|
HC MESH DULEX 18X24
|
Facility
IP
|
$3,848.40
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41602327
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,886.30 |
| Max. Negotiated Rate |
$3,579.01 |
| Rate for Payer: Aetna Commercial |
$3,325.02
|
| Rate for Payer: Cash Price |
$2,386.01
|
| Rate for Payer: Cigna All Commercial |
$3,321.17
|
| Rate for Payer: CORVEL All Commercial |
$3,579.01
|
| Rate for Payer: Coventry All Commercial |
$3,386.59
|
| Rate for Payer: Encore All Commercial |
$3,542.45
|
| Rate for Payer: Frontpath All Commercial |
$3,540.53
|
| Rate for Payer: Humana ChoiceCare |
$3,323.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,463.56
|
| Rate for Payer: PHCS All Commercial |
$2,886.30
|
| Rate for Payer: PHP All Commercial |
$2,918.63
|
| Rate for Payer: Sagamore Health Network All Products |
$2,970.96
|
| Rate for Payer: Signature Care EPO |
$3,194.17
|
| Rate for Payer: Signature Care PPO |
$3,386.59
|
| Rate for Payer: United Healthcare Commercial |
$3,032.54
|
|
|
HC MESH DULEX 18X24
|
Facility
OP
|
$3,848.40
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41602327
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,579.01 |
| Rate for Payer: Aetna Commercial |
$3,248.05
|
| Rate for Payer: Aetna Medicare |
$1,269.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,269.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,210.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,405.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,460.47
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,396.97
|
| Rate for Payer: Cash Price |
$2,386.01
|
| Rate for Payer: Cash Price |
$2,386.01
|
| Rate for Payer: Centivo All Commercial |
$1,962.68
|
| Rate for Payer: Cigna All Commercial |
$3,321.17
|
| Rate for Payer: CORVEL All Commercial |
$3,579.01
|
| Rate for Payer: Coventry All Commercial |
$3,386.59
|
| Rate for Payer: Encore All Commercial |
$3,542.45
|
| Rate for Payer: Frontpath All Commercial |
$3,540.53
|
| Rate for Payer: Humana ChoiceCare |
$3,323.86
|
| Rate for Payer: Humana Medicare |
$1,962.68
|
| Rate for Payer: Lucent All Commercial |
$1,962.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,463.56
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,886.30
|
| Rate for Payer: PHP All Commercial |
$2,918.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,500.88
|
| Rate for Payer: Sagamore Health Network All Products |
$2,970.96
|
| Rate for Payer: Signature Care EPO |
$3,194.17
|
| Rate for Payer: Signature Care PPO |
$3,386.59
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,271.14
|
| Rate for Payer: United Healthcare Commercial |
$3,032.54
|
| Rate for Payer: United Healthcare Medicare |
$1,269.97
|
|
|
HC MESH DULEX 20X30
|
Facility
OP
|
$5,331.60
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41602328
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$4,958.39 |
| Rate for Payer: Aetna Commercial |
$4,499.87
|
| Rate for Payer: Aetna Medicare |
$1,759.43
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,759.43
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,061.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,332.78
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,023.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,935.37
|
| Rate for Payer: Cash Price |
$3,305.59
|
| Rate for Payer: Cash Price |
$3,305.59
|
| Rate for Payer: Centivo All Commercial |
$2,719.12
|
| Rate for Payer: Cigna All Commercial |
$4,601.17
|
| Rate for Payer: CORVEL All Commercial |
$4,958.39
|
| Rate for Payer: Coventry All Commercial |
$4,691.81
|
| Rate for Payer: Encore All Commercial |
$4,907.74
|
| Rate for Payer: Frontpath All Commercial |
$4,905.07
|
| Rate for Payer: Humana ChoiceCare |
$4,604.90
|
| Rate for Payer: Humana Medicare |
$2,719.12
|
| Rate for Payer: Lucent All Commercial |
$2,719.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,798.44
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,998.70
|
| Rate for Payer: PHP All Commercial |
$4,043.49
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,079.32
|
| Rate for Payer: Sagamore Health Network All Products |
$4,116.00
|
| Rate for Payer: Signature Care EPO |
$4,425.23
|
| Rate for Payer: Signature Care PPO |
$4,691.81
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,531.86
|
| Rate for Payer: United Healthcare Commercial |
$4,201.30
|
| Rate for Payer: United Healthcare Medicare |
$1,759.43
|
|
|
HC MESH DULEX 20X30
|
Facility
IP
|
$5,331.60
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41602328
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,998.70 |
| Max. Negotiated Rate |
$4,958.39 |
| Rate for Payer: Aetna Commercial |
$4,606.50
|
| Rate for Payer: Cash Price |
$3,305.59
|
| Rate for Payer: Cigna All Commercial |
$4,601.17
|
| Rate for Payer: CORVEL All Commercial |
$4,958.39
|
| Rate for Payer: Coventry All Commercial |
$4,691.81
|
| Rate for Payer: Encore All Commercial |
$4,907.74
|
| Rate for Payer: Frontpath All Commercial |
$4,905.07
|
| Rate for Payer: Humana ChoiceCare |
$4,604.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,798.44
|
| Rate for Payer: PHCS All Commercial |
$3,998.70
|
| Rate for Payer: PHP All Commercial |
$4,043.49
|
| Rate for Payer: Sagamore Health Network All Products |
$4,116.00
|
| Rate for Payer: Signature Care EPO |
$4,425.23
|
| Rate for Payer: Signature Care PPO |
$4,691.81
|
| Rate for Payer: United Healthcare Commercial |
$4,201.30
|
|
|
HC MESH DULEX 26X34
|
Facility
IP
|
$7,016.40
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41602329
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,262.30 |
| Max. Negotiated Rate |
$6,525.25 |
| Rate for Payer: Aetna Commercial |
$6,062.17
|
| Rate for Payer: Cash Price |
$4,350.17
|
| Rate for Payer: Cigna All Commercial |
$6,055.15
|
| Rate for Payer: CORVEL All Commercial |
$6,525.25
|
| Rate for Payer: Coventry All Commercial |
$6,174.43
|
| Rate for Payer: Encore All Commercial |
$6,458.60
|
| Rate for Payer: Frontpath All Commercial |
$6,455.09
|
| Rate for Payer: Humana ChoiceCare |
$6,060.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,314.76
|
| Rate for Payer: PHCS All Commercial |
$5,262.30
|
| Rate for Payer: PHP All Commercial |
$5,321.24
|
| Rate for Payer: Sagamore Health Network All Products |
$5,416.66
|
| Rate for Payer: Signature Care EPO |
$5,823.61
|
| Rate for Payer: Signature Care PPO |
$6,174.43
|
| Rate for Payer: United Healthcare Commercial |
$5,528.92
|
|
|
HC MESH DULEX 26X34
|
Facility
OP
|
$7,016.40
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41602329
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$6,525.25 |
| Rate for Payer: Aetna Commercial |
$5,921.84
|
| Rate for Payer: Aetna Medicare |
$2,315.41
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,315.41
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,029.52
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,385.95
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,662.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,546.95
|
| Rate for Payer: Cash Price |
$4,350.17
|
| Rate for Payer: Cash Price |
$4,350.17
|
| Rate for Payer: Centivo All Commercial |
$3,578.36
|
| Rate for Payer: Cigna All Commercial |
$6,055.15
|
| Rate for Payer: CORVEL All Commercial |
$6,525.25
|
| Rate for Payer: Coventry All Commercial |
$6,174.43
|
| Rate for Payer: Encore All Commercial |
$6,458.60
|
| Rate for Payer: Frontpath All Commercial |
$6,455.09
|
| Rate for Payer: Humana ChoiceCare |
$6,060.06
|
| Rate for Payer: Humana Medicare |
$3,578.36
|
| Rate for Payer: Lucent All Commercial |
$3,578.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,314.76
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,262.30
|
| Rate for Payer: PHP All Commercial |
$5,321.24
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,736.40
|
| Rate for Payer: Sagamore Health Network All Products |
$5,416.66
|
| Rate for Payer: Signature Care EPO |
$5,823.61
|
| Rate for Payer: Signature Care PPO |
$6,174.43
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,963.94
|
| Rate for Payer: United Healthcare Commercial |
$5,528.92
|
| Rate for Payer: United Healthcare Medicare |
$2,315.41
|
|
|
HC MESH DULEX OVAL 10X15
|
Facility
OP
|
$1,895.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41602325
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,762.35 |
| Rate for Payer: Aetna Commercial |
$1,599.38
|
| Rate for Payer: Aetna Medicare |
$625.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$625.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,088.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,184.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$719.15
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$687.88
|
| Rate for Payer: Cash Price |
$1,174.90
|
| Rate for Payer: Cash Price |
$1,174.90
|
| Rate for Payer: Centivo All Commercial |
$966.45
|
| Rate for Payer: Cigna All Commercial |
$1,635.38
|
| Rate for Payer: CORVEL All Commercial |
$1,762.35
|
| Rate for Payer: Coventry All Commercial |
$1,667.60
|
| Rate for Payer: Encore All Commercial |
$1,744.35
|
| Rate for Payer: Frontpath All Commercial |
$1,743.40
|
| Rate for Payer: Humana ChoiceCare |
$1,636.71
|
| Rate for Payer: Humana Medicare |
$966.45
|
| Rate for Payer: Lucent All Commercial |
$966.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,705.50
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,421.25
|
| Rate for Payer: PHP All Commercial |
$1,437.17
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$739.05
|
| Rate for Payer: Sagamore Health Network All Products |
$1,462.94
|
| Rate for Payer: Signature Care EPO |
$1,572.85
|
| Rate for Payer: Signature Care PPO |
$1,667.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,610.75
|
| Rate for Payer: United Healthcare Commercial |
$1,493.26
|
| Rate for Payer: United Healthcare Medicare |
$625.35
|
|
|
HC MESH DULEX OVAL 10X15
|
Facility
IP
|
$1,895.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41602325
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,421.25 |
| Max. Negotiated Rate |
$1,762.35 |
| Rate for Payer: Aetna Commercial |
$1,637.28
|
| Rate for Payer: Cash Price |
$1,174.90
|
| Rate for Payer: Cigna All Commercial |
$1,635.38
|
| Rate for Payer: CORVEL All Commercial |
$1,762.35
|
| Rate for Payer: Coventry All Commercial |
$1,667.60
|
| Rate for Payer: Encore All Commercial |
$1,744.35
|
| Rate for Payer: Frontpath All Commercial |
$1,743.40
|
| Rate for Payer: Humana ChoiceCare |
$1,636.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,705.50
|
| Rate for Payer: PHCS All Commercial |
$1,421.25
|
| Rate for Payer: PHP All Commercial |
$1,437.17
|
| Rate for Payer: Sagamore Health Network All Products |
$1,462.94
|
| Rate for Payer: Signature Care EPO |
$1,572.85
|
| Rate for Payer: Signature Care PPO |
$1,667.60
|
| Rate for Payer: United Healthcare Commercial |
$1,493.26
|
|
|
HC MESH DULEX OVAL 15X19
|
Facility
OP
|
$2,548.80
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41602326
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,370.38 |
| Rate for Payer: Aetna Commercial |
$2,151.19
|
| Rate for Payer: Aetna Medicare |
$841.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$841.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,463.78
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,593.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$967.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$925.21
|
| Rate for Payer: Cash Price |
$1,580.26
|
| Rate for Payer: Cash Price |
$1,580.26
|
| Rate for Payer: Centivo All Commercial |
$1,299.89
|
| Rate for Payer: Cigna All Commercial |
$2,199.61
|
| Rate for Payer: CORVEL All Commercial |
$2,370.38
|
| Rate for Payer: Coventry All Commercial |
$2,242.94
|
| Rate for Payer: Encore All Commercial |
$2,346.17
|
| Rate for Payer: Frontpath All Commercial |
$2,344.90
|
| Rate for Payer: Humana ChoiceCare |
$2,201.40
|
| Rate for Payer: Humana Medicare |
$1,299.89
|
| Rate for Payer: Lucent All Commercial |
$1,299.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,293.92
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,911.60
|
| Rate for Payer: PHP All Commercial |
$1,933.01
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$994.03
|
| Rate for Payer: Sagamore Health Network All Products |
$1,967.67
|
| Rate for Payer: Signature Care EPO |
$2,115.50
|
| Rate for Payer: Signature Care PPO |
$2,242.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,166.48
|
| Rate for Payer: United Healthcare Commercial |
$2,008.45
|
| Rate for Payer: United Healthcare Medicare |
$841.10
|
|
|
HC MESH DULEX OVAL 15X19
|
Facility
IP
|
$2,548.80
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41602326
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,911.60 |
| Max. Negotiated Rate |
$2,370.38 |
| Rate for Payer: Aetna Commercial |
$2,202.16
|
| Rate for Payer: Cash Price |
$1,580.26
|
| Rate for Payer: Cigna All Commercial |
$2,199.61
|
| Rate for Payer: CORVEL All Commercial |
$2,370.38
|
| Rate for Payer: Coventry All Commercial |
$2,242.94
|
| Rate for Payer: Encore All Commercial |
$2,346.17
|
| Rate for Payer: Frontpath All Commercial |
$2,344.90
|
| Rate for Payer: Humana ChoiceCare |
$2,201.40
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,293.92
|
| Rate for Payer: PHCS All Commercial |
$1,911.60
|
| Rate for Payer: PHP All Commercial |
$1,933.01
|
| Rate for Payer: Sagamore Health Network All Products |
$1,967.67
|
| Rate for Payer: Signature Care EPO |
$2,115.50
|
| Rate for Payer: Signature Care PPO |
$2,242.94
|
| Rate for Payer: United Healthcare Commercial |
$2,008.45
|
|
|
HC MESH PERFIX PLUG LG
|
Facility
OP
|
$1,029.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601946
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$339.57 |
| Max. Negotiated Rate |
$956.97 |
| Rate for Payer: Aetna Commercial |
$868.48
|
| Rate for Payer: Aetna Medicare |
$339.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$339.57
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$590.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$643.23
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$390.51
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$373.53
|
| Rate for Payer: Cash Price |
$637.98
|
| Rate for Payer: Cash Price |
$637.98
|
| Rate for Payer: Centivo All Commercial |
$524.79
|
| Rate for Payer: Cigna All Commercial |
$888.03
|
| Rate for Payer: CORVEL All Commercial |
$956.97
|
| Rate for Payer: Coventry All Commercial |
$905.52
|
| Rate for Payer: Encore All Commercial |
$947.19
|
| Rate for Payer: Frontpath All Commercial |
$946.68
|
| Rate for Payer: Humana ChoiceCare |
$888.75
|
| Rate for Payer: Humana Medicare |
$524.79
|
| Rate for Payer: Lucent All Commercial |
$524.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$926.10
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$771.75
|
| Rate for Payer: PHP All Commercial |
$780.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$401.31
|
| Rate for Payer: Sagamore Health Network All Products |
$794.39
|
| Rate for Payer: Signature Care EPO |
$854.07
|
| Rate for Payer: Signature Care PPO |
$905.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$874.65
|
| Rate for Payer: United Healthcare Commercial |
$810.85
|
| Rate for Payer: United Healthcare Medicare |
$339.57
|
|
|
HC MESH PERFIX PLUG LG
|
Facility
IP
|
$1,029.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601946
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$771.75 |
| Max. Negotiated Rate |
$956.97 |
| Rate for Payer: Aetna Commercial |
$889.06
|
| Rate for Payer: Cash Price |
$637.98
|
| Rate for Payer: Cigna All Commercial |
$888.03
|
| Rate for Payer: CORVEL All Commercial |
$956.97
|
| Rate for Payer: Coventry All Commercial |
$905.52
|
| Rate for Payer: Encore All Commercial |
$947.19
|
| Rate for Payer: Frontpath All Commercial |
$946.68
|
| Rate for Payer: Humana ChoiceCare |
$888.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$926.10
|
| Rate for Payer: PHCS All Commercial |
$771.75
|
| Rate for Payer: PHP All Commercial |
$780.39
|
| Rate for Payer: Sagamore Health Network All Products |
$794.39
|
| Rate for Payer: Signature Care EPO |
$854.07
|
| Rate for Payer: Signature Care PPO |
$905.52
|
| Rate for Payer: United Healthcare Commercial |
$810.85
|
|
|
HC MESH PERFIX PLUG MED
|
Facility
OP
|
$1,029.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601947
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$339.57 |
| Max. Negotiated Rate |
$956.97 |
| Rate for Payer: Aetna Commercial |
$868.48
|
| Rate for Payer: Aetna Medicare |
$339.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$339.57
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$590.95
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$643.23
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$390.51
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$373.53
|
| Rate for Payer: Cash Price |
$637.98
|
| Rate for Payer: Cash Price |
$637.98
|
| Rate for Payer: Centivo All Commercial |
$524.79
|
| Rate for Payer: Cigna All Commercial |
$888.03
|
| Rate for Payer: CORVEL All Commercial |
$956.97
|
| Rate for Payer: Coventry All Commercial |
$905.52
|
| Rate for Payer: Encore All Commercial |
$947.19
|
| Rate for Payer: Frontpath All Commercial |
$946.68
|
| Rate for Payer: Humana ChoiceCare |
$888.75
|
| Rate for Payer: Humana Medicare |
$524.79
|
| Rate for Payer: Lucent All Commercial |
$524.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$926.10
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$771.75
|
| Rate for Payer: PHP All Commercial |
$780.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$401.31
|
| Rate for Payer: Sagamore Health Network All Products |
$794.39
|
| Rate for Payer: Signature Care EPO |
$854.07
|
| Rate for Payer: Signature Care PPO |
$905.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$874.65
|
| Rate for Payer: United Healthcare Commercial |
$810.85
|
| Rate for Payer: United Healthcare Medicare |
$339.57
|
|
|
HC MESH PERFIX PLUG MED
|
Facility
IP
|
$1,029.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601947
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$771.75 |
| Max. Negotiated Rate |
$956.97 |
| Rate for Payer: Aetna Commercial |
$889.06
|
| Rate for Payer: Cash Price |
$637.98
|
| Rate for Payer: Cigna All Commercial |
$888.03
|
| Rate for Payer: CORVEL All Commercial |
$956.97
|
| Rate for Payer: Coventry All Commercial |
$905.52
|
| Rate for Payer: Encore All Commercial |
$947.19
|
| Rate for Payer: Frontpath All Commercial |
$946.68
|
| Rate for Payer: Humana ChoiceCare |
$888.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$926.10
|
| Rate for Payer: PHCS All Commercial |
$771.75
|
| Rate for Payer: PHP All Commercial |
$780.39
|
| Rate for Payer: Sagamore Health Network All Products |
$794.39
|
| Rate for Payer: Signature Care EPO |
$854.07
|
| Rate for Payer: Signature Care PPO |
$905.52
|
| Rate for Payer: United Healthcare Commercial |
$810.85
|
|
|
HC MESH PERFIX PLUG XL
|
Facility
IP
|
$870.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41602172
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$652.50 |
| Max. Negotiated Rate |
$809.10 |
| Rate for Payer: Aetna Commercial |
$751.68
|
| Rate for Payer: Cash Price |
$539.40
|
| Rate for Payer: Cigna All Commercial |
$750.81
|
| Rate for Payer: CORVEL All Commercial |
$809.10
|
| Rate for Payer: Coventry All Commercial |
$765.60
|
| Rate for Payer: Encore All Commercial |
$800.84
|
| Rate for Payer: Frontpath All Commercial |
$800.40
|
| Rate for Payer: Humana ChoiceCare |
$751.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$783.00
|
| Rate for Payer: PHCS All Commercial |
$652.50
|
| Rate for Payer: PHP All Commercial |
$659.81
|
| Rate for Payer: Sagamore Health Network All Products |
$671.64
|
| Rate for Payer: Signature Care EPO |
$722.10
|
| Rate for Payer: Signature Care PPO |
$765.60
|
| Rate for Payer: United Healthcare Commercial |
$685.56
|
|
|
HC MESH PERFIX PLUG XL
|
Facility
OP
|
$870.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41602172
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$287.10 |
| Max. Negotiated Rate |
$809.10 |
| Rate for Payer: Aetna Commercial |
$734.28
|
| Rate for Payer: Aetna Medicare |
$287.10
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$287.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$499.64
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$543.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$330.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$315.81
|
| Rate for Payer: Cash Price |
$539.40
|
| Rate for Payer: Cash Price |
$539.40
|
| Rate for Payer: Centivo All Commercial |
$443.70
|
| Rate for Payer: Cigna All Commercial |
$750.81
|
| Rate for Payer: CORVEL All Commercial |
$809.10
|
| Rate for Payer: Coventry All Commercial |
$765.60
|
| Rate for Payer: Encore All Commercial |
$800.84
|
| Rate for Payer: Frontpath All Commercial |
$800.40
|
| Rate for Payer: Humana ChoiceCare |
$751.42
|
| Rate for Payer: Humana Medicare |
$443.70
|
| Rate for Payer: Lucent All Commercial |
$443.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$783.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$652.50
|
| Rate for Payer: PHP All Commercial |
$659.81
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$339.30
|
| Rate for Payer: Sagamore Health Network All Products |
$671.64
|
| Rate for Payer: Signature Care EPO |
$722.10
|
| Rate for Payer: Signature Care PPO |
$765.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$739.50
|
| Rate for Payer: United Healthcare Commercial |
$685.56
|
| Rate for Payer: United Healthcare Medicare |
$287.10
|
|
|
HC MESH PROCEED 15X15
|
Facility
OP
|
$1,889.42
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601948
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,757.16 |
| Rate for Payer: Aetna Commercial |
$1,594.67
|
| Rate for Payer: Aetna Medicare |
$623.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$623.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,085.09
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,181.08
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$717.03
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$685.86
|
| Rate for Payer: Cash Price |
$1,171.44
|
| Rate for Payer: Cash Price |
$1,171.44
|
| Rate for Payer: Centivo All Commercial |
$963.60
|
| Rate for Payer: Cigna All Commercial |
$1,630.57
|
| Rate for Payer: CORVEL All Commercial |
$1,757.16
|
| Rate for Payer: Coventry All Commercial |
$1,662.69
|
| Rate for Payer: Encore All Commercial |
$1,739.21
|
| Rate for Payer: Frontpath All Commercial |
$1,738.27
|
| Rate for Payer: Humana ChoiceCare |
$1,631.89
|
| Rate for Payer: Humana Medicare |
$963.60
|
| Rate for Payer: Lucent All Commercial |
$963.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,700.48
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,417.06
|
| Rate for Payer: PHP All Commercial |
$1,432.94
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$736.87
|
| Rate for Payer: Sagamore Health Network All Products |
$1,458.63
|
| Rate for Payer: Signature Care EPO |
$1,568.22
|
| Rate for Payer: Signature Care PPO |
$1,662.69
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,606.01
|
| Rate for Payer: United Healthcare Commercial |
$1,488.86
|
| Rate for Payer: United Healthcare Medicare |
$623.51
|
|
|
HC MESH PROCEED 15X15
|
Facility
IP
|
$1,889.42
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601948
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,417.06 |
| Max. Negotiated Rate |
$1,757.16 |
| Rate for Payer: Aetna Commercial |
$1,632.46
|
| Rate for Payer: Cash Price |
$1,171.44
|
| Rate for Payer: Cigna All Commercial |
$1,630.57
|
| Rate for Payer: CORVEL All Commercial |
$1,757.16
|
| Rate for Payer: Coventry All Commercial |
$1,662.69
|
| Rate for Payer: Encore All Commercial |
$1,739.21
|
| Rate for Payer: Frontpath All Commercial |
$1,738.27
|
| Rate for Payer: Humana ChoiceCare |
$1,631.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,700.48
|
| Rate for Payer: PHCS All Commercial |
$1,417.06
|
| Rate for Payer: PHP All Commercial |
$1,432.94
|
| Rate for Payer: Sagamore Health Network All Products |
$1,458.63
|
| Rate for Payer: Signature Care EPO |
$1,568.22
|
| Rate for Payer: Signature Care PPO |
$1,662.69
|
| Rate for Payer: United Healthcare Commercial |
$1,488.86
|
|
|
HC MESH PROCEED 15X20
|
Facility
IP
|
$2,613.20
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601949
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,959.90 |
| Max. Negotiated Rate |
$2,430.28 |
| Rate for Payer: Aetna Commercial |
$2,257.80
|
| Rate for Payer: Cash Price |
$1,620.18
|
| Rate for Payer: Cigna All Commercial |
$2,255.19
|
| Rate for Payer: CORVEL All Commercial |
$2,430.28
|
| Rate for Payer: Coventry All Commercial |
$2,299.62
|
| Rate for Payer: Encore All Commercial |
$2,405.45
|
| Rate for Payer: Frontpath All Commercial |
$2,404.14
|
| Rate for Payer: Humana ChoiceCare |
$2,257.02
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,351.88
|
| Rate for Payer: PHCS All Commercial |
$1,959.90
|
| Rate for Payer: PHP All Commercial |
$1,981.85
|
| Rate for Payer: Sagamore Health Network All Products |
$2,017.39
|
| Rate for Payer: Signature Care EPO |
$2,168.96
|
| Rate for Payer: Signature Care PPO |
$2,299.62
|
| Rate for Payer: United Healthcare Commercial |
$2,059.20
|
|
|
HC MESH PROCEED 15X20
|
Facility
OP
|
$2,613.20
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601949
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,430.28 |
| Rate for Payer: Aetna Commercial |
$2,205.54
|
| Rate for Payer: Aetna Medicare |
$862.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$862.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,500.76
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,633.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$991.71
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$948.59
|
| Rate for Payer: Cash Price |
$1,620.18
|
| Rate for Payer: Cash Price |
$1,620.18
|
| Rate for Payer: Centivo All Commercial |
$1,332.73
|
| Rate for Payer: Cigna All Commercial |
$2,255.19
|
| Rate for Payer: CORVEL All Commercial |
$2,430.28
|
| Rate for Payer: Coventry All Commercial |
$2,299.62
|
| Rate for Payer: Encore All Commercial |
$2,405.45
|
| Rate for Payer: Frontpath All Commercial |
$2,404.14
|
| Rate for Payer: Humana ChoiceCare |
$2,257.02
|
| Rate for Payer: Humana Medicare |
$1,332.73
|
| Rate for Payer: Lucent All Commercial |
$1,332.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,351.88
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,959.90
|
| Rate for Payer: PHP All Commercial |
$1,981.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,019.15
|
| Rate for Payer: Sagamore Health Network All Products |
$2,017.39
|
| Rate for Payer: Signature Care EPO |
$2,168.96
|
| Rate for Payer: Signature Care PPO |
$2,299.62
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,221.22
|
| Rate for Payer: United Healthcare Commercial |
$2,059.20
|
| Rate for Payer: United Healthcare Medicare |
$862.36
|
|
|
HC MESH SURGIPRO 3X5
|
Facility
OP
|
$454.23
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601952
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$149.90 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial |
$383.37
|
| Rate for Payer: Aetna Medicare |
$149.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$149.90
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$260.86
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$283.94
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$172.38
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$164.89
|
| Rate for Payer: Cash Price |
$281.62
|
| Rate for Payer: Cash Price |
$281.62
|
| Rate for Payer: Centivo All Commercial |
$231.66
|
| Rate for Payer: Cigna All Commercial |
$392.00
|
| Rate for Payer: CORVEL All Commercial |
$422.43
|
| Rate for Payer: Coventry All Commercial |
$399.72
|
| Rate for Payer: Encore All Commercial |
$418.12
|
| Rate for Payer: Frontpath All Commercial |
$417.89
|
| Rate for Payer: Humana ChoiceCare |
$392.32
|
| Rate for Payer: Humana Medicare |
$231.66
|
| Rate for Payer: Lucent All Commercial |
$231.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$408.81
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$340.67
|
| Rate for Payer: PHP All Commercial |
$344.49
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$177.15
|
| Rate for Payer: Sagamore Health Network All Products |
$350.67
|
| Rate for Payer: Signature Care EPO |
$377.01
|
| Rate for Payer: Signature Care PPO |
$399.72
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$386.10
|
| Rate for Payer: United Healthcare Commercial |
$357.93
|
| Rate for Payer: United Healthcare Medicare |
$149.90
|
|
|
HC MESH SURGIPRO 3X5
|
Facility
IP
|
$454.23
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601952
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$340.67 |
| Max. Negotiated Rate |
$422.43 |
| Rate for Payer: Aetna Commercial |
$392.45
|
| Rate for Payer: Cash Price |
$281.62
|
| Rate for Payer: Cigna All Commercial |
$392.00
|
| Rate for Payer: CORVEL All Commercial |
$422.43
|
| Rate for Payer: Coventry All Commercial |
$399.72
|
| Rate for Payer: Encore All Commercial |
$418.12
|
| Rate for Payer: Frontpath All Commercial |
$417.89
|
| Rate for Payer: Humana ChoiceCare |
$392.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$408.81
|
| Rate for Payer: PHCS All Commercial |
$340.67
|
| Rate for Payer: PHP All Commercial |
$344.49
|
| Rate for Payer: Sagamore Health Network All Products |
$350.67
|
| Rate for Payer: Signature Care EPO |
$377.01
|
| Rate for Payer: Signature Care PPO |
$399.72
|
| Rate for Payer: United Healthcare Commercial |
$357.93
|
|
|
HC MESH SURGIPRO 6X6
|
Facility
IP
|
$648.90
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41602257
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$486.68 |
| Max. Negotiated Rate |
$603.48 |
| Rate for Payer: Aetna Commercial |
$560.65
|
| Rate for Payer: Cash Price |
$402.32
|
| Rate for Payer: Cigna All Commercial |
$560.00
|
| Rate for Payer: CORVEL All Commercial |
$603.48
|
| Rate for Payer: Coventry All Commercial |
$571.03
|
| Rate for Payer: Encore All Commercial |
$597.31
|
| Rate for Payer: Frontpath All Commercial |
$596.99
|
| Rate for Payer: Humana ChoiceCare |
$560.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$584.01
|
| Rate for Payer: PHCS All Commercial |
$486.68
|
| Rate for Payer: PHP All Commercial |
$492.13
|
| Rate for Payer: Sagamore Health Network All Products |
$500.95
|
| Rate for Payer: Signature Care EPO |
$538.59
|
| Rate for Payer: Signature Care PPO |
$571.03
|
| Rate for Payer: United Healthcare Commercial |
$511.33
|
|
|
HC MESH SURGIPRO 6X6
|
Facility
OP
|
$648.90
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41602257
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$214.14 |
| Max. Negotiated Rate |
$603.48 |
| Rate for Payer: Aetna Commercial |
$547.67
|
| Rate for Payer: Aetna Medicare |
$214.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$214.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$372.66
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$405.63
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$246.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$235.55
|
| Rate for Payer: Cash Price |
$402.32
|
| Rate for Payer: Cash Price |
$402.32
|
| Rate for Payer: Centivo All Commercial |
$330.94
|
| Rate for Payer: Cigna All Commercial |
$560.00
|
| Rate for Payer: CORVEL All Commercial |
$603.48
|
| Rate for Payer: Coventry All Commercial |
$571.03
|
| Rate for Payer: Encore All Commercial |
$597.31
|
| Rate for Payer: Frontpath All Commercial |
$596.99
|
| Rate for Payer: Humana ChoiceCare |
$560.45
|
| Rate for Payer: Humana Medicare |
$330.94
|
| Rate for Payer: Lucent All Commercial |
$330.94
|
| Rate for Payer: Lutheran Preferred All Commercial |
$584.01
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$486.68
|
| Rate for Payer: PHP All Commercial |
$492.13
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$253.07
|
| Rate for Payer: Sagamore Health Network All Products |
$500.95
|
| Rate for Payer: Signature Care EPO |
$538.59
|
| Rate for Payer: Signature Care PPO |
$571.03
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$551.56
|
| Rate for Payer: United Healthcare Commercial |
$511.33
|
| Rate for Payer: United Healthcare Medicare |
$214.14
|
|
|
HC MESH VENTRALEX ST LG CIRCLE
|
Facility
OP
|
$2,304.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601870
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,142.72 |
| Rate for Payer: Aetna Commercial |
$1,944.58
|
| Rate for Payer: Aetna Medicare |
$760.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$760.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,323.19
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,440.23
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$874.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$836.35
|
| Rate for Payer: Cash Price |
$1,428.48
|
| Rate for Payer: Cash Price |
$1,428.48
|
| Rate for Payer: Centivo All Commercial |
$1,175.04
|
| Rate for Payer: Cigna All Commercial |
$1,988.35
|
| Rate for Payer: CORVEL All Commercial |
$2,142.72
|
| Rate for Payer: Coventry All Commercial |
$2,027.52
|
| Rate for Payer: Encore All Commercial |
$2,120.83
|
| Rate for Payer: Frontpath All Commercial |
$2,119.68
|
| Rate for Payer: Humana ChoiceCare |
$1,989.96
|
| Rate for Payer: Humana Medicare |
$1,175.04
|
| Rate for Payer: Lucent All Commercial |
$1,175.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,073.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,728.00
|
| Rate for Payer: PHP All Commercial |
$1,747.35
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$898.56
|
| Rate for Payer: Sagamore Health Network All Products |
$1,778.69
|
| Rate for Payer: Signature Care EPO |
$1,912.32
|
| Rate for Payer: Signature Care PPO |
$2,027.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,958.40
|
| Rate for Payer: United Healthcare Commercial |
$1,815.55
|
| Rate for Payer: United Healthcare Medicare |
$760.32
|
|
