|
HC LEAD PM INGEVITY 7731
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607176
|
|
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 7732
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607177
|
|
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 7732
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607177
|
|
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 7735
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607178
|
|
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 7735
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607178
|
|
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 7736
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607179
|
|
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 7736
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607179
|
|
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 7740
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607180
|
|
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 7740
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607180
|
|
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 7741
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607181
|
|
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 7741
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607181
|
|
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 7742
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607182
|
|
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 7742
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607182
|
|
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 MYOCARDIAL 4046
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607198
|
|
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 MYOCARDIAL 4046
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607198
|
|
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 MYOCARDIAL 4047
|
Facility
IP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607199
|
|
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 MYOCARDIAL 4047
|
Facility
OP
|
$1,631.25
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607199
|
|
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 TENDRIL STS 46CM MRI
|
Facility
IP
|
$1,595.70
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607547
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,196.78 |
| Max. Negotiated Rate |
$1,484.00 |
| Rate for Payer: Aetna Commercial |
$1,378.68
|
| Rate for Payer: Cash Price |
$989.33
|
| Rate for Payer: Cigna All Commercial |
$1,377.09
|
| Rate for Payer: CORVEL All Commercial |
$1,484.00
|
| Rate for Payer: Coventry All Commercial |
$1,404.22
|
| Rate for Payer: Encore All Commercial |
$1,468.84
|
| Rate for Payer: Frontpath All Commercial |
$1,468.04
|
| Rate for Payer: Humana ChoiceCare |
$1,378.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,436.13
|
| Rate for Payer: PHCS All Commercial |
$1,196.78
|
| Rate for Payer: PHP All Commercial |
$1,210.18
|
| Rate for Payer: Sagamore Health Network All Products |
$1,231.88
|
| Rate for Payer: Signature Care EPO |
$1,324.43
|
| Rate for Payer: Signature Care PPO |
$1,404.22
|
| Rate for Payer: United Healthcare Commercial |
$1,257.41
|
|
|
HC LEAD PM TENDRIL STS 46CM MRI
|
Facility
OP
|
$1,595.70
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607547
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,484.00 |
| Rate for Payer: Aetna Commercial |
$1,346.77
|
| Rate for Payer: Aetna Medicare |
$526.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$526.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$916.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$997.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$605.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$579.24
|
| Rate for Payer: Cash Price |
$989.33
|
| Rate for Payer: Cash Price |
$989.33
|
| Rate for Payer: Centivo All Commercial |
$813.81
|
| Rate for Payer: Cigna All Commercial |
$1,377.09
|
| Rate for Payer: CORVEL All Commercial |
$1,484.00
|
| Rate for Payer: Coventry All Commercial |
$1,404.22
|
| Rate for Payer: Encore All Commercial |
$1,468.84
|
| Rate for Payer: Frontpath All Commercial |
$1,468.04
|
| Rate for Payer: Humana ChoiceCare |
$1,378.21
|
| Rate for Payer: Humana Medicare |
$813.81
|
| Rate for Payer: Lucent All Commercial |
$813.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,436.13
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,196.78
|
| Rate for Payer: PHP All Commercial |
$1,210.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$622.32
|
| Rate for Payer: Sagamore Health Network All Products |
$1,231.88
|
| Rate for Payer: Signature Care EPO |
$1,324.43
|
| Rate for Payer: Signature Care PPO |
$1,404.22
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,356.34
|
| Rate for Payer: United Healthcare Commercial |
$1,257.41
|
| Rate for Payer: United Healthcare Medicare |
$526.58
|
|
|
HC LEAD PM TENDRIL STS 52CM MRI
|
Facility
IP
|
$1,595.70
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607548
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,196.78 |
| Max. Negotiated Rate |
$1,484.00 |
| Rate for Payer: Aetna Commercial |
$1,378.68
|
| Rate for Payer: Cash Price |
$989.33
|
| Rate for Payer: Cigna All Commercial |
$1,377.09
|
| Rate for Payer: CORVEL All Commercial |
$1,484.00
|
| Rate for Payer: Coventry All Commercial |
$1,404.22
|
| Rate for Payer: Encore All Commercial |
$1,468.84
|
| Rate for Payer: Frontpath All Commercial |
$1,468.04
|
| Rate for Payer: Humana ChoiceCare |
$1,378.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,436.13
|
| Rate for Payer: PHCS All Commercial |
$1,196.78
|
| Rate for Payer: PHP All Commercial |
$1,210.18
|
| Rate for Payer: Sagamore Health Network All Products |
$1,231.88
|
| Rate for Payer: Signature Care EPO |
$1,324.43
|
| Rate for Payer: Signature Care PPO |
$1,404.22
|
| Rate for Payer: United Healthcare Commercial |
$1,257.41
|
|
|
HC LEAD PM TENDRIL STS 52CM MRI
|
Facility
OP
|
$1,595.70
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607548
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,484.00 |
| Rate for Payer: Aetna Commercial |
$1,346.77
|
| Rate for Payer: Aetna Medicare |
$526.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$526.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$916.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$997.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$605.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$579.24
|
| Rate for Payer: Cash Price |
$989.33
|
| Rate for Payer: Cash Price |
$989.33
|
| Rate for Payer: Centivo All Commercial |
$813.81
|
| Rate for Payer: Cigna All Commercial |
$1,377.09
|
| Rate for Payer: CORVEL All Commercial |
$1,484.00
|
| Rate for Payer: Coventry All Commercial |
$1,404.22
|
| Rate for Payer: Encore All Commercial |
$1,468.84
|
| Rate for Payer: Frontpath All Commercial |
$1,468.04
|
| Rate for Payer: Humana ChoiceCare |
$1,378.21
|
| Rate for Payer: Humana Medicare |
$813.81
|
| Rate for Payer: Lucent All Commercial |
$813.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,436.13
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,196.78
|
| Rate for Payer: PHP All Commercial |
$1,210.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$622.32
|
| Rate for Payer: Sagamore Health Network All Products |
$1,231.88
|
| Rate for Payer: Signature Care EPO |
$1,324.43
|
| Rate for Payer: Signature Care PPO |
$1,404.22
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,356.34
|
| Rate for Payer: United Healthcare Commercial |
$1,257.41
|
| Rate for Payer: United Healthcare Medicare |
$526.58
|
|
|
HC LEAD PM TENDRIL STS 58CM MRI
|
Facility
IP
|
$1,595.70
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607549
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,196.78 |
| Max. Negotiated Rate |
$1,484.00 |
| Rate for Payer: Aetna Commercial |
$1,378.68
|
| Rate for Payer: Cash Price |
$989.33
|
| Rate for Payer: Cigna All Commercial |
$1,377.09
|
| Rate for Payer: CORVEL All Commercial |
$1,484.00
|
| Rate for Payer: Coventry All Commercial |
$1,404.22
|
| Rate for Payer: Encore All Commercial |
$1,468.84
|
| Rate for Payer: Frontpath All Commercial |
$1,468.04
|
| Rate for Payer: Humana ChoiceCare |
$1,378.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,436.13
|
| Rate for Payer: PHCS All Commercial |
$1,196.78
|
| Rate for Payer: PHP All Commercial |
$1,210.18
|
| Rate for Payer: Sagamore Health Network All Products |
$1,231.88
|
| Rate for Payer: Signature Care EPO |
$1,324.43
|
| Rate for Payer: Signature Care PPO |
$1,404.22
|
| Rate for Payer: United Healthcare Commercial |
$1,257.41
|
|
|
HC LEAD PM TENDRIL STS 58CM MRI
|
Facility
OP
|
$1,595.70
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607549
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,484.00 |
| Rate for Payer: Aetna Commercial |
$1,346.77
|
| Rate for Payer: Aetna Medicare |
$526.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$526.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$916.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$997.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$605.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$579.24
|
| Rate for Payer: Cash Price |
$989.33
|
| Rate for Payer: Cash Price |
$989.33
|
| Rate for Payer: Centivo All Commercial |
$813.81
|
| Rate for Payer: Cigna All Commercial |
$1,377.09
|
| Rate for Payer: CORVEL All Commercial |
$1,484.00
|
| Rate for Payer: Coventry All Commercial |
$1,404.22
|
| Rate for Payer: Encore All Commercial |
$1,468.84
|
| Rate for Payer: Frontpath All Commercial |
$1,468.04
|
| Rate for Payer: Humana ChoiceCare |
$1,378.21
|
| Rate for Payer: Humana Medicare |
$813.81
|
| Rate for Payer: Lucent All Commercial |
$813.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,436.13
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,196.78
|
| Rate for Payer: PHP All Commercial |
$1,210.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$622.32
|
| Rate for Payer: Sagamore Health Network All Products |
$1,231.88
|
| Rate for Payer: Signature Care EPO |
$1,324.43
|
| Rate for Payer: Signature Care PPO |
$1,404.22
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,356.34
|
| Rate for Payer: United Healthcare Commercial |
$1,257.41
|
| Rate for Payer: United Healthcare Medicare |
$526.58
|
|
|
HC LEAD PM TENDRIL STS 65CM
|
Facility
IP
|
$1,595.70
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607550
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,196.78 |
| Max. Negotiated Rate |
$1,484.00 |
| Rate for Payer: Aetna Commercial |
$1,378.68
|
| Rate for Payer: Cash Price |
$989.33
|
| Rate for Payer: Cigna All Commercial |
$1,377.09
|
| Rate for Payer: CORVEL All Commercial |
$1,484.00
|
| Rate for Payer: Coventry All Commercial |
$1,404.22
|
| Rate for Payer: Encore All Commercial |
$1,468.84
|
| Rate for Payer: Frontpath All Commercial |
$1,468.04
|
| Rate for Payer: Humana ChoiceCare |
$1,378.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,436.13
|
| Rate for Payer: PHCS All Commercial |
$1,196.78
|
| Rate for Payer: PHP All Commercial |
$1,210.18
|
| Rate for Payer: Sagamore Health Network All Products |
$1,231.88
|
| Rate for Payer: Signature Care EPO |
$1,324.43
|
| Rate for Payer: Signature Care PPO |
$1,404.22
|
| Rate for Payer: United Healthcare Commercial |
$1,257.41
|
|
|
HC LEAD PM TENDRIL STS 65CM
|
Facility
OP
|
$1,595.70
|
|
|
Service Code
|
CPT C1898
|
| Hospital Charge Code |
41607550
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,484.00 |
| Rate for Payer: Aetna Commercial |
$1,346.77
|
| Rate for Payer: Aetna Medicare |
$526.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$526.58
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$916.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$997.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$605.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$579.24
|
| Rate for Payer: Cash Price |
$989.33
|
| Rate for Payer: Cash Price |
$989.33
|
| Rate for Payer: Centivo All Commercial |
$813.81
|
| Rate for Payer: Cigna All Commercial |
$1,377.09
|
| Rate for Payer: CORVEL All Commercial |
$1,484.00
|
| Rate for Payer: Coventry All Commercial |
$1,404.22
|
| Rate for Payer: Encore All Commercial |
$1,468.84
|
| Rate for Payer: Frontpath All Commercial |
$1,468.04
|
| Rate for Payer: Humana ChoiceCare |
$1,378.21
|
| Rate for Payer: Humana Medicare |
$813.81
|
| Rate for Payer: Lucent All Commercial |
$813.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,436.13
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,196.78
|
| Rate for Payer: PHP All Commercial |
$1,210.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$622.32
|
| Rate for Payer: Sagamore Health Network All Products |
$1,231.88
|
| Rate for Payer: Signature Care EPO |
$1,324.43
|
| Rate for Payer: Signature Care PPO |
$1,404.22
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,356.34
|
| Rate for Payer: United Healthcare Commercial |
$1,257.41
|
| Rate for Payer: United Healthcare Medicare |
$526.58
|
|
