
|
| Rate for Payer: Humana ChoiceCare |
$4,663.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,860.00
|
| Rate for Payer: PHCS All Commercial |
$4,050.00
|
| Rate for Payer: PHP All Commercial |
$4,095.36
|
| Rate for Payer: Sagamore Health Network All Products |
$4,168.80
|
| Rate for Payer: Signature Care EPO |
$4,482.00
|
| Rate for Payer: Signature Care PPO |
$4,752.00
|
| Rate for Payer: United Healthcare Commercial |
$4,255.20
|
|
|
HC GRAFT SEMI TEND 0.65X22
|
Facility
|
OP
|
$5,400.00
|
|
|
Service Code
|
CPT C1762
|
| Hospital Charge Code |
41608115
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$5,022.00 |
| Rate for Payer: Aetna Commercial |
$4,557.60
|
| Rate for Payer: Aetna Medicare |
$1,728.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,674.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$3,101.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,375.54
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,987.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,900.80
|
| Rate for Payer: Cash Price |
$3,240.00
|
| Rate for Payer: Cash Price |
$3,240.00
|
| Rate for Payer: Centivo All Commercial |
$2,937.60
|
| Rate for Payer: Cigna All Commercial |
$4,660.20
|
| Rate for Payer: CORVEL All Commercial |
$5,022.00
|
| Rate for Payer: Coventry All Commercial |
$4,752.00
|
| Rate for Payer: Encore All Commercial |
$4,970.70
|
| Rate for Payer: Frontpath All Commercial |
$4,968.00
|
| Rate for Payer: Humana ChoiceCare |
$4,663.98
|
| Rate for Payer: Humana Medicare |
$1,728.00
|
| Rate for Payer: Lucent All Commercial |
$2,937.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,860.00
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$4,050.00
|
| Rate for Payer: PHP All Commercial |
$4,095.36
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,106.00
|
| Rate for Payer: Sagamore Health Network All Products |
$4,168.80
|
| Rate for Payer: Signature Care EPO |
$4,482.00
|
| Rate for Payer: Signature Care PPO |
$4,752.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,590.00
|
| Rate for Payer: United Healthcare Commercial |
$4,255.20
|
| Rate for Payer: United Healthcare Medicare |
$1,728.00
|
|
|
HC GRAMSTAIN
|
Facility
|
OP
|
$100.74
|
|
|
Service Code
|
CPT 87205
|
| Hospital Charge Code |
63001077
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.27 |
| Max. Negotiated Rate |
$93.69 |
| Rate for Payer: Aetna Commercial |
$85.02
|
| Rate for Payer: Aetna Medicare |
$32.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$4.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$31.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$46.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$46.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$4.27
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$37.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$35.46
|
| Rate for Payer: Cash Price |
$60.44
|
| Rate for Payer: Cash Price |
$60.44
|
| Rate for Payer: Centivo All Commercial |
$54.80
|
| Rate for Payer: Cigna All Commercial |
$86.94
|
| Rate for Payer: CORVEL All Commercial |
$93.69
|
| Rate for Payer: Coventry All Commercial |
$88.65
|
| Rate for Payer: Encore All Commercial |
$92.73
|
| Rate for Payer: Frontpath All Commercial |
$92.68
|
| Rate for Payer: Humana ChoiceCare |
$87.01
|
| Rate for Payer: Humana Medicare |
$32.24
|
| Rate for Payer: Lucent All Commercial |
$54.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$90.67
|
| Rate for Payer: Managed Health Services Medicaid |
$4.27
|
| Rate for Payer: MDWise Medicaid |
$4.27
|
| Rate for Payer: PHCS All Commercial |
$75.56
|
| Rate for Payer: PHP All Commercial |
$76.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$39.29
|
| Rate for Payer: Sagamore Health Network All Products |
$77.77
|
| Rate for Payer: Signature Care EPO |
$83.61
|
| Rate for Payer: Signature Care PPO |
$88.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$85.63
|
| Rate for Payer: United Healthcare Commercial |
$79.38
|
| Rate for Payer: United Healthcare Medicare |
$32.24
|
|
|
HC GRAMSTAIN
|
Facility
|
IP
|
$100.74
|
|
|
Service Code
|
CPT 87205
|
| Hospital Charge Code |
63001077
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$75.56 |
| Max. Negotiated Rate |
$93.69 |
| Rate for Payer: Aetna Commercial |
$87.04
|
| Rate for Payer: Cash Price |
$60.44
|
| Rate for Payer: Cigna All Commercial |
$86.94
|
| Rate for Payer: CORVEL All Commercial |
$93.69
|
| Rate for Payer: Coventry All Commercial |
$88.65
|
| Rate for Payer: Encore All Commercial |
$92.73
|
| Rate for Payer: Frontpath All Commercial |
$92.68
|
| Rate for Payer: Humana ChoiceCare |
$87.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$90.67
|
| Rate for Payer: PHCS All Commercial |
$75.56
|
| Rate for Payer: PHP All Commercial |
$76.40
|
| Rate for Payer: Sagamore Health Network All Products |
$77.77
|
| Rate for Payer: Signature Care EPO |
$83.61
|
| Rate for Payer: Signature Care PPO |
$88.65
|
| Rate for Payer: United Healthcare Commercial |
$79.38
|
|
|
HC GRIPPER PLUS PAC 19GX3/4
|
Facility
|
IP
|
$83.93
|
|
| Hospital Charge Code |
41603102
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$62.95 |
| Max. Negotiated Rate |
$78.05 |
| Rate for Payer: Aetna Commercial |
$72.52
|
| Rate for Payer: Cash Price |
$50.36
|
| Rate for Payer: Cigna All Commercial |
$72.43
|
| Rate for Payer: CORVEL All Commercial |
$78.05
|
| Rate for Payer: Coventry All Commercial |
$73.86
|
| Rate for Payer: Encore All Commercial |
$77.26
|
| Rate for Payer: Frontpath All Commercial |
$77.22
|
| Rate for Payer: Humana ChoiceCare |
$72.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$75.54
|
| Rate for Payer: PHCS All Commercial |
$62.95
|
| Rate for Payer: PHP All Commercial |
$63.65
|
| Rate for Payer: Sagamore Health Network All Products |
$64.79
|
| Rate for Payer: Signature Care EPO |
$69.66
|
| Rate for Payer: Signature Care PPO |
$73.86
|
| Rate for Payer: United Healthcare Commercial |
$66.14
|
|
|
HC GRIPPER PLUS PAC 19GX3/4
|
Facility
|
OP
|
$83.93
|
|
| Hospital Charge Code |
41603102
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.83 |
| Max. Negotiated Rate |
$78.05 |
| Rate for Payer: Aetna Commercial |
$70.84
|
| Rate for Payer: Aetna Medicare |
$26.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$24.83
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$26.02
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$48.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$52.46
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$24.83
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$30.89
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$29.54
|
| Rate for Payer: Cash Price |
$50.36
|
| Rate for Payer: Cash Price |
$50.36
|
| Rate for Payer: Centivo All Commercial |
$45.66
|
| Rate for Payer: Cigna All Commercial |
$72.43
|
| Rate for Payer: CORVEL All Commercial |
$78.05
|
| Rate for Payer: Coventry All Commercial |
$73.86
|
| Rate for Payer: Encore All Commercial |
$77.26
|
| Rate for Payer: Frontpath All Commercial |
$77.22
|
| Rate for Payer: Humana ChoiceCare |
$72.49
|
| Rate for Payer: Humana Medicare |
$26.86
|
| Rate for Payer: Lucent All Commercial |
$45.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$75.54
|
| Rate for Payer: Managed Health Services Medicaid |
$24.83
|
| Rate for Payer: MDWise Medicaid |
$24.83
|
| Rate for Payer: PHCS All Commercial |
$62.95
|
| Rate for Payer: PHP All Commercial |
$63.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$32.73
|
| Rate for Payer: Sagamore Health Network All Products |
$64.79
|
| Rate for Payer: Signature Care EPO |
$69.66
|
| Rate for Payer: Signature Care PPO |
$73.86
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$71.34
|
| Rate for Payer: United Healthcare Commercial |
$66.14
|
| Rate for Payer: United Healthcare Medicare |
$26.86
|
|
|
HC GRIPPER PLUS PAC 20GX1 1/4
|
Facility
|
OP
|
$56.98
|
|
| Hospital Charge Code |
41602362
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.66 |
| Max. Negotiated Rate |
$52.99 |
| Rate for Payer: Aetna Commercial |
$48.09
|
| Rate for Payer: Aetna Medicare |
$18.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$24.83
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$17.66
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$32.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$35.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$24.83
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$20.97
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$20.06
|
| Rate for Payer: Cash Price |
$34.19
|
| Rate for Payer: Cash Price |
$34.19
|
| Rate for Payer: Centivo All Commercial |
$31.00
|
| Rate for Payer: Cigna All Commercial |
$49.17
|
| Rate for Payer: CORVEL All Commercial |
$52.99
|
| Rate for Payer: Coventry All Commercial |
$50.14
|
| Rate for Payer: Encore All Commercial |
$52.45
|
| Rate for Payer: Frontpath All Commercial |
$52.42
|
| Rate for Payer: Humana ChoiceCare |
$49.21
|
| Rate for Payer: Humana Medicare |
$18.23
|
| Rate for Payer: Lucent All Commercial |
$31.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$51.28
|
| Rate for Payer: Managed Health Services Medicaid |
$24.83
|
| Rate for Payer: MDWise Medicaid |
$24.83
|
| Rate for Payer: PHCS All Commercial |
$42.73
|
| Rate for Payer: PHP All Commercial |
$43.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$22.22
|
| Rate for Payer: Sagamore Health Network All Products |
$43.99
|
| Rate for Payer: Signature Care EPO |
$47.29
|
| Rate for Payer: Signature Care PPO |
$50.14
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$48.43
|
| Rate for Payer: United Healthcare Commercial |
$44.90
|
| Rate for Payer: United Healthcare Medicare |
$18.23
|
|
|
HC GRIPPER PLUS PAC 20GX1 1/4
|
Facility
|
IP
|
$56.98
|
|
| Hospital Charge Code |
41602362
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$42.73 |
| Max. Negotiated Rate |
$52.99 |
| Rate for Payer: Aetna Commercial |
$49.23
|
| Rate for Payer: Cash Price |
$34.19
|
| Rate for Payer: Cigna All Commercial |
$49.17
|
| Rate for Payer: CORVEL All Commercial |
$52.99
|
| Rate for Payer: Coventry All Commercial |
$50.14
|
| Rate for Payer: Encore All Commercial |
$52.45
|
| Rate for Payer: Frontpath All Commercial |
$52.42
|
| Rate for Payer: Humana ChoiceCare |
$49.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$51.28
|
| Rate for Payer: PHCS All Commercial |
$42.73
|
| Rate for Payer: PHP All Commercial |
$43.21
|
| Rate for Payer: Sagamore Health Network All Products |
$43.99
|
| Rate for Payer: Signature Care EPO |
$47.29
|
| Rate for Payer: Signature Care PPO |
$50.14
|
| Rate for Payer: United Healthcare Commercial |
$44.90
|
|
|
HC GROUP B STREP AMPLIFIED DNA PROBE
|
Facility
|
OP
|
$231.83
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
63003007
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$35.09 |
| Max. Negotiated Rate |
$215.60 |
| Rate for Payer: Aetna Commercial |
$195.66
|
| Rate for Payer: Aetna Medicare |
$74.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$35.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$71.87
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$106.55
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$106.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$35.09
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$85.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$81.60
|
| Rate for Payer: Cash Price |
$139.10
|
| Rate for Payer: Cash Price |
$139.10
|
| Rate for Payer: Centivo All Commercial |
$126.12
|
| Rate for Payer: Cigna All Commercial |
$200.07
|
| Rate for Payer: CORVEL All Commercial |
$215.60
|
| Rate for Payer: Coventry All Commercial |
$204.01
|
| Rate for Payer: Encore All Commercial |
$213.40
|
| Rate for Payer: Frontpath All Commercial |
$213.28
|
| Rate for Payer: Humana ChoiceCare |
$200.23
|
| Rate for Payer: Humana Medicare |
$74.19
|
| Rate for Payer: Lucent All Commercial |
$126.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$208.65
|
| Rate for Payer: Managed Health Services Medicaid |
$35.09
|
| Rate for Payer: MDWise Medicaid |
$35.09
|
| Rate for Payer: PHCS All Commercial |
$173.87
|
| Rate for Payer: PHP All Commercial |
$175.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$90.41
|
| Rate for Payer: Sagamore Health Network All Products |
$178.97
|
| Rate for Payer: Signature Care EPO |
$192.42
|
| Rate for Payer: Signature Care PPO |
$204.01
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$197.06
|
| Rate for Payer: United Healthcare Commercial |
$182.68
|
| Rate for Payer: United Healthcare Medicare |
$74.19
|
|
|
HC GROUP B STREP AMPLIFIED DNA PROBE
|
Facility
|
IP
|
$231.83
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
63003007
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$173.87 |
| Max. Negotiated Rate |
$215.60 |
| Rate for Payer: Aetna Commercial |
$200.30
|
| Rate for Payer: Cash Price |
$139.10
|
| Rate for Payer: Cigna All Commercial |
$200.07
|
| Rate for Payer: CORVEL All Commercial |
$215.60
|
| Rate for Payer: Coventry All Commercial |
$204.01
|
| Rate for Payer: Encore All Commercial |
$213.40
|
| Rate for Payer: Frontpath All Commercial |
$213.28
|
| Rate for Payer: Humana ChoiceCare |
$200.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$208.65
|
| Rate for Payer: PHCS All Commercial |
$173.87
|
| Rate for Payer: PHP All Commercial |
$175.82
|
| Rate for Payer: Sagamore Health Network All Products |
$178.97
|
| Rate for Payer: Signature Care EPO |
$192.42
|
| Rate for Payer: Signature Care PPO |
$204.01
|
| Rate for Payer: United Healthcare Commercial |
$182.68
|
|
|
HC GTT 1H 3 SPECIMENS
|
Facility
|
OP
|
$124.54
|
|
|
Service Code
|
CPT 82951
|
| Hospital Charge Code |
63001135
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.87 |
| Max. Negotiated Rate |
$115.82 |
| Rate for Payer: Aetna Commercial |
$105.11
|
| Rate for Payer: Aetna Medicare |
$39.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$12.87
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$38.61
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$57.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$57.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$12.87
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$45.83
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$43.84
|
| Rate for Payer: Cash Price |
$74.72
|
| Rate for Payer: Cash Price |
$74.72
|
| Rate for Payer: Centivo All Commercial |
$67.75
|
| Rate for Payer: Cigna All Commercial |
$107.48
|
| Rate for Payer: CORVEL All Commercial |
$115.82
|
| Rate for Payer: Coventry All Commercial |
$109.60
|
| Rate for Payer: Encore All Commercial |
$114.64
|
| Rate for Payer: Frontpath All Commercial |
$114.58
|
| Rate for Payer: Humana ChoiceCare |
$107.57
|
| Rate for Payer: Humana Medicare |
$39.85
|
| Rate for Payer: Lucent All Commercial |
$67.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$112.09
|
| Rate for Payer: Managed Health Services Medicaid |
$12.87
|
| Rate for Payer: MDWise Medicaid |
$12.87
|
| Rate for Payer: PHCS All Commercial |
$93.41
|
| Rate for Payer: PHP All Commercial |
$94.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$48.57
|
| Rate for Payer: Sagamore Health Network All Products |
$96.14
|
| Rate for Payer: Signature Care EPO |
$103.37
|
| Rate for Payer: Signature Care PPO |
$109.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$105.86
|
| Rate for Payer: United Healthcare Commercial |
$98.14
|
| Rate for Payer: United Healthcare Medicare |
$39.85
|
|
|
HC GTT 1H 3 SPECIMENS
|
Facility
|
IP
|
$124.54
|
|
|
Service Code
|
CPT 82951
|
| Hospital Charge Code |
63001135
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$93.41 |
| Max. Negotiated Rate |
$115.82 |
| Rate for Payer: Aetna Commercial |
$107.60
|
| Rate for Payer: Cash Price |
$74.72
|
| Rate for Payer: Cigna All Commercial |
$107.48
|
| Rate for Payer: CORVEL All Commercial |
$115.82
|
| Rate for Payer: Coventry All Commercial |
$109.60
|
| Rate for Payer: Encore All Commercial |
$114.64
|
| Rate for Payer: Frontpath All Commercial |
$114.58
|
| Rate for Payer: Humana ChoiceCare |
$107.57
|
| Rate for Payer: Lutheran Preferred All Commercial |
$112.09
|
| Rate for Payer: PHCS All Commercial |
$93.41
|
| Rate for Payer: PHP All Commercial |
$94.45
|
| Rate for Payer: Sagamore Health Network All Products |
$96.14
|
| Rate for Payer: Signature Care EPO |
$103.37
|
| Rate for Payer: Signature Care PPO |
$109.60
|
| Rate for Payer: United Healthcare Commercial |
$98.14
|
|
|
HC GUIDEWIRE X STIFF 75CM
|
Facility
|
IP
|
$182.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
41607840
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$136.50 |
| Max. Negotiated Rate |
$169.26 |
| Rate for Payer: Aetna Commercial |
$157.25
|
| Rate for Payer: Cash Price |
$109.20
|
| Rate for Payer: Cigna All Commercial |
$157.07
|
| Rate for Payer: CORVEL All Commercial |
$169.26
|
| Rate for Payer: Coventry All Commercial |
$160.16
|
| Rate for Payer: Encore All Commercial |
$167.53
|
| Rate for Payer: Frontpath All Commercial |
$167.44
|
| Rate for Payer: Humana ChoiceCare |
$157.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$163.80
|
| Rate for Payer: PHCS All Commercial |
$136.50
|
| Rate for Payer: PHP All Commercial |
$138.03
|
| Rate for Payer: Sagamore Health Network All Products |
$140.50
|
| Rate for Payer: Signature Care EPO |
$151.06
|
| Rate for Payer: Signature Care PPO |
$160.16
|
| Rate for Payer: United Healthcare Commercial |
$143.42
|
|
|
HC GUIDEWIRE X STIFF 75CM
|
Facility
|
OP
|
$182.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
41607840
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$169.26 |
| Rate for Payer: Aetna Commercial |
$153.61
|
| Rate for Payer: Aetna Medicare |
$58.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$56.42
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$104.52
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$113.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$66.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$64.06
|
| Rate for Payer: Cash Price |
$109.20
|
| Rate for Payer: Cash Price |
$109.20
|
| Rate for Payer: Centivo All Commercial |
$99.01
|
| Rate for Payer: Cigna All Commercial |
$157.07
|
| Rate for Payer: CORVEL All Commercial |
$169.26
|
| Rate for Payer: Coventry All Commercial |
$160.16
|
| Rate for Payer: Encore All Commercial |
$167.53
|
| Rate for Payer: Frontpath All Commercial |
$167.44
|
| Rate for Payer: Humana ChoiceCare |
$157.19
|
| Rate for Payer: Humana Medicare |
$58.24
|
| Rate for Payer: Lucent All Commercial |
$99.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$163.80
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$136.50
|
| Rate for Payer: PHP All Commercial |
$138.03
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$70.98
|
| Rate for Payer: Sagamore Health Network All Products |
$140.50
|
| Rate for Payer: Signature Care EPO |
$151.06
|
| Rate for Payer: Signature Care PPO |
$160.16
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$154.70
|
| Rate for Payer: United Healthcare Commercial |
$143.42
|
| Rate for Payer: United Healthcare Medicare |
$58.24
|
|
|
HC HANDLING FEE
|
Facility
|
OP
|
$26.52
|
|
|
Service Code
|
CPT 99001
|
| Hospital Charge Code |
63002145
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.90 |
| Max. Negotiated Rate |
$24.66 |
| Rate for Payer: Aetna Commercial |
$22.38
|
| Rate for Payer: Aetna Medicare |
$8.49
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$3.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$8.22
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$12.19
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$12.19
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$3.90
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$9.76
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$9.34
|
| Rate for Payer: Cash Price |
$15.91
|
| Rate for Payer: Cash Price |
$15.91
|
| Rate for Payer: Centivo All Commercial |
$14.43
|
| Rate for Payer: Cigna All Commercial |
$22.89
|
| Rate for Payer: CORVEL All Commercial |
$24.66
|
| Rate for Payer: Coventry All Commercial |
$23.34
|
| Rate for Payer: Encore All Commercial |
$24.41
|
| Rate for Payer: Frontpath All Commercial |
$24.40
|
| Rate for Payer: Humana ChoiceCare |
$22.91
|
| Rate for Payer: Humana Medicare |
$8.49
|
| Rate for Payer: Lucent All Commercial |
$14.43
|
| Rate for Payer: Lutheran Preferred All Commercial |
$23.87
|
| Rate for Payer: Managed Health Services Medicaid |
$3.90
|
| Rate for Payer: MDWise Medicaid |
$3.90
|
| Rate for Payer: PHCS All Commercial |
$19.89
|
| Rate for Payer: PHP All Commercial |
$20.11
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$10.34
|
| Rate for Payer: Sagamore Health Network All Products |
$20.47
|
| Rate for Payer: Signature Care EPO |
$22.01
|
| Rate for Payer: Signature Care PPO |
$23.34
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$22.54
|
| Rate for Payer: United Healthcare Commercial |
$20.90
|
| Rate for Payer: United Healthcare Medicare |
$8.49
|
|
|
HC HANDLING FEE
|
Facility
|
IP
|
$26.52
|
|
|
Service Code
|
CPT 99001
|
| Hospital Charge Code |
63002145
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.89 |
| Max. Negotiated Rate |
$24.66 |
| Rate for Payer: Aetna Commercial |
$22.91
|
| Rate for Payer: Cash Price |
$15.91
|
| Rate for Payer: Cigna All Commercial |
$22.89
|
| Rate for Payer: CORVEL All Commercial |
$24.66
|
| Rate for Payer: Coventry All Commercial |
$23.34
|
| Rate for Payer: Encore All Commercial |
$24.41
|
| Rate for Payer: Frontpath All Commercial |
$24.40
|
| Rate for Payer: Humana ChoiceCare |
$22.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$23.87
|
| Rate for Payer: PHCS All Commercial |
$19.89
|
| Rate for Payer: PHP All Commercial |
$20.11
|
| Rate for Payer: Sagamore Health Network All Products |
$20.47
|
| Rate for Payer: Signature Care EPO |
$22.01
|
| Rate for Payer: Signature Care PPO |
$23.34
|
| Rate for Payer: United Healthcare Commercial |
$20.90
|
|
|
HC HAPTOGLOBIN
|
Facility
|
IP
|
$170.20
|
|
|
Service Code
|
CPT 83010
|
| Hospital Charge Code |
63001276
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$127.65 |
| Max. Negotiated Rate |
$158.29 |
| Rate for Payer: Aetna Commercial |
$147.05
|
| Rate for Payer: Cash Price |
$102.12
|
| Rate for Payer: Cigna All Commercial |
$146.88
|
| Rate for Payer: CORVEL All Commercial |
$158.29
|
| Rate for Payer: Coventry All Commercial |
$149.78
|
| Rate for Payer: Encore All Commercial |
$156.67
|
| Rate for Payer: Frontpath All Commercial |
$156.58
|
| Rate for Payer: Humana ChoiceCare |
$147.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$153.18
|
| Rate for Payer: PHCS All Commercial |
$127.65
|
| Rate for Payer: PHP All Commercial |
$129.08
|
| Rate for Payer: Sagamore Health Network All Products |
$131.39
|
| Rate for Payer: Signature Care EPO |
$141.27
|
| Rate for Payer: Signature Care PPO |
$149.78
|
| Rate for Payer: United Healthcare Commercial |
$134.12
|
|
|
HC HAPTOGLOBIN
|
Facility
|
OP
|
$170.20
|
|
|
Service Code
|
CPT 83010
|
| Hospital Charge Code |
63001276
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.58 |
| Max. Negotiated Rate |
$158.29 |
| Rate for Payer: Aetna Commercial |
$143.65
|
| Rate for Payer: Aetna Medicare |
$54.46
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$12.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$52.76
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$78.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$78.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$12.58
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$62.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$59.91
|
| Rate for Payer: Cash Price |
$102.12
|
| Rate for Payer: Cash Price |
$102.12
|
| Rate for Payer: Centivo All Commercial |
$92.59
|
| Rate for Payer: Cigna All Commercial |
$146.88
|
| Rate for Payer: CORVEL All Commercial |
$158.29
|
| Rate for Payer: Coventry All Commercial |
$149.78
|
| Rate for Payer: Encore All Commercial |
$156.67
|
| Rate for Payer: Frontpath All Commercial |
$156.58
|
| Rate for Payer: Humana ChoiceCare |
$147.00
|
| Rate for Payer: Humana Medicare |
$54.46
|
| Rate for Payer: Lucent All Commercial |
$92.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$153.18
|
| Rate for Payer: Managed Health Services Medicaid |
$12.58
|
| Rate for Payer: MDWise Medicaid |
$12.58
|
| Rate for Payer: PHCS All Commercial |
$127.65
|
| Rate for Payer: PHP All Commercial |
$129.08
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$66.38
|
| Rate for Payer: Sagamore Health Network All Products |
$131.39
|
| Rate for Payer: Signature Care EPO |
$141.27
|
| Rate for Payer: Signature Care PPO |
$149.78
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$144.67
|
| Rate for Payer: United Healthcare Commercial |
$134.12
|
| Rate for Payer: United Healthcare Medicare |
$54.46
|
|
|
HC HARMONIC 1100 SHEAR 20CM
|
Facility
|
OP
|
$2,081.56
|
|
| Hospital Charge Code |
41607743
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$1,935.85 |
| Rate for Payer: Aetna Commercial |
$1,756.84
|
| Rate for Payer: Aetna Medicare |
$666.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$645.28
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,195.44
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,301.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$766.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$732.71
|
| Rate for Payer: Cash Price |
$1,248.94
|
| Rate for Payer: Cash Price |
$1,248.94
|
| Rate for Payer: Centivo All Commercial |
$1,132.37
|
| Rate for Payer: Cigna All Commercial |
$1,796.39
|
| Rate for Payer: CORVEL All Commercial |
$1,935.85
|
| Rate for Payer: Coventry All Commercial |
$1,831.77
|
| Rate for Payer: Encore All Commercial |
$1,916.08
|
| Rate for Payer: Frontpath All Commercial |
$1,915.04
|
| Rate for Payer: Humana ChoiceCare |
$1,797.84
|
| Rate for Payer: Humana Medicare |
$666.10
|
| Rate for Payer: Lucent All Commercial |
$1,132.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,873.40
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$1,561.17
|
| Rate for Payer: PHP All Commercial |
$1,578.66
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$811.81
|
| Rate for Payer: Sagamore Health Network All Products |
$1,606.96
|
| Rate for Payer: Signature Care EPO |
$1,727.69
|
| Rate for Payer: Signature Care PPO |
$1,831.77
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,769.33
|
| Rate for Payer: United Healthcare Commercial |
$1,640.27
|
| Rate for Payer: United Healthcare Medicare |
$666.10
|
|
|
HC HARMONIC 1100 SHEAR 20CM
|
Facility
|
IP
|
$2,081.56
|
|
| Hospital Charge Code |
41607743
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,561.17 |
| Max. Negotiated Rate |
$1,935.85 |
| Rate for Payer: Aetna Commercial |
$1,798.47
|
| Rate for Payer: Cash Price |
$1,248.94
|
| Rate for Payer: Cigna All Commercial |
$1,796.39
|
| Rate for Payer: CORVEL All Commercial |
$1,935.85
|
| Rate for Payer: Coventry All Commercial |
$1,831.77
|
| Rate for Payer: Encore All Commercial |
$1,916.08
|
| Rate for Payer: Frontpath All Commercial |
$1,915.04
|
| Rate for Payer: Humana ChoiceCare |
$1,797.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,873.40
|
| Rate for Payer: PHCS All Commercial |
$1,561.17
|
| Rate for Payer: PHP All Commercial |
$1,578.66
|
| Rate for Payer: Sagamore Health Network All Products |
$1,606.96
|
| Rate for Payer: Signature Care EPO |
$1,727.69
|
| Rate for Payer: Signature Care PPO |
$1,831.77
|
| Rate for Payer: United Healthcare Commercial |
$1,640.27
|
|
|
HC HARMONIC 1100 SHEAR 36CM
|
Facility
|
IP
|
$2,370.28
|
|
| Hospital Charge Code |
41607744
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,777.71 |
| Max. Negotiated Rate |
$2,204.36 |
| Rate for Payer: Aetna Commercial |
$2,047.92
|
| Rate for Payer: Cash Price |
$1,422.17
|
| Rate for Payer: Cigna All Commercial |
$2,045.55
|
| Rate for Payer: CORVEL All Commercial |
$2,204.36
|
| Rate for Payer: Coventry All Commercial |
$2,085.85
|
| Rate for Payer: Encore All Commercial |
$2,181.84
|
| Rate for Payer: Frontpath All Commercial |
$2,180.66
|
| Rate for Payer: Humana ChoiceCare |
$2,047.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,133.25
|
| Rate for Payer: PHCS All Commercial |
$1,777.71
|
| Rate for Payer: PHP All Commercial |
$1,797.62
|
| Rate for Payer: Sagamore Health Network All Products |
$1,829.86
|
| Rate for Payer: Signature Care EPO |
$1,967.33
|
| Rate for Payer: Signature Care PPO |
$2,085.85
|
| Rate for Payer: United Healthcare Commercial |
$1,867.78
|
|
|
HC HARMONIC 1100 SHEAR 36CM
|
Facility
|
OP
|
$2,370.28
|
|
| Hospital Charge Code |
41607744
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$2,204.36 |
| Rate for Payer: Aetna Commercial |
$2,000.52
|
| Rate for Payer: Aetna Medicare |
$758.49
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$734.79
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,361.25
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,481.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$872.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$834.34
|
| Rate for Payer: Cash Price |
$1,422.17
|
| Rate for Payer: Cash Price |
$1,422.17
|
| Rate for Payer: Centivo All Commercial |
$1,289.43
|
| Rate for Payer: Cigna All Commercial |
$2,045.55
|
| Rate for Payer: CORVEL All Commercial |
$2,204.36
|
| Rate for Payer: Coventry All Commercial |
$2,085.85
|
| Rate for Payer: Encore All Commercial |
$2,181.84
|
| Rate for Payer: Frontpath All Commercial |
$2,180.66
|
| Rate for Payer: Humana ChoiceCare |
$2,047.21
|
| Rate for Payer: Humana Medicare |
$758.49
|
| Rate for Payer: Lucent All Commercial |
$1,289.43
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,133.25
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$1,777.71
|
| Rate for Payer: PHP All Commercial |
$1,797.62
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$924.41
|
| Rate for Payer: Sagamore Health Network All Products |
$1,829.86
|
| Rate for Payer: Signature Care EPO |
$1,967.33
|
| Rate for Payer: Signature Care PPO |
$2,085.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,014.74
|
| Rate for Payer: United Healthcare Commercial |
$1,867.78
|
| Rate for Payer: United Healthcare Medicare |
$758.49
|
|
|
HC HARMONIC SHEAR 36
|
Facility
|
IP
|
$3,308.66
|
|
| Hospital Charge Code |
41601920
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,481.49 |
| Max. Negotiated Rate |
$3,077.05 |
| Rate for Payer: Aetna Commercial |
$2,858.68
|
| Rate for Payer: Cash Price |
$1,985.20
|
| Rate for Payer: Cigna All Commercial |
$2,855.37
|
| Rate for Payer: CORVEL All Commercial |
$3,077.05
|
| Rate for Payer: Coventry All Commercial |
$2,911.62
|
| Rate for Payer: Encore All Commercial |
$3,045.62
|
| Rate for Payer: Frontpath All Commercial |
$3,043.97
|
| Rate for Payer: Humana ChoiceCare |
$2,857.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,977.79
|
| Rate for Payer: PHCS All Commercial |
$2,481.49
|
| Rate for Payer: PHP All Commercial |
$2,509.29
|
| Rate for Payer: Sagamore Health Network All Products |
$2,554.29
|
| Rate for Payer: Signature Care EPO |
$2,746.19
|
| Rate for Payer: Signature Care PPO |
$2,911.62
|
| Rate for Payer: United Healthcare Commercial |
$2,607.22
|
|
|
HC HARMONIC SHEAR 36
|
Facility
|
OP
|
$3,308.66
|
|
| Hospital Charge Code |
41601920
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$3,077.05 |
| Rate for Payer: Aetna Commercial |
$2,792.51
|
| Rate for Payer: Aetna Medicare |
$1,058.77
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,025.68
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,900.16
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,068.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,217.59
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,164.65
|
| Rate for Payer: Cash Price |
$1,985.20
|
| Rate for Payer: Cash Price |
$1,985.20
|
| Rate for Payer: Centivo All Commercial |
$1,799.91
|
| Rate for Payer: Cigna All Commercial |
$2,855.37
|
| Rate for Payer: CORVEL All Commercial |
$3,077.05
|
| Rate for Payer: Coventry All Commercial |
$2,911.62
|
| Rate for Payer: Encore All Commercial |
$3,045.62
|
| Rate for Payer: Frontpath All Commercial |
$3,043.97
|
| Rate for Payer: Humana ChoiceCare |
$2,857.69
|
| Rate for Payer: Humana Medicare |
$1,058.77
|
| Rate for Payer: Lucent All Commercial |
$1,799.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,977.79
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$2,481.49
|
| Rate for Payer: PHP All Commercial |
$2,509.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,290.38
|
| Rate for Payer: Sagamore Health Network All Products |
$2,554.29
|
| Rate for Payer: Signature Care EPO |
$2,746.19
|
| Rate for Payer: Signature Care PPO |
$2,911.62
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,812.36
|
| Rate for Payer: United Healthcare Commercial |
$2,607.22
|
| Rate for Payer: United Healthcare Medicare |
$1,058.77
|
|
|
HC HARMONIC SHEAR 36CM
|
Facility
|
OP
|
$2,877.38
|
|
| Hospital Charge Code |
41606644
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$2,675.96 |
| Rate for Payer: Aetna Commercial |
$2,428.51
|
| Rate for Payer: Aetna Medicare |
$920.76
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$891.99
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,652.48
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,798.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,058.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,012.84
|
| Rate for Payer: Cash Price |
$1,726.43
|
| Rate for Payer: Cash Price |
$1,726.43
|
| Rate for Payer: Centivo All Commercial |
$1,565.29
|
| Rate for Payer: Cigna All Commercial |
$2,483.18
|
| Rate for Payer: CORVEL All Commercial |
$2,675.96
|
| Rate for Payer: Coventry All Commercial |
$2,532.09
|
| Rate for Payer: Encore All Commercial |
$2,648.63
|
| Rate for Payer: Frontpath All Commercial |
$2,647.19
|
| Rate for Payer: Humana ChoiceCare |
$2,485.19
|
| Rate for Payer: Humana Medicare |
$920.76
|
| Rate for Payer: Lucent All Commercial |
$1,565.29
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,589.64
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$2,158.03
|
| Rate for Payer: PHP All Commercial |
$2,182.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,122.18
|
| Rate for Payer: Sagamore Health Network All Products |
$2,221.34
|
| Rate for Payer: Signature Care EPO |
$2,388.23
|
| Rate for Payer: Signature Care PPO |
$2,532.09
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,445.77
|
| Rate for Payer: United Healthcare Commercial |
$2,267.38
|
| Rate for Payer: United Healthcare Medicare |
$920.76
|
|
