|
HC LEAD ICD SPRINT QUAT 6935M 55
|
Facility
IP
|
$12,257.00
|
|
|
Service Code
|
CPT C1777
|
| Hospital Charge Code |
41607346
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,192.75 |
| Max. Negotiated Rate |
$11,399.01 |
| Rate for Payer: Aetna Commercial |
$10,590.05
|
| Rate for Payer: Cash Price |
$7,599.34
|
| Rate for Payer: Cigna All Commercial |
$10,577.79
|
| Rate for Payer: CORVEL All Commercial |
$11,399.01
|
| Rate for Payer: Coventry All Commercial |
$10,786.16
|
| Rate for Payer: Encore All Commercial |
$11,282.57
|
| Rate for Payer: Frontpath All Commercial |
$11,276.44
|
| Rate for Payer: Humana ChoiceCare |
$10,586.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,031.30
|
| Rate for Payer: PHCS All Commercial |
$9,192.75
|
| Rate for Payer: PHP All Commercial |
$9,295.71
|
| Rate for Payer: Sagamore Health Network All Products |
$9,462.40
|
| Rate for Payer: Signature Care EPO |
$10,173.31
|
| Rate for Payer: Signature Care PPO |
$10,786.16
|
| Rate for Payer: United Healthcare Commercial |
$9,658.52
|
|
|
HC LEAD ICD SPRINT QUAT 6935M 62
|
Facility
IP
|
$12,257.00
|
|
|
Service Code
|
CPT C1777
|
| Hospital Charge Code |
41607347
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,192.75 |
| Max. Negotiated Rate |
$11,399.01 |
| Rate for Payer: Aetna Commercial |
$10,590.05
|
| Rate for Payer: Cash Price |
$7,599.34
|
| Rate for Payer: Cigna All Commercial |
$10,577.79
|
| Rate for Payer: CORVEL All Commercial |
$11,399.01
|
| Rate for Payer: Coventry All Commercial |
$10,786.16
|
| Rate for Payer: Encore All Commercial |
$11,282.57
|
| Rate for Payer: Frontpath All Commercial |
$11,276.44
|
| Rate for Payer: Humana ChoiceCare |
$10,586.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,031.30
|
| Rate for Payer: PHCS All Commercial |
$9,192.75
|
| Rate for Payer: PHP All Commercial |
$9,295.71
|
| Rate for Payer: Sagamore Health Network All Products |
$9,462.40
|
| Rate for Payer: Signature Care EPO |
$10,173.31
|
| Rate for Payer: Signature Care PPO |
$10,786.16
|
| Rate for Payer: United Healthcare Commercial |
$9,658.52
|
|
|
HC LEAD ICD SPRINT QUAT 6935M 62
|
Facility
OP
|
$12,257.00
|
|
|
Service Code
|
CPT C1777
|
| Hospital Charge Code |
41607347
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$11,399.01 |
| Rate for Payer: Aetna Commercial |
$10,344.91
|
| Rate for Payer: Aetna Medicare |
$4,044.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,044.81
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$7,039.20
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,661.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,651.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,449.29
|
| Rate for Payer: Cash Price |
$7,599.34
|
| Rate for Payer: Cash Price |
$7,599.34
|
| Rate for Payer: Centivo All Commercial |
$6,251.07
|
| Rate for Payer: Cigna All Commercial |
$10,577.79
|
| Rate for Payer: CORVEL All Commercial |
$11,399.01
|
| Rate for Payer: Coventry All Commercial |
$10,786.16
|
| Rate for Payer: Encore All Commercial |
$11,282.57
|
| Rate for Payer: Frontpath All Commercial |
$11,276.44
|
| Rate for Payer: Humana ChoiceCare |
$10,586.37
|
| Rate for Payer: Humana Medicare |
$6,251.07
|
| Rate for Payer: Lucent All Commercial |
$6,251.07
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,031.30
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$9,192.75
|
| Rate for Payer: PHP All Commercial |
$9,295.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,780.23
|
| Rate for Payer: Sagamore Health Network All Products |
$9,462.40
|
| Rate for Payer: Signature Care EPO |
$10,173.31
|
| Rate for Payer: Signature Care PPO |
$10,786.16
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,418.45
|
| Rate for Payer: United Healthcare Commercial |
$9,658.52
|
| Rate for Payer: United Healthcare Medicare |
$4,044.81
|
|
|
HC LEAD ICD SQ DEL SYS
|
Facility
OP
|
$3,500.00
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607242
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,255.00 |
| Rate for Payer: Aetna Commercial |
$2,954.00
|
| Rate for Payer: Aetna Medicare |
$1,155.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,155.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,010.05
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,187.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,328.25
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,270.50
|
| Rate for Payer: Cash Price |
$2,170.00
|
| Rate for Payer: Cash Price |
$2,170.00
|
| Rate for Payer: Centivo All Commercial |
$1,785.00
|
| Rate for Payer: Cigna All Commercial |
$3,020.50
|
| Rate for Payer: CORVEL All Commercial |
$3,255.00
|
| Rate for Payer: Coventry All Commercial |
$3,080.00
|
| Rate for Payer: Encore All Commercial |
$3,221.75
|
| Rate for Payer: Frontpath All Commercial |
$3,220.00
|
| Rate for Payer: Humana ChoiceCare |
$3,022.95
|
| Rate for Payer: Humana Medicare |
$1,785.00
|
| Rate for Payer: Lucent All Commercial |
$1,785.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,150.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,625.00
|
| Rate for Payer: PHP All Commercial |
$2,654.40
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,365.00
|
| Rate for Payer: Sagamore Health Network All Products |
$2,702.00
|
| Rate for Payer: Signature Care EPO |
$2,905.00
|
| Rate for Payer: Signature Care PPO |
$3,080.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,975.00
|
| Rate for Payer: United Healthcare Commercial |
$2,758.00
|
| Rate for Payer: United Healthcare Medicare |
$1,155.00
|
|
|
HC LEAD ICD SQ DEL SYS
|
Facility
IP
|
$3,500.00
|
|
|
Service Code
|
CPT C1900
|
| Hospital Charge Code |
41607242
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,625.00 |
| Max. Negotiated Rate |
$3,255.00 |
| Rate for Payer: Aetna Commercial |
$3,024.00
|
| Rate for Payer: Cash Price |
$2,170.00
|
| Rate for Payer: Cigna All Commercial |
$3,020.50
|
| Rate for Payer: CORVEL All Commercial |
$3,255.00
|
| Rate for Payer: Coventry All Commercial |
$3,080.00
|
| Rate for Payer: Encore All Commercial |
$3,221.75
|
| Rate for Payer: Frontpath All Commercial |
$3,220.00
|
| Rate for Payer: Humana ChoiceCare |
$3,022.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,150.00
|
| Rate for Payer: PHCS All Commercial |
$2,625.00
|
| Rate for Payer: PHP All Commercial |
$2,654.40
|
| Rate for Payer: Sagamore Health Network All Products |
$2,702.00
|
| Rate for Payer: Signature Care EPO |
$2,905.00
|
| Rate for Payer: Signature Care PPO |
$3,080.00
|
| Rate for Payer: United Healthcare Commercial |
$2,758.00
|
|
|
HC LEAD ICD SQ EMBLEM
|
Facility
OP
|
$15,750.00
|
|
|
Service Code
|
CPT C1896
|
| Hospital Charge Code |
41607241
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$14,647.50 |
| Rate for Payer: Aetna Commercial |
$13,293.00
|
| Rate for Payer: Aetna Medicare |
$5,197.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5,197.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$9,045.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,845.32
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,977.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,717.25
|
| Rate for Payer: Cash Price |
$9,765.00
|
| Rate for Payer: Cash Price |
$9,765.00
|
| Rate for Payer: Centivo All Commercial |
$8,032.50
|
| Rate for Payer: Cigna All Commercial |
$13,592.25
|
| Rate for Payer: CORVEL All Commercial |
$14,647.50
|
| Rate for Payer: Coventry All Commercial |
$13,860.00
|
| Rate for Payer: Encore All Commercial |
$14,497.88
|
| Rate for Payer: Frontpath All Commercial |
$14,490.00
|
| Rate for Payer: Humana ChoiceCare |
$13,603.28
|
| Rate for Payer: Humana Medicare |
$8,032.50
|
| Rate for Payer: Lucent All Commercial |
$8,032.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14,175.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$11,812.50
|
| Rate for Payer: PHP All Commercial |
$11,944.80
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$6,142.50
|
| Rate for Payer: Sagamore Health Network All Products |
$12,159.00
|
| Rate for Payer: Signature Care EPO |
$13,072.50
|
| Rate for Payer: Signature Care PPO |
$13,860.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,387.50
|
| Rate for Payer: United Healthcare Commercial |
$12,411.00
|
| Rate for Payer: United Healthcare Medicare |
$5,197.50
|
|
|
HC LEAD ICD SQ EMBLEM
|
Facility
IP
|
$15,750.00
|
|
|
Service Code
|
CPT C1896
|
| Hospital Charge Code |
41607241
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,812.50 |
| Max. Negotiated Rate |
$14,647.50 |
| Rate for Payer: Aetna Commercial |
$13,608.00
|
| Rate for Payer: Cash Price |
$9,765.00
|
| Rate for Payer: Cigna All Commercial |
$13,592.25
|
| Rate for Payer: CORVEL All Commercial |
$14,647.50
|
| Rate for Payer: Coventry All Commercial |
$13,860.00
|
| Rate for Payer: Encore All Commercial |
$14,497.88
|
| Rate for Payer: Frontpath All Commercial |
$14,490.00
|
| Rate for Payer: Humana ChoiceCare |
$13,603.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14,175.00
|
| Rate for Payer: PHCS All Commercial |
$11,812.50
|
| Rate for Payer: PHP All Commercial |
$11,944.80
|
| Rate for Payer: Sagamore Health Network All Products |
$12,159.00
|
| Rate for Payer: Signature Care EPO |
$13,072.50
|
| Rate for Payer: Signature Care PPO |
$13,860.00
|
| Rate for Payer: United Healthcare Commercial |
$12,411.00
|
|
|
HC LEAD PM CAP NOVUS 5076-45
|
Facility
IP
|
$1,738.13
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607338
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,303.60 |
| Max. Negotiated Rate |
$1,616.46 |
| Rate for Payer: Aetna Commercial |
$1,501.74
|
| Rate for Payer: Cash Price |
$1,077.64
|
| Rate for Payer: Cigna All Commercial |
$1,500.01
|
| Rate for Payer: CORVEL All Commercial |
$1,616.46
|
| Rate for Payer: Coventry All Commercial |
$1,529.55
|
| Rate for Payer: Encore All Commercial |
$1,599.95
|
| Rate for Payer: Frontpath All Commercial |
$1,599.08
|
| Rate for Payer: Humana ChoiceCare |
$1,501.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,564.32
|
| Rate for Payer: PHCS All Commercial |
$1,303.60
|
| Rate for Payer: PHP All Commercial |
$1,318.20
|
| Rate for Payer: Sagamore Health Network All Products |
$1,341.84
|
| Rate for Payer: Signature Care EPO |
$1,442.65
|
| Rate for Payer: Signature Care PPO |
$1,529.55
|
| Rate for Payer: United Healthcare Commercial |
$1,369.65
|
|
|
HC LEAD PM CAP NOVUS 5076-45
|
Facility
OP
|
$1,738.13
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607338
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,616.46 |
| Rate for Payer: Aetna Commercial |
$1,466.98
|
| Rate for Payer: Aetna Medicare |
$573.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$573.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$998.21
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,086.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$659.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$630.94
|
| Rate for Payer: Cash Price |
$1,077.64
|
| Rate for Payer: Cash Price |
$1,077.64
|
| Rate for Payer: Centivo All Commercial |
$886.45
|
| Rate for Payer: Cigna All Commercial |
$1,500.01
|
| Rate for Payer: CORVEL All Commercial |
$1,616.46
|
| Rate for Payer: Coventry All Commercial |
$1,529.55
|
| Rate for Payer: Encore All Commercial |
$1,599.95
|
| Rate for Payer: Frontpath All Commercial |
$1,599.08
|
| Rate for Payer: Humana ChoiceCare |
$1,501.22
|
| Rate for Payer: Humana Medicare |
$886.45
|
| Rate for Payer: Lucent All Commercial |
$886.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,564.32
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,303.60
|
| Rate for Payer: PHP All Commercial |
$1,318.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$677.87
|
| Rate for Payer: Sagamore Health Network All Products |
$1,341.84
|
| Rate for Payer: Signature Care EPO |
$1,442.65
|
| Rate for Payer: Signature Care PPO |
$1,529.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,477.41
|
| Rate for Payer: United Healthcare Commercial |
$1,369.65
|
| Rate for Payer: United Healthcare Medicare |
$573.58
|
|
|
HC LEAD PM CAP NOVUS 5076-52
|
Facility
OP
|
$1,738.13
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607339
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,616.46 |
| Rate for Payer: Aetna Commercial |
$1,466.98
|
| Rate for Payer: Aetna Medicare |
$573.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$573.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$998.21
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,086.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$659.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$630.94
|
| Rate for Payer: Cash Price |
$1,077.64
|
| Rate for Payer: Cash Price |
$1,077.64
|
| Rate for Payer: Centivo All Commercial |
$886.45
|
| Rate for Payer: Cigna All Commercial |
$1,500.01
|
| Rate for Payer: CORVEL All Commercial |
$1,616.46
|
| Rate for Payer: Coventry All Commercial |
$1,529.55
|
| Rate for Payer: Encore All Commercial |
$1,599.95
|
| Rate for Payer: Frontpath All Commercial |
$1,599.08
|
| Rate for Payer: Humana ChoiceCare |
$1,501.22
|
| Rate for Payer: Humana Medicare |
$886.45
|
| Rate for Payer: Lucent All Commercial |
$886.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,564.32
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,303.60
|
| Rate for Payer: PHP All Commercial |
$1,318.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$677.87
|
| Rate for Payer: Sagamore Health Network All Products |
$1,341.84
|
| Rate for Payer: Signature Care EPO |
$1,442.65
|
| Rate for Payer: Signature Care PPO |
$1,529.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,477.41
|
| Rate for Payer: United Healthcare Commercial |
$1,369.65
|
| Rate for Payer: United Healthcare Medicare |
$573.58
|
|
|
HC LEAD PM CAP NOVUS 5076-52
|
Facility
IP
|
$1,738.13
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607339
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,303.60 |
| Max. Negotiated Rate |
$1,616.46 |
| Rate for Payer: Aetna Commercial |
$1,501.74
|
| Rate for Payer: Cash Price |
$1,077.64
|
| Rate for Payer: Cigna All Commercial |
$1,500.01
|
| Rate for Payer: CORVEL All Commercial |
$1,616.46
|
| Rate for Payer: Coventry All Commercial |
$1,529.55
|
| Rate for Payer: Encore All Commercial |
$1,599.95
|
| Rate for Payer: Frontpath All Commercial |
$1,599.08
|
| Rate for Payer: Humana ChoiceCare |
$1,501.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,564.32
|
| Rate for Payer: PHCS All Commercial |
$1,303.60
|
| Rate for Payer: PHP All Commercial |
$1,318.20
|
| Rate for Payer: Sagamore Health Network All Products |
$1,341.84
|
| Rate for Payer: Signature Care EPO |
$1,442.65
|
| Rate for Payer: Signature Care PPO |
$1,529.55
|
| Rate for Payer: United Healthcare Commercial |
$1,369.65
|
|
|
HC LEAD PM CAP NOVUS 5076-58
|
Facility
OP
|
$1,738.13
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607340
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,616.46 |
| Rate for Payer: Aetna Commercial |
$1,466.98
|
| Rate for Payer: Aetna Medicare |
$573.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$573.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$998.21
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,086.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$659.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$630.94
|
| Rate for Payer: Cash Price |
$1,077.64
|
| Rate for Payer: Cash Price |
$1,077.64
|
| Rate for Payer: Centivo All Commercial |
$886.45
|
| Rate for Payer: Cigna All Commercial |
$1,500.01
|
| Rate for Payer: CORVEL All Commercial |
$1,616.46
|
| Rate for Payer: Coventry All Commercial |
$1,529.55
|
| Rate for Payer: Encore All Commercial |
$1,599.95
|
| Rate for Payer: Frontpath All Commercial |
$1,599.08
|
| Rate for Payer: Humana ChoiceCare |
$1,501.22
|
| Rate for Payer: Humana Medicare |
$886.45
|
| Rate for Payer: Lucent All Commercial |
$886.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,564.32
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,303.60
|
| Rate for Payer: PHP All Commercial |
$1,318.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$677.87
|
| Rate for Payer: Sagamore Health Network All Products |
$1,341.84
|
| Rate for Payer: Signature Care EPO |
$1,442.65
|
| Rate for Payer: Signature Care PPO |
$1,529.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,477.41
|
| Rate for Payer: United Healthcare Commercial |
$1,369.65
|
| Rate for Payer: United Healthcare Medicare |
$573.58
|
|
|
HC LEAD PM CAP NOVUS 5076-58
|
Facility
IP
|
$1,738.13
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607340
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,303.60 |
| Max. Negotiated Rate |
$1,616.46 |
| Rate for Payer: Aetna Commercial |
$1,501.74
|
| Rate for Payer: Cash Price |
$1,077.64
|
| Rate for Payer: Cigna All Commercial |
$1,500.01
|
| Rate for Payer: CORVEL All Commercial |
$1,616.46
|
| Rate for Payer: Coventry All Commercial |
$1,529.55
|
| Rate for Payer: Encore All Commercial |
$1,599.95
|
| Rate for Payer: Frontpath All Commercial |
$1,599.08
|
| Rate for Payer: Humana ChoiceCare |
$1,501.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,564.32
|
| Rate for Payer: PHCS All Commercial |
$1,303.60
|
| Rate for Payer: PHP All Commercial |
$1,318.20
|
| Rate for Payer: Sagamore Health Network All Products |
$1,341.84
|
| Rate for Payer: Signature Care EPO |
$1,442.65
|
| Rate for Payer: Signature Care PPO |
$1,529.55
|
| Rate for Payer: United Healthcare Commercial |
$1,369.65
|
|
|
HC LEAD PM FINELINE II STERX 4456
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607183
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,223.44 |
| Max. Negotiated Rate |
$1,517.06 |
| Rate for Payer: Aetna Commercial |
$1,409.40
|
| Rate for Payer: Cash Price |
$1,011.38
|
| Rate for Payer: Cigna All Commercial |
$1,407.77
|
| Rate for Payer: CORVEL All Commercial |
$1,517.06
|
| Rate for Payer: Coventry All Commercial |
$1,435.50
|
| Rate for Payer: Encore All Commercial |
$1,501.57
|
| Rate for Payer: Frontpath All Commercial |
$1,500.75
|
| Rate for Payer: Humana ChoiceCare |
$1,408.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,468.12
|
| Rate for Payer: PHCS All Commercial |
$1,223.44
|
| Rate for Payer: PHP All Commercial |
$1,237.14
|
| Rate for Payer: Sagamore Health Network All Products |
$1,259.32
|
| Rate for Payer: Signature Care EPO |
$1,353.94
|
| Rate for Payer: Signature Care PPO |
$1,435.50
|
| Rate for Payer: United Healthcare Commercial |
$1,285.42
|
|
|
HC LEAD PM FINELINE II STERX 4456
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607183
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,517.06 |
| Rate for Payer: Aetna Commercial |
$1,376.78
|
| Rate for Payer: Aetna Medicare |
$538.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$538.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$936.83
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,019.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$619.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$592.14
|
| Rate for Payer: Cash Price |
$1,011.38
|
| Rate for Payer: Cash Price |
$1,011.38
|
| Rate for Payer: Centivo All Commercial |
$831.94
|
| Rate for Payer: Cigna All Commercial |
$1,407.77
|
| Rate for Payer: CORVEL All Commercial |
$1,517.06
|
| Rate for Payer: Coventry All Commercial |
$1,435.50
|
| Rate for Payer: Encore All Commercial |
$1,501.57
|
| Rate for Payer: Frontpath All Commercial |
$1,500.75
|
| Rate for Payer: Humana ChoiceCare |
$1,408.91
|
| Rate for Payer: Humana Medicare |
$831.94
|
| Rate for Payer: Lucent All Commercial |
$831.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,468.12
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,223.44
|
| Rate for Payer: PHP All Commercial |
$1,237.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$636.19
|
| Rate for Payer: Sagamore Health Network All Products |
$1,259.32
|
| Rate for Payer: Signature Care EPO |
$1,353.94
|
| Rate for Payer: Signature Care PPO |
$1,435.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,386.56
|
| Rate for Payer: United Healthcare Commercial |
$1,285.42
|
| Rate for Payer: United Healthcare Medicare |
$538.31
|
|
|
HC LEAD PM FINELINE II STERX 4457
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607184
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,517.06 |
| Rate for Payer: Aetna Commercial |
$1,376.78
|
| Rate for Payer: Aetna Medicare |
$538.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$538.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$936.83
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,019.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$619.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$592.14
|
| Rate for Payer: Cash Price |
$1,011.38
|
| Rate for Payer: Cash Price |
$1,011.38
|
| Rate for Payer: Centivo All Commercial |
$831.94
|
| Rate for Payer: Cigna All Commercial |
$1,407.77
|
| Rate for Payer: CORVEL All Commercial |
$1,517.06
|
| Rate for Payer: Coventry All Commercial |
$1,435.50
|
| Rate for Payer: Encore All Commercial |
$1,501.57
|
| Rate for Payer: Frontpath All Commercial |
$1,500.75
|
| Rate for Payer: Humana ChoiceCare |
$1,408.91
|
| Rate for Payer: Humana Medicare |
$831.94
|
| Rate for Payer: Lucent All Commercial |
$831.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,468.12
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,223.44
|
| Rate for Payer: PHP All Commercial |
$1,237.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$636.19
|
| Rate for Payer: Sagamore Health Network All Products |
$1,259.32
|
| Rate for Payer: Signature Care EPO |
$1,353.94
|
| Rate for Payer: Signature Care PPO |
$1,435.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,386.56
|
| Rate for Payer: United Healthcare Commercial |
$1,285.42
|
| Rate for Payer: United Healthcare Medicare |
$538.31
|
|
|
HC LEAD PM FINELINE II STERX 4457
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607184
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,223.44 |
| Max. Negotiated Rate |
$1,517.06 |
| Rate for Payer: Aetna Commercial |
$1,409.40
|
| Rate for Payer: Cash Price |
$1,011.38
|
| Rate for Payer: Cigna All Commercial |
$1,407.77
|
| Rate for Payer: CORVEL All Commercial |
$1,517.06
|
| Rate for Payer: Coventry All Commercial |
$1,435.50
|
| Rate for Payer: Encore All Commercial |
$1,501.57
|
| Rate for Payer: Frontpath All Commercial |
$1,500.75
|
| Rate for Payer: Humana ChoiceCare |
$1,408.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,468.12
|
| Rate for Payer: PHCS All Commercial |
$1,223.44
|
| Rate for Payer: PHP All Commercial |
$1,237.14
|
| Rate for Payer: Sagamore Health Network All Products |
$1,259.32
|
| Rate for Payer: Signature Care EPO |
$1,353.94
|
| Rate for Payer: Signature Care PPO |
$1,435.50
|
| Rate for Payer: United Healthcare Commercial |
$1,285.42
|
|
|
HC LEAD PM FINELINE II STERX 4458
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607185
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,517.06 |
| Rate for Payer: Aetna Commercial |
$1,376.78
|
| Rate for Payer: Aetna Medicare |
$538.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$538.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$936.83
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,019.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$619.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$592.14
|
| Rate for Payer: Cash Price |
$1,011.38
|
| Rate for Payer: Cash Price |
$1,011.38
|
| Rate for Payer: Centivo All Commercial |
$831.94
|
| Rate for Payer: Cigna All Commercial |
$1,407.77
|
| Rate for Payer: CORVEL All Commercial |
$1,517.06
|
| Rate for Payer: Coventry All Commercial |
$1,435.50
|
| Rate for Payer: Encore All Commercial |
$1,501.57
|
| Rate for Payer: Frontpath All Commercial |
$1,500.75
|
| Rate for Payer: Humana ChoiceCare |
$1,408.91
|
| Rate for Payer: Humana Medicare |
$831.94
|
| Rate for Payer: Lucent All Commercial |
$831.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,468.12
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,223.44
|
| Rate for Payer: PHP All Commercial |
$1,237.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$636.19
|
| Rate for Payer: Sagamore Health Network All Products |
$1,259.32
|
| Rate for Payer: Signature Care EPO |
$1,353.94
|
| Rate for Payer: Signature Care PPO |
$1,435.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,386.56
|
| Rate for Payer: United Healthcare Commercial |
$1,285.42
|
| Rate for Payer: United Healthcare Medicare |
$538.31
|
|
|
HC LEAD PM FINELINE II STERX 4458
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607185
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,223.44 |
| Max. Negotiated Rate |
$1,517.06 |
| Rate for Payer: Aetna Commercial |
$1,409.40
|
| Rate for Payer: Cash Price |
$1,011.38
|
| Rate for Payer: Cigna All Commercial |
$1,407.77
|
| Rate for Payer: CORVEL All Commercial |
$1,517.06
|
| Rate for Payer: Coventry All Commercial |
$1,435.50
|
| Rate for Payer: Encore All Commercial |
$1,501.57
|
| Rate for Payer: Frontpath All Commercial |
$1,500.75
|
| Rate for Payer: Humana ChoiceCare |
$1,408.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,468.12
|
| Rate for Payer: PHCS All Commercial |
$1,223.44
|
| Rate for Payer: PHP All Commercial |
$1,237.14
|
| Rate for Payer: Sagamore Health Network All Products |
$1,259.32
|
| Rate for Payer: Signature Care EPO |
$1,353.94
|
| Rate for Payer: Signature Care PPO |
$1,435.50
|
| Rate for Payer: United Healthcare Commercial |
$1,285.42
|
|
|
HC LEAD PM FINELINE II STERX 4459
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607186
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,517.06 |
| Rate for Payer: Aetna Commercial |
$1,376.78
|
| Rate for Payer: Aetna Medicare |
$538.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$538.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$936.83
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,019.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$619.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$592.14
|
| Rate for Payer: Cash Price |
$1,011.38
|
| Rate for Payer: Cash Price |
$1,011.38
|
| Rate for Payer: Centivo All Commercial |
$831.94
|
| Rate for Payer: Cigna All Commercial |
$1,407.77
|
| Rate for Payer: CORVEL All Commercial |
$1,517.06
|
| Rate for Payer: Coventry All Commercial |
$1,435.50
|
| Rate for Payer: Encore All Commercial |
$1,501.57
|
| Rate for Payer: Frontpath All Commercial |
$1,500.75
|
| Rate for Payer: Humana ChoiceCare |
$1,408.91
|
| Rate for Payer: Humana Medicare |
$831.94
|
| Rate for Payer: Lucent All Commercial |
$831.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,468.12
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,223.44
|
| Rate for Payer: PHP All Commercial |
$1,237.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$636.19
|
| Rate for Payer: Sagamore Health Network All Products |
$1,259.32
|
| Rate for Payer: Signature Care EPO |
$1,353.94
|
| Rate for Payer: Signature Care PPO |
$1,435.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,386.56
|
| Rate for Payer: United Healthcare Commercial |
$1,285.42
|
| Rate for Payer: United Healthcare Medicare |
$538.31
|
|
|
HC LEAD PM FINELINE II STERX 4459
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607186
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,223.44 |
| Max. Negotiated Rate |
$1,517.06 |
| Rate for Payer: Aetna Commercial |
$1,409.40
|
| Rate for Payer: Cash Price |
$1,011.38
|
| Rate for Payer: Cigna All Commercial |
$1,407.77
|
| Rate for Payer: CORVEL All Commercial |
$1,517.06
|
| Rate for Payer: Coventry All Commercial |
$1,435.50
|
| Rate for Payer: Encore All Commercial |
$1,501.57
|
| Rate for Payer: Frontpath All Commercial |
$1,500.75
|
| Rate for Payer: Humana ChoiceCare |
$1,408.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,468.12
|
| Rate for Payer: PHCS All Commercial |
$1,223.44
|
| Rate for Payer: PHP All Commercial |
$1,237.14
|
| Rate for Payer: Sagamore Health Network All Products |
$1,259.32
|
| Rate for Payer: Signature Care EPO |
$1,353.94
|
| Rate for Payer: Signature Care PPO |
$1,435.50
|
| Rate for Payer: United Healthcare Commercial |
$1,285.42
|
|
|
HC LEAD PM FINELINE II STERX 4469
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607189
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,517.06 |
| Rate for Payer: Aetna Commercial |
$1,376.78
|
| Rate for Payer: Aetna Medicare |
$538.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$538.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$936.83
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,019.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$619.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$592.14
|
| Rate for Payer: Cash Price |
$1,011.38
|
| Rate for Payer: Cash Price |
$1,011.38
|
| Rate for Payer: Centivo All Commercial |
$831.94
|
| Rate for Payer: Cigna All Commercial |
$1,407.77
|
| Rate for Payer: CORVEL All Commercial |
$1,517.06
|
| Rate for Payer: Coventry All Commercial |
$1,435.50
|
| Rate for Payer: Encore All Commercial |
$1,501.57
|
| Rate for Payer: Frontpath All Commercial |
$1,500.75
|
| Rate for Payer: Humana ChoiceCare |
$1,408.91
|
| Rate for Payer: Humana Medicare |
$831.94
|
| Rate for Payer: Lucent All Commercial |
$831.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,468.12
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,223.44
|
| Rate for Payer: PHP All Commercial |
$1,237.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$636.19
|
| Rate for Payer: Sagamore Health Network All Products |
$1,259.32
|
| Rate for Payer: Signature Care EPO |
$1,353.94
|
| Rate for Payer: Signature Care PPO |
$1,435.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,386.56
|
| Rate for Payer: United Healthcare Commercial |
$1,285.42
|
| Rate for Payer: United Healthcare Medicare |
$538.31
|
|
|
HC LEAD PM FINELINE II STERX 4469
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607189
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,223.44 |
| Max. Negotiated Rate |
$1,517.06 |
| Rate for Payer: Aetna Commercial |
$1,409.40
|
| Rate for Payer: Cash Price |
$1,011.38
|
| Rate for Payer: Cigna All Commercial |
$1,407.77
|
| Rate for Payer: CORVEL All Commercial |
$1,517.06
|
| Rate for Payer: Coventry All Commercial |
$1,435.50
|
| Rate for Payer: Encore All Commercial |
$1,501.57
|
| Rate for Payer: Frontpath All Commercial |
$1,500.75
|
| Rate for Payer: Humana ChoiceCare |
$1,408.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,468.12
|
| Rate for Payer: PHCS All Commercial |
$1,223.44
|
| Rate for Payer: PHP All Commercial |
$1,237.14
|
| Rate for Payer: Sagamore Health Network All Products |
$1,259.32
|
| Rate for Payer: Signature Care EPO |
$1,353.94
|
| Rate for Payer: Signature Care PPO |
$1,435.50
|
| Rate for Payer: United Healthcare Commercial |
$1,285.42
|
|
|
HC LEAD PM FINELINE II STERX 4470
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607190
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,223.44 |
| Max. Negotiated Rate |
$1,517.06 |
| Rate for Payer: Aetna Commercial |
$1,409.40
|
| Rate for Payer: Cash Price |
$1,011.38
|
| Rate for Payer: Cigna All Commercial |
$1,407.77
|
| Rate for Payer: CORVEL All Commercial |
$1,517.06
|
| Rate for Payer: Coventry All Commercial |
$1,435.50
|
| Rate for Payer: Encore All Commercial |
$1,501.57
|
| Rate for Payer: Frontpath All Commercial |
$1,500.75
|
| Rate for Payer: Humana ChoiceCare |
$1,408.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,468.12
|
| Rate for Payer: PHCS All Commercial |
$1,223.44
|
| Rate for Payer: PHP All Commercial |
$1,237.14
|
| Rate for Payer: Sagamore Health Network All Products |
$1,259.32
|
| Rate for Payer: Signature Care EPO |
$1,353.94
|
| Rate for Payer: Signature Care PPO |
$1,435.50
|
| Rate for Payer: United Healthcare Commercial |
$1,285.42
|
|
|
HC LEAD PM FINELINE II STERX 4470
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607190
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,517.06 |
| Rate for Payer: Aetna Commercial |
$1,376.78
|
| Rate for Payer: Aetna Medicare |
$538.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$538.31
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$936.83
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,019.69
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$619.06
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$592.14
|
| Rate for Payer: Cash Price |
$1,011.38
|
| Rate for Payer: Cash Price |
$1,011.38
|
| Rate for Payer: Centivo All Commercial |
$831.94
|
| Rate for Payer: Cigna All Commercial |
$1,407.77
|
| Rate for Payer: CORVEL All Commercial |
$1,517.06
|
| Rate for Payer: Coventry All Commercial |
$1,435.50
|
| Rate for Payer: Encore All Commercial |
$1,501.57
|
| Rate for Payer: Frontpath All Commercial |
$1,500.75
|
| Rate for Payer: Humana ChoiceCare |
$1,408.91
|
| Rate for Payer: Humana Medicare |
$831.94
|
| Rate for Payer: Lucent All Commercial |
$831.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,468.12
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,223.44
|
| Rate for Payer: PHP All Commercial |
$1,237.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$636.19
|
| Rate for Payer: Sagamore Health Network All Products |
$1,259.32
|
| Rate for Payer: Signature Care EPO |
$1,353.94
|
| Rate for Payer: Signature Care PPO |
$1,435.50
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,386.56
|
| Rate for Payer: United Healthcare Commercial |
$1,285.42
|
| Rate for Payer: United Healthcare Medicare |
$538.31
|
|
