|
HC HEMOGLOBIN ELECTROPHORESIS
|
Facility
|
OP
|
$185.13
|
|
|
Service Code
|
CPT 83020
|
| Hospital Charge Code |
63001304
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.87 |
| Max. Negotiated Rate |
$172.17 |
| Rate for Payer: Aetna Commercial |
$156.25
|
| Rate for Payer: Aetna Medicare |
$59.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$12.87
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$57.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$85.09
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$85.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$12.87
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$68.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$65.17
|
| Rate for Payer: Cash Price |
$111.08
|
| Rate for Payer: Cash Price |
$111.08
|
| Rate for Payer: Centivo All Commercial |
$100.71
|
| Rate for Payer: Cigna All Commercial |
$159.77
|
| Rate for Payer: CORVEL All Commercial |
$172.17
|
| Rate for Payer: Coventry All Commercial |
$162.91
|
| Rate for Payer: Encore All Commercial |
$170.41
|
| Rate for Payer: Frontpath All Commercial |
$170.32
|
| Rate for Payer: Humana ChoiceCare |
$159.90
|
| Rate for Payer: Humana Medicare |
$59.24
|
| Rate for Payer: Lucent All Commercial |
$100.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$166.62
|
| Rate for Payer: Managed Health Services Medicaid |
$12.87
|
| Rate for Payer: MDWise Medicaid |
$12.87
|
| Rate for Payer: PHCS All Commercial |
$138.85
|
| Rate for Payer: PHP All Commercial |
$140.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$72.20
|
| Rate for Payer: Sagamore Health Network All Products |
$142.92
|
| Rate for Payer: Signature Care EPO |
$153.66
|
| Rate for Payer: Signature Care PPO |
$162.91
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$157.36
|
| Rate for Payer: United Healthcare Commercial |
$145.88
|
| Rate for Payer: United Healthcare Medicare |
$59.24
|
|
|
HC HEMOGLOBIN ELECTROPHORESIS
|
Facility
|
IP
|
$185.13
|
|
|
Service Code
|
CPT 83020
|
| Hospital Charge Code |
63001304
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$138.85 |
| Max. Negotiated Rate |
$172.17 |
| Rate for Payer: Aetna Commercial |
$159.95
|
| Rate for Payer: Cash Price |
$111.08
|
| Rate for Payer: Cigna All Commercial |
$159.77
|
| Rate for Payer: CORVEL All Commercial |
$172.17
|
| Rate for Payer: Coventry All Commercial |
$162.91
|
| Rate for Payer: Encore All Commercial |
$170.41
|
| Rate for Payer: Frontpath All Commercial |
$170.32
|
| Rate for Payer: Humana ChoiceCare |
$159.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$166.62
|
| Rate for Payer: PHCS All Commercial |
$138.85
|
| Rate for Payer: PHP All Commercial |
$140.40
|
| Rate for Payer: Sagamore Health Network All Products |
$142.92
|
| Rate for Payer: Signature Care EPO |
$153.66
|
| Rate for Payer: Signature Care PPO |
$162.91
|
| Rate for Payer: United Healthcare Commercial |
$145.88
|
|
|
HC HEPARIN-DEPENDENT PLATELET ANTIBODY (SEROTONIN RELEASE ASSAY)
|
Facility
|
OP
|
$420.75
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
63044079
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.09 |
| Max. Negotiated Rate |
$391.30 |
| Rate for Payer: Aetna Commercial |
$355.11
|
| Rate for Payer: Aetna Medicare |
$134.64
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$24.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$130.43
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$193.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$193.38
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$24.09
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$154.84
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$148.10
|
| Rate for Payer: Cash Price |
$252.45
|
| Rate for Payer: Cash Price |
$252.45
|
| Rate for Payer: Centivo All Commercial |
$228.89
|
| Rate for Payer: Cigna All Commercial |
$363.11
|
| Rate for Payer: CORVEL All Commercial |
$391.30
|
| Rate for Payer: Coventry All Commercial |
$370.26
|
| Rate for Payer: Encore All Commercial |
$387.30
|
| Rate for Payer: Frontpath All Commercial |
$387.09
|
| Rate for Payer: Humana ChoiceCare |
$363.40
|
| Rate for Payer: Humana Medicare |
$134.64
|
| Rate for Payer: Lucent All Commercial |
$228.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$378.68
|
| Rate for Payer: Managed Health Services Medicaid |
$24.09
|
| Rate for Payer: MDWise Medicaid |
$24.09
|
| Rate for Payer: PHCS All Commercial |
$315.56
|
| Rate for Payer: PHP All Commercial |
$319.10
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$164.09
|
| Rate for Payer: Sagamore Health Network All Products |
$324.82
|
| Rate for Payer: Signature Care EPO |
$349.22
|
| Rate for Payer: Signature Care PPO |
$370.26
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$357.64
|
| Rate for Payer: United Healthcare Commercial |
$331.55
|
| Rate for Payer: United Healthcare Medicare |
$134.64
|
|
|
HC HEPARIN-DEPENDENT PLATELET ANTIBODY (SEROTONIN RELEASE ASSAY)
|
Facility
|
IP
|
$420.75
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
63044079
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$315.56 |
| Max. Negotiated Rate |
$391.30 |
| Rate for Payer: Aetna Commercial |
$363.53
|
| Rate for Payer: Cash Price |
$252.45
|
| Rate for Payer: Cigna All Commercial |
$363.11
|
| Rate for Payer: CORVEL All Commercial |
$391.30
|
| Rate for Payer: Coventry All Commercial |
$370.26
|
| Rate for Payer: Encore All Commercial |
$387.30
|
| Rate for Payer: Frontpath All Commercial |
$387.09
|
| Rate for Payer: Humana ChoiceCare |
$363.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$378.68
|
| Rate for Payer: PHCS All Commercial |
$315.56
|
| Rate for Payer: PHP All Commercial |
$319.10
|
| Rate for Payer: Sagamore Health Network All Products |
$324.82
|
| Rate for Payer: Signature Care EPO |
$349.22
|
| Rate for Payer: Signature Care PPO |
$370.26
|
| Rate for Payer: United Healthcare Commercial |
$331.55
|
|
|
HC HEPARIN PF4 AB
|
Facility
|
IP
|
$440.45
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
63001193
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$330.34 |
| Max. Negotiated Rate |
$409.62 |
| Rate for Payer: Aetna Commercial |
$380.55
|
| Rate for Payer: Cash Price |
$264.27
|
| Rate for Payer: Cigna All Commercial |
$380.11
|
| Rate for Payer: CORVEL All Commercial |
$409.62
|
| Rate for Payer: Coventry All Commercial |
$387.60
|
| Rate for Payer: Encore All Commercial |
$405.43
|
| Rate for Payer: Frontpath All Commercial |
$405.21
|
| Rate for Payer: Humana ChoiceCare |
$380.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$396.40
|
| Rate for Payer: PHCS All Commercial |
$330.34
|
| Rate for Payer: PHP All Commercial |
$334.04
|
| Rate for Payer: Sagamore Health Network All Products |
$340.03
|
| Rate for Payer: Signature Care EPO |
$365.57
|
| Rate for Payer: Signature Care PPO |
$387.60
|
| Rate for Payer: United Healthcare Commercial |
$347.07
|
|
|
HC HEPARIN PF4 AB
|
Facility
|
OP
|
$440.45
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
63001193
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.37 |
| Max. Negotiated Rate |
$409.62 |
| Rate for Payer: Aetna Commercial |
$371.74
|
| Rate for Payer: Aetna Medicare |
$140.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$18.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$136.54
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$202.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$202.43
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$18.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$162.09
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$155.04
|
| Rate for Payer: Cash Price |
$264.27
|
| Rate for Payer: Cash Price |
$264.27
|
| Rate for Payer: Centivo All Commercial |
$239.60
|
| Rate for Payer: Cigna All Commercial |
$380.11
|
| Rate for Payer: CORVEL All Commercial |
$409.62
|
| Rate for Payer: Coventry All Commercial |
$387.60
|
| Rate for Payer: Encore All Commercial |
$405.43
|
| Rate for Payer: Frontpath All Commercial |
$405.21
|
| Rate for Payer: Humana ChoiceCare |
$380.42
|
| Rate for Payer: Humana Medicare |
$140.94
|
| Rate for Payer: Lucent All Commercial |
$239.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$396.40
|
| Rate for Payer: Managed Health Services Medicaid |
$18.37
|
| Rate for Payer: MDWise Medicaid |
$18.37
|
| Rate for Payer: PHCS All Commercial |
$330.34
|
| Rate for Payer: PHP All Commercial |
$334.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$171.78
|
| Rate for Payer: Sagamore Health Network All Products |
$340.03
|
| Rate for Payer: Signature Care EPO |
$365.57
|
| Rate for Payer: Signature Care PPO |
$387.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$374.38
|
| Rate for Payer: United Healthcare Commercial |
$347.07
|
| Rate for Payer: United Healthcare Medicare |
$140.94
|
|
|
HC HEPATITIS A IGM
|
Facility
|
OP
|
$155.05
|
|
|
Service Code
|
CPT 86709
|
| Hospital Charge Code |
63002203
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.26 |
| Max. Negotiated Rate |
$144.20 |
| Rate for Payer: Aetna Commercial |
$130.86
|
| Rate for Payer: Aetna Medicare |
$49.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$11.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$48.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$71.26
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$71.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$11.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$57.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$54.58
|
| Rate for Payer: Cash Price |
$93.03
|
| Rate for Payer: Cash Price |
$93.03
|
| Rate for Payer: Centivo All Commercial |
$84.35
|
| Rate for Payer: Cigna All Commercial |
$133.81
|
| Rate for Payer: CORVEL All Commercial |
$144.20
|
| Rate for Payer: Coventry All Commercial |
$136.44
|
| Rate for Payer: Encore All Commercial |
$142.72
|
| Rate for Payer: Frontpath All Commercial |
$142.65
|
| Rate for Payer: Humana ChoiceCare |
$133.92
|
| Rate for Payer: Humana Medicare |
$49.62
|
| Rate for Payer: Lucent All Commercial |
$84.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$139.54
|
| Rate for Payer: Managed Health Services Medicaid |
$11.26
|
| Rate for Payer: MDWise Medicaid |
$11.26
|
| Rate for Payer: PHCS All Commercial |
$116.29
|
| Rate for Payer: PHP All Commercial |
$117.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$60.47
|
| Rate for Payer: Sagamore Health Network All Products |
$119.70
|
| Rate for Payer: Signature Care EPO |
$128.69
|
| Rate for Payer: Signature Care PPO |
$136.44
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$131.79
|
| Rate for Payer: United Healthcare Commercial |
$122.18
|
| Rate for Payer: United Healthcare Medicare |
$49.62
|
|
|
HC HEPATITIS A IGM
|
Facility
|
IP
|
$155.05
|
|
|
Service Code
|
CPT 86709
|
| Hospital Charge Code |
63002203
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$116.29 |
| Max. Negotiated Rate |
$144.20 |
| Rate for Payer: Aetna Commercial |
$133.96
|
| Rate for Payer: Cash Price |
$93.03
|
| Rate for Payer: Cigna All Commercial |
$133.81
|
| Rate for Payer: CORVEL All Commercial |
$144.20
|
| Rate for Payer: Coventry All Commercial |
$136.44
|
| Rate for Payer: Encore All Commercial |
$142.72
|
| Rate for Payer: Frontpath All Commercial |
$142.65
|
| Rate for Payer: Humana ChoiceCare |
$133.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$139.54
|
| Rate for Payer: PHCS All Commercial |
$116.29
|
| Rate for Payer: PHP All Commercial |
$117.59
|
| Rate for Payer: Sagamore Health Network All Products |
$119.70
|
| Rate for Payer: Signature Care EPO |
$128.69
|
| Rate for Payer: Signature Care PPO |
$136.44
|
| Rate for Payer: United Healthcare Commercial |
$122.18
|
|
|
HC HEPATITIS B CORE AN
|
Facility
|
IP
|
$168.30
|
|
|
Service Code
|
CPT 86704
|
| Hospital Charge Code |
63001954
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$126.22 |
| Max. Negotiated Rate |
$156.52 |
| Rate for Payer: Aetna Commercial |
$145.41
|
| Rate for Payer: Cash Price |
$100.98
|
| Rate for Payer: Cigna All Commercial |
$145.24
|
| Rate for Payer: CORVEL All Commercial |
$156.52
|
| Rate for Payer: Coventry All Commercial |
$148.10
|
| Rate for Payer: Encore All Commercial |
$154.92
|
| Rate for Payer: Frontpath All Commercial |
$154.84
|
| Rate for Payer: Humana ChoiceCare |
$145.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$151.47
|
| Rate for Payer: PHCS All Commercial |
$126.22
|
| Rate for Payer: PHP All Commercial |
$127.64
|
| Rate for Payer: Sagamore Health Network All Products |
$129.93
|
| Rate for Payer: Signature Care EPO |
$139.69
|
| Rate for Payer: Signature Care PPO |
$148.10
|
| Rate for Payer: United Healthcare Commercial |
$132.62
|
|
|
HC HEPATITIS B CORE AN
|
Facility
|
OP
|
$168.30
|
|
|
Service Code
|
CPT 86704
|
| Hospital Charge Code |
63001954
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.05 |
| Max. Negotiated Rate |
$156.52 |
| Rate for Payer: Aetna Commercial |
$142.05
|
| Rate for Payer: Aetna Medicare |
$53.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$12.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$52.17
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$77.35
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$77.35
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$12.05
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$61.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$59.24
|
| Rate for Payer: Cash Price |
$100.98
|
| Rate for Payer: Cash Price |
$100.98
|
| Rate for Payer: Centivo All Commercial |
$91.56
|
| Rate for Payer: Cigna All Commercial |
$145.24
|
| Rate for Payer: CORVEL All Commercial |
$156.52
|
| Rate for Payer: Coventry All Commercial |
$148.10
|
| Rate for Payer: Encore All Commercial |
$154.92
|
| Rate for Payer: Frontpath All Commercial |
$154.84
|
| Rate for Payer: Humana ChoiceCare |
$145.36
|
| Rate for Payer: Humana Medicare |
$53.86
|
| Rate for Payer: Lucent All Commercial |
$91.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$151.47
|
| Rate for Payer: Managed Health Services Medicaid |
$12.05
|
| Rate for Payer: MDWise Medicaid |
$12.05
|
| Rate for Payer: PHCS All Commercial |
$126.22
|
| Rate for Payer: PHP All Commercial |
$127.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$65.64
|
| Rate for Payer: Sagamore Health Network All Products |
$129.93
|
| Rate for Payer: Signature Care EPO |
$139.69
|
| Rate for Payer: Signature Care PPO |
$148.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$143.06
|
| Rate for Payer: United Healthcare Commercial |
$132.62
|
| Rate for Payer: United Healthcare Medicare |
$53.86
|
|
|
HC HEPATITIS B SUR ANT
|
Facility
|
OP
|
$132.35
|
|
|
Service Code
|
CPT 87340
|
| Hospital Charge Code |
63001335
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.33 |
| Max. Negotiated Rate |
$123.09 |
| Rate for Payer: Aetna Commercial |
$111.70
|
| Rate for Payer: Aetna Medicare |
$42.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$10.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$41.03
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$60.83
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$60.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$10.33
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$48.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$46.59
|
| Rate for Payer: Cash Price |
$79.41
|
| Rate for Payer: Cash Price |
$79.41
|
| Rate for Payer: Centivo All Commercial |
$72.00
|
| Rate for Payer: Cigna All Commercial |
$114.22
|
| Rate for Payer: CORVEL All Commercial |
$123.09
|
| Rate for Payer: Coventry All Commercial |
$116.47
|
| Rate for Payer: Encore All Commercial |
$121.83
|
| Rate for Payer: Frontpath All Commercial |
$121.76
|
| Rate for Payer: Humana ChoiceCare |
$114.31
|
| Rate for Payer: Humana Medicare |
$42.35
|
| Rate for Payer: Lucent All Commercial |
$72.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$119.11
|
| Rate for Payer: Managed Health Services Medicaid |
$10.33
|
| Rate for Payer: MDWise Medicaid |
$10.33
|
| Rate for Payer: PHCS All Commercial |
$99.26
|
| Rate for Payer: PHP All Commercial |
$100.37
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$51.62
|
| Rate for Payer: Sagamore Health Network All Products |
$102.17
|
| Rate for Payer: Signature Care EPO |
$109.85
|
| Rate for Payer: Signature Care PPO |
$116.47
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$112.50
|
| Rate for Payer: United Healthcare Commercial |
$104.29
|
| Rate for Payer: United Healthcare Medicare |
$42.35
|
|
|
HC HEPATITIS B SUR ANT
|
Facility
|
IP
|
$132.35
|
|
|
Service Code
|
CPT 87340
|
| Hospital Charge Code |
63001335
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$99.26 |
| Max. Negotiated Rate |
$123.09 |
| Rate for Payer: Aetna Commercial |
$114.35
|
| Rate for Payer: Cash Price |
$79.41
|
| Rate for Payer: Cigna All Commercial |
$114.22
|
| Rate for Payer: CORVEL All Commercial |
$123.09
|
| Rate for Payer: Coventry All Commercial |
$116.47
|
| Rate for Payer: Encore All Commercial |
$121.83
|
| Rate for Payer: Frontpath All Commercial |
$121.76
|
| Rate for Payer: Humana ChoiceCare |
$114.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$119.11
|
| Rate for Payer: PHCS All Commercial |
$99.26
|
| Rate for Payer: PHP All Commercial |
$100.37
|
| Rate for Payer: Sagamore Health Network All Products |
$102.17
|
| Rate for Payer: Signature Care EPO |
$109.85
|
| Rate for Payer: Signature Care PPO |
$116.47
|
| Rate for Payer: United Healthcare Commercial |
$104.29
|
|
|
HC HEPATITIS C VIRUS
|
Facility
|
OP
|
$223.18
|
|
|
Service Code
|
CPT 86803
|
| Hospital Charge Code |
63001980
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.27 |
| Max. Negotiated Rate |
$207.56 |
| Rate for Payer: Aetna Commercial |
$188.36
|
| Rate for Payer: Aetna Medicare |
$71.42
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$14.27
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$69.19
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$102.57
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$102.57
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$14.27
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$82.13
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$78.56
|
| Rate for Payer: Cash Price |
$133.91
|
| Rate for Payer: Cash Price |
$133.91
|
| Rate for Payer: Centivo All Commercial |
$121.41
|
| Rate for Payer: Cigna All Commercial |
$192.60
|
| Rate for Payer: CORVEL All Commercial |
$207.56
|
| Rate for Payer: Coventry All Commercial |
$196.40
|
| Rate for Payer: Encore All Commercial |
$205.44
|
| Rate for Payer: Frontpath All Commercial |
$205.33
|
| Rate for Payer: Humana ChoiceCare |
$192.76
|
| Rate for Payer: Humana Medicare |
$71.42
|
| Rate for Payer: Lucent All Commercial |
$121.41
|
| Rate for Payer: Lutheran Preferred All Commercial |
$200.86
|
| Rate for Payer: Managed Health Services Medicaid |
$14.27
|
| Rate for Payer: MDWise Medicaid |
$14.27
|
| Rate for Payer: PHCS All Commercial |
$167.38
|
| Rate for Payer: PHP All Commercial |
$169.26
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$87.04
|
| Rate for Payer: Sagamore Health Network All Products |
$172.29
|
| Rate for Payer: Signature Care EPO |
$185.24
|
| Rate for Payer: Signature Care PPO |
$196.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$189.70
|
| Rate for Payer: United Healthcare Commercial |
$175.87
|
| Rate for Payer: United Healthcare Medicare |
$71.42
|
|
|
HC HEPATITIS C VIRUS
|
Facility
|
IP
|
$223.18
|
|
|
Service Code
|
CPT 86803
|
| Hospital Charge Code |
63001980
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$167.38 |
| Max. Negotiated Rate |
$207.56 |
| Rate for Payer: Aetna Commercial |
$192.83
|
| Rate for Payer: Cash Price |
$133.91
|
| Rate for Payer: Cigna All Commercial |
$192.60
|
| Rate for Payer: CORVEL All Commercial |
$207.56
|
| Rate for Payer: Coventry All Commercial |
$196.40
|
| Rate for Payer: Encore All Commercial |
$205.44
|
| Rate for Payer: Frontpath All Commercial |
$205.33
|
| Rate for Payer: Humana ChoiceCare |
$192.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$200.86
|
| Rate for Payer: PHCS All Commercial |
$167.38
|
| Rate for Payer: PHP All Commercial |
$169.26
|
| Rate for Payer: Sagamore Health Network All Products |
$172.29
|
| Rate for Payer: Signature Care EPO |
$185.24
|
| Rate for Payer: Signature Care PPO |
$196.40
|
| Rate for Payer: United Healthcare Commercial |
$175.87
|
|
|
HC HEPATITIS PANEL-ACUTE
|
Facility
|
OP
|
$582.32
|
|
|
Service Code
|
CPT 80074
|
| Hospital Charge Code |
63001297
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$47.63 |
| Max. Negotiated Rate |
$541.56 |
| Rate for Payer: Aetna Commercial |
$491.48
|
| Rate for Payer: Aetna Medicare |
$186.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$47.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$180.52
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$267.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$267.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$47.63
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$214.29
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$204.98
|
| Rate for Payer: Cash Price |
$349.39
|
| Rate for Payer: Cash Price |
$349.39
|
| Rate for Payer: Centivo All Commercial |
$316.78
|
| Rate for Payer: Cigna All Commercial |
$502.54
|
| Rate for Payer: CORVEL All Commercial |
$541.56
|
| Rate for Payer: Coventry All Commercial |
$512.44
|
| Rate for Payer: Encore All Commercial |
$536.03
|
| Rate for Payer: Frontpath All Commercial |
$535.73
|
| Rate for Payer: Humana ChoiceCare |
$502.95
|
| Rate for Payer: Humana Medicare |
$186.34
|
| Rate for Payer: Lucent All Commercial |
$316.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$524.09
|
| Rate for Payer: Managed Health Services Medicaid |
$47.63
|
| Rate for Payer: MDWise Medicaid |
$47.63
|
| Rate for Payer: PHCS All Commercial |
$436.74
|
| Rate for Payer: PHP All Commercial |
$441.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$227.10
|
| Rate for Payer: Sagamore Health Network All Products |
$449.55
|
| Rate for Payer: Signature Care EPO |
$483.33
|
| Rate for Payer: Signature Care PPO |
$512.44
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$494.97
|
| Rate for Payer: United Healthcare Commercial |
$458.87
|
| Rate for Payer: United Healthcare Medicare |
$186.34
|
|
|
HC HEPATITIS PANEL-ACUTE
|
Facility
|
IP
|
$582.32
|
|
|
Service Code
|
CPT 80074
|
| Hospital Charge Code |
63001297
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$436.74 |
| Max. Negotiated Rate |
$541.56 |
| Rate for Payer: Aetna Commercial |
$503.12
|
| Rate for Payer: Cash Price |
$349.39
|
| Rate for Payer: Cigna All Commercial |
$502.54
|
| Rate for Payer: CORVEL All Commercial |
$541.56
|
| Rate for Payer: Coventry All Commercial |
$512.44
|
| Rate for Payer: Encore All Commercial |
$536.03
|
| Rate for Payer: Frontpath All Commercial |
$535.73
|
| Rate for Payer: Humana ChoiceCare |
$502.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$524.09
|
| Rate for Payer: PHCS All Commercial |
$436.74
|
| Rate for Payer: PHP All Commercial |
$441.63
|
| Rate for Payer: Sagamore Health Network All Products |
$449.55
|
| Rate for Payer: Signature Care EPO |
$483.33
|
| Rate for Payer: Signature Care PPO |
$512.44
|
| Rate for Payer: United Healthcare Commercial |
$458.87
|
|
|
HC HEPATOBILIARY SYSTEM IMAGING
|
Facility
|
IP
|
$2,456.43
|
|
|
Service Code
|
CPT 78226
|
| Hospital Charge Code |
1638226
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,842.32 |
| Max. Negotiated Rate |
$2,284.48 |
| Rate for Payer: Aetna Commercial |
$2,122.36
|
| Rate for Payer: Cash Price |
$1,473.86
|
| Rate for Payer: Cigna All Commercial |
$2,119.90
|
| Rate for Payer: CORVEL All Commercial |
$2,284.48
|
| Rate for Payer: Coventry All Commercial |
$2,161.66
|
| Rate for Payer: Encore All Commercial |
$2,261.14
|
| Rate for Payer: Frontpath All Commercial |
$2,259.92
|
| Rate for Payer: Humana ChoiceCare |
$2,121.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,210.79
|
| Rate for Payer: PHCS All Commercial |
$1,842.32
|
| Rate for Payer: PHP All Commercial |
$1,862.96
|
| Rate for Payer: Sagamore Health Network All Products |
$1,896.36
|
| Rate for Payer: Signature Care EPO |
$2,038.84
|
| Rate for Payer: Signature Care PPO |
$2,161.66
|
| Rate for Payer: United Healthcare Commercial |
$1,935.67
|
|
|
HC HEPATOBILIARY SYSTEM IMAGING
|
Facility
|
OP
|
$2,456.43
|
|
|
Service Code
|
CPT 78226
|
| Hospital Charge Code |
1638226
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$208.08 |
| Max. Negotiated Rate |
$2,284.48 |
| Rate for Payer: Aetna Commercial |
$2,073.23
|
| Rate for Payer: Aetna Medicare |
$786.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$208.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$761.49
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,410.73
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,535.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$208.08
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$903.97
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$864.66
|
| Rate for Payer: Cash Price |
$1,473.86
|
| Rate for Payer: Cash Price |
$1,473.86
|
| Rate for Payer: Centivo All Commercial |
$1,336.30
|
| Rate for Payer: Cigna All Commercial |
$2,119.90
|
| Rate for Payer: CORVEL All Commercial |
$2,284.48
|
| Rate for Payer: Coventry All Commercial |
$2,161.66
|
| Rate for Payer: Encore All Commercial |
$2,261.14
|
| Rate for Payer: Frontpath All Commercial |
$2,259.92
|
| Rate for Payer: Humana ChoiceCare |
$2,121.62
|
| Rate for Payer: Humana Medicare |
$786.06
|
| Rate for Payer: Lucent All Commercial |
$1,336.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,210.79
|
| Rate for Payer: Managed Health Services Medicaid |
$208.08
|
| Rate for Payer: MDWise Medicaid |
$208.08
|
| Rate for Payer: PHCS All Commercial |
$1,842.32
|
| Rate for Payer: PHP All Commercial |
$1,862.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$958.01
|
| Rate for Payer: Sagamore Health Network All Products |
$1,896.36
|
| Rate for Payer: Signature Care EPO |
$2,038.84
|
| Rate for Payer: Signature Care PPO |
$2,161.66
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,087.97
|
| Rate for Payer: United Healthcare Commercial |
$1,935.67
|
| Rate for Payer: United Healthcare Medicare |
$786.06
|
|
|
HC HEPATOBIL SYST IMAGE W/DRUG
|
Facility
|
IP
|
$2,510.09
|
|
|
Service Code
|
CPT 78227
|
| Hospital Charge Code |
1638227
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,882.57 |
| Max. Negotiated Rate |
$2,334.38 |
| Rate for Payer: Aetna Commercial |
$2,168.72
|
| Rate for Payer: Cash Price |
$1,506.05
|
| Rate for Payer: Cigna All Commercial |
$2,166.21
|
| Rate for Payer: CORVEL All Commercial |
$2,334.38
|
| Rate for Payer: Coventry All Commercial |
$2,208.88
|
| Rate for Payer: Encore All Commercial |
$2,310.54
|
| Rate for Payer: Frontpath All Commercial |
$2,309.28
|
| Rate for Payer: Humana ChoiceCare |
$2,167.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,259.08
|
| Rate for Payer: PHCS All Commercial |
$1,882.57
|
| Rate for Payer: PHP All Commercial |
$1,903.65
|
| Rate for Payer: Sagamore Health Network All Products |
$1,937.79
|
| Rate for Payer: Signature Care EPO |
$2,083.37
|
| Rate for Payer: Signature Care PPO |
$2,208.88
|
| Rate for Payer: United Healthcare Commercial |
$1,977.95
|
|
|
HC HEPATOBIL SYST IMAGE W/DRUG
|
Facility
|
OP
|
$2,510.09
|
|
|
Service Code
|
CPT 78227
|
| Hospital Charge Code |
1638227
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$285.53 |
| Max. Negotiated Rate |
$2,334.38 |
| Rate for Payer: Aetna Commercial |
$2,118.52
|
| Rate for Payer: Aetna Medicare |
$803.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$285.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$778.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,441.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,569.06
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$285.53
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$923.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$883.55
|
| Rate for Payer: Cash Price |
$1,506.05
|
| Rate for Payer: Cash Price |
$1,506.05
|
| Rate for Payer: Centivo All Commercial |
$1,365.49
|
| Rate for Payer: Cigna All Commercial |
$2,166.21
|
| Rate for Payer: CORVEL All Commercial |
$2,334.38
|
| Rate for Payer: Coventry All Commercial |
$2,208.88
|
| Rate for Payer: Encore All Commercial |
$2,310.54
|
| Rate for Payer: Frontpath All Commercial |
$2,309.28
|
| Rate for Payer: Humana ChoiceCare |
$2,167.96
|
| Rate for Payer: Humana Medicare |
$803.23
|
| Rate for Payer: Lucent All Commercial |
$1,365.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,259.08
|
| Rate for Payer: Managed Health Services Medicaid |
$285.53
|
| Rate for Payer: MDWise Medicaid |
$285.53
|
| Rate for Payer: PHCS All Commercial |
$1,882.57
|
| Rate for Payer: PHP All Commercial |
$1,903.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$978.94
|
| Rate for Payer: Sagamore Health Network All Products |
$1,937.79
|
| Rate for Payer: Signature Care EPO |
$2,083.37
|
| Rate for Payer: Signature Care PPO |
$2,208.88
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,133.58
|
| Rate for Payer: United Healthcare Commercial |
$1,977.95
|
| Rate for Payer: United Healthcare Medicare |
$803.23
|
|
|
HC HEP A TOTAL AB
|
Facility
|
OP
|
$167.18
|
|
|
Service Code
|
CPT 86708
|
| Hospital Charge Code |
63001956
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.39 |
| Max. Negotiated Rate |
$155.48 |
| Rate for Payer: Aetna Commercial |
$141.10
|
| Rate for Payer: Aetna Medicare |
$53.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$12.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$51.83
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$76.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$76.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$12.39
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$61.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$58.85
|
| Rate for Payer: Cash Price |
$100.31
|
| Rate for Payer: Cash Price |
$100.31
|
| Rate for Payer: Centivo All Commercial |
$90.95
|
| Rate for Payer: Cigna All Commercial |
$144.28
|
| Rate for Payer: CORVEL All Commercial |
$155.48
|
| Rate for Payer: Coventry All Commercial |
$147.12
|
| Rate for Payer: Encore All Commercial |
$153.89
|
| Rate for Payer: Frontpath All Commercial |
$153.81
|
| Rate for Payer: Humana ChoiceCare |
$144.39
|
| Rate for Payer: Humana Medicare |
$53.50
|
| Rate for Payer: Lucent All Commercial |
$90.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$150.46
|
| Rate for Payer: Managed Health Services Medicaid |
$12.39
|
| Rate for Payer: MDWise Medicaid |
$12.39
|
| Rate for Payer: PHCS All Commercial |
$125.39
|
| Rate for Payer: PHP All Commercial |
$126.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$65.20
|
| Rate for Payer: Sagamore Health Network All Products |
$129.06
|
| Rate for Payer: Signature Care EPO |
$138.76
|
| Rate for Payer: Signature Care PPO |
$147.12
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$142.10
|
| Rate for Payer: United Healthcare Commercial |
$131.74
|
| Rate for Payer: United Healthcare Medicare |
$53.50
|
|
|
HC HEP A TOTAL AB
|
Facility
|
IP
|
$167.18
|
|
|
Service Code
|
CPT 86708
|
| Hospital Charge Code |
63001956
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$125.39 |
| Max. Negotiated Rate |
$155.48 |
| Rate for Payer: Aetna Commercial |
$144.44
|
| Rate for Payer: Cash Price |
$100.31
|
| Rate for Payer: Cigna All Commercial |
$144.28
|
| Rate for Payer: CORVEL All Commercial |
$155.48
|
| Rate for Payer: Coventry All Commercial |
$147.12
|
| Rate for Payer: Encore All Commercial |
$153.89
|
| Rate for Payer: Frontpath All Commercial |
$153.81
|
| Rate for Payer: Humana ChoiceCare |
$144.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$150.46
|
| Rate for Payer: PHCS All Commercial |
$125.39
|
| Rate for Payer: PHP All Commercial |
$126.79
|
| Rate for Payer: Sagamore Health Network All Products |
$129.06
|
| Rate for Payer: Signature Care EPO |
$138.76
|
| Rate for Payer: Signature Care PPO |
$147.12
|
| Rate for Payer: United Healthcare Commercial |
$131.74
|
|
|
HC HEP A TOTAL AB W/ IGM IF INDICATED
|
Facility
|
IP
|
$167.18
|
|
|
Service Code
|
CPT 86708
|
| Hospital Charge Code |
63001957
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$125.39 |
| Max. Negotiated Rate |
$155.48 |
| Rate for Payer: Aetna Commercial |
$144.44
|
| Rate for Payer: Cash Price |
$100.31
|
| Rate for Payer: Cigna All Commercial |
$144.28
|
| Rate for Payer: CORVEL All Commercial |
$155.48
|
| Rate for Payer: Coventry All Commercial |
$147.12
|
| Rate for Payer: Encore All Commercial |
$153.89
|
| Rate for Payer: Frontpath All Commercial |
$153.81
|
| Rate for Payer: Humana ChoiceCare |
$144.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$150.46
|
| Rate for Payer: PHCS All Commercial |
$125.39
|
| Rate for Payer: PHP All Commercial |
$126.79
|
| Rate for Payer: Sagamore Health Network All Products |
$129.06
|
| Rate for Payer: Signature Care EPO |
$138.76
|
| Rate for Payer: Signature Care PPO |
$147.12
|
| Rate for Payer: United Healthcare Commercial |
$131.74
|
|
|
HC HEP A TOTAL AB W/ IGM IF INDICATED
|
Facility
|
OP
|
$167.18
|
|
|
Service Code
|
CPT 86708
|
| Hospital Charge Code |
63001957
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.39 |
| Max. Negotiated Rate |
$155.48 |
| Rate for Payer: Aetna Commercial |
$141.10
|
| Rate for Payer: Aetna Medicare |
$53.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$12.39
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$51.83
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$76.84
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$76.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$12.39
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$61.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$58.85
|
| Rate for Payer: Cash Price |
$100.31
|
| Rate for Payer: Cash Price |
$100.31
|
| Rate for Payer: Centivo All Commercial |
$90.95
|
| Rate for Payer: Cigna All Commercial |
$144.28
|
| Rate for Payer: CORVEL All Commercial |
$155.48
|
| Rate for Payer: Coventry All Commercial |
$147.12
|
| Rate for Payer: Encore All Commercial |
$153.89
|
| Rate for Payer: Frontpath All Commercial |
$153.81
|
| Rate for Payer: Humana ChoiceCare |
$144.39
|
| Rate for Payer: Humana Medicare |
$53.50
|
| Rate for Payer: Lucent All Commercial |
$90.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$150.46
|
| Rate for Payer: Managed Health Services Medicaid |
$12.39
|
| Rate for Payer: MDWise Medicaid |
$12.39
|
| Rate for Payer: PHCS All Commercial |
$125.39
|
| Rate for Payer: PHP All Commercial |
$126.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$65.20
|
| Rate for Payer: Sagamore Health Network All Products |
$129.06
|
| Rate for Payer: Signature Care EPO |
$138.76
|
| Rate for Payer: Signature Care PPO |
$147.12
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$142.10
|
| Rate for Payer: United Healthcare Commercial |
$131.74
|
| Rate for Payer: United Healthcare Medicare |
$53.50
|
|
|
HC HEP B CORE IGM
|
Facility
|
OP
|
$163.56
|
|
|
Service Code
|
CPT 86705
|
| Hospital Charge Code |
63001336
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.77 |
| Max. Negotiated Rate |
$152.11 |
| Rate for Payer: Aetna Commercial |
$138.04
|
| Rate for Payer: Aetna Medicare |
$52.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$11.77
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$50.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$75.17
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$75.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$11.77
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$60.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$57.57
|
| Rate for Payer: Cash Price |
$98.14
|
| Rate for Payer: Cash Price |
$98.14
|
| Rate for Payer: Centivo All Commercial |
$88.98
|
| Rate for Payer: Cigna All Commercial |
$141.15
|
| Rate for Payer: CORVEL All Commercial |
$152.11
|
| Rate for Payer: Coventry All Commercial |
$143.93
|
| Rate for Payer: Encore All Commercial |
$150.56
|
| Rate for Payer: Frontpath All Commercial |
$150.48
|
| Rate for Payer: Humana ChoiceCare |
$141.27
|
| Rate for Payer: Humana Medicare |
$52.34
|
| Rate for Payer: Lucent All Commercial |
$88.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$147.20
|
| Rate for Payer: Managed Health Services Medicaid |
$11.77
|
| Rate for Payer: MDWise Medicaid |
$11.77
|
| Rate for Payer: PHCS All Commercial |
$122.67
|
| Rate for Payer: PHP All Commercial |
$124.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$63.79
|
| Rate for Payer: Sagamore Health Network All Products |
$126.27
|
| Rate for Payer: Signature Care EPO |
$135.75
|
| Rate for Payer: Signature Care PPO |
$143.93
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$139.03
|
| Rate for Payer: United Healthcare Commercial |
$128.89
|
| Rate for Payer: United Healthcare Medicare |
$52.34
|
|
