|
HC LEAD
|
Facility
IP
|
$84.05
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
63001619
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$63.04 |
| Max. Negotiated Rate |
$78.16 |
| Rate for Payer: Aetna Commercial |
$72.62
|
| Rate for Payer: Cash Price |
$52.11
|
| Rate for Payer: Cigna All Commercial |
$72.53
|
| Rate for Payer: CORVEL All Commercial |
$78.16
|
| Rate for Payer: Coventry All Commercial |
$73.96
|
| Rate for Payer: Encore All Commercial |
$77.37
|
| Rate for Payer: Frontpath All Commercial |
$77.32
|
| Rate for Payer: Humana ChoiceCare |
$72.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$75.64
|
| Rate for Payer: PHCS All Commercial |
$63.04
|
| Rate for Payer: PHP All Commercial |
$63.74
|
| Rate for Payer: Sagamore Health Network All Products |
$64.89
|
| Rate for Payer: Signature Care EPO |
$69.76
|
| Rate for Payer: Signature Care PPO |
$73.96
|
| Rate for Payer: United Healthcare Commercial |
$66.23
|
|
|
HC LEAD
|
Facility
OP
|
$128.13
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
63001620
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$119.16 |
| Rate for Payer: Aetna Commercial |
$108.14
|
| Rate for Payer: Aetna Medicare |
$42.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$42.28
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$73.59
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$80.10
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$12.11
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$48.63
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$46.51
|
| Rate for Payer: Cash Price |
$79.44
|
| Rate for Payer: Cash Price |
$79.44
|
| Rate for Payer: Centivo All Commercial |
$65.35
|
| Rate for Payer: Cigna All Commercial |
$110.58
|
| Rate for Payer: CORVEL All Commercial |
$119.16
|
| Rate for Payer: Coventry All Commercial |
$112.76
|
| Rate for Payer: Encore All Commercial |
$117.95
|
| Rate for Payer: Frontpath All Commercial |
$117.88
|
| Rate for Payer: Humana ChoiceCare |
$110.67
|
| Rate for Payer: Humana Medicare |
$65.35
|
| Rate for Payer: Lucent All Commercial |
$65.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$115.32
|
| Rate for Payer: Managed Health Services Medicaid |
$12.11
|
| Rate for Payer: MDWise Medicaid |
$12.11
|
| Rate for Payer: PHCS All Commercial |
$96.10
|
| Rate for Payer: PHP All Commercial |
$97.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$49.97
|
| Rate for Payer: Sagamore Health Network All Products |
$98.92
|
| Rate for Payer: Signature Care EPO |
$106.35
|
| Rate for Payer: Signature Care PPO |
$112.76
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$108.91
|
| Rate for Payer: United Healthcare Commercial |
$100.97
|
| Rate for Payer: United Healthcare Medicare |
$42.28
|
|
|
HC LEAD ACUITY STEER./SPIRAL 4554
|
Facility
OP
|
$5,906.25
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607266
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,492.81 |
| Rate for Payer: Aetna Commercial |
$4,984.88
|
| Rate for Payer: Aetna Medicare |
$1,949.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,949.06
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,391.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,692.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,241.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,143.97
|
| Rate for Payer: Cash Price |
$3,661.88
|
| Rate for Payer: Cash Price |
$3,661.88
|
| Rate for Payer: Centivo All Commercial |
$3,012.19
|
| Rate for Payer: Cigna All Commercial |
$5,097.09
|
| Rate for Payer: CORVEL All Commercial |
$5,492.81
|
| Rate for Payer: Coventry All Commercial |
$5,197.50
|
| Rate for Payer: Encore All Commercial |
$5,436.70
|
| Rate for Payer: Frontpath All Commercial |
$5,433.75
|
| Rate for Payer: Humana ChoiceCare |
$5,101.23
|
| Rate for Payer: Humana Medicare |
$3,012.19
|
| Rate for Payer: Lucent All Commercial |
$3,012.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,315.62
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,429.69
|
| Rate for Payer: PHP All Commercial |
$4,479.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,303.44
|
| Rate for Payer: Sagamore Health Network All Products |
$4,559.62
|
| Rate for Payer: Signature Care EPO |
$4,902.19
|
| Rate for Payer: Signature Care PPO |
$5,197.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,020.31
|
| Rate for Payer: United Healthcare Commercial |
$4,654.12
|
| Rate for Payer: United Healthcare Medicare |
$1,949.06
|
|
|
HC LEAD ACUITY STEER./SPIRAL 4554
|
Facility
IP
|
$5,906.25
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607266
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,429.69 |
| Max. Negotiated Rate |
$5,492.81 |
| Rate for Payer: Aetna Commercial |
$5,103.00
|
| Rate for Payer: Cash Price |
$3,661.88
|
| Rate for Payer: Cigna All Commercial |
$5,097.09
|
| Rate for Payer: CORVEL All Commercial |
$5,492.81
|
| Rate for Payer: Coventry All Commercial |
$5,197.50
|
| Rate for Payer: Encore All Commercial |
$5,436.70
|
| Rate for Payer: Frontpath All Commercial |
$5,433.75
|
| Rate for Payer: Humana ChoiceCare |
$5,101.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,315.62
|
| Rate for Payer: PHCS All Commercial |
$4,429.69
|
| Rate for Payer: PHP All Commercial |
$4,479.30
|
| Rate for Payer: Sagamore Health Network All Products |
$4,559.62
|
| Rate for Payer: Signature Care EPO |
$4,902.19
|
| Rate for Payer: Signature Care PPO |
$5,197.50
|
| Rate for Payer: United Healthcare Commercial |
$4,654.12
|
|
|
HC LEAD ACUITY STEER./SPIRAL 4555
|
Facility
OP
|
$5,906.25
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607267
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,492.81 |
| Rate for Payer: Aetna Commercial |
$4,984.88
|
| Rate for Payer: Aetna Medicare |
$1,949.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,949.06
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,391.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,692.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,241.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,143.97
|
| Rate for Payer: Cash Price |
$3,661.88
|
| Rate for Payer: Cash Price |
$3,661.88
|
| Rate for Payer: Centivo All Commercial |
$3,012.19
|
| Rate for Payer: Cigna All Commercial |
$5,097.09
|
| Rate for Payer: CORVEL All Commercial |
$5,492.81
|
| Rate for Payer: Coventry All Commercial |
$5,197.50
|
| Rate for Payer: Encore All Commercial |
$5,436.70
|
| Rate for Payer: Frontpath All Commercial |
$5,433.75
|
| Rate for Payer: Humana ChoiceCare |
$5,101.23
|
| Rate for Payer: Humana Medicare |
$3,012.19
|
| Rate for Payer: Lucent All Commercial |
$3,012.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,315.62
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,429.69
|
| Rate for Payer: PHP All Commercial |
$4,479.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,303.44
|
| Rate for Payer: Sagamore Health Network All Products |
$4,559.62
|
| Rate for Payer: Signature Care EPO |
$4,902.19
|
| Rate for Payer: Signature Care PPO |
$5,197.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,020.31
|
| Rate for Payer: United Healthcare Commercial |
$4,654.12
|
| Rate for Payer: United Healthcare Medicare |
$1,949.06
|
|
|
HC LEAD ACUITY STEER./SPIRAL 4555
|
Facility
IP
|
$5,906.25
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607267
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,429.69 |
| Max. Negotiated Rate |
$5,492.81 |
| Rate for Payer: Aetna Commercial |
$5,103.00
|
| Rate for Payer: Cash Price |
$3,661.88
|
| Rate for Payer: Cigna All Commercial |
$5,097.09
|
| Rate for Payer: CORVEL All Commercial |
$5,492.81
|
| Rate for Payer: Coventry All Commercial |
$5,197.50
|
| Rate for Payer: Encore All Commercial |
$5,436.70
|
| Rate for Payer: Frontpath All Commercial |
$5,433.75
|
| Rate for Payer: Humana ChoiceCare |
$5,101.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,315.62
|
| Rate for Payer: PHCS All Commercial |
$4,429.69
|
| Rate for Payer: PHP All Commercial |
$4,479.30
|
| Rate for Payer: Sagamore Health Network All Products |
$4,559.62
|
| Rate for Payer: Signature Care EPO |
$4,902.19
|
| Rate for Payer: Signature Care PPO |
$5,197.50
|
| Rate for Payer: United Healthcare Commercial |
$4,654.12
|
|
|
HC LEAD ACUITY STEER./SPIRAL 4591
|
Facility
OP
|
$5,906.25
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607268
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,492.81 |
| Rate for Payer: Aetna Commercial |
$4,984.88
|
| Rate for Payer: Aetna Medicare |
$1,949.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,949.06
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,391.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,692.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,241.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,143.97
|
| Rate for Payer: Cash Price |
$3,661.88
|
| Rate for Payer: Cash Price |
$3,661.88
|
| Rate for Payer: Centivo All Commercial |
$3,012.19
|
| Rate for Payer: Cigna All Commercial |
$5,097.09
|
| Rate for Payer: CORVEL All Commercial |
$5,492.81
|
| Rate for Payer: Coventry All Commercial |
$5,197.50
|
| Rate for Payer: Encore All Commercial |
$5,436.70
|
| Rate for Payer: Frontpath All Commercial |
$5,433.75
|
| Rate for Payer: Humana ChoiceCare |
$5,101.23
|
| Rate for Payer: Humana Medicare |
$3,012.19
|
| Rate for Payer: Lucent All Commercial |
$3,012.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,315.62
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,429.69
|
| Rate for Payer: PHP All Commercial |
$4,479.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,303.44
|
| Rate for Payer: Sagamore Health Network All Products |
$4,559.62
|
| Rate for Payer: Signature Care EPO |
$4,902.19
|
| Rate for Payer: Signature Care PPO |
$5,197.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,020.31
|
| Rate for Payer: United Healthcare Commercial |
$4,654.12
|
| Rate for Payer: United Healthcare Medicare |
$1,949.06
|
|
|
HC LEAD ACUITY STEER./SPIRAL 4591
|
Facility
IP
|
$5,906.25
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607268
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,429.69 |
| Max. Negotiated Rate |
$5,492.81 |
| Rate for Payer: Aetna Commercial |
$5,103.00
|
| Rate for Payer: Cash Price |
$3,661.88
|
| Rate for Payer: Cigna All Commercial |
$5,097.09
|
| Rate for Payer: CORVEL All Commercial |
$5,492.81
|
| Rate for Payer: Coventry All Commercial |
$5,197.50
|
| Rate for Payer: Encore All Commercial |
$5,436.70
|
| Rate for Payer: Frontpath All Commercial |
$5,433.75
|
| Rate for Payer: Humana ChoiceCare |
$5,101.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,315.62
|
| Rate for Payer: PHCS All Commercial |
$4,429.69
|
| Rate for Payer: PHP All Commercial |
$4,479.30
|
| Rate for Payer: Sagamore Health Network All Products |
$4,559.62
|
| Rate for Payer: Signature Care EPO |
$4,902.19
|
| Rate for Payer: Signature Care PPO |
$5,197.50
|
| Rate for Payer: United Healthcare Commercial |
$4,654.12
|
|
|
HC LEAD ACUITY STEER./SPIRAL 4592
|
Facility
IP
|
$5,906.25
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607269
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,429.69 |
| Max. Negotiated Rate |
$5,492.81 |
| Rate for Payer: Aetna Commercial |
$5,103.00
|
| Rate for Payer: Cash Price |
$3,661.88
|
| Rate for Payer: Cigna All Commercial |
$5,097.09
|
| Rate for Payer: CORVEL All Commercial |
$5,492.81
|
| Rate for Payer: Coventry All Commercial |
$5,197.50
|
| Rate for Payer: Encore All Commercial |
$5,436.70
|
| Rate for Payer: Frontpath All Commercial |
$5,433.75
|
| Rate for Payer: Humana ChoiceCare |
$5,101.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,315.62
|
| Rate for Payer: PHCS All Commercial |
$4,429.69
|
| Rate for Payer: PHP All Commercial |
$4,479.30
|
| Rate for Payer: Sagamore Health Network All Products |
$4,559.62
|
| Rate for Payer: Signature Care EPO |
$4,902.19
|
| Rate for Payer: Signature Care PPO |
$5,197.50
|
| Rate for Payer: United Healthcare Commercial |
$4,654.12
|
|
|
HC LEAD ACUITY STEER./SPIRAL 4592
|
Facility
OP
|
$5,906.25
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607269
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,492.81 |
| Rate for Payer: Aetna Commercial |
$4,984.88
|
| Rate for Payer: Aetna Medicare |
$1,949.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,949.06
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,391.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,692.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,241.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,143.97
|
| Rate for Payer: Cash Price |
$3,661.88
|
| Rate for Payer: Cash Price |
$3,661.88
|
| Rate for Payer: Centivo All Commercial |
$3,012.19
|
| Rate for Payer: Cigna All Commercial |
$5,097.09
|
| Rate for Payer: CORVEL All Commercial |
$5,492.81
|
| Rate for Payer: Coventry All Commercial |
$5,197.50
|
| Rate for Payer: Encore All Commercial |
$5,436.70
|
| Rate for Payer: Frontpath All Commercial |
$5,433.75
|
| Rate for Payer: Humana ChoiceCare |
$5,101.23
|
| Rate for Payer: Humana Medicare |
$3,012.19
|
| Rate for Payer: Lucent All Commercial |
$3,012.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,315.62
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,429.69
|
| Rate for Payer: PHP All Commercial |
$4,479.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,303.44
|
| Rate for Payer: Sagamore Health Network All Products |
$4,559.62
|
| Rate for Payer: Signature Care EPO |
$4,902.19
|
| Rate for Payer: Signature Care PPO |
$5,197.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,020.31
|
| Rate for Payer: United Healthcare Commercial |
$4,654.12
|
| Rate for Payer: United Healthcare Medicare |
$1,949.06
|
|
|
HC LEAD ACUITY STEER./SPIRAL 4593
|
Facility
IP
|
$5,906.25
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607270
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,429.69 |
| Max. Negotiated Rate |
$5,492.81 |
| Rate for Payer: Aetna Commercial |
$5,103.00
|
| Rate for Payer: Cash Price |
$3,661.88
|
| Rate for Payer: Cigna All Commercial |
$5,097.09
|
| Rate for Payer: CORVEL All Commercial |
$5,492.81
|
| Rate for Payer: Coventry All Commercial |
$5,197.50
|
| Rate for Payer: Encore All Commercial |
$5,436.70
|
| Rate for Payer: Frontpath All Commercial |
$5,433.75
|
| Rate for Payer: Humana ChoiceCare |
$5,101.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,315.62
|
| Rate for Payer: PHCS All Commercial |
$4,429.69
|
| Rate for Payer: PHP All Commercial |
$4,479.30
|
| Rate for Payer: Sagamore Health Network All Products |
$4,559.62
|
| Rate for Payer: Signature Care EPO |
$4,902.19
|
| Rate for Payer: Signature Care PPO |
$5,197.50
|
| Rate for Payer: United Healthcare Commercial |
$4,654.12
|
|
|
HC LEAD ACUITY STEER./SPIRAL 4593
|
Facility
OP
|
$5,906.25
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607270
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,492.81 |
| Rate for Payer: Aetna Commercial |
$4,984.88
|
| Rate for Payer: Aetna Medicare |
$1,949.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,949.06
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,391.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,692.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,241.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,143.97
|
| Rate for Payer: Cash Price |
$3,661.88
|
| Rate for Payer: Cash Price |
$3,661.88
|
| Rate for Payer: Centivo All Commercial |
$3,012.19
|
| Rate for Payer: Cigna All Commercial |
$5,097.09
|
| Rate for Payer: CORVEL All Commercial |
$5,492.81
|
| Rate for Payer: Coventry All Commercial |
$5,197.50
|
| Rate for Payer: Encore All Commercial |
$5,436.70
|
| Rate for Payer: Frontpath All Commercial |
$5,433.75
|
| Rate for Payer: Humana ChoiceCare |
$5,101.23
|
| Rate for Payer: Humana Medicare |
$3,012.19
|
| Rate for Payer: Lucent All Commercial |
$3,012.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,315.62
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,429.69
|
| Rate for Payer: PHP All Commercial |
$4,479.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,303.44
|
| Rate for Payer: Sagamore Health Network All Products |
$4,559.62
|
| Rate for Payer: Signature Care EPO |
$4,902.19
|
| Rate for Payer: Signature Care PPO |
$5,197.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,020.31
|
| Rate for Payer: United Healthcare Commercial |
$4,654.12
|
| Rate for Payer: United Healthcare Medicare |
$1,949.06
|
|
|
HC LEAD ACUITY X4 4671
|
Facility
OP
|
$6,693.75
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607260
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,225.19 |
| Rate for Payer: Aetna Commercial |
$5,649.52
|
| Rate for Payer: Aetna Medicare |
$2,208.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,208.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,844.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,184.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,540.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,429.83
|
| Rate for Payer: Cash Price |
$4,150.13
|
| Rate for Payer: Cash Price |
$4,150.13
|
| Rate for Payer: Centivo All Commercial |
$3,413.81
|
| Rate for Payer: Cigna All Commercial |
$5,776.71
|
| Rate for Payer: CORVEL All Commercial |
$6,225.19
|
| Rate for Payer: Coventry All Commercial |
$5,890.50
|
| Rate for Payer: Encore All Commercial |
$6,161.60
|
| Rate for Payer: Frontpath All Commercial |
$6,158.25
|
| Rate for Payer: Humana ChoiceCare |
$5,781.39
|
| Rate for Payer: Humana Medicare |
$3,413.81
|
| Rate for Payer: Lucent All Commercial |
$3,413.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,024.38
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,020.31
|
| Rate for Payer: PHP All Commercial |
$5,076.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,610.56
|
| Rate for Payer: Sagamore Health Network All Products |
$5,167.58
|
| Rate for Payer: Signature Care EPO |
$5,555.81
|
| Rate for Payer: Signature Care PPO |
$5,890.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,689.69
|
| Rate for Payer: United Healthcare Commercial |
$5,274.68
|
| Rate for Payer: United Healthcare Medicare |
$2,208.94
|
|
|
HC LEAD ACUITY X4 4671
|
Facility
IP
|
$6,693.75
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607260
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,020.31 |
| Max. Negotiated Rate |
$6,225.19 |
| Rate for Payer: Aetna Commercial |
$5,783.40
|
| Rate for Payer: Cash Price |
$4,150.13
|
| Rate for Payer: Cigna All Commercial |
$5,776.71
|
| Rate for Payer: CORVEL All Commercial |
$6,225.19
|
| Rate for Payer: Coventry All Commercial |
$5,890.50
|
| Rate for Payer: Encore All Commercial |
$6,161.60
|
| Rate for Payer: Frontpath All Commercial |
$6,158.25
|
| Rate for Payer: Humana ChoiceCare |
$5,781.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,024.38
|
| Rate for Payer: PHCS All Commercial |
$5,020.31
|
| Rate for Payer: PHP All Commercial |
$5,076.54
|
| Rate for Payer: Sagamore Health Network All Products |
$5,167.58
|
| Rate for Payer: Signature Care EPO |
$5,555.81
|
| Rate for Payer: Signature Care PPO |
$5,890.50
|
| Rate for Payer: United Healthcare Commercial |
$5,274.68
|
|
|
HC LEAD ACUITY X4 4672
|
Facility
OP
|
$6,693.75
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607261
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,225.19 |
| Rate for Payer: Aetna Commercial |
$5,649.52
|
| Rate for Payer: Aetna Medicare |
$2,208.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,208.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,844.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,184.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,540.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,429.83
|
| Rate for Payer: Cash Price |
$4,150.13
|
| Rate for Payer: Cash Price |
$4,150.13
|
| Rate for Payer: Centivo All Commercial |
$3,413.81
|
| Rate for Payer: Cigna All Commercial |
$5,776.71
|
| Rate for Payer: CORVEL All Commercial |
$6,225.19
|
| Rate for Payer: Coventry All Commercial |
$5,890.50
|
| Rate for Payer: Encore All Commercial |
$6,161.60
|
| Rate for Payer: Frontpath All Commercial |
$6,158.25
|
| Rate for Payer: Humana ChoiceCare |
$5,781.39
|
| Rate for Payer: Humana Medicare |
$3,413.81
|
| Rate for Payer: Lucent All Commercial |
$3,413.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,024.38
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,020.31
|
| Rate for Payer: PHP All Commercial |
$5,076.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,610.56
|
| Rate for Payer: Sagamore Health Network All Products |
$5,167.58
|
| Rate for Payer: Signature Care EPO |
$5,555.81
|
| Rate for Payer: Signature Care PPO |
$5,890.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,689.69
|
| Rate for Payer: United Healthcare Commercial |
$5,274.68
|
| Rate for Payer: United Healthcare Medicare |
$2,208.94
|
|
|
HC LEAD ACUITY X4 4672
|
Facility
IP
|
$6,693.75
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607261
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,020.31 |
| Max. Negotiated Rate |
$6,225.19 |
| Rate for Payer: Aetna Commercial |
$5,783.40
|
| Rate for Payer: Cash Price |
$4,150.13
|
| Rate for Payer: Cigna All Commercial |
$5,776.71
|
| Rate for Payer: CORVEL All Commercial |
$6,225.19
|
| Rate for Payer: Coventry All Commercial |
$5,890.50
|
| Rate for Payer: Encore All Commercial |
$6,161.60
|
| Rate for Payer: Frontpath All Commercial |
$6,158.25
|
| Rate for Payer: Humana ChoiceCare |
$5,781.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,024.38
|
| Rate for Payer: PHCS All Commercial |
$5,020.31
|
| Rate for Payer: PHP All Commercial |
$5,076.54
|
| Rate for Payer: Sagamore Health Network All Products |
$5,167.58
|
| Rate for Payer: Signature Care EPO |
$5,555.81
|
| Rate for Payer: Signature Care PPO |
$5,890.50
|
| Rate for Payer: United Healthcare Commercial |
$5,274.68
|
|
|
HC LEAD ACUITY X4 4674
|
Facility
IP
|
$6,693.75
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607262
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,020.31 |
| Max. Negotiated Rate |
$6,225.19 |
| Rate for Payer: Aetna Commercial |
$5,783.40
|
| Rate for Payer: Cash Price |
$4,150.13
|
| Rate for Payer: Cigna All Commercial |
$5,776.71
|
| Rate for Payer: CORVEL All Commercial |
$6,225.19
|
| Rate for Payer: Coventry All Commercial |
$5,890.50
|
| Rate for Payer: Encore All Commercial |
$6,161.60
|
| Rate for Payer: Frontpath All Commercial |
$6,158.25
|
| Rate for Payer: Humana ChoiceCare |
$5,781.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,024.38
|
| Rate for Payer: PHCS All Commercial |
$5,020.31
|
| Rate for Payer: PHP All Commercial |
$5,076.54
|
| Rate for Payer: Sagamore Health Network All Products |
$5,167.58
|
| Rate for Payer: Signature Care EPO |
$5,555.81
|
| Rate for Payer: Signature Care PPO |
$5,890.50
|
| Rate for Payer: United Healthcare Commercial |
$5,274.68
|
|
|
HC LEAD ACUITY X4 4674
|
Facility
OP
|
$6,693.75
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607262
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,225.19 |
| Rate for Payer: Aetna Commercial |
$5,649.52
|
| Rate for Payer: Aetna Medicare |
$2,208.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,208.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,844.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,184.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,540.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,429.83
|
| Rate for Payer: Cash Price |
$4,150.13
|
| Rate for Payer: Cash Price |
$4,150.13
|
| Rate for Payer: Centivo All Commercial |
$3,413.81
|
| Rate for Payer: Cigna All Commercial |
$5,776.71
|
| Rate for Payer: CORVEL All Commercial |
$6,225.19
|
| Rate for Payer: Coventry All Commercial |
$5,890.50
|
| Rate for Payer: Encore All Commercial |
$6,161.60
|
| Rate for Payer: Frontpath All Commercial |
$6,158.25
|
| Rate for Payer: Humana ChoiceCare |
$5,781.39
|
| Rate for Payer: Humana Medicare |
$3,413.81
|
| Rate for Payer: Lucent All Commercial |
$3,413.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,024.38
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,020.31
|
| Rate for Payer: PHP All Commercial |
$5,076.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,610.56
|
| Rate for Payer: Sagamore Health Network All Products |
$5,167.58
|
| Rate for Payer: Signature Care EPO |
$5,555.81
|
| Rate for Payer: Signature Care PPO |
$5,890.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,689.69
|
| Rate for Payer: United Healthcare Commercial |
$5,274.68
|
| Rate for Payer: United Healthcare Medicare |
$2,208.94
|
|
|
HC LEAD ACUITY X4 4675
|
Facility
OP
|
$6,693.75
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607263
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,225.19 |
| Rate for Payer: Aetna Commercial |
$5,649.52
|
| Rate for Payer: Aetna Medicare |
$2,208.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,208.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,844.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,184.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,540.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,429.83
|
| Rate for Payer: Cash Price |
$4,150.13
|
| Rate for Payer: Cash Price |
$4,150.13
|
| Rate for Payer: Centivo All Commercial |
$3,413.81
|
| Rate for Payer: Cigna All Commercial |
$5,776.71
|
| Rate for Payer: CORVEL All Commercial |
$6,225.19
|
| Rate for Payer: Coventry All Commercial |
$5,890.50
|
| Rate for Payer: Encore All Commercial |
$6,161.60
|
| Rate for Payer: Frontpath All Commercial |
$6,158.25
|
| Rate for Payer: Humana ChoiceCare |
$5,781.39
|
| Rate for Payer: Humana Medicare |
$3,413.81
|
| Rate for Payer: Lucent All Commercial |
$3,413.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,024.38
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,020.31
|
| Rate for Payer: PHP All Commercial |
$5,076.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,610.56
|
| Rate for Payer: Sagamore Health Network All Products |
$5,167.58
|
| Rate for Payer: Signature Care EPO |
$5,555.81
|
| Rate for Payer: Signature Care PPO |
$5,890.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,689.69
|
| Rate for Payer: United Healthcare Commercial |
$5,274.68
|
| Rate for Payer: United Healthcare Medicare |
$2,208.94
|
|
|
HC LEAD ACUITY X4 4675
|
Facility
IP
|
$6,693.75
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607263
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,020.31 |
| Max. Negotiated Rate |
$6,225.19 |
| Rate for Payer: Aetna Commercial |
$5,783.40
|
| Rate for Payer: Cash Price |
$4,150.13
|
| Rate for Payer: Cigna All Commercial |
$5,776.71
|
| Rate for Payer: CORVEL All Commercial |
$6,225.19
|
| Rate for Payer: Coventry All Commercial |
$5,890.50
|
| Rate for Payer: Encore All Commercial |
$6,161.60
|
| Rate for Payer: Frontpath All Commercial |
$6,158.25
|
| Rate for Payer: Humana ChoiceCare |
$5,781.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,024.38
|
| Rate for Payer: PHCS All Commercial |
$5,020.31
|
| Rate for Payer: PHP All Commercial |
$5,076.54
|
| Rate for Payer: Sagamore Health Network All Products |
$5,167.58
|
| Rate for Payer: Signature Care EPO |
$5,555.81
|
| Rate for Payer: Signature Care PPO |
$5,890.50
|
| Rate for Payer: United Healthcare Commercial |
$5,274.68
|
|
|
HC LEAD ACUITY X4 4677
|
Facility
IP
|
$6,693.75
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607264
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,020.31 |
| Max. Negotiated Rate |
$6,225.19 |
| Rate for Payer: Aetna Commercial |
$5,783.40
|
| Rate for Payer: Cash Price |
$4,150.13
|
| Rate for Payer: Cigna All Commercial |
$5,776.71
|
| Rate for Payer: CORVEL All Commercial |
$6,225.19
|
| Rate for Payer: Coventry All Commercial |
$5,890.50
|
| Rate for Payer: Encore All Commercial |
$6,161.60
|
| Rate for Payer: Frontpath All Commercial |
$6,158.25
|
| Rate for Payer: Humana ChoiceCare |
$5,781.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,024.38
|
| Rate for Payer: PHCS All Commercial |
$5,020.31
|
| Rate for Payer: PHP All Commercial |
$5,076.54
|
| Rate for Payer: Sagamore Health Network All Products |
$5,167.58
|
| Rate for Payer: Signature Care EPO |
$5,555.81
|
| Rate for Payer: Signature Care PPO |
$5,890.50
|
| Rate for Payer: United Healthcare Commercial |
$5,274.68
|
|
|
HC LEAD ACUITY X4 4677
|
Facility
OP
|
$6,693.75
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607264
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,225.19 |
| Rate for Payer: Aetna Commercial |
$5,649.52
|
| Rate for Payer: Aetna Medicare |
$2,208.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,208.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,844.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,184.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,540.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,429.83
|
| Rate for Payer: Cash Price |
$4,150.13
|
| Rate for Payer: Cash Price |
$4,150.13
|
| Rate for Payer: Centivo All Commercial |
$3,413.81
|
| Rate for Payer: Cigna All Commercial |
$5,776.71
|
| Rate for Payer: CORVEL All Commercial |
$6,225.19
|
| Rate for Payer: Coventry All Commercial |
$5,890.50
|
| Rate for Payer: Encore All Commercial |
$6,161.60
|
| Rate for Payer: Frontpath All Commercial |
$6,158.25
|
| Rate for Payer: Humana ChoiceCare |
$5,781.39
|
| Rate for Payer: Humana Medicare |
$3,413.81
|
| Rate for Payer: Lucent All Commercial |
$3,413.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,024.38
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,020.31
|
| Rate for Payer: PHP All Commercial |
$5,076.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,610.56
|
| Rate for Payer: Sagamore Health Network All Products |
$5,167.58
|
| Rate for Payer: Signature Care EPO |
$5,555.81
|
| Rate for Payer: Signature Care PPO |
$5,890.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,689.69
|
| Rate for Payer: United Healthcare Commercial |
$5,274.68
|
| Rate for Payer: United Healthcare Medicare |
$2,208.94
|
|
|
HC LEAD ACUITY X4 4678
|
Facility
IP
|
$6,693.75
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607265
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,020.31 |
| Max. Negotiated Rate |
$6,225.19 |
| Rate for Payer: Aetna Commercial |
$5,783.40
|
| Rate for Payer: Cash Price |
$4,150.13
|
| Rate for Payer: Cigna All Commercial |
$5,776.71
|
| Rate for Payer: CORVEL All Commercial |
$6,225.19
|
| Rate for Payer: Coventry All Commercial |
$5,890.50
|
| Rate for Payer: Encore All Commercial |
$6,161.60
|
| Rate for Payer: Frontpath All Commercial |
$6,158.25
|
| Rate for Payer: Humana ChoiceCare |
$5,781.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,024.38
|
| Rate for Payer: PHCS All Commercial |
$5,020.31
|
| Rate for Payer: PHP All Commercial |
$5,076.54
|
| Rate for Payer: Sagamore Health Network All Products |
$5,167.58
|
| Rate for Payer: Signature Care EPO |
$5,555.81
|
| Rate for Payer: Signature Care PPO |
$5,890.50
|
| Rate for Payer: United Healthcare Commercial |
$5,274.68
|
|
|
HC LEAD ACUITY X4 4678
|
Facility
OP
|
$6,693.75
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607265
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,225.19 |
| Rate for Payer: Aetna Commercial |
$5,649.52
|
| Rate for Payer: Aetna Medicare |
$2,208.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,208.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,844.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,184.26
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,540.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,429.83
|
| Rate for Payer: Cash Price |
$4,150.13
|
| Rate for Payer: Cash Price |
$4,150.13
|
| Rate for Payer: Centivo All Commercial |
$3,413.81
|
| Rate for Payer: Cigna All Commercial |
$5,776.71
|
| Rate for Payer: CORVEL All Commercial |
$6,225.19
|
| Rate for Payer: Coventry All Commercial |
$5,890.50
|
| Rate for Payer: Encore All Commercial |
$6,161.60
|
| Rate for Payer: Frontpath All Commercial |
$6,158.25
|
| Rate for Payer: Humana ChoiceCare |
$5,781.39
|
| Rate for Payer: Humana Medicare |
$3,413.81
|
| Rate for Payer: Lucent All Commercial |
$3,413.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,024.38
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,020.31
|
| Rate for Payer: PHP All Commercial |
$5,076.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,610.56
|
| Rate for Payer: Sagamore Health Network All Products |
$5,167.58
|
| Rate for Payer: Signature Care EPO |
$5,555.81
|
| Rate for Payer: Signature Care PPO |
$5,890.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,689.69
|
| Rate for Payer: United Healthcare Commercial |
$5,274.68
|
| Rate for Payer: United Healthcare Medicare |
$2,208.94
|
|
|
HC LEAD BIV ICD LV ATTAIN STAB QU
|
Facility
OP
|
$8,803.41
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607356
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$8,187.17 |
| Rate for Payer: Aetna Commercial |
$7,430.08
|
| Rate for Payer: Aetna Medicare |
$2,905.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,905.13
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$5,055.80
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$5,503.01
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$3,340.89
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3,195.64
|
| Rate for Payer: Cash Price |
$5,458.11
|
| Rate for Payer: Cash Price |
$5,458.11
|
| Rate for Payer: Centivo All Commercial |
$4,489.74
|
| Rate for Payer: Cigna All Commercial |
$7,597.34
|
| Rate for Payer: CORVEL All Commercial |
$8,187.17
|
| Rate for Payer: Coventry All Commercial |
$7,747.00
|
| Rate for Payer: Encore All Commercial |
$8,103.54
|
| Rate for Payer: Frontpath All Commercial |
$8,099.14
|
| Rate for Payer: Humana ChoiceCare |
$7,603.51
|
| Rate for Payer: Humana Medicare |
$4,489.74
|
| Rate for Payer: Lucent All Commercial |
$4,489.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$7,923.07
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$6,602.56
|
| Rate for Payer: PHP All Commercial |
$6,676.51
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$3,433.33
|
| Rate for Payer: Sagamore Health Network All Products |
$6,796.23
|
| Rate for Payer: Signature Care EPO |
$7,306.83
|
| Rate for Payer: Signature Care PPO |
$7,747.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$7,482.90
|
| Rate for Payer: United Healthcare Commercial |
$6,937.09
|
| Rate for Payer: United Healthcare Medicare |
$2,905.13
|
|
