|
HC LUMBAR PUNCTURE
|
Facility
|
OP
|
$663.00
|
|
| Hospital Charge Code |
1682011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$205.53 |
| Max. Negotiated Rate |
$616.59 |
| Rate for Payer: Aetna Commercial |
$559.57
|
| Rate for Payer: Aetna Medicare |
$212.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$205.53
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$380.76
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$414.44
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$243.98
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$233.38
|
| Rate for Payer: Cash Price |
$397.80
|
| Rate for Payer: Centivo All Commercial |
$360.67
|
| Rate for Payer: Cigna All Commercial |
$572.17
|
| Rate for Payer: CORVEL All Commercial |
$616.59
|
| Rate for Payer: Coventry All Commercial |
$583.44
|
| Rate for Payer: Encore All Commercial |
$610.29
|
| Rate for Payer: Frontpath All Commercial |
$609.96
|
| Rate for Payer: Humana ChoiceCare |
$572.63
|
| Rate for Payer: Humana Medicare |
$212.16
|
| Rate for Payer: Lucent All Commercial |
$360.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$596.70
|
| Rate for Payer: PHCS All Commercial |
$497.25
|
| Rate for Payer: PHP All Commercial |
$502.82
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$258.57
|
| Rate for Payer: Sagamore Health Network All Products |
$511.84
|
| Rate for Payer: Signature Care EPO |
$550.29
|
| Rate for Payer: Signature Care PPO |
$583.44
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$563.55
|
| Rate for Payer: United Healthcare Commercial |
$522.44
|
| Rate for Payer: United Healthcare Medicare |
$212.16
|
|
|
HC LUMB PUNC KIT
|
Facility
|
OP
|
$52.15
|
|
| Hospital Charge Code |
41601068
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.17 |
| Max. Negotiated Rate |
$48.50 |
| Rate for Payer: Aetna Commercial |
$44.01
|
| Rate for Payer: Aetna Medicare |
$16.69
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$16.17
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$29.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$32.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$19.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$18.36
|
| Rate for Payer: Cash Price |
$31.29
|
| Rate for Payer: Cash Price |
$31.29
|
| Rate for Payer: Centivo All Commercial |
$28.37
|
| Rate for Payer: Cigna All Commercial |
$45.01
|
| Rate for Payer: CORVEL All Commercial |
$48.50
|
| Rate for Payer: Coventry All Commercial |
$45.89
|
| Rate for Payer: Encore All Commercial |
$48.00
|
| Rate for Payer: Frontpath All Commercial |
$47.98
|
| Rate for Payer: Humana ChoiceCare |
$45.04
|
| Rate for Payer: Humana Medicare |
$16.69
|
| Rate for Payer: Lucent All Commercial |
$28.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$46.94
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$39.11
|
| Rate for Payer: PHP All Commercial |
$39.55
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$20.34
|
| Rate for Payer: Sagamore Health Network All Products |
$40.26
|
| Rate for Payer: Signature Care EPO |
$43.28
|
| Rate for Payer: Signature Care PPO |
$45.89
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$44.33
|
| Rate for Payer: United Healthcare Commercial |
$41.09
|
| Rate for Payer: United Healthcare Medicare |
$16.69
|
|
|
HC LUMB PUNC KIT
|
Facility
|
IP
|
$52.15
|
|
| Hospital Charge Code |
41601068
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.11 |
| Max. Negotiated Rate |
$48.50 |
| Rate for Payer: Aetna Commercial |
$45.06
|
| Rate for Payer: Cash Price |
$31.29
|
| Rate for Payer: Cigna All Commercial |
$45.01
|
| Rate for Payer: CORVEL All Commercial |
$48.50
|
| Rate for Payer: Coventry All Commercial |
$45.89
|
| Rate for Payer: Encore All Commercial |
$48.00
|
| Rate for Payer: Frontpath All Commercial |
$47.98
|
| Rate for Payer: Humana ChoiceCare |
$45.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$46.94
|
| Rate for Payer: PHCS All Commercial |
$39.11
|
| Rate for Payer: PHP All Commercial |
$39.55
|
| Rate for Payer: Sagamore Health Network All Products |
$40.26
|
| Rate for Payer: Signature Care EPO |
$43.28
|
| Rate for Payer: Signature Care PPO |
$45.89
|
| Rate for Payer: United Healthcare Commercial |
$41.09
|
|
|
HC LUNG SCAN PERFUSION
|
Facility
|
IP
|
$1,921.84
|
|
|
Service Code
|
CPT 78580
|
| Hospital Charge Code |
1638360
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,441.38 |
| Max. Negotiated Rate |
$1,787.31 |
| Rate for Payer: Aetna Commercial |
$1,660.47
|
| Rate for Payer: Cash Price |
$1,153.10
|
| Rate for Payer: Cigna All Commercial |
$1,658.55
|
| Rate for Payer: CORVEL All Commercial |
$1,787.31
|
| Rate for Payer: Coventry All Commercial |
$1,691.22
|
| Rate for Payer: Encore All Commercial |
$1,769.05
|
| Rate for Payer: Frontpath All Commercial |
$1,768.09
|
| Rate for Payer: Humana ChoiceCare |
$1,659.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,729.66
|
| Rate for Payer: PHCS All Commercial |
$1,441.38
|
| Rate for Payer: PHP All Commercial |
$1,457.52
|
| Rate for Payer: Sagamore Health Network All Products |
$1,483.66
|
| Rate for Payer: Signature Care EPO |
$1,595.13
|
| Rate for Payer: Signature Care PPO |
$1,691.22
|
| Rate for Payer: United Healthcare Commercial |
$1,514.41
|
|
|
HC LUNG SCAN PERFUSION
|
Facility
|
OP
|
$1,921.84
|
|
|
Service Code
|
CPT 78580
|
| Hospital Charge Code |
1638360
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$143.18 |
| Max. Negotiated Rate |
$1,787.31 |
| Rate for Payer: Aetna Commercial |
$1,622.03
|
| Rate for Payer: Aetna Medicare |
$614.99
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$143.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$595.77
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,103.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,201.34
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$143.18
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$707.24
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$676.49
|
| Rate for Payer: Cash Price |
$1,153.10
|
| Rate for Payer: Cash Price |
$1,153.10
|
| Rate for Payer: Centivo All Commercial |
$1,045.48
|
| Rate for Payer: Cigna All Commercial |
$1,658.55
|
| Rate for Payer: CORVEL All Commercial |
$1,787.31
|
| Rate for Payer: Coventry All Commercial |
$1,691.22
|
| Rate for Payer: Encore All Commercial |
$1,769.05
|
| Rate for Payer: Frontpath All Commercial |
$1,768.09
|
| Rate for Payer: Humana ChoiceCare |
$1,659.89
|
| Rate for Payer: Humana Medicare |
$614.99
|
| Rate for Payer: Lucent All Commercial |
$1,045.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,729.66
|
| Rate for Payer: Managed Health Services Medicaid |
$143.18
|
| Rate for Payer: MDWise Medicaid |
$143.18
|
| Rate for Payer: PHCS All Commercial |
$1,441.38
|
| Rate for Payer: PHP All Commercial |
$1,457.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$749.52
|
| Rate for Payer: Sagamore Health Network All Products |
$1,483.66
|
| Rate for Payer: Signature Care EPO |
$1,595.13
|
| Rate for Payer: Signature Care PPO |
$1,691.22
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,633.56
|
| Rate for Payer: United Healthcare Commercial |
$1,514.41
|
| Rate for Payer: United Healthcare Medicare |
$614.99
|
|
|
HC LUNG VENTILAT&PERFUS IMAGING
|
Facility
|
IP
|
$2,955.50
|
|
|
Service Code
|
CPT 78582
|
| Hospital Charge Code |
1638582
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$2,216.62 |
| Max. Negotiated Rate |
$2,748.61 |
| Rate for Payer: Aetna Commercial |
$2,553.55
|
| Rate for Payer: Cash Price |
$1,773.30
|
| Rate for Payer: Cigna All Commercial |
$2,550.60
|
| Rate for Payer: CORVEL All Commercial |
$2,748.61
|
| Rate for Payer: Coventry All Commercial |
$2,600.84
|
| Rate for Payer: Encore All Commercial |
$2,720.54
|
| Rate for Payer: Frontpath All Commercial |
$2,719.06
|
| Rate for Payer: Humana ChoiceCare |
$2,552.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,659.95
|
| Rate for Payer: PHCS All Commercial |
$2,216.62
|
| Rate for Payer: PHP All Commercial |
$2,241.45
|
| Rate for Payer: Sagamore Health Network All Products |
$2,281.65
|
| Rate for Payer: Signature Care EPO |
$2,453.07
|
| Rate for Payer: Signature Care PPO |
$2,600.84
|
| Rate for Payer: United Healthcare Commercial |
$2,328.93
|
|
|
HC LUNG VENTILAT&PERFUS IMAGING
|
Facility
|
OP
|
$2,955.50
|
|
|
Service Code
|
CPT 78582
|
| Hospital Charge Code |
1638582
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$199.91 |
| Max. Negotiated Rate |
$2,748.61 |
| Rate for Payer: Aetna Commercial |
$2,494.44
|
| Rate for Payer: Aetna Medicare |
$945.76
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$199.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$916.21
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,697.34
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,847.48
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$199.91
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,087.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,040.34
|
| Rate for Payer: Cash Price |
$1,773.30
|
| Rate for Payer: Cash Price |
$1,773.30
|
| Rate for Payer: Centivo All Commercial |
$1,607.79
|
| Rate for Payer: Cigna All Commercial |
$2,550.60
|
| Rate for Payer: CORVEL All Commercial |
$2,748.61
|
| Rate for Payer: Coventry All Commercial |
$2,600.84
|
| Rate for Payer: Encore All Commercial |
$2,720.54
|
| Rate for Payer: Frontpath All Commercial |
$2,719.06
|
| Rate for Payer: Humana ChoiceCare |
$2,552.67
|
| Rate for Payer: Humana Medicare |
$945.76
|
| Rate for Payer: Lucent All Commercial |
$1,607.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,659.95
|
| Rate for Payer: Managed Health Services Medicaid |
$199.91
|
| Rate for Payer: MDWise Medicaid |
$199.91
|
| Rate for Payer: PHCS All Commercial |
$2,216.62
|
| Rate for Payer: PHP All Commercial |
$2,241.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,152.64
|
| Rate for Payer: Sagamore Health Network All Products |
$2,281.65
|
| Rate for Payer: Signature Care EPO |
$2,453.07
|
| Rate for Payer: Signature Care PPO |
$2,600.84
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,512.18
|
| Rate for Payer: United Healthcare Commercial |
$2,328.93
|
| Rate for Payer: United Healthcare Medicare |
$945.76
|
|
|
HC LUPUS PANEL CHARGE
|
Facility
|
IP
|
$155.59
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
63001880
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$116.69 |
| Max. Negotiated Rate |
$144.70 |
| Rate for Payer: Aetna Commercial |
$134.43
|
| Rate for Payer: Cash Price |
$93.35
|
| Rate for Payer: Cigna All Commercial |
$134.27
|
| Rate for Payer: CORVEL All Commercial |
$144.70
|
| Rate for Payer: Coventry All Commercial |
$136.92
|
| Rate for Payer: Encore All Commercial |
$143.22
|
| Rate for Payer: Frontpath All Commercial |
$143.14
|
| Rate for Payer: Humana ChoiceCare |
$134.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$140.03
|
| Rate for Payer: PHCS All Commercial |
$116.69
|
| Rate for Payer: PHP All Commercial |
$118.00
|
| Rate for Payer: Sagamore Health Network All Products |
$120.12
|
| Rate for Payer: Signature Care EPO |
$129.14
|
| Rate for Payer: Signature Care PPO |
$136.92
|
| Rate for Payer: United Healthcare Commercial |
$122.60
|
|
|
HC LUPUS PANEL CHARGE
|
Facility
|
OP
|
$155.59
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
63001880
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.93 |
| Max. Negotiated Rate |
$144.70 |
| Rate for Payer: Aetna Commercial |
$131.32
|
| Rate for Payer: Aetna Medicare |
$49.79
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$17.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$48.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$71.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$71.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$17.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$57.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$54.77
|
| Rate for Payer: Cash Price |
$93.35
|
| Rate for Payer: Cash Price |
$93.35
|
| Rate for Payer: Centivo All Commercial |
$84.64
|
| Rate for Payer: Cigna All Commercial |
$134.27
|
| Rate for Payer: CORVEL All Commercial |
$144.70
|
| Rate for Payer: Coventry All Commercial |
$136.92
|
| Rate for Payer: Encore All Commercial |
$143.22
|
| Rate for Payer: Frontpath All Commercial |
$143.14
|
| Rate for Payer: Humana ChoiceCare |
$134.38
|
| Rate for Payer: Humana Medicare |
$49.79
|
| Rate for Payer: Lucent All Commercial |
$84.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$140.03
|
| Rate for Payer: Managed Health Services Medicaid |
$17.93
|
| Rate for Payer: MDWise Medicaid |
$17.93
|
| Rate for Payer: PHCS All Commercial |
$116.69
|
| Rate for Payer: PHP All Commercial |
$118.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$60.68
|
| Rate for Payer: Sagamore Health Network All Products |
$120.12
|
| Rate for Payer: Signature Care EPO |
$129.14
|
| Rate for Payer: Signature Care PPO |
$136.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$132.25
|
| Rate for Payer: United Healthcare Commercial |
$122.60
|
| Rate for Payer: United Healthcare Medicare |
$49.79
|
|
|
HC LUPUS PANEL CHARGE 1 ST
|
Facility
|
OP
|
$57.22
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
63001875
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.74 |
| Max. Negotiated Rate |
$53.21 |
| Rate for Payer: Aetna Commercial |
$48.29
|
| Rate for Payer: Aetna Medicare |
$18.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$13.74
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$17.74
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$26.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$26.30
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$13.74
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$21.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$20.14
|
| Rate for Payer: Cash Price |
$34.33
|
| Rate for Payer: Cash Price |
$34.33
|
| Rate for Payer: Centivo All Commercial |
$31.13
|
| Rate for Payer: Cigna All Commercial |
$49.38
|
| Rate for Payer: CORVEL All Commercial |
$53.21
|
| Rate for Payer: Coventry All Commercial |
$50.35
|
| Rate for Payer: Encore All Commercial |
$52.67
|
| Rate for Payer: Frontpath All Commercial |
$52.64
|
| Rate for Payer: Humana ChoiceCare |
$49.42
|
| Rate for Payer: Humana Medicare |
$18.31
|
| Rate for Payer: Lucent All Commercial |
$31.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$51.50
|
| Rate for Payer: Managed Health Services Medicaid |
$13.74
|
| Rate for Payer: MDWise Medicaid |
$13.74
|
| Rate for Payer: PHCS All Commercial |
$42.91
|
| Rate for Payer: PHP All Commercial |
$43.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$22.32
|
| Rate for Payer: Sagamore Health Network All Products |
$44.17
|
| Rate for Payer: Signature Care EPO |
$47.49
|
| Rate for Payer: Signature Care PPO |
$50.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$48.64
|
| Rate for Payer: United Healthcare Commercial |
$45.09
|
| Rate for Payer: United Healthcare Medicare |
$18.31
|
|
|
HC LUPUS PANEL CHARGE 1 ST
|
Facility
|
IP
|
$57.22
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
63001875
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$42.91 |
| Max. Negotiated Rate |
$53.21 |
| Rate for Payer: Aetna Commercial |
$49.44
|
| Rate for Payer: Cash Price |
$34.33
|
| Rate for Payer: Cigna All Commercial |
$49.38
|
| Rate for Payer: CORVEL All Commercial |
$53.21
|
| Rate for Payer: Coventry All Commercial |
$50.35
|
| Rate for Payer: Encore All Commercial |
$52.67
|
| Rate for Payer: Frontpath All Commercial |
$52.64
|
| Rate for Payer: Humana ChoiceCare |
$49.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$51.50
|
| Rate for Payer: PHCS All Commercial |
$42.91
|
| Rate for Payer: PHP All Commercial |
$43.40
|
| Rate for Payer: Sagamore Health Network All Products |
$44.17
|
| Rate for Payer: Signature Care EPO |
$47.49
|
| Rate for Payer: Signature Care PPO |
$50.35
|
| Rate for Payer: United Healthcare Commercial |
$45.09
|
|
|
HC LYME DISEASE
|
Facility
|
IP
|
$214.26
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
63001039
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$160.69 |
| Max. Negotiated Rate |
$199.26 |
| Rate for Payer: Aetna Commercial |
$185.12
|
| Rate for Payer: Cash Price |
$128.56
|
| Rate for Payer: Cigna All Commercial |
$184.91
|
| Rate for Payer: CORVEL All Commercial |
$199.26
|
| Rate for Payer: Coventry All Commercial |
$188.55
|
| Rate for Payer: Encore All Commercial |
$197.23
|
| Rate for Payer: Frontpath All Commercial |
$197.12
|
| Rate for Payer: Humana ChoiceCare |
$185.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$192.83
|
| Rate for Payer: PHCS All Commercial |
$160.69
|
| Rate for Payer: PHP All Commercial |
$162.49
|
| Rate for Payer: Sagamore Health Network All Products |
$165.41
|
| Rate for Payer: Signature Care EPO |
$177.84
|
| Rate for Payer: Signature Care PPO |
$188.55
|
| Rate for Payer: United Healthcare Commercial |
$168.84
|
|
|
HC LYME DISEASE
|
Facility
|
OP
|
$214.26
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
63001039
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.03 |
| Max. Negotiated Rate |
$199.26 |
| Rate for Payer: Aetna Commercial |
$180.84
|
| Rate for Payer: Aetna Medicare |
$68.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$17.03
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$66.42
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$98.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$98.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$17.03
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$78.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$75.42
|
| Rate for Payer: Cash Price |
$128.56
|
| Rate for Payer: Cash Price |
$128.56
|
| Rate for Payer: Centivo All Commercial |
$116.56
|
| Rate for Payer: Cigna All Commercial |
$184.91
|
| Rate for Payer: CORVEL All Commercial |
$199.26
|
| Rate for Payer: Coventry All Commercial |
$188.55
|
| Rate for Payer: Encore All Commercial |
$197.23
|
| Rate for Payer: Frontpath All Commercial |
$197.12
|
| Rate for Payer: Humana ChoiceCare |
$185.06
|
| Rate for Payer: Humana Medicare |
$68.56
|
| Rate for Payer: Lucent All Commercial |
$116.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$192.83
|
| Rate for Payer: Managed Health Services Medicaid |
$17.03
|
| Rate for Payer: MDWise Medicaid |
$17.03
|
| Rate for Payer: PHCS All Commercial |
$160.69
|
| Rate for Payer: PHP All Commercial |
$162.49
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$83.56
|
| Rate for Payer: Sagamore Health Network All Products |
$165.41
|
| Rate for Payer: Signature Care EPO |
$177.84
|
| Rate for Payer: Signature Care PPO |
$188.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$182.12
|
| Rate for Payer: United Healthcare Commercial |
$168.84
|
| Rate for Payer: United Healthcare Medicare |
$68.56
|
|
|
HC LYME DISEASE IGG WESTERN BLOT
|
Facility
|
OP
|
$206.74
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
63001925
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.49 |
| Max. Negotiated Rate |
$192.27 |
| Rate for Payer: Aetna Commercial |
$174.49
|
| Rate for Payer: Aetna Medicare |
$66.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$15.49
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$64.09
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$95.02
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$95.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$15.49
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$76.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$72.77
|
| Rate for Payer: Cash Price |
$124.04
|
| Rate for Payer: Cash Price |
$124.04
|
| Rate for Payer: Centivo All Commercial |
$112.47
|
| Rate for Payer: Cigna All Commercial |
$178.42
|
| Rate for Payer: CORVEL All Commercial |
$192.27
|
| Rate for Payer: Coventry All Commercial |
$181.93
|
| Rate for Payer: Encore All Commercial |
$190.30
|
| Rate for Payer: Frontpath All Commercial |
$190.20
|
| Rate for Payer: Humana ChoiceCare |
$178.56
|
| Rate for Payer: Humana Medicare |
$66.16
|
| Rate for Payer: Lucent All Commercial |
$112.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$186.07
|
| Rate for Payer: Managed Health Services Medicaid |
$15.49
|
| Rate for Payer: MDWise Medicaid |
$15.49
|
| Rate for Payer: PHCS All Commercial |
$155.06
|
| Rate for Payer: PHP All Commercial |
$156.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$80.63
|
| Rate for Payer: Sagamore Health Network All Products |
$159.60
|
| Rate for Payer: Signature Care EPO |
$171.59
|
| Rate for Payer: Signature Care PPO |
$181.93
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$175.73
|
| Rate for Payer: United Healthcare Commercial |
$162.91
|
| Rate for Payer: United Healthcare Medicare |
$66.16
|
|
|
HC LYME DISEASE IGG WESTERN BLOT
|
Facility
|
IP
|
$206.74
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
63001925
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$155.06 |
| Max. Negotiated Rate |
$192.27 |
| Rate for Payer: Aetna Commercial |
$178.62
|
| Rate for Payer: Cash Price |
$124.04
|
| Rate for Payer: Cigna All Commercial |
$178.42
|
| Rate for Payer: CORVEL All Commercial |
$192.27
|
| Rate for Payer: Coventry All Commercial |
$181.93
|
| Rate for Payer: Encore All Commercial |
$190.30
|
| Rate for Payer: Frontpath All Commercial |
$190.20
|
| Rate for Payer: Humana ChoiceCare |
$178.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$186.07
|
| Rate for Payer: PHCS All Commercial |
$155.06
|
| Rate for Payer: PHP All Commercial |
$156.79
|
| Rate for Payer: Sagamore Health Network All Products |
$159.60
|
| Rate for Payer: Signature Care EPO |
$171.59
|
| Rate for Payer: Signature Care PPO |
$181.93
|
| Rate for Payer: United Healthcare Commercial |
$162.91
|
|
|
HC LYME DISEASE IGM WESTERN BLOT
|
Facility
|
OP
|
$206.74
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
63001926
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.49 |
| Max. Negotiated Rate |
$192.27 |
| Rate for Payer: Aetna Commercial |
$174.49
|
| Rate for Payer: Aetna Medicare |
$66.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$15.49
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$64.09
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$95.02
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$95.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$15.49
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$76.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$72.77
|
| Rate for Payer: Cash Price |
$124.04
|
| Rate for Payer: Cash Price |
$124.04
|
| Rate for Payer: Centivo All Commercial |
$112.47
|
| Rate for Payer: Cigna All Commercial |
$178.42
|
| Rate for Payer: CORVEL All Commercial |
$192.27
|
| Rate for Payer: Coventry All Commercial |
$181.93
|
| Rate for Payer: Encore All Commercial |
$190.30
|
| Rate for Payer: Frontpath All Commercial |
$190.20
|
| Rate for Payer: Humana ChoiceCare |
$178.56
|
| Rate for Payer: Humana Medicare |
$66.16
|
| Rate for Payer: Lucent All Commercial |
$112.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$186.07
|
| Rate for Payer: Managed Health Services Medicaid |
$15.49
|
| Rate for Payer: MDWise Medicaid |
$15.49
|
| Rate for Payer: PHCS All Commercial |
$155.06
|
| Rate for Payer: PHP All Commercial |
$156.79
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$80.63
|
| Rate for Payer: Sagamore Health Network All Products |
$159.60
|
| Rate for Payer: Signature Care EPO |
$171.59
|
| Rate for Payer: Signature Care PPO |
$181.93
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$175.73
|
| Rate for Payer: United Healthcare Commercial |
$162.91
|
| Rate for Payer: United Healthcare Medicare |
$66.16
|
|
|
HC LYME DISEASE IGM WESTERN BLOT
|
Facility
|
IP
|
$206.74
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
63001926
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$155.06 |
| Max. Negotiated Rate |
$192.27 |
| Rate for Payer: Aetna Commercial |
$178.62
|
| Rate for Payer: Cash Price |
$124.04
|
| Rate for Payer: Cigna All Commercial |
$178.42
|
| Rate for Payer: CORVEL All Commercial |
$192.27
|
| Rate for Payer: Coventry All Commercial |
$181.93
|
| Rate for Payer: Encore All Commercial |
$190.30
|
| Rate for Payer: Frontpath All Commercial |
$190.20
|
| Rate for Payer: Humana ChoiceCare |
$178.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$186.07
|
| Rate for Payer: PHCS All Commercial |
$155.06
|
| Rate for Payer: PHP All Commercial |
$156.79
|
| Rate for Payer: Sagamore Health Network All Products |
$159.60
|
| Rate for Payer: Signature Care EPO |
$171.59
|
| Rate for Payer: Signature Care PPO |
$181.93
|
| Rate for Payer: United Healthcare Commercial |
$162.91
|
|
|
HC LYMPHOSCINTIGRAPHY
|
Facility
|
IP
|
$2,126.41
|
|
|
Service Code
|
CPT 78195
|
| Hospital Charge Code |
1638195
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,594.81 |
| Max. Negotiated Rate |
$1,977.56 |
| Rate for Payer: Aetna Commercial |
$1,837.22
|
| Rate for Payer: Cash Price |
$1,275.85
|
| Rate for Payer: Cigna All Commercial |
$1,835.09
|
| Rate for Payer: CORVEL All Commercial |
$1,977.56
|
| Rate for Payer: Coventry All Commercial |
$1,871.24
|
| Rate for Payer: Encore All Commercial |
$1,957.36
|
| Rate for Payer: Frontpath All Commercial |
$1,956.30
|
| Rate for Payer: Humana ChoiceCare |
$1,836.58
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,913.77
|
| Rate for Payer: PHCS All Commercial |
$1,594.81
|
| Rate for Payer: PHP All Commercial |
$1,612.67
|
| Rate for Payer: Sagamore Health Network All Products |
$1,641.59
|
| Rate for Payer: Signature Care EPO |
$1,764.92
|
| Rate for Payer: Signature Care PPO |
$1,871.24
|
| Rate for Payer: United Healthcare Commercial |
$1,675.61
|
|
|
HC LYMPHOSCINTIGRAPHY
|
Facility
|
OP
|
$2,126.41
|
|
|
Service Code
|
CPT 78195
|
| Hospital Charge Code |
1638195
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$210.31 |
| Max. Negotiated Rate |
$1,977.56 |
| Rate for Payer: Aetna Commercial |
$1,794.69
|
| Rate for Payer: Aetna Medicare |
$680.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$210.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$659.19
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,221.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,329.22
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$210.31
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$782.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$748.50
|
| Rate for Payer: Cash Price |
$1,275.85
|
| Rate for Payer: Cash Price |
$1,275.85
|
| Rate for Payer: Centivo All Commercial |
$1,156.77
|
| Rate for Payer: Cigna All Commercial |
$1,835.09
|
| Rate for Payer: CORVEL All Commercial |
$1,977.56
|
| Rate for Payer: Coventry All Commercial |
$1,871.24
|
| Rate for Payer: Encore All Commercial |
$1,957.36
|
| Rate for Payer: Frontpath All Commercial |
$1,956.30
|
| Rate for Payer: Humana ChoiceCare |
$1,836.58
|
| Rate for Payer: Humana Medicare |
$680.45
|
| Rate for Payer: Lucent All Commercial |
$1,156.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,913.77
|
| Rate for Payer: Managed Health Services Medicaid |
$210.31
|
| Rate for Payer: MDWise Medicaid |
$210.31
|
| Rate for Payer: PHCS All Commercial |
$1,594.81
|
| Rate for Payer: PHP All Commercial |
$1,612.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$829.30
|
| Rate for Payer: Sagamore Health Network All Products |
$1,641.59
|
| Rate for Payer: Signature Care EPO |
$1,764.92
|
| Rate for Payer: Signature Care PPO |
$1,871.24
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,807.45
|
| Rate for Payer: United Healthcare Commercial |
$1,675.61
|
| Rate for Payer: United Healthcare Medicare |
$680.45
|
|
|
HC MAGNESIUM
|
Facility
|
IP
|
$108.49
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
63001197
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$81.37 |
| Max. Negotiated Rate |
$100.90 |
| Rate for Payer: Aetna Commercial |
$93.74
|
| Rate for Payer: Cash Price |
$65.09
|
| Rate for Payer: Cigna All Commercial |
$93.63
|
| Rate for Payer: CORVEL All Commercial |
$100.90
|
| Rate for Payer: Coventry All Commercial |
$95.47
|
| Rate for Payer: Encore All Commercial |
$99.87
|
| Rate for Payer: Frontpath All Commercial |
$99.81
|
| Rate for Payer: Humana ChoiceCare |
$93.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$97.64
|
| Rate for Payer: PHCS All Commercial |
$81.37
|
| Rate for Payer: PHP All Commercial |
$82.28
|
| Rate for Payer: Sagamore Health Network All Products |
$83.75
|
| Rate for Payer: Signature Care EPO |
$90.05
|
| Rate for Payer: Signature Care PPO |
$95.47
|
| Rate for Payer: United Healthcare Commercial |
$85.49
|
|
|
HC MAGNESIUM
|
Facility
|
OP
|
$108.49
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
63001197
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.70 |
| Max. Negotiated Rate |
$100.90 |
| Rate for Payer: Aetna Commercial |
$91.57
|
| Rate for Payer: Aetna Medicare |
$34.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$6.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$33.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$49.86
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$49.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$6.70
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$39.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$38.19
|
| Rate for Payer: Cash Price |
$65.09
|
| Rate for Payer: Cash Price |
$65.09
|
| Rate for Payer: Centivo All Commercial |
$59.02
|
| Rate for Payer: Cigna All Commercial |
$93.63
|
| Rate for Payer: CORVEL All Commercial |
$100.90
|
| Rate for Payer: Coventry All Commercial |
$95.47
|
| Rate for Payer: Encore All Commercial |
$99.87
|
| Rate for Payer: Frontpath All Commercial |
$99.81
|
| Rate for Payer: Humana ChoiceCare |
$93.70
|
| Rate for Payer: Humana Medicare |
$34.72
|
| Rate for Payer: Lucent All Commercial |
$59.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$97.64
|
| Rate for Payer: Managed Health Services Medicaid |
$6.70
|
| Rate for Payer: MDWise Medicaid |
$6.70
|
| Rate for Payer: PHCS All Commercial |
$81.37
|
| Rate for Payer: PHP All Commercial |
$82.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$42.31
|
| Rate for Payer: Sagamore Health Network All Products |
$83.75
|
| Rate for Payer: Signature Care EPO |
$90.05
|
| Rate for Payer: Signature Care PPO |
$95.47
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$92.22
|
| Rate for Payer: United Healthcare Commercial |
$85.49
|
| Rate for Payer: United Healthcare Medicare |
$34.72
|
|
|
HC MAGNESIUM, RBCS
|
Facility
|
OP
|
$108.49
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
63001629
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.70 |
| Max. Negotiated Rate |
$100.90 |
| Rate for Payer: Aetna Commercial |
$91.57
|
| Rate for Payer: Aetna Medicare |
$34.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$6.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$33.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$49.86
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$49.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$6.70
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$39.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$38.19
|
| Rate for Payer: Cash Price |
$65.09
|
| Rate for Payer: Cash Price |
$65.09
|
| Rate for Payer: Centivo All Commercial |
$59.02
|
| Rate for Payer: Cigna All Commercial |
$93.63
|
| Rate for Payer: CORVEL All Commercial |
$100.90
|
| Rate for Payer: Coventry All Commercial |
$95.47
|
| Rate for Payer: Encore All Commercial |
$99.87
|
| Rate for Payer: Frontpath All Commercial |
$99.81
|
| Rate for Payer: Humana ChoiceCare |
$93.70
|
| Rate for Payer: Humana Medicare |
$34.72
|
| Rate for Payer: Lucent All Commercial |
$59.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$97.64
|
| Rate for Payer: Managed Health Services Medicaid |
$6.70
|
| Rate for Payer: MDWise Medicaid |
$6.70
|
| Rate for Payer: PHCS All Commercial |
$81.37
|
| Rate for Payer: PHP All Commercial |
$82.28
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$42.31
|
| Rate for Payer: Sagamore Health Network All Products |
$83.75
|
| Rate for Payer: Signature Care EPO |
$90.05
|
| Rate for Payer: Signature Care PPO |
$95.47
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$92.22
|
| Rate for Payer: United Healthcare Commercial |
$85.49
|
| Rate for Payer: United Healthcare Medicare |
$34.72
|
|
|
HC MAGNESIUM, RBCS
|
Facility
|
IP
|
$108.49
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
63001629
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$81.37 |
| Max. Negotiated Rate |
$100.90 |
| Rate for Payer: Aetna Commercial |
$93.74
|
| Rate for Payer: Cash Price |
$65.09
|
| Rate for Payer: Cigna All Commercial |
$93.63
|
| Rate for Payer: CORVEL All Commercial |
$100.90
|
| Rate for Payer: Coventry All Commercial |
$95.47
|
| Rate for Payer: Encore All Commercial |
$99.87
|
| Rate for Payer: Frontpath All Commercial |
$99.81
|
| Rate for Payer: Humana ChoiceCare |
$93.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$97.64
|
| Rate for Payer: PHCS All Commercial |
$81.37
|
| Rate for Payer: PHP All Commercial |
$82.28
|
| Rate for Payer: Sagamore Health Network All Products |
$83.75
|
| Rate for Payer: Signature Care EPO |
$90.05
|
| Rate for Payer: Signature Care PPO |
$95.47
|
| Rate for Payer: United Healthcare Commercial |
$85.49
|
|
|
HC MAGNESIUM UR
|
Facility
|
IP
|
$84.26
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
63001628
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$63.20 |
| Max. Negotiated Rate |
$78.36 |
| Rate for Payer: Aetna Commercial |
$72.80
|
| Rate for Payer: Cash Price |
$50.56
|
| Rate for Payer: Cigna All Commercial |
$72.72
|
| Rate for Payer: CORVEL All Commercial |
$78.36
|
| Rate for Payer: Coventry All Commercial |
$74.15
|
| Rate for Payer: Encore All Commercial |
$77.56
|
| Rate for Payer: Frontpath All Commercial |
$77.52
|
| Rate for Payer: Humana ChoiceCare |
$72.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$75.83
|
| Rate for Payer: PHCS All Commercial |
$63.20
|
| Rate for Payer: PHP All Commercial |
$63.90
|
| Rate for Payer: Sagamore Health Network All Products |
$65.05
|
| Rate for Payer: Signature Care EPO |
$69.94
|
| Rate for Payer: Signature Care PPO |
$74.15
|
| Rate for Payer: United Healthcare Commercial |
$66.40
|
|
|
HC MAGNESIUM UR
|
Facility
|
OP
|
$84.26
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
63001628
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.70 |
| Max. Negotiated Rate |
$78.36 |
| Rate for Payer: Aetna Commercial |
$71.12
|
| Rate for Payer: Aetna Medicare |
$26.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$6.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$26.12
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$38.73
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$38.73
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$6.70
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$31.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$29.66
|
| Rate for Payer: Cash Price |
$50.56
|
| Rate for Payer: Cash Price |
$50.56
|
| Rate for Payer: Centivo All Commercial |
$45.84
|
| Rate for Payer: Cigna All Commercial |
$72.72
|
| Rate for Payer: CORVEL All Commercial |
$78.36
|
| Rate for Payer: Coventry All Commercial |
$74.15
|
| Rate for Payer: Encore All Commercial |
$77.56
|
| Rate for Payer: Frontpath All Commercial |
$77.52
|
| Rate for Payer: Humana ChoiceCare |
$72.78
|
| Rate for Payer: Humana Medicare |
$26.96
|
| Rate for Payer: Lucent All Commercial |
$45.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$75.83
|
| Rate for Payer: Managed Health Services Medicaid |
$6.70
|
| Rate for Payer: MDWise Medicaid |
$6.70
|
| Rate for Payer: PHCS All Commercial |
$63.20
|
| Rate for Payer: PHP All Commercial |
$63.90
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$32.86
|
| Rate for Payer: Sagamore Health Network All Products |
$65.05
|
| Rate for Payer: Signature Care EPO |
$69.94
|
| Rate for Payer: Signature Care PPO |
$74.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$71.62
|
| Rate for Payer: United Healthcare Commercial |
$66.40
|
| Rate for Payer: United Healthcare Medicare |
$26.96
|
|
