|
HC LEAD PM FINELINE II STERX 4471
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607191
|
|
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 4471
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607191
|
|
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 4472
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607192
|
|
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 4472
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607192
|
|
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 4473
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607193
|
|
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 4473
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607193
|
|
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 4474
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607194
|
|
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 4474
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607194
|
|
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 4479
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607187
|
|
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 4479
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607187
|
|
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 4480
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607188
|
|
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 4480
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607188
|
|
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 FLEXTEND 4086
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607195
|
|
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 FLEXTEND 4086
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607195
|
|
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 FLEXTEND 4087
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607196
|
|
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 FLEXTEND 4087
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607196
|
|
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 FLEXTEND 4088
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607197
|
|
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 FLEXTEND 4088
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607197
|
|
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 INGEVITY + 4469
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607173
|
|
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 INGEVITY + 4469
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607173
|
|
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 INGEVITY + 4470
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607174
|
|
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 INGEVITY + 4470
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607174
|
|
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 INGEVITY + 4471
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607175
|
|
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 INGEVITY + 4471
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607175
|
|
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 INGEVITY 7731
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607176
|
|
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
|
|
