|
HC MESH VENTRALEX ST LG CIRCLE
|
Facility
IP
|
$2,304.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601870
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,728.00 |
| Max. Negotiated Rate |
$2,142.72 |
| Rate for Payer: Aetna Commercial |
$1,990.66
|
| Rate for Payer: Cash Price |
$1,428.48
|
| 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: Lutheran Preferred All Commercial |
$2,073.60
|
| Rate for Payer: PHCS All Commercial |
$1,728.00
|
| Rate for Payer: PHP All Commercial |
$1,747.35
|
| 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: United Healthcare Commercial |
$1,815.55
|
|
|
HC MESH VENTRALEX ST MED CIRCLE
|
Facility
OP
|
$2,264.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601953
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,105.52 |
| Rate for Payer: Aetna Commercial |
$1,910.82
|
| Rate for Payer: Aetna Medicare |
$747.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$747.12
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,300.22
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,415.23
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$859.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$821.83
|
| Rate for Payer: Cash Price |
$1,403.68
|
| Rate for Payer: Cash Price |
$1,403.68
|
| Rate for Payer: Centivo All Commercial |
$1,154.64
|
| Rate for Payer: Cigna All Commercial |
$1,953.83
|
| Rate for Payer: CORVEL All Commercial |
$2,105.52
|
| Rate for Payer: Coventry All Commercial |
$1,992.32
|
| Rate for Payer: Encore All Commercial |
$2,084.01
|
| Rate for Payer: Frontpath All Commercial |
$2,082.88
|
| Rate for Payer: Humana ChoiceCare |
$1,955.42
|
| Rate for Payer: Humana Medicare |
$1,154.64
|
| Rate for Payer: Lucent All Commercial |
$1,154.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,037.60
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,698.00
|
| Rate for Payer: PHP All Commercial |
$1,717.02
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$882.96
|
| Rate for Payer: Sagamore Health Network All Products |
$1,747.81
|
| Rate for Payer: Signature Care EPO |
$1,879.12
|
| Rate for Payer: Signature Care PPO |
$1,992.32
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,924.40
|
| Rate for Payer: United Healthcare Commercial |
$1,784.03
|
| Rate for Payer: United Healthcare Medicare |
$747.12
|
|
|
HC MESH VENTRALEX ST MED CIRCLE
|
Facility
IP
|
$2,264.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601953
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,698.00 |
| Max. Negotiated Rate |
$2,105.52 |
| Rate for Payer: Aetna Commercial |
$1,956.10
|
| Rate for Payer: Cash Price |
$1,403.68
|
| Rate for Payer: Cigna All Commercial |
$1,953.83
|
| Rate for Payer: CORVEL All Commercial |
$2,105.52
|
| Rate for Payer: Coventry All Commercial |
$1,992.32
|
| Rate for Payer: Encore All Commercial |
$2,084.01
|
| Rate for Payer: Frontpath All Commercial |
$2,082.88
|
| Rate for Payer: Humana ChoiceCare |
$1,955.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,037.60
|
| Rate for Payer: PHCS All Commercial |
$1,698.00
|
| Rate for Payer: PHP All Commercial |
$1,717.02
|
| Rate for Payer: Sagamore Health Network All Products |
$1,747.81
|
| Rate for Payer: Signature Care EPO |
$1,879.12
|
| Rate for Payer: Signature Care PPO |
$1,992.32
|
| Rate for Payer: United Healthcare Commercial |
$1,784.03
|
|
|
HC MESH VENTRALEX ST SM CIRCLE
|
Facility
IP
|
$1,899.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601954
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,424.25 |
| Max. Negotiated Rate |
$1,766.07 |
| Rate for Payer: Aetna Commercial |
$1,640.74
|
| Rate for Payer: Cash Price |
$1,177.38
|
| Rate for Payer: Cigna All Commercial |
$1,638.84
|
| Rate for Payer: CORVEL All Commercial |
$1,766.07
|
| Rate for Payer: Coventry All Commercial |
$1,671.12
|
| Rate for Payer: Encore All Commercial |
$1,748.03
|
| Rate for Payer: Frontpath All Commercial |
$1,747.08
|
| Rate for Payer: Humana ChoiceCare |
$1,640.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,709.10
|
| Rate for Payer: PHCS All Commercial |
$1,424.25
|
| Rate for Payer: PHP All Commercial |
$1,440.20
|
| Rate for Payer: Sagamore Health Network All Products |
$1,466.03
|
| Rate for Payer: Signature Care EPO |
$1,576.17
|
| Rate for Payer: Signature Care PPO |
$1,671.12
|
| Rate for Payer: United Healthcare Commercial |
$1,496.41
|
|
|
HC MESH VENTRALEX ST SM CIRCLE
|
Facility
OP
|
$1,899.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601954
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,766.07 |
| Rate for Payer: Aetna Commercial |
$1,602.76
|
| Rate for Payer: Aetna Medicare |
$626.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$626.67
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,090.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,187.06
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$720.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$689.34
|
| Rate for Payer: Cash Price |
$1,177.38
|
| Rate for Payer: Cash Price |
$1,177.38
|
| Rate for Payer: Centivo All Commercial |
$968.49
|
| Rate for Payer: Cigna All Commercial |
$1,638.84
|
| Rate for Payer: CORVEL All Commercial |
$1,766.07
|
| Rate for Payer: Coventry All Commercial |
$1,671.12
|
| Rate for Payer: Encore All Commercial |
$1,748.03
|
| Rate for Payer: Frontpath All Commercial |
$1,747.08
|
| Rate for Payer: Humana ChoiceCare |
$1,640.17
|
| Rate for Payer: Humana Medicare |
$968.49
|
| Rate for Payer: Lucent All Commercial |
$968.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,709.10
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,424.25
|
| Rate for Payer: PHP All Commercial |
$1,440.20
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$740.61
|
| Rate for Payer: Sagamore Health Network All Products |
$1,466.03
|
| Rate for Payer: Signature Care EPO |
$1,576.17
|
| Rate for Payer: Signature Care PPO |
$1,671.12
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,614.15
|
| Rate for Payer: United Healthcare Commercial |
$1,496.41
|
| Rate for Payer: United Healthcare Medicare |
$626.67
|
|
|
HC MESH VENTRALIGHT ST 10X13
|
Facility
OP
|
$5,931.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41606249
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,515.83 |
| Rate for Payer: Aetna Commercial |
$5,005.76
|
| Rate for Payer: Aetna Medicare |
$1,957.23
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,957.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,406.17
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,707.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,250.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,152.95
|
| Rate for Payer: Cash Price |
$3,677.22
|
| Rate for Payer: Cash Price |
$3,677.22
|
| Rate for Payer: Centivo All Commercial |
$3,024.81
|
| Rate for Payer: Cigna All Commercial |
$5,118.45
|
| Rate for Payer: CORVEL All Commercial |
$5,515.83
|
| Rate for Payer: Coventry All Commercial |
$5,219.28
|
| Rate for Payer: Encore All Commercial |
$5,459.49
|
| Rate for Payer: Frontpath All Commercial |
$5,456.52
|
| Rate for Payer: Humana ChoiceCare |
$5,122.60
|
| Rate for Payer: Humana Medicare |
$3,024.81
|
| Rate for Payer: Lucent All Commercial |
$3,024.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,337.90
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,448.25
|
| Rate for Payer: PHP All Commercial |
$4,498.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,313.09
|
| Rate for Payer: Sagamore Health Network All Products |
$4,578.73
|
| Rate for Payer: Signature Care EPO |
$4,922.73
|
| Rate for Payer: Signature Care PPO |
$5,219.28
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,041.35
|
| Rate for Payer: United Healthcare Commercial |
$4,673.63
|
| Rate for Payer: United Healthcare Medicare |
$1,957.23
|
|
|
HC MESH VENTRALIGHT ST 10X13
|
Facility
IP
|
$5,931.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41606249
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,448.25 |
| Max. Negotiated Rate |
$5,515.83 |
| Rate for Payer: Aetna Commercial |
$5,124.38
|
| Rate for Payer: Cash Price |
$3,677.22
|
| Rate for Payer: Cigna All Commercial |
$5,118.45
|
| Rate for Payer: CORVEL All Commercial |
$5,515.83
|
| Rate for Payer: Coventry All Commercial |
$5,219.28
|
| Rate for Payer: Encore All Commercial |
$5,459.49
|
| Rate for Payer: Frontpath All Commercial |
$5,456.52
|
| Rate for Payer: Humana ChoiceCare |
$5,122.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,337.90
|
| Rate for Payer: PHCS All Commercial |
$4,448.25
|
| Rate for Payer: PHP All Commercial |
$4,498.07
|
| Rate for Payer: Sagamore Health Network All Products |
$4,578.73
|
| Rate for Payer: Signature Care EPO |
$4,922.73
|
| Rate for Payer: Signature Care PPO |
$5,219.28
|
| Rate for Payer: United Healthcare Commercial |
$4,673.63
|
|
|
HC MESH VENTRALIGHT ST 4.5 CIRCLE
|
Facility
IP
|
$2,187.50
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41603983
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,640.62 |
| Max. Negotiated Rate |
$2,034.38 |
| Rate for Payer: Aetna Commercial |
$1,890.00
|
| Rate for Payer: Cash Price |
$1,356.25
|
| Rate for Payer: Cigna All Commercial |
$1,887.81
|
| Rate for Payer: CORVEL All Commercial |
$2,034.38
|
| Rate for Payer: Coventry All Commercial |
$1,925.00
|
| Rate for Payer: Encore All Commercial |
$2,013.59
|
| Rate for Payer: Frontpath All Commercial |
$2,012.50
|
| Rate for Payer: Humana ChoiceCare |
$1,889.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,968.75
|
| Rate for Payer: PHCS All Commercial |
$1,640.62
|
| Rate for Payer: PHP All Commercial |
$1,659.00
|
| Rate for Payer: Sagamore Health Network All Products |
$1,688.75
|
| Rate for Payer: Signature Care EPO |
$1,815.62
|
| Rate for Payer: Signature Care PPO |
$1,925.00
|
| Rate for Payer: United Healthcare Commercial |
$1,723.75
|
|
|
HC MESH VENTRALIGHT ST 4.5 CIRCLE
|
Facility
OP
|
$2,187.50
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41603983
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,034.38 |
| Rate for Payer: Aetna Commercial |
$1,846.25
|
| Rate for Payer: Aetna Medicare |
$721.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$721.88
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,256.28
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,367.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$830.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$794.06
|
| Rate for Payer: Cash Price |
$1,356.25
|
| Rate for Payer: Cash Price |
$1,356.25
|
| Rate for Payer: Centivo All Commercial |
$1,115.62
|
| Rate for Payer: Cigna All Commercial |
$1,887.81
|
| Rate for Payer: CORVEL All Commercial |
$2,034.38
|
| Rate for Payer: Coventry All Commercial |
$1,925.00
|
| Rate for Payer: Encore All Commercial |
$2,013.59
|
| Rate for Payer: Frontpath All Commercial |
$2,012.50
|
| Rate for Payer: Humana ChoiceCare |
$1,889.34
|
| Rate for Payer: Humana Medicare |
$1,115.62
|
| Rate for Payer: Lucent All Commercial |
$1,115.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,968.75
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,640.62
|
| Rate for Payer: PHP All Commercial |
$1,659.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$853.12
|
| Rate for Payer: Sagamore Health Network All Products |
$1,688.75
|
| Rate for Payer: Signature Care EPO |
$1,815.62
|
| Rate for Payer: Signature Care PPO |
$1,925.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,859.38
|
| Rate for Payer: United Healthcare Commercial |
$1,723.75
|
| Rate for Payer: United Healthcare Medicare |
$721.88
|
|
|
HC MESH VENTRALIGHT ST 4X6 ELLIPSE
|
Facility
OP
|
$1,862.50
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601337
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$1,732.12 |
| Rate for Payer: Aetna Commercial |
$1,571.95
|
| Rate for Payer: Aetna Medicare |
$614.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$614.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,069.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,164.25
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$706.82
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$676.09
|
| Rate for Payer: Cash Price |
$1,154.75
|
| Rate for Payer: Cash Price |
$1,154.75
|
| Rate for Payer: Centivo All Commercial |
$949.88
|
| Rate for Payer: Cigna All Commercial |
$1,607.34
|
| Rate for Payer: CORVEL All Commercial |
$1,732.12
|
| Rate for Payer: Coventry All Commercial |
$1,639.00
|
| Rate for Payer: Encore All Commercial |
$1,714.43
|
| Rate for Payer: Frontpath All Commercial |
$1,713.50
|
| Rate for Payer: Humana ChoiceCare |
$1,608.64
|
| Rate for Payer: Humana Medicare |
$949.88
|
| Rate for Payer: Lucent All Commercial |
$949.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,676.25
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$1,396.88
|
| Rate for Payer: PHP All Commercial |
$1,412.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$726.38
|
| Rate for Payer: Sagamore Health Network All Products |
$1,437.85
|
| Rate for Payer: Signature Care EPO |
$1,545.88
|
| Rate for Payer: Signature Care PPO |
$1,639.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,583.12
|
| Rate for Payer: United Healthcare Commercial |
$1,467.65
|
| Rate for Payer: United Healthcare Medicare |
$614.62
|
|
|
HC MESH VENTRALIGHT ST 4X6 ELLIPSE
|
Facility
IP
|
$1,862.50
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601337
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,396.88 |
| Max. Negotiated Rate |
$1,732.12 |
| Rate for Payer: Aetna Commercial |
$1,609.20
|
| Rate for Payer: Cash Price |
$1,154.75
|
| Rate for Payer: Cigna All Commercial |
$1,607.34
|
| Rate for Payer: CORVEL All Commercial |
$1,732.12
|
| Rate for Payer: Coventry All Commercial |
$1,639.00
|
| Rate for Payer: Encore All Commercial |
$1,714.43
|
| Rate for Payer: Frontpath All Commercial |
$1,713.50
|
| Rate for Payer: Humana ChoiceCare |
$1,608.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,676.25
|
| Rate for Payer: PHCS All Commercial |
$1,396.88
|
| Rate for Payer: PHP All Commercial |
$1,412.52
|
| Rate for Payer: Sagamore Health Network All Products |
$1,437.85
|
| Rate for Payer: Signature Care EPO |
$1,545.88
|
| Rate for Payer: Signature Care PPO |
$1,639.00
|
| Rate for Payer: United Healthcare Commercial |
$1,467.65
|
|
|
HC MESH VENTRALIGHT ST 6X10 OVAL
|
Facility
OP
|
$3,780.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601338
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$3,515.40 |
| Rate for Payer: Aetna Commercial |
$3,190.32
|
| Rate for Payer: Aetna Medicare |
$1,247.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,247.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,170.85
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,362.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,434.51
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,372.14
|
| Rate for Payer: Cash Price |
$2,343.60
|
| Rate for Payer: Cash Price |
$2,343.60
|
| Rate for Payer: Centivo All Commercial |
$1,927.80
|
| Rate for Payer: Cigna All Commercial |
$3,262.14
|
| Rate for Payer: CORVEL All Commercial |
$3,515.40
|
| Rate for Payer: Coventry All Commercial |
$3,326.40
|
| Rate for Payer: Encore All Commercial |
$3,479.49
|
| Rate for Payer: Frontpath All Commercial |
$3,477.60
|
| Rate for Payer: Humana ChoiceCare |
$3,264.79
|
| Rate for Payer: Humana Medicare |
$1,927.80
|
| Rate for Payer: Lucent All Commercial |
$1,927.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,402.00
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$2,835.00
|
| Rate for Payer: PHP All Commercial |
$2,866.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,474.20
|
| Rate for Payer: Sagamore Health Network All Products |
$2,918.16
|
| Rate for Payer: Signature Care EPO |
$3,137.40
|
| Rate for Payer: Signature Care PPO |
$3,326.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,213.00
|
| Rate for Payer: United Healthcare Commercial |
$2,978.64
|
| Rate for Payer: United Healthcare Medicare |
$1,247.40
|
|
|
HC MESH VENTRALIGHT ST 6X10 OVAL
|
Facility
IP
|
$3,780.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601338
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,835.00 |
| Max. Negotiated Rate |
$3,515.40 |
| Rate for Payer: Aetna Commercial |
$3,265.92
|
| Rate for Payer: Cash Price |
$2,343.60
|
| Rate for Payer: Cigna All Commercial |
$3,262.14
|
| Rate for Payer: CORVEL All Commercial |
$3,515.40
|
| Rate for Payer: Coventry All Commercial |
$3,326.40
|
| Rate for Payer: Encore All Commercial |
$3,479.49
|
| Rate for Payer: Frontpath All Commercial |
$3,477.60
|
| Rate for Payer: Humana ChoiceCare |
$3,264.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,402.00
|
| Rate for Payer: PHCS All Commercial |
$2,835.00
|
| Rate for Payer: PHP All Commercial |
$2,866.75
|
| Rate for Payer: Sagamore Health Network All Products |
$2,918.16
|
| Rate for Payer: Signature Care EPO |
$3,137.40
|
| Rate for Payer: Signature Care PPO |
$3,326.40
|
| Rate for Payer: United Healthcare Commercial |
$2,978.64
|
|
|
HC MESH VENTRALIGHT ST 6X8 ELLIPSE
|
Facility
IP
|
$2,880.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601339
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,160.00 |
| Max. Negotiated Rate |
$2,678.40 |
| Rate for Payer: Aetna Commercial |
$2,488.32
|
| Rate for Payer: Cash Price |
$1,785.60
|
| Rate for Payer: Cigna All Commercial |
$2,485.44
|
| Rate for Payer: CORVEL All Commercial |
$2,678.40
|
| Rate for Payer: Coventry All Commercial |
$2,534.40
|
| Rate for Payer: Encore All Commercial |
$2,651.04
|
| Rate for Payer: Frontpath All Commercial |
$2,649.60
|
| Rate for Payer: Humana ChoiceCare |
$2,487.46
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,592.00
|
| Rate for Payer: PHCS All Commercial |
$2,160.00
|
| Rate for Payer: PHP All Commercial |
$2,184.19
|
| Rate for Payer: Sagamore Health Network All Products |
$2,223.36
|
| Rate for Payer: Signature Care EPO |
$2,390.40
|
| Rate for Payer: Signature Care PPO |
$2,534.40
|
| Rate for Payer: United Healthcare Commercial |
$2,269.44
|
|
|
HC MESH VENTRALIGHT ST 6X8 ELLIPSE
|
Facility
OP
|
$2,880.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601339
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$2,678.40 |
| Rate for Payer: Aetna Commercial |
$2,430.72
|
| Rate for Payer: Aetna Medicare |
$950.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$950.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,653.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,800.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,092.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,045.44
|
| Rate for Payer: Cash Price |
$1,785.60
|
| Rate for Payer: Cash Price |
$1,785.60
|
| Rate for Payer: Centivo All Commercial |
$1,468.80
|
| Rate for Payer: Cigna All Commercial |
$2,485.44
|
| Rate for Payer: CORVEL All Commercial |
$2,678.40
|
| Rate for Payer: Coventry All Commercial |
$2,534.40
|
| Rate for Payer: Encore All Commercial |
$2,651.04
|
| Rate for Payer: Frontpath All Commercial |
$2,649.60
|
| Rate for Payer: Humana ChoiceCare |
$2,487.46
|
| Rate for Payer: Humana Medicare |
$1,468.80
|
| Rate for Payer: Lucent All Commercial |
$1,468.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,592.00
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$2,160.00
|
| Rate for Payer: PHP All Commercial |
$2,184.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,123.20
|
| Rate for Payer: Sagamore Health Network All Products |
$2,223.36
|
| Rate for Payer: Signature Care EPO |
$2,390.40
|
| Rate for Payer: Signature Care PPO |
$2,534.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,448.00
|
| Rate for Payer: United Healthcare Commercial |
$2,269.44
|
| Rate for Payer: United Healthcare Medicare |
$950.40
|
|
|
HC MESH VENTRALIGHT ST 7X9 ELLIPSE
|
Facility
IP
|
$3,840.84
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601340
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,880.63 |
| Max. Negotiated Rate |
$3,571.98 |
| Rate for Payer: Aetna Commercial |
$3,318.49
|
| Rate for Payer: Cash Price |
$2,381.32
|
| Rate for Payer: Cigna All Commercial |
$3,314.64
|
| Rate for Payer: CORVEL All Commercial |
$3,571.98
|
| Rate for Payer: Coventry All Commercial |
$3,379.94
|
| Rate for Payer: Encore All Commercial |
$3,535.49
|
| Rate for Payer: Frontpath All Commercial |
$3,533.57
|
| Rate for Payer: Humana ChoiceCare |
$3,317.33
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,456.76
|
| Rate for Payer: PHCS All Commercial |
$2,880.63
|
| Rate for Payer: PHP All Commercial |
$2,912.89
|
| Rate for Payer: Sagamore Health Network All Products |
$2,965.13
|
| Rate for Payer: Signature Care EPO |
$3,187.90
|
| Rate for Payer: Signature Care PPO |
$3,379.94
|
| Rate for Payer: United Healthcare Commercial |
$3,026.58
|
|
|
HC MESH VENTRALIGHT ST 7X9 ELLIPSE
|
Facility
OP
|
$3,840.84
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601340
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$3,571.98 |
| Rate for Payer: Aetna Commercial |
$3,241.67
|
| Rate for Payer: Aetna Medicare |
$1,267.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,267.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,205.79
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,400.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,457.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,394.22
|
| Rate for Payer: Cash Price |
$2,381.32
|
| Rate for Payer: Cash Price |
$2,381.32
|
| Rate for Payer: Centivo All Commercial |
$1,958.83
|
| Rate for Payer: Cigna All Commercial |
$3,314.64
|
| Rate for Payer: CORVEL All Commercial |
$3,571.98
|
| Rate for Payer: Coventry All Commercial |
$3,379.94
|
| Rate for Payer: Encore All Commercial |
$3,535.49
|
| Rate for Payer: Frontpath All Commercial |
$3,533.57
|
| Rate for Payer: Humana ChoiceCare |
$3,317.33
|
| Rate for Payer: Humana Medicare |
$1,958.83
|
| Rate for Payer: Lucent All Commercial |
$1,958.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,456.76
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$2,880.63
|
| Rate for Payer: PHP All Commercial |
$2,912.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,497.93
|
| Rate for Payer: Sagamore Health Network All Products |
$2,965.13
|
| Rate for Payer: Signature Care EPO |
$3,187.90
|
| Rate for Payer: Signature Care PPO |
$3,379.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,264.71
|
| Rate for Payer: United Healthcare Commercial |
$3,026.58
|
| Rate for Payer: United Healthcare Medicare |
$1,267.48
|
|
|
HC MESH VENTRALIGHT ST 8 CIRCLE
|
Facility
OP
|
$3,855.60
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41603984
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,585.71 |
| Rate for Payer: Aetna Commercial |
$3,254.13
|
| Rate for Payer: Aetna Medicare |
$1,272.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,272.35
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,214.27
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,410.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,463.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,399.58
|
| Rate for Payer: Cash Price |
$2,390.47
|
| Rate for Payer: Cash Price |
$2,390.47
|
| Rate for Payer: Centivo All Commercial |
$1,966.36
|
| Rate for Payer: Cigna All Commercial |
$3,327.38
|
| Rate for Payer: CORVEL All Commercial |
$3,585.71
|
| Rate for Payer: Coventry All Commercial |
$3,392.93
|
| Rate for Payer: Encore All Commercial |
$3,549.08
|
| Rate for Payer: Frontpath All Commercial |
$3,547.15
|
| Rate for Payer: Humana ChoiceCare |
$3,330.08
|
| Rate for Payer: Humana Medicare |
$1,966.36
|
| Rate for Payer: Lucent All Commercial |
$1,966.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,470.04
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,891.70
|
| Rate for Payer: PHP All Commercial |
$2,924.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,503.68
|
| Rate for Payer: Sagamore Health Network All Products |
$2,976.52
|
| Rate for Payer: Signature Care EPO |
$3,200.15
|
| Rate for Payer: Signature Care PPO |
$3,392.93
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,277.26
|
| Rate for Payer: United Healthcare Commercial |
$3,038.21
|
| Rate for Payer: United Healthcare Medicare |
$1,272.35
|
|
|
HC MESH VENTRALIGHT ST 8 CIRCLE
|
Facility
IP
|
$3,855.60
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41603984
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,891.70 |
| Max. Negotiated Rate |
$3,585.71 |
| Rate for Payer: Aetna Commercial |
$3,331.24
|
| Rate for Payer: Cash Price |
$2,390.47
|
| Rate for Payer: Cigna All Commercial |
$3,327.38
|
| Rate for Payer: CORVEL All Commercial |
$3,585.71
|
| Rate for Payer: Coventry All Commercial |
$3,392.93
|
| Rate for Payer: Encore All Commercial |
$3,549.08
|
| Rate for Payer: Frontpath All Commercial |
$3,547.15
|
| Rate for Payer: Humana ChoiceCare |
$3,330.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,470.04
|
| Rate for Payer: PHCS All Commercial |
$2,891.70
|
| Rate for Payer: PHP All Commercial |
$2,924.09
|
| Rate for Payer: Sagamore Health Network All Products |
$2,976.52
|
| Rate for Payer: Signature Care EPO |
$3,200.15
|
| Rate for Payer: Signature Care PPO |
$3,392.93
|
| Rate for Payer: United Healthcare Commercial |
$3,038.21
|
|
|
HC MESH VENTRALIGHT ST 8X10
|
Facility
OP
|
$4,550.04
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601341
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.68 |
| Max. Negotiated Rate |
$4,231.54 |
| Rate for Payer: Aetna Commercial |
$3,840.23
|
| Rate for Payer: Aetna Medicare |
$1,501.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,501.51
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,613.09
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,844.23
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$121.68
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,726.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,651.66
|
| Rate for Payer: Cash Price |
$2,821.03
|
| Rate for Payer: Cash Price |
$2,821.03
|
| Rate for Payer: Centivo All Commercial |
$2,320.52
|
| Rate for Payer: Cigna All Commercial |
$3,926.68
|
| Rate for Payer: CORVEL All Commercial |
$4,231.54
|
| Rate for Payer: Coventry All Commercial |
$4,004.04
|
| Rate for Payer: Encore All Commercial |
$4,188.31
|
| Rate for Payer: Frontpath All Commercial |
$4,186.04
|
| Rate for Payer: Humana ChoiceCare |
$3,929.87
|
| Rate for Payer: Humana Medicare |
$2,320.52
|
| Rate for Payer: Lucent All Commercial |
$2,320.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,095.04
|
| Rate for Payer: Managed Health Services Medicaid |
$121.68
|
| Rate for Payer: MDWise Medicaid |
$121.68
|
| Rate for Payer: PHCS All Commercial |
$3,412.53
|
| Rate for Payer: PHP All Commercial |
$3,450.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,774.52
|
| Rate for Payer: Sagamore Health Network All Products |
$3,512.63
|
| Rate for Payer: Signature Care EPO |
$3,776.53
|
| Rate for Payer: Signature Care PPO |
$4,004.04
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,867.53
|
| Rate for Payer: United Healthcare Commercial |
$3,585.43
|
| Rate for Payer: United Healthcare Medicare |
$1,501.51
|
|
|
HC MESH VENTRALIGHT ST 8X10
|
Facility
IP
|
$4,550.04
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601341
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,412.53 |
| Max. Negotiated Rate |
$4,231.54 |
| Rate for Payer: Aetna Commercial |
$3,931.23
|
| Rate for Payer: Cash Price |
$2,821.03
|
| Rate for Payer: Cigna All Commercial |
$3,926.68
|
| Rate for Payer: CORVEL All Commercial |
$4,231.54
|
| Rate for Payer: Coventry All Commercial |
$4,004.04
|
| Rate for Payer: Encore All Commercial |
$4,188.31
|
| Rate for Payer: Frontpath All Commercial |
$4,186.04
|
| Rate for Payer: Humana ChoiceCare |
$3,929.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,095.04
|
| Rate for Payer: PHCS All Commercial |
$3,412.53
|
| Rate for Payer: PHP All Commercial |
$3,450.75
|
| Rate for Payer: Sagamore Health Network All Products |
$3,512.63
|
| Rate for Payer: Signature Care EPO |
$3,776.53
|
| Rate for Payer: Signature Care PPO |
$4,004.04
|
| Rate for Payer: United Healthcare Commercial |
$3,585.43
|
|
|
HC MESH VENTRIO ST LG CIRCLE 11 X 11
|
Facility
IP
|
$2,529.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601342
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,896.75 |
| Max. Negotiated Rate |
$2,351.97 |
| Rate for Payer: Aetna Commercial |
$2,185.06
|
| Rate for Payer: Cash Price |
$1,567.98
|
| Rate for Payer: Cigna All Commercial |
$2,182.53
|
| Rate for Payer: CORVEL All Commercial |
$2,351.97
|
| Rate for Payer: Coventry All Commercial |
$2,225.52
|
| Rate for Payer: Encore All Commercial |
$2,327.94
|
| Rate for Payer: Frontpath All Commercial |
$2,326.68
|
| Rate for Payer: Humana ChoiceCare |
$2,184.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,276.10
|
| Rate for Payer: PHCS All Commercial |
$1,896.75
|
| Rate for Payer: PHP All Commercial |
$1,917.99
|
| Rate for Payer: Sagamore Health Network All Products |
$1,952.39
|
| Rate for Payer: Signature Care EPO |
$2,099.07
|
| Rate for Payer: Signature Care PPO |
$2,225.52
|
| Rate for Payer: United Healthcare Commercial |
$1,992.85
|
|
|
HC MESH VENTRIO ST LG CIRCLE 11 X 11
|
Facility
OP
|
$2,529.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601342
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,351.97 |
| Rate for Payer: Aetna Commercial |
$2,134.48
|
| Rate for Payer: Aetna Medicare |
$834.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$834.57
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,452.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,580.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$959.76
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$918.03
|
| Rate for Payer: Cash Price |
$1,567.98
|
| Rate for Payer: Cash Price |
$1,567.98
|
| Rate for Payer: Centivo All Commercial |
$1,289.79
|
| Rate for Payer: Cigna All Commercial |
$2,182.53
|
| Rate for Payer: CORVEL All Commercial |
$2,351.97
|
| Rate for Payer: Coventry All Commercial |
$2,225.52
|
| Rate for Payer: Encore All Commercial |
$2,327.94
|
| Rate for Payer: Frontpath All Commercial |
$2,326.68
|
| Rate for Payer: Humana ChoiceCare |
$2,184.30
|
| Rate for Payer: Humana Medicare |
$1,289.79
|
| Rate for Payer: Lucent All Commercial |
$1,289.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,276.10
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,896.75
|
| Rate for Payer: PHP All Commercial |
$1,917.99
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$986.31
|
| Rate for Payer: Sagamore Health Network All Products |
$1,952.39
|
| Rate for Payer: Signature Care EPO |
$2,099.07
|
| Rate for Payer: Signature Care PPO |
$2,225.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,149.65
|
| Rate for Payer: United Healthcare Commercial |
$1,992.85
|
| Rate for Payer: United Healthcare Medicare |
$834.57
|
|
|
HC MESH VENTRIO ST LG OVAL 13 X 17
|
Facility
OP
|
$4,245.48
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601343
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,948.30 |
| Rate for Payer: Aetna Commercial |
$3,583.19
|
| Rate for Payer: Aetna Medicare |
$1,401.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,401.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$2,438.18
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,653.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,611.16
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,541.11
|
| Rate for Payer: Cash Price |
$2,632.20
|
| Rate for Payer: Cash Price |
$2,632.20
|
| Rate for Payer: Centivo All Commercial |
$2,165.19
|
| Rate for Payer: Cigna All Commercial |
$3,663.85
|
| Rate for Payer: CORVEL All Commercial |
$3,948.30
|
| Rate for Payer: Coventry All Commercial |
$3,736.02
|
| Rate for Payer: Encore All Commercial |
$3,907.96
|
| Rate for Payer: Frontpath All Commercial |
$3,905.84
|
| Rate for Payer: Humana ChoiceCare |
$3,666.82
|
| Rate for Payer: Humana Medicare |
$2,165.19
|
| Rate for Payer: Lucent All Commercial |
$2,165.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,820.93
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$3,184.11
|
| Rate for Payer: PHP All Commercial |
$3,219.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,655.74
|
| Rate for Payer: Sagamore Health Network All Products |
$3,277.51
|
| Rate for Payer: Signature Care EPO |
$3,523.75
|
| Rate for Payer: Signature Care PPO |
$3,736.02
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,608.66
|
| Rate for Payer: United Healthcare Commercial |
$3,345.44
|
| Rate for Payer: United Healthcare Medicare |
$1,401.01
|
|
|
HC MESH VENTRIO ST LG OVAL 13 X 17
|
Facility
IP
|
$4,245.48
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601343
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,184.11 |
| Max. Negotiated Rate |
$3,948.30 |
| Rate for Payer: Aetna Commercial |
$3,668.09
|
| Rate for Payer: Cash Price |
$2,632.20
|
| Rate for Payer: Cigna All Commercial |
$3,663.85
|
| Rate for Payer: CORVEL All Commercial |
$3,948.30
|
| Rate for Payer: Coventry All Commercial |
$3,736.02
|
| Rate for Payer: Encore All Commercial |
$3,907.96
|
| Rate for Payer: Frontpath All Commercial |
$3,905.84
|
| Rate for Payer: Humana ChoiceCare |
$3,666.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,820.93
|
| Rate for Payer: PHCS All Commercial |
$3,184.11
|
| Rate for Payer: PHP All Commercial |
$3,219.77
|
| Rate for Payer: Sagamore Health Network All Products |
$3,277.51
|
| Rate for Payer: Signature Care EPO |
$3,523.75
|
| Rate for Payer: Signature Care PPO |
$3,736.02
|
| Rate for Payer: United Healthcare Commercial |
$3,345.44
|
|
