|
HC INJ ELBOW ARTHROGRAM RT
|
Facility
|
OP
|
$589.82
|
|
|
Service Code
|
CPT 24220
|
| Hospital Charge Code |
11614229
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$73.30 |
| Max. Negotiated Rate |
$548.53 |
| Rate for Payer: Aetna Commercial |
$497.81
|
| Rate for Payer: Aetna Medicare |
$188.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$73.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$182.84
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$338.73
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$368.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$73.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$217.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$207.62
|
| Rate for Payer: Cash Price |
$353.89
|
| Rate for Payer: Cash Price |
$353.89
|
| Rate for Payer: Centivo All Commercial |
$320.86
|
| Rate for Payer: Cigna All Commercial |
$509.01
|
| Rate for Payer: CORVEL All Commercial |
$548.53
|
| Rate for Payer: Coventry All Commercial |
$519.04
|
| Rate for Payer: Encore All Commercial |
$542.93
|
| Rate for Payer: Frontpath All Commercial |
$542.63
|
| Rate for Payer: Humana ChoiceCare |
$509.43
|
| Rate for Payer: Humana Medicare |
$188.74
|
| Rate for Payer: Lucent All Commercial |
$320.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$530.84
|
| Rate for Payer: Managed Health Services Medicaid |
$73.30
|
| Rate for Payer: MDWise Medicaid |
$73.30
|
| Rate for Payer: PHCS All Commercial |
$442.37
|
| Rate for Payer: PHP All Commercial |
$447.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$230.03
|
| Rate for Payer: Sagamore Health Network All Products |
$455.34
|
| Rate for Payer: Signature Care EPO |
$489.55
|
| Rate for Payer: Signature Care PPO |
$519.04
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$501.35
|
| Rate for Payer: United Healthcare Commercial |
$464.78
|
| Rate for Payer: United Healthcare Medicare |
$188.74
|
|
|
HC INJ EPIDURAL BLOOD OR CLOT PATCH
|
Facility
|
OP
|
$2,033.33
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
1689117
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$318.54 |
| Max. Negotiated Rate |
$1,891.00 |
| Rate for Payer: Aetna Commercial |
$1,716.13
|
| Rate for Payer: Aetna Medicare |
$650.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$318.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$630.33
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,167.74
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,271.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$318.54
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$748.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$715.73
|
| Rate for Payer: Cash Price |
$1,220.00
|
| Rate for Payer: Cash Price |
$1,220.00
|
| Rate for Payer: Centivo All Commercial |
$1,106.13
|
| Rate for Payer: Cigna All Commercial |
$1,754.76
|
| Rate for Payer: CORVEL All Commercial |
$1,891.00
|
| Rate for Payer: Coventry All Commercial |
$1,789.33
|
| Rate for Payer: Encore All Commercial |
$1,871.68
|
| Rate for Payer: Frontpath All Commercial |
$1,870.66
|
| Rate for Payer: Humana ChoiceCare |
$1,756.19
|
| Rate for Payer: Humana Medicare |
$650.67
|
| Rate for Payer: Lucent All Commercial |
$1,106.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,830.00
|
| Rate for Payer: Managed Health Services Medicaid |
$318.54
|
| Rate for Payer: MDWise Medicaid |
$318.54
|
| Rate for Payer: PHCS All Commercial |
$1,525.00
|
| Rate for Payer: PHP All Commercial |
$1,542.08
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$793.00
|
| Rate for Payer: Sagamore Health Network All Products |
$1,569.73
|
| Rate for Payer: Signature Care EPO |
$1,687.66
|
| Rate for Payer: Signature Care PPO |
$1,789.33
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,728.33
|
| Rate for Payer: United Healthcare Commercial |
$1,602.26
|
| Rate for Payer: United Healthcare Medicare |
$650.67
|
|
|
HC INJ EPIDURAL BLOOD OR CLOT PATCH
|
Facility
|
IP
|
$2,033.33
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
1689117
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,525.00 |
| Max. Negotiated Rate |
$1,891.00 |
| Rate for Payer: Aetna Commercial |
$1,756.80
|
| Rate for Payer: Cash Price |
$1,220.00
|
| Rate for Payer: Cigna All Commercial |
$1,754.76
|
| Rate for Payer: CORVEL All Commercial |
$1,891.00
|
| Rate for Payer: Coventry All Commercial |
$1,789.33
|
| Rate for Payer: Encore All Commercial |
$1,871.68
|
| Rate for Payer: Frontpath All Commercial |
$1,870.66
|
| Rate for Payer: Humana ChoiceCare |
$1,756.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,830.00
|
| Rate for Payer: PHCS All Commercial |
$1,525.00
|
| Rate for Payer: PHP All Commercial |
$1,542.08
|
| Rate for Payer: Sagamore Health Network All Products |
$1,569.73
|
| Rate for Payer: Signature Care EPO |
$1,687.66
|
| Rate for Payer: Signature Care PPO |
$1,789.33
|
| Rate for Payer: United Healthcare Commercial |
$1,602.26
|
|
|
HC INJ HIP ARTHROGRAM BI
|
Facility
|
IP
|
$1,057.25
|
|
|
Service Code
|
CPT 27093 50
|
| Hospital Charge Code |
21617093
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$792.94 |
| Max. Negotiated Rate |
$983.24 |
| Rate for Payer: Aetna Commercial |
$913.46
|
| Rate for Payer: Cash Price |
$634.35
|
| Rate for Payer: Cigna All Commercial |
$912.41
|
| Rate for Payer: CORVEL All Commercial |
$983.24
|
| Rate for Payer: Coventry All Commercial |
$930.38
|
| Rate for Payer: Encore All Commercial |
$973.20
|
| Rate for Payer: Frontpath All Commercial |
$972.67
|
| Rate for Payer: Humana ChoiceCare |
$913.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$951.52
|
| Rate for Payer: PHCS All Commercial |
$792.94
|
| Rate for Payer: PHP All Commercial |
$801.82
|
| Rate for Payer: Sagamore Health Network All Products |
$816.20
|
| Rate for Payer: Signature Care EPO |
$877.52
|
| Rate for Payer: Signature Care PPO |
$930.38
|
| Rate for Payer: United Healthcare Commercial |
$833.11
|
|
|
HC INJ HIP ARTHROGRAM BI
|
Facility
|
OP
|
$1,057.25
|
|
|
Service Code
|
CPT 27093 50
|
| Hospital Charge Code |
21617093
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$73.30 |
| Max. Negotiated Rate |
$983.24 |
| Rate for Payer: Aetna Commercial |
$892.32
|
| Rate for Payer: Aetna Medicare |
$338.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$73.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$327.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$607.18
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$660.89
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$73.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$389.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$372.15
|
| Rate for Payer: Cash Price |
$634.35
|
| Rate for Payer: Cash Price |
$634.35
|
| Rate for Payer: Centivo All Commercial |
$575.14
|
| Rate for Payer: Cigna All Commercial |
$912.41
|
| Rate for Payer: CORVEL All Commercial |
$983.24
|
| Rate for Payer: Coventry All Commercial |
$930.38
|
| Rate for Payer: Encore All Commercial |
$973.20
|
| Rate for Payer: Frontpath All Commercial |
$972.67
|
| Rate for Payer: Humana ChoiceCare |
$913.15
|
| Rate for Payer: Humana Medicare |
$338.32
|
| Rate for Payer: Lucent All Commercial |
$575.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$951.52
|
| Rate for Payer: Managed Health Services Medicaid |
$73.30
|
| Rate for Payer: MDWise Medicaid |
$73.30
|
| Rate for Payer: PHCS All Commercial |
$792.94
|
| Rate for Payer: PHP All Commercial |
$801.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$412.33
|
| Rate for Payer: Sagamore Health Network All Products |
$816.20
|
| Rate for Payer: Signature Care EPO |
$877.52
|
| Rate for Payer: Signature Care PPO |
$930.38
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$898.66
|
| Rate for Payer: United Healthcare Commercial |
$833.11
|
| Rate for Payer: United Healthcare Medicare |
$338.32
|
|
|
HC INJ HIP ARTHROGRAM LT
|
Facility
|
OP
|
$704.82
|
|
|
Service Code
|
CPT 27093
|
| Hospital Charge Code |
1617093
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$73.30 |
| Max. Negotiated Rate |
$655.48 |
| Rate for Payer: Aetna Commercial |
$594.87
|
| Rate for Payer: Aetna Medicare |
$225.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$73.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$218.49
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$404.78
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$440.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$73.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$259.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$248.10
|
| Rate for Payer: Cash Price |
$422.89
|
| Rate for Payer: Cash Price |
$422.89
|
| Rate for Payer: Centivo All Commercial |
$383.42
|
| Rate for Payer: Cigna All Commercial |
$608.26
|
| Rate for Payer: CORVEL All Commercial |
$655.48
|
| Rate for Payer: Coventry All Commercial |
$620.24
|
| Rate for Payer: Encore All Commercial |
$648.79
|
| Rate for Payer: Frontpath All Commercial |
$648.43
|
| Rate for Payer: Humana ChoiceCare |
$608.75
|
| Rate for Payer: Humana Medicare |
$225.54
|
| Rate for Payer: Lucent All Commercial |
$383.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$634.34
|
| Rate for Payer: Managed Health Services Medicaid |
$73.30
|
| Rate for Payer: MDWise Medicaid |
$73.30
|
| Rate for Payer: PHCS All Commercial |
$528.62
|
| Rate for Payer: PHP All Commercial |
$534.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$274.88
|
| Rate for Payer: Sagamore Health Network All Products |
$544.12
|
| Rate for Payer: Signature Care EPO |
$585.00
|
| Rate for Payer: Signature Care PPO |
$620.24
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$599.10
|
| Rate for Payer: United Healthcare Commercial |
$555.40
|
| Rate for Payer: United Healthcare Medicare |
$225.54
|
|
|
HC INJ HIP ARTHROGRAM LT
|
Facility
|
IP
|
$704.82
|
|
|
Service Code
|
CPT 27093
|
| Hospital Charge Code |
1617093
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$528.62 |
| Max. Negotiated Rate |
$655.48 |
| Rate for Payer: Aetna Commercial |
$608.96
|
| Rate for Payer: Cash Price |
$422.89
|
| Rate for Payer: Cigna All Commercial |
$608.26
|
| Rate for Payer: CORVEL All Commercial |
$655.48
|
| Rate for Payer: Coventry All Commercial |
$620.24
|
| Rate for Payer: Encore All Commercial |
$648.79
|
| Rate for Payer: Frontpath All Commercial |
$648.43
|
| Rate for Payer: Humana ChoiceCare |
$608.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$634.34
|
| Rate for Payer: PHCS All Commercial |
$528.62
|
| Rate for Payer: PHP All Commercial |
$534.54
|
| Rate for Payer: Sagamore Health Network All Products |
$544.12
|
| Rate for Payer: Signature Care EPO |
$585.00
|
| Rate for Payer: Signature Care PPO |
$620.24
|
| Rate for Payer: United Healthcare Commercial |
$555.40
|
|
|
HC INJ HIP ARTHROGRAM RT
|
Facility
|
IP
|
$704.82
|
|
|
Service Code
|
CPT 27093
|
| Hospital Charge Code |
11617093
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$528.62 |
| Max. Negotiated Rate |
$655.48 |
| Rate for Payer: Aetna Commercial |
$608.96
|
| Rate for Payer: Cash Price |
$422.89
|
| Rate for Payer: Cigna All Commercial |
$608.26
|
| Rate for Payer: CORVEL All Commercial |
$655.48
|
| Rate for Payer: Coventry All Commercial |
$620.24
|
| Rate for Payer: Encore All Commercial |
$648.79
|
| Rate for Payer: Frontpath All Commercial |
$648.43
|
| Rate for Payer: Humana ChoiceCare |
$608.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$634.34
|
| Rate for Payer: PHCS All Commercial |
$528.62
|
| Rate for Payer: PHP All Commercial |
$534.54
|
| Rate for Payer: Sagamore Health Network All Products |
$544.12
|
| Rate for Payer: Signature Care EPO |
$585.00
|
| Rate for Payer: Signature Care PPO |
$620.24
|
| Rate for Payer: United Healthcare Commercial |
$555.40
|
|
|
HC INJ HIP ARTHROGRAM RT
|
Facility
|
OP
|
$704.82
|
|
|
Service Code
|
CPT 27093
|
| Hospital Charge Code |
11617093
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$73.30 |
| Max. Negotiated Rate |
$655.48 |
| Rate for Payer: Aetna Commercial |
$594.87
|
| Rate for Payer: Aetna Medicare |
$225.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$73.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$218.49
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$404.78
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$440.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$73.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$259.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$248.10
|
| Rate for Payer: Cash Price |
$422.89
|
| Rate for Payer: Cash Price |
$422.89
|
| Rate for Payer: Centivo All Commercial |
$383.42
|
| Rate for Payer: Cigna All Commercial |
$608.26
|
| Rate for Payer: CORVEL All Commercial |
$655.48
|
| Rate for Payer: Coventry All Commercial |
$620.24
|
| Rate for Payer: Encore All Commercial |
$648.79
|
| Rate for Payer: Frontpath All Commercial |
$648.43
|
| Rate for Payer: Humana ChoiceCare |
$608.75
|
| Rate for Payer: Humana Medicare |
$225.54
|
| Rate for Payer: Lucent All Commercial |
$383.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$634.34
|
| Rate for Payer: Managed Health Services Medicaid |
$73.30
|
| Rate for Payer: MDWise Medicaid |
$73.30
|
| Rate for Payer: PHCS All Commercial |
$528.62
|
| Rate for Payer: PHP All Commercial |
$534.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$274.88
|
| Rate for Payer: Sagamore Health Network All Products |
$544.12
|
| Rate for Payer: Signature Care EPO |
$585.00
|
| Rate for Payer: Signature Care PPO |
$620.24
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$599.10
|
| Rate for Payer: United Healthcare Commercial |
$555.40
|
| Rate for Payer: United Healthcare Medicare |
$225.54
|
|
|
HC INJ HYSTEROSALPINGOGRAM
|
Facility
|
IP
|
$757.35
|
|
|
Service Code
|
CPT 58340
|
| Hospital Charge Code |
1618340
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$568.01 |
| Max. Negotiated Rate |
$704.34 |
| Rate for Payer: Aetna Commercial |
$654.35
|
| Rate for Payer: Cash Price |
$454.41
|
| Rate for Payer: Cigna All Commercial |
$653.59
|
| Rate for Payer: CORVEL All Commercial |
$704.34
|
| Rate for Payer: Coventry All Commercial |
$666.47
|
| Rate for Payer: Encore All Commercial |
$697.14
|
| Rate for Payer: Frontpath All Commercial |
$696.76
|
| Rate for Payer: Humana ChoiceCare |
$654.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$681.62
|
| Rate for Payer: PHCS All Commercial |
$568.01
|
| Rate for Payer: PHP All Commercial |
$574.37
|
| Rate for Payer: Sagamore Health Network All Products |
$584.67
|
| Rate for Payer: Signature Care EPO |
$628.60
|
| Rate for Payer: Signature Care PPO |
$666.47
|
| Rate for Payer: United Healthcare Commercial |
$596.79
|
|
|
HC INJ HYSTEROSALPINGOGRAM
|
Facility
|
OP
|
$757.35
|
|
|
Service Code
|
CPT 58340
|
| Hospital Charge Code |
1618340
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$73.30 |
| Max. Negotiated Rate |
$704.34 |
| Rate for Payer: Aetna Commercial |
$639.20
|
| Rate for Payer: Aetna Medicare |
$242.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$73.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$234.78
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$434.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$473.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$73.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$278.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$266.59
|
| Rate for Payer: Cash Price |
$454.41
|
| Rate for Payer: Cash Price |
$454.41
|
| Rate for Payer: Centivo All Commercial |
$412.00
|
| Rate for Payer: Cigna All Commercial |
$653.59
|
| Rate for Payer: CORVEL All Commercial |
$704.34
|
| Rate for Payer: Coventry All Commercial |
$666.47
|
| Rate for Payer: Encore All Commercial |
$697.14
|
| Rate for Payer: Frontpath All Commercial |
$696.76
|
| Rate for Payer: Humana ChoiceCare |
$654.12
|
| Rate for Payer: Humana Medicare |
$242.35
|
| Rate for Payer: Lucent All Commercial |
$412.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$681.62
|
| Rate for Payer: Managed Health Services Medicaid |
$73.30
|
| Rate for Payer: MDWise Medicaid |
$73.30
|
| Rate for Payer: PHCS All Commercial |
$568.01
|
| Rate for Payer: PHP All Commercial |
$574.37
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$295.37
|
| Rate for Payer: Sagamore Health Network All Products |
$584.67
|
| Rate for Payer: Signature Care EPO |
$628.60
|
| Rate for Payer: Signature Care PPO |
$666.47
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$643.75
|
| Rate for Payer: United Healthcare Commercial |
$596.79
|
| Rate for Payer: United Healthcare Medicare |
$242.35
|
|
|
HC INJ INTESTINAL TUBE
|
Facility
|
OP
|
$1,261.72
|
|
|
Service Code
|
CPT 49465
|
| Hospital Charge Code |
1614799
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$97.73 |
| Max. Negotiated Rate |
$1,173.40 |
| Rate for Payer: Aetna Commercial |
$1,064.89
|
| Rate for Payer: Aetna Medicare |
$403.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$97.73
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$391.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$724.61
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$788.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$97.73
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$464.31
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$444.13
|
| Rate for Payer: Cash Price |
$757.03
|
| Rate for Payer: Cash Price |
$757.03
|
| Rate for Payer: Centivo All Commercial |
$686.38
|
| Rate for Payer: Cigna All Commercial |
$1,088.86
|
| Rate for Payer: CORVEL All Commercial |
$1,173.40
|
| Rate for Payer: Coventry All Commercial |
$1,110.31
|
| Rate for Payer: Encore All Commercial |
$1,161.41
|
| Rate for Payer: Frontpath All Commercial |
$1,160.78
|
| Rate for Payer: Humana ChoiceCare |
$1,089.75
|
| Rate for Payer: Humana Medicare |
$403.75
|
| Rate for Payer: Lucent All Commercial |
$686.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,135.55
|
| Rate for Payer: Managed Health Services Medicaid |
$97.73
|
| Rate for Payer: MDWise Medicaid |
$97.73
|
| Rate for Payer: PHCS All Commercial |
$946.29
|
| Rate for Payer: PHP All Commercial |
$956.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$492.07
|
| Rate for Payer: Sagamore Health Network All Products |
$974.05
|
| Rate for Payer: Signature Care EPO |
$1,047.23
|
| Rate for Payer: Signature Care PPO |
$1,110.31
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,072.46
|
| Rate for Payer: United Healthcare Commercial |
$994.24
|
| Rate for Payer: United Healthcare Medicare |
$403.75
|
|
|
HC INJ INTESTINAL TUBE
|
Facility
|
IP
|
$1,261.72
|
|
|
Service Code
|
CPT 49465
|
| Hospital Charge Code |
1614799
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$946.29 |
| Max. Negotiated Rate |
$1,173.40 |
| Rate for Payer: Aetna Commercial |
$1,090.13
|
| Rate for Payer: Cash Price |
$757.03
|
| Rate for Payer: Cigna All Commercial |
$1,088.86
|
| Rate for Payer: CORVEL All Commercial |
$1,173.40
|
| Rate for Payer: Coventry All Commercial |
$1,110.31
|
| Rate for Payer: Encore All Commercial |
$1,161.41
|
| Rate for Payer: Frontpath All Commercial |
$1,160.78
|
| Rate for Payer: Humana ChoiceCare |
$1,089.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,135.55
|
| Rate for Payer: PHCS All Commercial |
$946.29
|
| Rate for Payer: PHP All Commercial |
$956.89
|
| Rate for Payer: Sagamore Health Network All Products |
$974.05
|
| Rate for Payer: Signature Care EPO |
$1,047.23
|
| Rate for Payer: Signature Care PPO |
$1,110.31
|
| Rate for Payer: United Healthcare Commercial |
$994.24
|
|
|
HC INJ KNEE ARTHROGRAM LT
|
Facility
|
IP
|
$704.82
|
|
|
Service Code
|
CPT 27369
|
| Hospital Charge Code |
1617370
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$528.62 |
| Max. Negotiated Rate |
$655.48 |
| Rate for Payer: Aetna Commercial |
$608.96
|
| Rate for Payer: Cash Price |
$422.89
|
| Rate for Payer: Cigna All Commercial |
$608.26
|
| Rate for Payer: CORVEL All Commercial |
$655.48
|
| Rate for Payer: Coventry All Commercial |
$620.24
|
| Rate for Payer: Encore All Commercial |
$648.79
|
| Rate for Payer: Frontpath All Commercial |
$648.43
|
| Rate for Payer: Humana ChoiceCare |
$608.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$634.34
|
| Rate for Payer: PHCS All Commercial |
$528.62
|
| Rate for Payer: PHP All Commercial |
$534.54
|
| Rate for Payer: Sagamore Health Network All Products |
$544.12
|
| Rate for Payer: Signature Care EPO |
$585.00
|
| Rate for Payer: Signature Care PPO |
$620.24
|
| Rate for Payer: United Healthcare Commercial |
$555.40
|
|
|
HC INJ KNEE ARTHROGRAM LT
|
Facility
|
OP
|
$704.82
|
|
|
Service Code
|
CPT 27369
|
| Hospital Charge Code |
1617370
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$70.48 |
| Max. Negotiated Rate |
$655.48 |
| Rate for Payer: Aetna Commercial |
$594.87
|
| Rate for Payer: Aetna Medicare |
$225.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$70.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$218.49
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$404.78
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$440.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$70.48
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$259.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$248.10
|
| Rate for Payer: Cash Price |
$422.89
|
| Rate for Payer: Centivo All Commercial |
$383.42
|
| Rate for Payer: Cigna All Commercial |
$608.26
|
| Rate for Payer: CORVEL All Commercial |
$655.48
|
| Rate for Payer: Coventry All Commercial |
$620.24
|
| Rate for Payer: Encore All Commercial |
$648.79
|
| Rate for Payer: Frontpath All Commercial |
$648.43
|
| Rate for Payer: Humana ChoiceCare |
$608.75
|
| Rate for Payer: Humana Medicare |
$225.54
|
| Rate for Payer: Lucent All Commercial |
$383.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$634.34
|
| Rate for Payer: Managed Health Services Medicaid |
$70.48
|
| Rate for Payer: MDWise Medicaid |
$70.48
|
| Rate for Payer: PHCS All Commercial |
$528.62
|
| Rate for Payer: PHP All Commercial |
$534.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$274.88
|
| Rate for Payer: Sagamore Health Network All Products |
$544.12
|
| Rate for Payer: Signature Care EPO |
$585.00
|
| Rate for Payer: Signature Care PPO |
$620.24
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$599.10
|
| Rate for Payer: United Healthcare Commercial |
$555.40
|
| Rate for Payer: United Healthcare Medicare |
$225.54
|
|
|
HC INJ KNEE ARTHROGRAM RT
|
Facility
|
IP
|
$704.82
|
|
|
Service Code
|
CPT 27369
|
| Hospital Charge Code |
11617370
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$528.62 |
| Max. Negotiated Rate |
$655.48 |
| Rate for Payer: Aetna Commercial |
$608.96
|
| Rate for Payer: Cash Price |
$422.89
|
| Rate for Payer: Cigna All Commercial |
$608.26
|
| Rate for Payer: CORVEL All Commercial |
$655.48
|
| Rate for Payer: Coventry All Commercial |
$620.24
|
| Rate for Payer: Encore All Commercial |
$648.79
|
| Rate for Payer: Frontpath All Commercial |
$648.43
|
| Rate for Payer: Humana ChoiceCare |
$608.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$634.34
|
| Rate for Payer: PHCS All Commercial |
$528.62
|
| Rate for Payer: PHP All Commercial |
$534.54
|
| Rate for Payer: Sagamore Health Network All Products |
$544.12
|
| Rate for Payer: Signature Care EPO |
$585.00
|
| Rate for Payer: Signature Care PPO |
$620.24
|
| Rate for Payer: United Healthcare Commercial |
$555.40
|
|
|
HC INJ KNEE ARTHROGRAM RT
|
Facility
|
OP
|
$704.82
|
|
|
Service Code
|
CPT 27369
|
| Hospital Charge Code |
11617370
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$70.48 |
| Max. Negotiated Rate |
$655.48 |
| Rate for Payer: Aetna Commercial |
$594.87
|
| Rate for Payer: Aetna Medicare |
$225.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$70.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$218.49
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$404.78
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$440.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$70.48
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$259.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$248.10
|
| Rate for Payer: Cash Price |
$422.89
|
| Rate for Payer: Centivo All Commercial |
$383.42
|
| Rate for Payer: Cigna All Commercial |
$608.26
|
| Rate for Payer: CORVEL All Commercial |
$655.48
|
| Rate for Payer: Coventry All Commercial |
$620.24
|
| Rate for Payer: Encore All Commercial |
$648.79
|
| Rate for Payer: Frontpath All Commercial |
$648.43
|
| Rate for Payer: Humana ChoiceCare |
$608.75
|
| Rate for Payer: Humana Medicare |
$225.54
|
| Rate for Payer: Lucent All Commercial |
$383.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$634.34
|
| Rate for Payer: Managed Health Services Medicaid |
$70.48
|
| Rate for Payer: MDWise Medicaid |
$70.48
|
| Rate for Payer: PHCS All Commercial |
$528.62
|
| Rate for Payer: PHP All Commercial |
$534.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$274.88
|
| Rate for Payer: Sagamore Health Network All Products |
$544.12
|
| Rate for Payer: Signature Care EPO |
$585.00
|
| Rate for Payer: Signature Care PPO |
$620.24
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$599.10
|
| Rate for Payer: United Healthcare Commercial |
$555.40
|
| Rate for Payer: United Healthcare Medicare |
$225.54
|
|
|
HC INJ SHOULDER ARTHROGRAM BI
|
Facility
|
IP
|
$822.29
|
|
|
Service Code
|
CPT 23350 50
|
| Hospital Charge Code |
21613350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$616.72 |
| Max. Negotiated Rate |
$764.73 |
| Rate for Payer: Aetna Commercial |
$710.46
|
| Rate for Payer: Cash Price |
$493.37
|
| Rate for Payer: Cigna All Commercial |
$709.64
|
| Rate for Payer: CORVEL All Commercial |
$764.73
|
| Rate for Payer: Coventry All Commercial |
$723.62
|
| Rate for Payer: Encore All Commercial |
$756.92
|
| Rate for Payer: Frontpath All Commercial |
$756.51
|
| Rate for Payer: Humana ChoiceCare |
$710.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$740.06
|
| Rate for Payer: PHCS All Commercial |
$616.72
|
| Rate for Payer: PHP All Commercial |
$623.62
|
| Rate for Payer: Sagamore Health Network All Products |
$634.81
|
| Rate for Payer: Signature Care EPO |
$682.50
|
| Rate for Payer: Signature Care PPO |
$723.62
|
| Rate for Payer: United Healthcare Commercial |
$647.96
|
|
|
HC INJ SHOULDER ARTHROGRAM BI
|
Facility
|
OP
|
$822.29
|
|
|
Service Code
|
CPT 23350 50
|
| Hospital Charge Code |
21613350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$73.30 |
| Max. Negotiated Rate |
$764.73 |
| Rate for Payer: Aetna Commercial |
$694.01
|
| Rate for Payer: Aetna Medicare |
$263.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$73.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$254.91
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$472.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$514.01
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$73.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$302.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$289.45
|
| Rate for Payer: Cash Price |
$493.37
|
| Rate for Payer: Cash Price |
$493.37
|
| Rate for Payer: Centivo All Commercial |
$447.33
|
| Rate for Payer: Cigna All Commercial |
$709.64
|
| Rate for Payer: CORVEL All Commercial |
$764.73
|
| Rate for Payer: Coventry All Commercial |
$723.62
|
| Rate for Payer: Encore All Commercial |
$756.92
|
| Rate for Payer: Frontpath All Commercial |
$756.51
|
| Rate for Payer: Humana ChoiceCare |
$710.21
|
| Rate for Payer: Humana Medicare |
$263.13
|
| Rate for Payer: Lucent All Commercial |
$447.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$740.06
|
| Rate for Payer: Managed Health Services Medicaid |
$73.30
|
| Rate for Payer: MDWise Medicaid |
$73.30
|
| Rate for Payer: PHCS All Commercial |
$616.72
|
| Rate for Payer: PHP All Commercial |
$623.62
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$320.69
|
| Rate for Payer: Sagamore Health Network All Products |
$634.81
|
| Rate for Payer: Signature Care EPO |
$682.50
|
| Rate for Payer: Signature Care PPO |
$723.62
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$698.95
|
| Rate for Payer: United Healthcare Commercial |
$647.96
|
| Rate for Payer: United Healthcare Medicare |
$263.13
|
|
|
HC INJ SHOULDER ARTHROGRAM LT
|
Facility
|
OP
|
$649.74
|
|
|
Service Code
|
CPT 23350
|
| Hospital Charge Code |
1613350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$73.30 |
| Max. Negotiated Rate |
$604.26 |
| Rate for Payer: Aetna Commercial |
$548.38
|
| Rate for Payer: Aetna Medicare |
$207.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$73.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$201.42
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$373.15
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$406.15
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$73.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$239.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$228.71
|
| Rate for Payer: Cash Price |
$389.84
|
| Rate for Payer: Cash Price |
$389.84
|
| Rate for Payer: Centivo All Commercial |
$353.46
|
| Rate for Payer: Cigna All Commercial |
$560.73
|
| Rate for Payer: CORVEL All Commercial |
$604.26
|
| Rate for Payer: Coventry All Commercial |
$571.77
|
| Rate for Payer: Encore All Commercial |
$598.09
|
| Rate for Payer: Frontpath All Commercial |
$597.76
|
| Rate for Payer: Humana ChoiceCare |
$561.18
|
| Rate for Payer: Humana Medicare |
$207.92
|
| Rate for Payer: Lucent All Commercial |
$353.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$584.77
|
| Rate for Payer: Managed Health Services Medicaid |
$73.30
|
| Rate for Payer: MDWise Medicaid |
$73.30
|
| Rate for Payer: PHCS All Commercial |
$487.31
|
| Rate for Payer: PHP All Commercial |
$492.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$253.40
|
| Rate for Payer: Sagamore Health Network All Products |
$501.60
|
| Rate for Payer: Signature Care EPO |
$539.28
|
| Rate for Payer: Signature Care PPO |
$571.77
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$552.28
|
| Rate for Payer: United Healthcare Commercial |
$512.00
|
| Rate for Payer: United Healthcare Medicare |
$207.92
|
|
|
HC INJ SHOULDER ARTHROGRAM LT
|
Facility
|
IP
|
$649.74
|
|
|
Service Code
|
CPT 23350
|
| Hospital Charge Code |
1613350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$487.31 |
| Max. Negotiated Rate |
$604.26 |
| Rate for Payer: Aetna Commercial |
$561.38
|
| Rate for Payer: Cash Price |
$389.84
|
| Rate for Payer: Cigna All Commercial |
$560.73
|
| Rate for Payer: CORVEL All Commercial |
$604.26
|
| Rate for Payer: Coventry All Commercial |
$571.77
|
| Rate for Payer: Encore All Commercial |
$598.09
|
| Rate for Payer: Frontpath All Commercial |
$597.76
|
| Rate for Payer: Humana ChoiceCare |
$561.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$584.77
|
| Rate for Payer: PHCS All Commercial |
$487.31
|
| Rate for Payer: PHP All Commercial |
$492.76
|
| Rate for Payer: Sagamore Health Network All Products |
$501.60
|
| Rate for Payer: Signature Care EPO |
$539.28
|
| Rate for Payer: Signature Care PPO |
$571.77
|
| Rate for Payer: United Healthcare Commercial |
$512.00
|
|
|
HC INJ SHOULDER ARTHROGRAM RT
|
Facility
|
IP
|
$649.74
|
|
|
Service Code
|
CPT 23350
|
| Hospital Charge Code |
11613350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$487.31 |
| Max. Negotiated Rate |
$604.26 |
| Rate for Payer: Aetna Commercial |
$561.38
|
| Rate for Payer: Cash Price |
$389.84
|
| Rate for Payer: Cigna All Commercial |
$560.73
|
| Rate for Payer: CORVEL All Commercial |
$604.26
|
| Rate for Payer: Coventry All Commercial |
$571.77
|
| Rate for Payer: Encore All Commercial |
$598.09
|
| Rate for Payer: Frontpath All Commercial |
$597.76
|
| Rate for Payer: Humana ChoiceCare |
$561.18
|
| Rate for Payer: Lutheran Preferred All Commercial |
$584.77
|
| Rate for Payer: PHCS All Commercial |
$487.31
|
| Rate for Payer: PHP All Commercial |
$492.76
|
| Rate for Payer: Sagamore Health Network All Products |
$501.60
|
| Rate for Payer: Signature Care EPO |
$539.28
|
| Rate for Payer: Signature Care PPO |
$571.77
|
| Rate for Payer: United Healthcare Commercial |
$512.00
|
|
|
HC INJ SHOULDER ARTHROGRAM RT
|
Facility
|
OP
|
$649.74
|
|
|
Service Code
|
CPT 23350
|
| Hospital Charge Code |
11613350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$73.30 |
| Max. Negotiated Rate |
$604.26 |
| Rate for Payer: Aetna Commercial |
$548.38
|
| Rate for Payer: Aetna Medicare |
$207.92
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$73.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$201.42
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$373.15
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$406.15
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$73.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$239.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$228.71
|
| Rate for Payer: Cash Price |
$389.84
|
| Rate for Payer: Cash Price |
$389.84
|
| Rate for Payer: Centivo All Commercial |
$353.46
|
| Rate for Payer: Cigna All Commercial |
$560.73
|
| Rate for Payer: CORVEL All Commercial |
$604.26
|
| Rate for Payer: Coventry All Commercial |
$571.77
|
| Rate for Payer: Encore All Commercial |
$598.09
|
| Rate for Payer: Frontpath All Commercial |
$597.76
|
| Rate for Payer: Humana ChoiceCare |
$561.18
|
| Rate for Payer: Humana Medicare |
$207.92
|
| Rate for Payer: Lucent All Commercial |
$353.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$584.77
|
| Rate for Payer: Managed Health Services Medicaid |
$73.30
|
| Rate for Payer: MDWise Medicaid |
$73.30
|
| Rate for Payer: PHCS All Commercial |
$487.31
|
| Rate for Payer: PHP All Commercial |
$492.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$253.40
|
| Rate for Payer: Sagamore Health Network All Products |
$501.60
|
| Rate for Payer: Signature Care EPO |
$539.28
|
| Rate for Payer: Signature Care PPO |
$571.77
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$552.28
|
| Rate for Payer: United Healthcare Commercial |
$512.00
|
| Rate for Payer: United Healthcare Medicare |
$207.92
|
|
|
HC INJ WRIST ARTHROGRAM LT
|
Facility
|
IP
|
$726.24
|
|
|
Service Code
|
CPT 25246
|
| Hospital Charge Code |
1615246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$544.68 |
| Max. Negotiated Rate |
$675.40 |
| Rate for Payer: Aetna Commercial |
$627.47
|
| Rate for Payer: Cash Price |
$435.74
|
| Rate for Payer: Cigna All Commercial |
$626.75
|
| Rate for Payer: CORVEL All Commercial |
$675.40
|
| Rate for Payer: Coventry All Commercial |
$639.09
|
| Rate for Payer: Encore All Commercial |
$668.50
|
| Rate for Payer: Frontpath All Commercial |
$668.14
|
| Rate for Payer: Humana ChoiceCare |
$627.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$653.62
|
| Rate for Payer: PHCS All Commercial |
$544.68
|
| Rate for Payer: PHP All Commercial |
$550.78
|
| Rate for Payer: Sagamore Health Network All Products |
$560.66
|
| Rate for Payer: Signature Care EPO |
$602.78
|
| Rate for Payer: Signature Care PPO |
$639.09
|
| Rate for Payer: United Healthcare Commercial |
$572.28
|
|
|
HC INJ WRIST ARTHROGRAM LT
|
Facility
|
OP
|
$726.24
|
|
|
Service Code
|
CPT 25246
|
| Hospital Charge Code |
1615246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$73.30 |
| Max. Negotiated Rate |
$675.40 |
| Rate for Payer: Aetna Commercial |
$612.95
|
| Rate for Payer: Aetna Medicare |
$232.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$73.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$225.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$417.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$453.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$73.30
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$267.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$255.64
|
| Rate for Payer: Cash Price |
$435.74
|
| Rate for Payer: Cash Price |
$435.74
|
| Rate for Payer: Centivo All Commercial |
$395.07
|
| Rate for Payer: Cigna All Commercial |
$626.75
|
| Rate for Payer: CORVEL All Commercial |
$675.40
|
| Rate for Payer: Coventry All Commercial |
$639.09
|
| Rate for Payer: Encore All Commercial |
$668.50
|
| Rate for Payer: Frontpath All Commercial |
$668.14
|
| Rate for Payer: Humana ChoiceCare |
$627.25
|
| Rate for Payer: Humana Medicare |
$232.40
|
| Rate for Payer: Lucent All Commercial |
$395.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$653.62
|
| Rate for Payer: Managed Health Services Medicaid |
$73.30
|
| Rate for Payer: MDWise Medicaid |
$73.30
|
| Rate for Payer: PHCS All Commercial |
$544.68
|
| Rate for Payer: PHP All Commercial |
$550.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$283.23
|
| Rate for Payer: Sagamore Health Network All Products |
$560.66
|
| Rate for Payer: Signature Care EPO |
$602.78
|
| Rate for Payer: Signature Care PPO |
$639.09
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$617.30
|
| Rate for Payer: United Healthcare Commercial |
$572.28
|
| Rate for Payer: United Healthcare Medicare |
$232.40
|
|
