|
HC HOMOCYSTEINE
|
Facility
|
IP
|
$255.24
|
|
|
Service Code
|
CPT 83090
|
| Hospital Charge Code |
63001305
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$191.43 |
| Max. Negotiated Rate |
$237.37 |
| Rate for Payer: Aetna Commercial |
$220.53
|
| Rate for Payer: Cash Price |
$153.14
|
| Rate for Payer: Cigna All Commercial |
$220.27
|
| Rate for Payer: CORVEL All Commercial |
$237.37
|
| Rate for Payer: Coventry All Commercial |
$224.61
|
| Rate for Payer: Encore All Commercial |
$234.95
|
| Rate for Payer: Frontpath All Commercial |
$234.82
|
| Rate for Payer: Humana ChoiceCare |
$220.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$229.72
|
| Rate for Payer: PHCS All Commercial |
$191.43
|
| Rate for Payer: PHP All Commercial |
$193.57
|
| Rate for Payer: Sagamore Health Network All Products |
$197.05
|
| Rate for Payer: Signature Care EPO |
$211.85
|
| Rate for Payer: Signature Care PPO |
$224.61
|
| Rate for Payer: United Healthcare Commercial |
$201.13
|
|
|
HC HOMOCYSTEINE
|
Facility
|
OP
|
$255.24
|
|
|
Service Code
|
CPT 83090
|
| Hospital Charge Code |
63001305
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.92 |
| Max. Negotiated Rate |
$237.37 |
| Rate for Payer: Aetna Commercial |
$215.42
|
| Rate for Payer: Aetna Medicare |
$81.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$17.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$79.12
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$117.31
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$117.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$17.92
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$93.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$89.84
|
| Rate for Payer: Cash Price |
$153.14
|
| Rate for Payer: Cash Price |
$153.14
|
| Rate for Payer: Centivo All Commercial |
$138.85
|
| Rate for Payer: Cigna All Commercial |
$220.27
|
| Rate for Payer: CORVEL All Commercial |
$237.37
|
| Rate for Payer: Coventry All Commercial |
$224.61
|
| Rate for Payer: Encore All Commercial |
$234.95
|
| Rate for Payer: Frontpath All Commercial |
$234.82
|
| Rate for Payer: Humana ChoiceCare |
$220.45
|
| Rate for Payer: Humana Medicare |
$81.68
|
| Rate for Payer: Lucent All Commercial |
$138.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$229.72
|
| Rate for Payer: Managed Health Services Medicaid |
$17.92
|
| Rate for Payer: MDWise Medicaid |
$17.92
|
| Rate for Payer: PHCS All Commercial |
$191.43
|
| Rate for Payer: PHP All Commercial |
$193.57
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$99.54
|
| Rate for Payer: Sagamore Health Network All Products |
$197.05
|
| Rate for Payer: Signature Care EPO |
$211.85
|
| Rate for Payer: Signature Care PPO |
$224.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$216.95
|
| Rate for Payer: United Healthcare Commercial |
$201.13
|
| Rate for Payer: United Healthcare Medicare |
$81.68
|
|
|
HC HOSPICE ROOM
|
Facility
|
IP
|
$1,644.24
|
|
| Hospital Charge Code |
10010054
|
|
Hospital Revenue Code
|
125
|
| Min. Negotiated Rate |
$1,233.18 |
| Max. Negotiated Rate |
$6,636.80 |
| Rate for Payer: Aetna Commercial |
$1,420.62
|
| Rate for Payer: Aetna Medicare |
$3,904.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$3,864.00
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,489.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,294.40
|
| Rate for Payer: Cash Price |
$986.54
|
| Rate for Payer: Cash Price |
$986.54
|
| Rate for Payer: Centivo All Commercial |
$6,636.80
|
| Rate for Payer: Cigna All Commercial |
$1,418.98
|
| Rate for Payer: CORVEL All Commercial |
$1,529.14
|
| Rate for Payer: Coventry All Commercial |
$1,446.93
|
| Rate for Payer: Encore All Commercial |
$1,513.52
|
| Rate for Payer: Frontpath All Commercial |
$1,512.70
|
| Rate for Payer: Humana ChoiceCare |
$1,420.13
|
| Rate for Payer: Humana Medicare |
$3,904.00
|
| Rate for Payer: Lucent All Commercial |
$6,636.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,479.82
|
| Rate for Payer: PHCS All Commercial |
$1,233.18
|
| Rate for Payer: PHP All Commercial |
$1,246.99
|
| Rate for Payer: Sagamore Health Network All Products |
$1,269.35
|
| Rate for Payer: Signature Care EPO |
$1,364.72
|
| Rate for Payer: Signature Care PPO |
$1,446.93
|
| Rate for Payer: United Healthcare Commercial |
$1,295.66
|
| Rate for Payer: United Healthcare Medicare |
$3,904.00
|
|
|
HC HPV
|
Facility
|
IP
|
$114.75
|
|
|
Service Code
|
CPT 87624
|
| Hospital Charge Code |
63087803
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$86.06 |
| Max. Negotiated Rate |
$106.72 |
| Rate for Payer: Aetna Commercial |
$99.14
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Cigna All Commercial |
$99.03
|
| Rate for Payer: CORVEL All Commercial |
$106.72
|
| Rate for Payer: Coventry All Commercial |
$100.98
|
| Rate for Payer: Encore All Commercial |
$105.63
|
| Rate for Payer: Frontpath All Commercial |
$105.57
|
| Rate for Payer: Humana ChoiceCare |
$99.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$103.28
|
| Rate for Payer: PHCS All Commercial |
$86.06
|
| Rate for Payer: PHP All Commercial |
$87.03
|
| Rate for Payer: Sagamore Health Network All Products |
$88.59
|
| Rate for Payer: Signature Care EPO |
$95.24
|
| Rate for Payer: Signature Care PPO |
$100.98
|
| Rate for Payer: United Healthcare Commercial |
$90.42
|
|
|
HC HPV
|
Facility
|
OP
|
$114.75
|
|
|
Service Code
|
CPT 87624
|
| Hospital Charge Code |
63087803
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.09 |
| Max. Negotiated Rate |
$106.72 |
| Rate for Payer: Aetna Commercial |
$96.85
|
| Rate for Payer: Aetna Medicare |
$36.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$35.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$35.57
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$52.74
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$52.74
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$35.09
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$42.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$40.39
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Centivo All Commercial |
$62.42
|
| Rate for Payer: Cigna All Commercial |
$99.03
|
| Rate for Payer: CORVEL All Commercial |
$106.72
|
| Rate for Payer: Coventry All Commercial |
$100.98
|
| Rate for Payer: Encore All Commercial |
$105.63
|
| Rate for Payer: Frontpath All Commercial |
$105.57
|
| Rate for Payer: Humana ChoiceCare |
$99.11
|
| Rate for Payer: Humana Medicare |
$36.72
|
| Rate for Payer: Lucent All Commercial |
$62.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$103.28
|
| Rate for Payer: Managed Health Services Medicaid |
$35.09
|
| Rate for Payer: MDWise Medicaid |
$35.09
|
| Rate for Payer: PHCS All Commercial |
$86.06
|
| Rate for Payer: PHP All Commercial |
$87.03
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$44.75
|
| Rate for Payer: Sagamore Health Network All Products |
$88.59
|
| Rate for Payer: Signature Care EPO |
$95.24
|
| Rate for Payer: Signature Care PPO |
$100.98
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$97.54
|
| Rate for Payer: United Healthcare Commercial |
$90.42
|
| Rate for Payer: United Healthcare Medicare |
$36.72
|
|
|
HC HSV1 GLYCO-G CSF
|
Facility
|
IP
|
$104.91
|
|
|
Service Code
|
CPT 86695
|
| Hospital Charge Code |
63001946
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$78.68 |
| Max. Negotiated Rate |
$97.57 |
| Rate for Payer: Aetna Commercial |
$90.64
|
| Rate for Payer: Cash Price |
$62.95
|
| Rate for Payer: Cigna All Commercial |
$90.54
|
| Rate for Payer: CORVEL All Commercial |
$97.57
|
| Rate for Payer: Coventry All Commercial |
$92.32
|
| Rate for Payer: Encore All Commercial |
$96.57
|
| Rate for Payer: Frontpath All Commercial |
$96.52
|
| Rate for Payer: Humana ChoiceCare |
$90.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$94.42
|
| Rate for Payer: PHCS All Commercial |
$78.68
|
| Rate for Payer: PHP All Commercial |
$79.56
|
| Rate for Payer: Sagamore Health Network All Products |
$80.99
|
| Rate for Payer: Signature Care EPO |
$87.08
|
| Rate for Payer: Signature Care PPO |
$92.32
|
| Rate for Payer: United Healthcare Commercial |
$82.67
|
|
|
HC HSV1 GLYCO-G CSF
|
Facility
|
OP
|
$104.91
|
|
|
Service Code
|
CPT 86695
|
| Hospital Charge Code |
63001946
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.19 |
| Max. Negotiated Rate |
$97.57 |
| Rate for Payer: Aetna Commercial |
$88.54
|
| Rate for Payer: Aetna Medicare |
$33.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$13.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$32.52
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$48.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$48.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$13.19
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$38.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$36.93
|
| Rate for Payer: Cash Price |
$62.95
|
| Rate for Payer: Cash Price |
$62.95
|
| Rate for Payer: Centivo All Commercial |
$57.07
|
| Rate for Payer: Cigna All Commercial |
$90.54
|
| Rate for Payer: CORVEL All Commercial |
$97.57
|
| Rate for Payer: Coventry All Commercial |
$92.32
|
| Rate for Payer: Encore All Commercial |
$96.57
|
| Rate for Payer: Frontpath All Commercial |
$96.52
|
| Rate for Payer: Humana ChoiceCare |
$90.61
|
| Rate for Payer: Humana Medicare |
$33.57
|
| Rate for Payer: Lucent All Commercial |
$57.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$94.42
|
| Rate for Payer: Managed Health Services Medicaid |
$13.19
|
| Rate for Payer: MDWise Medicaid |
$13.19
|
| Rate for Payer: PHCS All Commercial |
$78.68
|
| Rate for Payer: PHP All Commercial |
$79.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$40.91
|
| Rate for Payer: Sagamore Health Network All Products |
$80.99
|
| Rate for Payer: Signature Care EPO |
$87.08
|
| Rate for Payer: Signature Care PPO |
$92.32
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$89.17
|
| Rate for Payer: United Healthcare Commercial |
$82.67
|
| Rate for Payer: United Healthcare Medicare |
$33.57
|
|
|
HC HUMAN GROWTH HORMONE
|
Facility
|
IP
|
$191.86
|
|
|
Service Code
|
CPT 83003
|
| Hospital Charge Code |
63001566
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$143.90 |
| Max. Negotiated Rate |
$178.43 |
| Rate for Payer: Aetna Commercial |
$165.77
|
| Rate for Payer: Cash Price |
$115.12
|
| Rate for Payer: Cigna All Commercial |
$165.58
|
| Rate for Payer: CORVEL All Commercial |
$178.43
|
| Rate for Payer: Coventry All Commercial |
$168.84
|
| Rate for Payer: Encore All Commercial |
$176.61
|
| Rate for Payer: Frontpath All Commercial |
$176.51
|
| Rate for Payer: Humana ChoiceCare |
$165.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$172.67
|
| Rate for Payer: PHCS All Commercial |
$143.90
|
| Rate for Payer: PHP All Commercial |
$145.51
|
| Rate for Payer: Sagamore Health Network All Products |
$148.12
|
| Rate for Payer: Signature Care EPO |
$159.24
|
| Rate for Payer: Signature Care PPO |
$168.84
|
| Rate for Payer: United Healthcare Commercial |
$151.19
|
|
|
HC HUMAN GROWTH HORMONE
|
Facility
|
OP
|
$191.86
|
|
|
Service Code
|
CPT 83003
|
| Hospital Charge Code |
63001566
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.67 |
| Max. Negotiated Rate |
$178.43 |
| Rate for Payer: Aetna Commercial |
$161.93
|
| Rate for Payer: Aetna Medicare |
$61.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$16.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$59.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$88.18
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$88.18
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$16.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$70.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$67.53
|
| Rate for Payer: Cash Price |
$115.12
|
| Rate for Payer: Cash Price |
$115.12
|
| Rate for Payer: Centivo All Commercial |
$104.37
|
| Rate for Payer: Cigna All Commercial |
$165.58
|
| Rate for Payer: CORVEL All Commercial |
$178.43
|
| Rate for Payer: Coventry All Commercial |
$168.84
|
| Rate for Payer: Encore All Commercial |
$176.61
|
| Rate for Payer: Frontpath All Commercial |
$176.51
|
| Rate for Payer: Humana ChoiceCare |
$165.71
|
| Rate for Payer: Humana Medicare |
$61.40
|
| Rate for Payer: Lucent All Commercial |
$104.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$172.67
|
| Rate for Payer: Managed Health Services Medicaid |
$16.67
|
| Rate for Payer: MDWise Medicaid |
$16.67
|
| Rate for Payer: PHCS All Commercial |
$143.90
|
| Rate for Payer: PHP All Commercial |
$145.51
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$74.83
|
| Rate for Payer: Sagamore Health Network All Products |
$148.12
|
| Rate for Payer: Signature Care EPO |
$159.24
|
| Rate for Payer: Signature Care PPO |
$168.84
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$163.08
|
| Rate for Payer: United Healthcare Commercial |
$151.19
|
| Rate for Payer: United Healthcare Medicare |
$61.40
|
|
|
HC HYSTEROSALPINGOGRAM
|
Facility
|
OP
|
$1,211.69
|
|
|
Service Code
|
CPT 74740
|
| Hospital Charge Code |
1614741
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$41.29 |
| Max. Negotiated Rate |
$1,126.87 |
| Rate for Payer: Aetna Commercial |
$1,022.67
|
| Rate for Payer: Aetna Medicare |
$387.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$41.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$375.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$695.87
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$757.43
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$41.29
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$445.90
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$426.51
|
| Rate for Payer: Cash Price |
$727.01
|
| Rate for Payer: Cash Price |
$727.01
|
| Rate for Payer: Centivo All Commercial |
$659.16
|
| Rate for Payer: Cigna All Commercial |
$1,045.69
|
| Rate for Payer: CORVEL All Commercial |
$1,126.87
|
| Rate for Payer: Coventry All Commercial |
$1,066.29
|
| Rate for Payer: Encore All Commercial |
$1,115.36
|
| Rate for Payer: Frontpath All Commercial |
$1,114.75
|
| Rate for Payer: Humana ChoiceCare |
$1,046.54
|
| Rate for Payer: Humana Medicare |
$387.74
|
| Rate for Payer: Lucent All Commercial |
$659.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,090.52
|
| Rate for Payer: Managed Health Services Medicaid |
$41.29
|
| Rate for Payer: MDWise Medicaid |
$41.29
|
| Rate for Payer: PHCS All Commercial |
$908.77
|
| Rate for Payer: PHP All Commercial |
$918.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$472.56
|
| Rate for Payer: Sagamore Health Network All Products |
$935.42
|
| Rate for Payer: Signature Care EPO |
$1,005.70
|
| Rate for Payer: Signature Care PPO |
$1,066.29
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,029.94
|
| Rate for Payer: United Healthcare Commercial |
$954.81
|
| Rate for Payer: United Healthcare Medicare |
$387.74
|
|
|
HC HYSTEROSALPINGOGRAM
|
Facility
|
IP
|
$1,211.69
|
|
|
Service Code
|
CPT 74740
|
| Hospital Charge Code |
1614741
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$908.77 |
| Max. Negotiated Rate |
$1,126.87 |
| Rate for Payer: Aetna Commercial |
$1,046.90
|
| Rate for Payer: Cash Price |
$727.01
|
| Rate for Payer: Cigna All Commercial |
$1,045.69
|
| Rate for Payer: CORVEL All Commercial |
$1,126.87
|
| Rate for Payer: Coventry All Commercial |
$1,066.29
|
| Rate for Payer: Encore All Commercial |
$1,115.36
|
| Rate for Payer: Frontpath All Commercial |
$1,114.75
|
| Rate for Payer: Humana ChoiceCare |
$1,046.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,090.52
|
| Rate for Payer: PHCS All Commercial |
$908.77
|
| Rate for Payer: PHP All Commercial |
$918.95
|
| Rate for Payer: Sagamore Health Network All Products |
$935.42
|
| Rate for Payer: Signature Care EPO |
$1,005.70
|
| Rate for Payer: Signature Care PPO |
$1,066.29
|
| Rate for Payer: United Healthcare Commercial |
$954.81
|
|
|
HC I2B 2.0/2.5 COLAG KIT
|
Facility
|
IP
|
$2,736.00
|
|
| Hospital Charge Code |
41608260
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,052.00 |
| Max. Negotiated Rate |
$2,544.48 |
| Rate for Payer: Aetna Commercial |
$2,363.90
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Cigna All Commercial |
$2,361.17
|
| Rate for Payer: CORVEL All Commercial |
$2,544.48
|
| Rate for Payer: Coventry All Commercial |
$2,407.68
|
| Rate for Payer: Encore All Commercial |
$2,518.49
|
| Rate for Payer: Frontpath All Commercial |
$2,517.12
|
| Rate for Payer: Humana ChoiceCare |
$2,363.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,462.40
|
| Rate for Payer: PHCS All Commercial |
$2,052.00
|
| Rate for Payer: PHP All Commercial |
$2,074.98
|
| Rate for Payer: Sagamore Health Network All Products |
$2,112.19
|
| Rate for Payer: Signature Care EPO |
$2,270.88
|
| Rate for Payer: Signature Care PPO |
$2,407.68
|
| Rate for Payer: United Healthcare Commercial |
$2,155.97
|
|
|
HC I2B 2.0/2.5 COLAG KIT
|
Facility
|
OP
|
$2,736.00
|
|
| Hospital Charge Code |
41608260
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$2,544.48 |
| Rate for Payer: Aetna Commercial |
$2,309.18
|
| Rate for Payer: Aetna Medicare |
$875.52
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$848.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,571.28
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,710.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,006.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$963.07
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Centivo All Commercial |
$1,488.38
|
| Rate for Payer: Cigna All Commercial |
$2,361.17
|
| Rate for Payer: CORVEL All Commercial |
$2,544.48
|
| Rate for Payer: Coventry All Commercial |
$2,407.68
|
| Rate for Payer: Encore All Commercial |
$2,518.49
|
| Rate for Payer: Frontpath All Commercial |
$2,517.12
|
| Rate for Payer: Humana ChoiceCare |
$2,363.08
|
| Rate for Payer: Humana Medicare |
$875.52
|
| Rate for Payer: Lucent All Commercial |
$1,488.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,462.40
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$2,052.00
|
| Rate for Payer: PHP All Commercial |
$2,074.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,067.04
|
| Rate for Payer: Sagamore Health Network All Products |
$2,112.19
|
| Rate for Payer: Signature Care EPO |
$2,270.88
|
| Rate for Payer: Signature Care PPO |
$2,407.68
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,325.60
|
| Rate for Payer: United Healthcare Commercial |
$2,155.97
|
| Rate for Payer: United Healthcare Medicare |
$875.52
|
|
|
HC I2B 2.0/2.5 COUNTERSINK
|
Facility
|
IP
|
$2,736.00
|
|
| Hospital Charge Code |
41608261
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,052.00 |
| Max. Negotiated Rate |
$2,544.48 |
| Rate for Payer: Aetna Commercial |
$2,363.90
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Cigna All Commercial |
$2,361.17
|
| Rate for Payer: CORVEL All Commercial |
$2,544.48
|
| Rate for Payer: Coventry All Commercial |
$2,407.68
|
| Rate for Payer: Encore All Commercial |
$2,518.49
|
| Rate for Payer: Frontpath All Commercial |
$2,517.12
|
| Rate for Payer: Humana ChoiceCare |
$2,363.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,462.40
|
| Rate for Payer: PHCS All Commercial |
$2,052.00
|
| Rate for Payer: PHP All Commercial |
$2,074.98
|
| Rate for Payer: Sagamore Health Network All Products |
$2,112.19
|
| Rate for Payer: Signature Care EPO |
$2,270.88
|
| Rate for Payer: Signature Care PPO |
$2,407.68
|
| Rate for Payer: United Healthcare Commercial |
$2,155.97
|
|
|
HC I2B 2.0/2.5 COUNTERSINK
|
Facility
|
OP
|
$2,736.00
|
|
| Hospital Charge Code |
41608261
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$2,544.48 |
| Rate for Payer: Aetna Commercial |
$2,309.18
|
| Rate for Payer: Aetna Medicare |
$875.52
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$848.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,571.28
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,710.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,006.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$963.07
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Cash Price |
$1,641.60
|
| Rate for Payer: Centivo All Commercial |
$1,488.38
|
| Rate for Payer: Cigna All Commercial |
$2,361.17
|
| Rate for Payer: CORVEL All Commercial |
$2,544.48
|
| Rate for Payer: Coventry All Commercial |
$2,407.68
|
| Rate for Payer: Encore All Commercial |
$2,518.49
|
| Rate for Payer: Frontpath All Commercial |
$2,517.12
|
| Rate for Payer: Humana ChoiceCare |
$2,363.08
|
| Rate for Payer: Humana Medicare |
$875.52
|
| Rate for Payer: Lucent All Commercial |
$1,488.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,462.40
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$2,052.00
|
| Rate for Payer: PHP All Commercial |
$2,074.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,067.04
|
| Rate for Payer: Sagamore Health Network All Products |
$2,112.19
|
| Rate for Payer: Signature Care EPO |
$2,270.88
|
| Rate for Payer: Signature Care PPO |
$2,407.68
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,325.60
|
| Rate for Payer: United Healthcare Commercial |
$2,155.97
|
| Rate for Payer: United Healthcare Medicare |
$875.52
|
|
|
HC I2B DRIVER T7
|
Facility
|
OP
|
$1,805.00
|
|
| Hospital Charge Code |
41608262
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$1,678.65 |
| Rate for Payer: Aetna Commercial |
$1,523.42
|
| Rate for Payer: Aetna Medicare |
$577.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$559.55
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,036.61
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,128.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$664.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$635.36
|
| Rate for Payer: Cash Price |
$1,083.00
|
| Rate for Payer: Cash Price |
$1,083.00
|
| Rate for Payer: Centivo All Commercial |
$981.92
|
| Rate for Payer: Cigna All Commercial |
$1,557.71
|
| Rate for Payer: CORVEL All Commercial |
$1,678.65
|
| Rate for Payer: Coventry All Commercial |
$1,588.40
|
| Rate for Payer: Encore All Commercial |
$1,661.50
|
| Rate for Payer: Frontpath All Commercial |
$1,660.60
|
| Rate for Payer: Humana ChoiceCare |
$1,558.98
|
| Rate for Payer: Humana Medicare |
$577.60
|
| Rate for Payer: Lucent All Commercial |
$981.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,624.50
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$1,353.75
|
| Rate for Payer: PHP All Commercial |
$1,368.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$703.95
|
| Rate for Payer: Sagamore Health Network All Products |
$1,393.46
|
| Rate for Payer: Signature Care EPO |
$1,498.15
|
| Rate for Payer: Signature Care PPO |
$1,588.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,534.25
|
| Rate for Payer: United Healthcare Commercial |
$1,422.34
|
| Rate for Payer: United Healthcare Medicare |
$577.60
|
|
|
HC I2B DRIVER T7
|
Facility
|
IP
|
$1,805.00
|
|
| Hospital Charge Code |
41608262
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,353.75 |
| Max. Negotiated Rate |
$1,678.65 |
| Rate for Payer: Aetna Commercial |
$1,559.52
|
| Rate for Payer: Cash Price |
$1,083.00
|
| Rate for Payer: Cigna All Commercial |
$1,557.71
|
| Rate for Payer: CORVEL All Commercial |
$1,678.65
|
| Rate for Payer: Coventry All Commercial |
$1,588.40
|
| Rate for Payer: Encore All Commercial |
$1,661.50
|
| Rate for Payer: Frontpath All Commercial |
$1,660.60
|
| Rate for Payer: Humana ChoiceCare |
$1,558.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,624.50
|
| Rate for Payer: PHCS All Commercial |
$1,353.75
|
| Rate for Payer: PHP All Commercial |
$1,368.91
|
| Rate for Payer: Sagamore Health Network All Products |
$1,393.46
|
| Rate for Payer: Signature Care EPO |
$1,498.15
|
| Rate for Payer: Signature Care PPO |
$1,588.40
|
| Rate for Payer: United Healthcare Commercial |
$1,422.34
|
|
|
HC I2B INS KIT 5MS
|
Facility
|
OP
|
$3,322.80
|
|
| Hospital Charge Code |
41607911
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$3,090.20 |
| Rate for Payer: Aetna Commercial |
$2,804.44
|
| Rate for Payer: Aetna Medicare |
$1,063.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,030.07
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,908.28
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,077.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,222.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,169.63
|
| Rate for Payer: Cash Price |
$1,993.68
|
| Rate for Payer: Cash Price |
$1,993.68
|
| Rate for Payer: Centivo All Commercial |
$1,807.60
|
| Rate for Payer: Cigna All Commercial |
$2,867.58
|
| Rate for Payer: CORVEL All Commercial |
$3,090.20
|
| Rate for Payer: Coventry All Commercial |
$2,924.06
|
| Rate for Payer: Encore All Commercial |
$3,058.64
|
| Rate for Payer: Frontpath All Commercial |
$3,056.98
|
| Rate for Payer: Humana ChoiceCare |
$2,869.90
|
| Rate for Payer: Humana Medicare |
$1,063.30
|
| Rate for Payer: Lucent All Commercial |
$1,807.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,990.52
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$2,492.10
|
| Rate for Payer: PHP All Commercial |
$2,520.01
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,295.89
|
| Rate for Payer: Sagamore Health Network All Products |
$2,565.20
|
| Rate for Payer: Signature Care EPO |
$2,757.92
|
| Rate for Payer: Signature Care PPO |
$2,924.06
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,824.38
|
| Rate for Payer: United Healthcare Commercial |
$2,618.37
|
| Rate for Payer: United Healthcare Medicare |
$1,063.30
|
|
|
HC I2B INS KIT 5MS
|
Facility
|
IP
|
$3,322.80
|
|
| Hospital Charge Code |
41607911
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,492.10 |
| Max. Negotiated Rate |
$3,090.20 |
| Rate for Payer: Aetna Commercial |
$2,870.90
|
| Rate for Payer: Cash Price |
$1,993.68
|
| Rate for Payer: Cigna All Commercial |
$2,867.58
|
| Rate for Payer: CORVEL All Commercial |
$3,090.20
|
| Rate for Payer: Coventry All Commercial |
$2,924.06
|
| Rate for Payer: Encore All Commercial |
$3,058.64
|
| Rate for Payer: Frontpath All Commercial |
$3,056.98
|
| Rate for Payer: Humana ChoiceCare |
$2,869.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,990.52
|
| Rate for Payer: PHCS All Commercial |
$2,492.10
|
| Rate for Payer: PHP All Commercial |
$2,520.01
|
| Rate for Payer: Sagamore Health Network All Products |
$2,565.20
|
| Rate for Payer: Signature Care EPO |
$2,757.92
|
| Rate for Payer: Signature Care PPO |
$2,924.06
|
| Rate for Payer: United Healthcare Commercial |
$2,618.37
|
|
|
HC I2B PLATE 6-H LAT NK R
|
Facility
|
IP
|
$9,057.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607910
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,793.20 |
| Max. Negotiated Rate |
$8,423.57 |
| Rate for Payer: Aetna Commercial |
$7,825.77
|
| Rate for Payer: Cash Price |
$5,434.56
|
| Rate for Payer: Cigna All Commercial |
$7,816.71
|
| Rate for Payer: CORVEL All Commercial |
$8,423.57
|
| Rate for Payer: Coventry All Commercial |
$7,970.69
|
| Rate for Payer: Encore All Commercial |
$8,337.52
|
| Rate for Payer: Frontpath All Commercial |
$8,332.99
|
| Rate for Payer: Humana ChoiceCare |
$7,823.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,151.84
|
| Rate for Payer: PHCS All Commercial |
$6,793.20
|
| Rate for Payer: PHP All Commercial |
$6,869.28
|
| Rate for Payer: Sagamore Health Network All Products |
$6,992.47
|
| Rate for Payer: Signature Care EPO |
$7,517.81
|
| Rate for Payer: Signature Care PPO |
$7,970.69
|
| Rate for Payer: United Healthcare Commercial |
$7,137.39
|
|
|
HC I2B PLATE 6-H LAT NK R
|
Facility
|
OP
|
$9,057.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607910
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$8,423.57 |
| Rate for Payer: Aetna Commercial |
$7,644.61
|
| Rate for Payer: Aetna Medicare |
$2,898.43
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,807.86
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$5,201.78
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,661.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,333.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,188.28
|
| Rate for Payer: Cash Price |
$5,434.56
|
| Rate for Payer: Cash Price |
$5,434.56
|
| Rate for Payer: Centivo All Commercial |
$4,927.33
|
| Rate for Payer: Cigna All Commercial |
$7,816.71
|
| Rate for Payer: CORVEL All Commercial |
$8,423.57
|
| Rate for Payer: Coventry All Commercial |
$7,970.69
|
| Rate for Payer: Encore All Commercial |
$8,337.52
|
| Rate for Payer: Frontpath All Commercial |
$8,332.99
|
| Rate for Payer: Humana ChoiceCare |
$7,823.05
|
| Rate for Payer: Humana Medicare |
$2,898.43
|
| Rate for Payer: Lucent All Commercial |
$4,927.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$8,151.84
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$6,793.20
|
| Rate for Payer: PHP All Commercial |
$6,869.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,532.46
|
| Rate for Payer: Sagamore Health Network All Products |
$6,992.47
|
| Rate for Payer: Signature Care EPO |
$7,517.81
|
| Rate for Payer: Signature Care PPO |
$7,970.69
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,698.96
|
| Rate for Payer: United Healthcare Commercial |
$7,137.39
|
| Rate for Payer: United Healthcare Medicare |
$2,898.43
|
|
|
HC I2B PLATE 8-H LAT NK L
|
Facility
|
IP
|
$8,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608259
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,412.50 |
| Max. Negotiated Rate |
$7,951.50 |
| Rate for Payer: Aetna Commercial |
$7,387.20
|
| Rate for Payer: Cash Price |
$5,130.00
|
| Rate for Payer: Cigna All Commercial |
$7,378.65
|
| Rate for Payer: CORVEL All Commercial |
$7,951.50
|
| Rate for Payer: Coventry All Commercial |
$7,524.00
|
| Rate for Payer: Encore All Commercial |
$7,870.27
|
| Rate for Payer: Frontpath All Commercial |
$7,866.00
|
| Rate for Payer: Humana ChoiceCare |
$7,384.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,695.00
|
| Rate for Payer: PHCS All Commercial |
$6,412.50
|
| Rate for Payer: PHP All Commercial |
$6,484.32
|
| Rate for Payer: Sagamore Health Network All Products |
$6,600.60
|
| Rate for Payer: Signature Care EPO |
$7,096.50
|
| Rate for Payer: Signature Care PPO |
$7,524.00
|
| Rate for Payer: United Healthcare Commercial |
$6,737.40
|
|
|
HC I2B PLATE 8-H LAT NK L
|
Facility
|
OP
|
$8,550.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608259
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$7,951.50 |
| Rate for Payer: Aetna Commercial |
$7,216.20
|
| Rate for Payer: Aetna Medicare |
$2,736.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,650.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$4,910.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,344.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,146.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,009.60
|
| Rate for Payer: Cash Price |
$5,130.00
|
| Rate for Payer: Cash Price |
$5,130.00
|
| Rate for Payer: Centivo All Commercial |
$4,651.20
|
| Rate for Payer: Cigna All Commercial |
$7,378.65
|
| Rate for Payer: CORVEL All Commercial |
$7,951.50
|
| Rate for Payer: Coventry All Commercial |
$7,524.00
|
| Rate for Payer: Encore All Commercial |
$7,870.27
|
| Rate for Payer: Frontpath All Commercial |
$7,866.00
|
| Rate for Payer: Humana ChoiceCare |
$7,384.64
|
| Rate for Payer: Humana Medicare |
$2,736.00
|
| Rate for Payer: Lucent All Commercial |
$4,651.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,695.00
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$6,412.50
|
| Rate for Payer: PHP All Commercial |
$6,484.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,334.50
|
| Rate for Payer: Sagamore Health Network All Products |
$6,600.60
|
| Rate for Payer: Signature Care EPO |
$7,096.50
|
| Rate for Payer: Signature Care PPO |
$7,524.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,267.50
|
| Rate for Payer: United Healthcare Commercial |
$6,737.40
|
| Rate for Payer: United Healthcare Medicare |
$2,736.00
|
|
|
HC I2B SCREW 2.0X11 COLAG
|
Facility
|
IP
|
$2,217.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608497
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,663.20 |
| Max. Negotiated Rate |
$2,062.37 |
| Rate for Payer: Aetna Commercial |
$1,916.01
|
| Rate for Payer: Cash Price |
$1,330.56
|
| Rate for Payer: Cigna All Commercial |
$1,913.79
|
| Rate for Payer: CORVEL All Commercial |
$2,062.37
|
| Rate for Payer: Coventry All Commercial |
$1,951.49
|
| Rate for Payer: Encore All Commercial |
$2,041.30
|
| Rate for Payer: Frontpath All Commercial |
$2,040.19
|
| Rate for Payer: Humana ChoiceCare |
$1,915.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,995.84
|
| Rate for Payer: PHCS All Commercial |
$1,663.20
|
| Rate for Payer: PHP All Commercial |
$1,681.83
|
| Rate for Payer: Sagamore Health Network All Products |
$1,711.99
|
| Rate for Payer: Signature Care EPO |
$1,840.61
|
| Rate for Payer: Signature Care PPO |
$1,951.49
|
| Rate for Payer: United Healthcare Commercial |
$1,747.47
|
|
|
HC I2B SCREW 2.0X11 COLAG
|
Facility
|
OP
|
$2,217.60
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41608497
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$2,062.37 |
| Rate for Payer: Aetna Commercial |
$1,871.65
|
| Rate for Payer: Aetna Medicare |
$709.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$687.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,273.57
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,386.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$816.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$780.60
|
| Rate for Payer: Cash Price |
$1,330.56
|
| Rate for Payer: Cash Price |
$1,330.56
|
| Rate for Payer: Centivo All Commercial |
$1,206.37
|
| Rate for Payer: Cigna All Commercial |
$1,913.79
|
| Rate for Payer: CORVEL All Commercial |
$2,062.37
|
| Rate for Payer: Coventry All Commercial |
$1,951.49
|
| Rate for Payer: Encore All Commercial |
$2,041.30
|
| Rate for Payer: Frontpath All Commercial |
$2,040.19
|
| Rate for Payer: Humana ChoiceCare |
$1,915.34
|
| Rate for Payer: Humana Medicare |
$709.63
|
| Rate for Payer: Lucent All Commercial |
$1,206.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,995.84
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$1,663.20
|
| Rate for Payer: PHP All Commercial |
$1,681.83
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$864.86
|
| Rate for Payer: Sagamore Health Network All Products |
$1,711.99
|
| Rate for Payer: Signature Care EPO |
$1,840.61
|
| Rate for Payer: Signature Care PPO |
$1,951.49
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,884.96
|
| Rate for Payer: United Healthcare Commercial |
$1,747.47
|
| Rate for Payer: United Healthcare Medicare |
$709.63
|
|
