|
HC MESH VENTRIO ST MED OVAL 11 X 14
|
Facility
IP
|
$3,251.52
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601344
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,438.64 |
| Max. Negotiated Rate |
$3,023.91 |
| Rate for Payer: Aetna Commercial |
$2,809.31
|
| Rate for Payer: Cash Price |
$2,015.94
|
| Rate for Payer: Cigna All Commercial |
$2,806.06
|
| Rate for Payer: CORVEL All Commercial |
$3,023.91
|
| Rate for Payer: Coventry All Commercial |
$2,861.34
|
| Rate for Payer: Encore All Commercial |
$2,993.02
|
| Rate for Payer: Frontpath All Commercial |
$2,991.40
|
| Rate for Payer: Humana ChoiceCare |
$2,808.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,926.37
|
| Rate for Payer: PHCS All Commercial |
$2,438.64
|
| Rate for Payer: PHP All Commercial |
$2,465.95
|
| Rate for Payer: Sagamore Health Network All Products |
$2,510.17
|
| Rate for Payer: Signature Care EPO |
$2,698.76
|
| Rate for Payer: Signature Care PPO |
$2,861.34
|
| Rate for Payer: United Healthcare Commercial |
$2,562.20
|
|
|
HC MESH VENTRIO ST MED OVAL 11 X 14
|
Facility
OP
|
$3,251.52
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601344
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$3,023.91 |
| Rate for Payer: Aetna Commercial |
$2,744.28
|
| Rate for Payer: Aetna Medicare |
$1,073.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,073.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,867.35
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,032.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,233.95
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,180.30
|
| Rate for Payer: Cash Price |
$2,015.94
|
| Rate for Payer: Cash Price |
$2,015.94
|
| Rate for Payer: Centivo All Commercial |
$1,658.28
|
| Rate for Payer: Cigna All Commercial |
$2,806.06
|
| Rate for Payer: CORVEL All Commercial |
$3,023.91
|
| Rate for Payer: Coventry All Commercial |
$2,861.34
|
| Rate for Payer: Encore All Commercial |
$2,993.02
|
| Rate for Payer: Frontpath All Commercial |
$2,991.40
|
| Rate for Payer: Humana ChoiceCare |
$2,808.34
|
| Rate for Payer: Humana Medicare |
$1,658.28
|
| Rate for Payer: Lucent All Commercial |
$1,658.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,926.37
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$2,438.64
|
| Rate for Payer: PHP All Commercial |
$2,465.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,268.09
|
| Rate for Payer: Sagamore Health Network All Products |
$2,510.17
|
| Rate for Payer: Signature Care EPO |
$2,698.76
|
| Rate for Payer: Signature Care PPO |
$2,861.34
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,763.79
|
| Rate for Payer: United Healthcare Commercial |
$2,562.20
|
| Rate for Payer: United Healthcare Medicare |
$1,073.00
|
|
|
HC MESH VENTRIO ST MIDLINE 15 X 25
|
Facility
OP
|
$6,249.60
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601345
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,812.13 |
| Rate for Payer: Aetna Commercial |
$5,274.66
|
| Rate for Payer: Aetna Medicare |
$2,062.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,062.37
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,589.15
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,906.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,371.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,268.60
|
| Rate for Payer: Cash Price |
$3,874.75
|
| Rate for Payer: Cash Price |
$3,874.75
|
| Rate for Payer: Centivo All Commercial |
$3,187.30
|
| Rate for Payer: Cigna All Commercial |
$5,393.40
|
| Rate for Payer: CORVEL All Commercial |
$5,812.13
|
| Rate for Payer: Coventry All Commercial |
$5,499.65
|
| Rate for Payer: Encore All Commercial |
$5,752.76
|
| Rate for Payer: Frontpath All Commercial |
$5,749.63
|
| Rate for Payer: Humana ChoiceCare |
$5,397.78
|
| Rate for Payer: Humana Medicare |
$3,187.30
|
| Rate for Payer: Lucent All Commercial |
$3,187.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,624.64
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,687.20
|
| Rate for Payer: PHP All Commercial |
$4,739.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,437.34
|
| Rate for Payer: Sagamore Health Network All Products |
$4,824.69
|
| Rate for Payer: Signature Care EPO |
$5,187.17
|
| Rate for Payer: Signature Care PPO |
$5,499.65
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,312.16
|
| Rate for Payer: United Healthcare Commercial |
$4,924.68
|
| Rate for Payer: United Healthcare Medicare |
$2,062.37
|
|
|
HC MESH VENTRIO ST MIDLINE 15 X 25
|
Facility
IP
|
$6,249.60
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601345
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,687.20 |
| Max. Negotiated Rate |
$5,812.13 |
| Rate for Payer: Aetna Commercial |
$5,399.65
|
| Rate for Payer: Cash Price |
$3,874.75
|
| Rate for Payer: Cigna All Commercial |
$5,393.40
|
| Rate for Payer: CORVEL All Commercial |
$5,812.13
|
| Rate for Payer: Coventry All Commercial |
$5,499.65
|
| Rate for Payer: Encore All Commercial |
$5,752.76
|
| Rate for Payer: Frontpath All Commercial |
$5,749.63
|
| Rate for Payer: Humana ChoiceCare |
$5,397.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,624.64
|
| Rate for Payer: PHCS All Commercial |
$4,687.20
|
| Rate for Payer: PHP All Commercial |
$4,739.70
|
| Rate for Payer: Sagamore Health Network All Products |
$4,824.69
|
| Rate for Payer: Signature Care EPO |
$5,187.17
|
| Rate for Payer: Signature Care PPO |
$5,499.65
|
| Rate for Payer: United Healthcare Commercial |
$4,924.68
|
|
|
HC MESH VENTRIO ST SM CIRCLE 7 X
|
Facility
IP
|
$1,842.84
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41602490
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,382.13 |
| Max. Negotiated Rate |
$1,713.84 |
| Rate for Payer: Aetna Commercial |
$1,592.21
|
| Rate for Payer: Cash Price |
$1,142.56
|
| Rate for Payer: Cigna All Commercial |
$1,590.37
|
| Rate for Payer: CORVEL All Commercial |
$1,713.84
|
| Rate for Payer: Coventry All Commercial |
$1,621.70
|
| Rate for Payer: Encore All Commercial |
$1,696.33
|
| Rate for Payer: Frontpath All Commercial |
$1,695.41
|
| Rate for Payer: Humana ChoiceCare |
$1,591.66
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,658.56
|
| Rate for Payer: PHCS All Commercial |
$1,382.13
|
| Rate for Payer: PHP All Commercial |
$1,397.61
|
| Rate for Payer: Sagamore Health Network All Products |
$1,422.67
|
| Rate for Payer: Signature Care EPO |
$1,529.56
|
| Rate for Payer: Signature Care PPO |
$1,621.70
|
| Rate for Payer: United Healthcare Commercial |
$1,452.16
|
|
|
HC MESH VENTRIO ST SM CIRCLE 7 X
|
Facility
OP
|
$1,842.84
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41602490
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$1,713.84 |
| Rate for Payer: Aetna Commercial |
$1,555.36
|
| Rate for Payer: Aetna Medicare |
$608.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$608.14
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,058.34
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,151.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$699.36
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$668.95
|
| Rate for Payer: Cash Price |
$1,142.56
|
| Rate for Payer: Cash Price |
$1,142.56
|
| Rate for Payer: Centivo All Commercial |
$939.85
|
| Rate for Payer: Cigna All Commercial |
$1,590.37
|
| Rate for Payer: CORVEL All Commercial |
$1,713.84
|
| Rate for Payer: Coventry All Commercial |
$1,621.70
|
| Rate for Payer: Encore All Commercial |
$1,696.33
|
| Rate for Payer: Frontpath All Commercial |
$1,695.41
|
| Rate for Payer: Humana ChoiceCare |
$1,591.66
|
| Rate for Payer: Humana Medicare |
$939.85
|
| Rate for Payer: Lucent All Commercial |
$939.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,658.56
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,382.13
|
| Rate for Payer: PHP All Commercial |
$1,397.61
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$718.71
|
| Rate for Payer: Sagamore Health Network All Products |
$1,422.67
|
| Rate for Payer: Signature Care EPO |
$1,529.56
|
| Rate for Payer: Signature Care PPO |
$1,621.70
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,566.41
|
| Rate for Payer: United Healthcare Commercial |
$1,452.16
|
| Rate for Payer: United Healthcare Medicare |
$608.14
|
|
|
HC MESH VENTRIO ST SM OVAL 8 X 12
|
Facility
OP
|
$2,203.92
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601346
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$2,049.65 |
| Rate for Payer: Aetna Commercial |
$1,860.11
|
| Rate for Payer: Aetna Medicare |
$727.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$727.29
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$1,265.71
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,377.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$836.39
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$800.02
|
| Rate for Payer: Cash Price |
$1,366.43
|
| Rate for Payer: Cash Price |
$1,366.43
|
| Rate for Payer: Centivo All Commercial |
$1,124.00
|
| Rate for Payer: Cigna All Commercial |
$1,901.98
|
| Rate for Payer: CORVEL All Commercial |
$2,049.65
|
| Rate for Payer: Coventry All Commercial |
$1,939.45
|
| Rate for Payer: Encore All Commercial |
$2,028.71
|
| Rate for Payer: Frontpath All Commercial |
$2,027.61
|
| Rate for Payer: Humana ChoiceCare |
$1,903.53
|
| Rate for Payer: Humana Medicare |
$1,124.00
|
| Rate for Payer: Lucent All Commercial |
$1,124.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,983.53
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$1,652.94
|
| Rate for Payer: PHP All Commercial |
$1,671.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$859.53
|
| Rate for Payer: Sagamore Health Network All Products |
$1,701.43
|
| Rate for Payer: Signature Care EPO |
$1,829.25
|
| Rate for Payer: Signature Care PPO |
$1,939.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,873.33
|
| Rate for Payer: United Healthcare Commercial |
$1,736.69
|
| Rate for Payer: United Healthcare Medicare |
$727.29
|
|
|
HC MESH VENTRIO ST SM OVAL 8 X 12
|
Facility
IP
|
$2,203.92
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601346
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,652.94 |
| Max. Negotiated Rate |
$2,049.65 |
| Rate for Payer: Aetna Commercial |
$1,904.19
|
| Rate for Payer: Cash Price |
$1,366.43
|
| Rate for Payer: Cigna All Commercial |
$1,901.98
|
| Rate for Payer: CORVEL All Commercial |
$2,049.65
|
| Rate for Payer: Coventry All Commercial |
$1,939.45
|
| Rate for Payer: Encore All Commercial |
$2,028.71
|
| Rate for Payer: Frontpath All Commercial |
$2,027.61
|
| Rate for Payer: Humana ChoiceCare |
$1,903.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,983.53
|
| Rate for Payer: PHCS All Commercial |
$1,652.94
|
| Rate for Payer: PHP All Commercial |
$1,671.45
|
| Rate for Payer: Sagamore Health Network All Products |
$1,701.43
|
| Rate for Payer: Signature Care EPO |
$1,829.25
|
| Rate for Payer: Signature Care PPO |
$1,939.45
|
| Rate for Payer: United Healthcare Commercial |
$1,736.69
|
|
|
HC MESH VENTRIO ST XL OVAL 19 X 24
|
Facility
OP
|
$5,580.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601347
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,189.40 |
| Rate for Payer: Aetna Commercial |
$4,709.52
|
| Rate for Payer: Aetna Medicare |
$1,841.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,841.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,204.59
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,488.06
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,117.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,025.54
|
| Rate for Payer: Cash Price |
$3,459.60
|
| Rate for Payer: Cash Price |
$3,459.60
|
| Rate for Payer: Centivo All Commercial |
$2,845.80
|
| Rate for Payer: Cigna All Commercial |
$4,815.54
|
| Rate for Payer: CORVEL All Commercial |
$5,189.40
|
| Rate for Payer: Coventry All Commercial |
$4,910.40
|
| Rate for Payer: Encore All Commercial |
$5,136.39
|
| Rate for Payer: Frontpath All Commercial |
$5,133.60
|
| Rate for Payer: Humana ChoiceCare |
$4,819.45
|
| Rate for Payer: Humana Medicare |
$2,845.80
|
| Rate for Payer: Lucent All Commercial |
$2,845.80
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,022.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,185.00
|
| Rate for Payer: PHP All Commercial |
$4,231.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,176.20
|
| Rate for Payer: Sagamore Health Network All Products |
$4,307.76
|
| Rate for Payer: Signature Care EPO |
$4,631.40
|
| Rate for Payer: Signature Care PPO |
$4,910.40
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,743.00
|
| Rate for Payer: United Healthcare Commercial |
$4,397.04
|
| Rate for Payer: United Healthcare Medicare |
$1,841.40
|
|
|
HC MESH VENTRIO ST XL OVAL 19 X 24
|
Facility
IP
|
$5,580.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601347
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,185.00 |
| Max. Negotiated Rate |
$5,189.40 |
| Rate for Payer: Aetna Commercial |
$4,821.12
|
| Rate for Payer: Cash Price |
$3,459.60
|
| Rate for Payer: Cigna All Commercial |
$4,815.54
|
| Rate for Payer: CORVEL All Commercial |
$5,189.40
|
| Rate for Payer: Coventry All Commercial |
$4,910.40
|
| Rate for Payer: Encore All Commercial |
$5,136.39
|
| Rate for Payer: Frontpath All Commercial |
$5,133.60
|
| Rate for Payer: Humana ChoiceCare |
$4,819.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,022.00
|
| Rate for Payer: PHCS All Commercial |
$4,185.00
|
| Rate for Payer: PHP All Commercial |
$4,231.87
|
| Rate for Payer: Sagamore Health Network All Products |
$4,307.76
|
| Rate for Payer: Signature Care EPO |
$4,631.40
|
| Rate for Payer: Signature Care PPO |
$4,910.40
|
| Rate for Payer: United Healthcare Commercial |
$4,397.04
|
|
|
HC MESH VENTRIO ST XL OVAL 22 X 2
|
Facility
IP
|
$7,650.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41602491
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,737.50 |
| Max. Negotiated Rate |
$7,114.50 |
| Rate for Payer: Aetna Commercial |
$6,609.60
|
| Rate for Payer: Cash Price |
$4,743.00
|
| Rate for Payer: Cigna All Commercial |
$6,601.95
|
| Rate for Payer: CORVEL All Commercial |
$7,114.50
|
| Rate for Payer: Coventry All Commercial |
$6,732.00
|
| Rate for Payer: Encore All Commercial |
$7,041.82
|
| Rate for Payer: Frontpath All Commercial |
$7,038.00
|
| Rate for Payer: Humana ChoiceCare |
$6,607.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,885.00
|
| Rate for Payer: PHCS All Commercial |
$5,737.50
|
| Rate for Payer: PHP All Commercial |
$5,801.76
|
| Rate for Payer: Sagamore Health Network All Products |
$5,905.80
|
| Rate for Payer: Signature Care EPO |
$6,349.50
|
| Rate for Payer: Signature Care PPO |
$6,732.00
|
| Rate for Payer: United Healthcare Commercial |
$6,028.20
|
|
|
HC MESH VENTRIO ST XL OVAL 22 X 2
|
Facility
OP
|
$7,650.00
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41602491
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$7,114.50 |
| Rate for Payer: Aetna Commercial |
$6,456.60
|
| Rate for Payer: Aetna Medicare |
$2,524.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,524.50
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$4,393.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,782.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,903.18
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,776.95
|
| Rate for Payer: Cash Price |
$4,743.00
|
| Rate for Payer: Cash Price |
$4,743.00
|
| Rate for Payer: Centivo All Commercial |
$3,901.50
|
| Rate for Payer: Cigna All Commercial |
$6,601.95
|
| Rate for Payer: CORVEL All Commercial |
$7,114.50
|
| Rate for Payer: Coventry All Commercial |
$6,732.00
|
| Rate for Payer: Encore All Commercial |
$7,041.82
|
| Rate for Payer: Frontpath All Commercial |
$7,038.00
|
| Rate for Payer: Humana ChoiceCare |
$6,607.30
|
| Rate for Payer: Humana Medicare |
$3,901.50
|
| Rate for Payer: Lucent All Commercial |
$3,901.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$6,885.00
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$5,737.50
|
| Rate for Payer: PHP All Commercial |
$5,801.76
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,983.50
|
| Rate for Payer: Sagamore Health Network All Products |
$5,905.80
|
| Rate for Payer: Signature Care EPO |
$6,349.50
|
| Rate for Payer: Signature Care PPO |
$6,732.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$6,502.50
|
| Rate for Payer: United Healthcare Commercial |
$6,028.20
|
| Rate for Payer: United Healthcare Medicare |
$2,524.50
|
|
|
HC MESH VICRYL 12X12
|
Facility
IP
|
$5,693.40
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601955
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,270.05 |
| Max. Negotiated Rate |
$5,294.86 |
| Rate for Payer: Aetna Commercial |
$4,919.10
|
| Rate for Payer: Cash Price |
$3,529.91
|
| Rate for Payer: Cigna All Commercial |
$4,913.40
|
| Rate for Payer: CORVEL All Commercial |
$5,294.86
|
| Rate for Payer: Coventry All Commercial |
$5,010.19
|
| Rate for Payer: Encore All Commercial |
$5,240.77
|
| Rate for Payer: Frontpath All Commercial |
$5,237.93
|
| Rate for Payer: Humana ChoiceCare |
$4,917.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,124.06
|
| Rate for Payer: PHCS All Commercial |
$4,270.05
|
| Rate for Payer: PHP All Commercial |
$4,317.87
|
| Rate for Payer: Sagamore Health Network All Products |
$4,395.30
|
| Rate for Payer: Signature Care EPO |
$4,725.52
|
| Rate for Payer: Signature Care PPO |
$5,010.19
|
| Rate for Payer: United Healthcare Commercial |
$4,486.40
|
|
|
HC MESH VICRYL 12X12
|
Facility
OP
|
$5,693.40
|
|
|
Service Code
|
CPT C1781
|
| Hospital Charge Code |
41601955
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$524.16 |
| Max. Negotiated Rate |
$5,294.86 |
| Rate for Payer: Aetna Commercial |
$4,805.23
|
| Rate for Payer: Aetna Medicare |
$1,878.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,878.82
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$3,269.72
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,558.94
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$524.16
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,160.65
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,066.70
|
| Rate for Payer: Cash Price |
$3,529.91
|
| Rate for Payer: Cash Price |
$3,529.91
|
| Rate for Payer: Centivo All Commercial |
$2,903.63
|
| Rate for Payer: Cigna All Commercial |
$4,913.40
|
| Rate for Payer: CORVEL All Commercial |
$5,294.86
|
| Rate for Payer: Coventry All Commercial |
$5,010.19
|
| Rate for Payer: Encore All Commercial |
$5,240.77
|
| Rate for Payer: Frontpath All Commercial |
$5,237.93
|
| Rate for Payer: Humana ChoiceCare |
$4,917.39
|
| Rate for Payer: Humana Medicare |
$2,903.63
|
| Rate for Payer: Lucent All Commercial |
$2,903.63
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,124.06
|
| Rate for Payer: Managed Health Services Medicaid |
$524.16
|
| Rate for Payer: MDWise Medicaid |
$524.16
|
| Rate for Payer: PHCS All Commercial |
$4,270.05
|
| Rate for Payer: PHP All Commercial |
$4,317.87
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,220.43
|
| Rate for Payer: Sagamore Health Network All Products |
$4,395.30
|
| Rate for Payer: Signature Care EPO |
$4,725.52
|
| Rate for Payer: Signature Care PPO |
$5,010.19
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,839.39
|
| Rate for Payer: United Healthcare Commercial |
$4,486.40
|
| Rate for Payer: United Healthcare Medicare |
$1,878.82
|
|
|
HC METANEPHRINES
|
Facility
IP
|
$307.43
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
63001636
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$230.57 |
| Max. Negotiated Rate |
$285.91 |
| Rate for Payer: Aetna Commercial |
$265.62
|
| Rate for Payer: Cash Price |
$190.61
|
| Rate for Payer: Cigna All Commercial |
$265.31
|
| Rate for Payer: CORVEL All Commercial |
$285.91
|
| Rate for Payer: Coventry All Commercial |
$270.54
|
| Rate for Payer: Encore All Commercial |
$282.99
|
| Rate for Payer: Frontpath All Commercial |
$282.83
|
| Rate for Payer: Humana ChoiceCare |
$265.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$276.69
|
| Rate for Payer: PHCS All Commercial |
$230.57
|
| Rate for Payer: PHP All Commercial |
$233.15
|
| Rate for Payer: Sagamore Health Network All Products |
$237.33
|
| Rate for Payer: Signature Care EPO |
$255.17
|
| Rate for Payer: Signature Care PPO |
$270.54
|
| Rate for Payer: United Healthcare Commercial |
$242.25
|
|
|
HC METANEPHRINES
|
Facility
OP
|
$307.43
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
63001636
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.94 |
| Max. Negotiated Rate |
$285.91 |
| Rate for Payer: Aetna Commercial |
$259.47
|
| Rate for Payer: Aetna Medicare |
$101.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$101.45
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$141.29
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$141.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$16.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$116.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$111.60
|
| Rate for Payer: Cash Price |
$190.61
|
| Rate for Payer: Cash Price |
$190.61
|
| Rate for Payer: Centivo All Commercial |
$156.79
|
| Rate for Payer: Cigna All Commercial |
$265.31
|
| Rate for Payer: CORVEL All Commercial |
$285.91
|
| Rate for Payer: Coventry All Commercial |
$270.54
|
| Rate for Payer: Encore All Commercial |
$282.99
|
| Rate for Payer: Frontpath All Commercial |
$282.83
|
| Rate for Payer: Humana ChoiceCare |
$265.53
|
| Rate for Payer: Humana Medicare |
$156.79
|
| Rate for Payer: Lucent All Commercial |
$156.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$276.69
|
| Rate for Payer: Managed Health Services Medicaid |
$16.94
|
| Rate for Payer: MDWise Medicaid |
$16.94
|
| Rate for Payer: PHCS All Commercial |
$230.57
|
| Rate for Payer: PHP All Commercial |
$233.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$119.90
|
| Rate for Payer: Sagamore Health Network All Products |
$237.33
|
| Rate for Payer: Signature Care EPO |
$255.17
|
| Rate for Payer: Signature Care PPO |
$270.54
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$261.31
|
| Rate for Payer: United Healthcare Commercial |
$242.25
|
| Rate for Payer: United Healthcare Medicare |
$101.45
|
|
|
HC METANEPHRINES 24HR
|
Facility
OP
|
$307.43
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
63001637
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.94 |
| Max. Negotiated Rate |
$285.91 |
| Rate for Payer: Aetna Commercial |
$259.47
|
| Rate for Payer: Aetna Medicare |
$101.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$101.45
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$141.29
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$141.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$16.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$116.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$111.60
|
| Rate for Payer: Cash Price |
$190.61
|
| Rate for Payer: Cash Price |
$190.61
|
| Rate for Payer: Centivo All Commercial |
$156.79
|
| Rate for Payer: Cigna All Commercial |
$265.31
|
| Rate for Payer: CORVEL All Commercial |
$285.91
|
| Rate for Payer: Coventry All Commercial |
$270.54
|
| Rate for Payer: Encore All Commercial |
$282.99
|
| Rate for Payer: Frontpath All Commercial |
$282.83
|
| Rate for Payer: Humana ChoiceCare |
$265.53
|
| Rate for Payer: Humana Medicare |
$156.79
|
| Rate for Payer: Lucent All Commercial |
$156.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$276.69
|
| Rate for Payer: Managed Health Services Medicaid |
$16.94
|
| Rate for Payer: MDWise Medicaid |
$16.94
|
| Rate for Payer: PHCS All Commercial |
$230.57
|
| Rate for Payer: PHP All Commercial |
$233.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$119.90
|
| Rate for Payer: Sagamore Health Network All Products |
$237.33
|
| Rate for Payer: Signature Care EPO |
$255.17
|
| Rate for Payer: Signature Care PPO |
$270.54
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$261.31
|
| Rate for Payer: United Healthcare Commercial |
$242.25
|
| Rate for Payer: United Healthcare Medicare |
$101.45
|
|
|
HC METANEPHRINES 24HR
|
Facility
IP
|
$307.43
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
63001637
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$230.57 |
| Max. Negotiated Rate |
$285.91 |
| Rate for Payer: Aetna Commercial |
$265.62
|
| Rate for Payer: Cash Price |
$190.61
|
| Rate for Payer: Cigna All Commercial |
$265.31
|
| Rate for Payer: CORVEL All Commercial |
$285.91
|
| Rate for Payer: Coventry All Commercial |
$270.54
|
| Rate for Payer: Encore All Commercial |
$282.99
|
| Rate for Payer: Frontpath All Commercial |
$282.83
|
| Rate for Payer: Humana ChoiceCare |
$265.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$276.69
|
| Rate for Payer: PHCS All Commercial |
$230.57
|
| Rate for Payer: PHP All Commercial |
$233.15
|
| Rate for Payer: Sagamore Health Network All Products |
$237.33
|
| Rate for Payer: Signature Care EPO |
$255.17
|
| Rate for Payer: Signature Care PPO |
$270.54
|
| Rate for Payer: United Healthcare Commercial |
$242.25
|
|
|
HC METANEPHRINES, PHEOCHROMOCYTOMA EVALUATION
|
Facility
OP
|
$106.52
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
63044064
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.18 |
| Max. Negotiated Rate |
$99.06 |
| Rate for Payer: Aetna Commercial |
$89.90
|
| Rate for Payer: Aetna Medicare |
$35.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$35.15
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$48.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$48.96
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$5.18
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$40.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$38.67
|
| Rate for Payer: Cash Price |
$66.04
|
| Rate for Payer: Cash Price |
$66.04
|
| Rate for Payer: Centivo All Commercial |
$54.32
|
| Rate for Payer: Cigna All Commercial |
$91.93
|
| Rate for Payer: CORVEL All Commercial |
$99.06
|
| Rate for Payer: Coventry All Commercial |
$93.74
|
| Rate for Payer: Encore All Commercial |
$98.05
|
| Rate for Payer: Frontpath All Commercial |
$98.00
|
| Rate for Payer: Humana ChoiceCare |
$92.00
|
| Rate for Payer: Humana Medicare |
$54.32
|
| Rate for Payer: Lucent All Commercial |
$54.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$95.87
|
| Rate for Payer: Managed Health Services Medicaid |
$5.18
|
| Rate for Payer: MDWise Medicaid |
$5.18
|
| Rate for Payer: PHCS All Commercial |
$79.89
|
| Rate for Payer: PHP All Commercial |
$80.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$41.54
|
| Rate for Payer: Sagamore Health Network All Products |
$82.23
|
| Rate for Payer: Signature Care EPO |
$88.41
|
| Rate for Payer: Signature Care PPO |
$93.74
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$90.54
|
| Rate for Payer: United Healthcare Commercial |
$83.94
|
| Rate for Payer: United Healthcare Medicare |
$35.15
|
|
|
HC METANEPHRINES, PHEOCHROMOCYTOMA EVALUATION
|
Facility
IP
|
$106.52
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
63044064
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$79.89 |
| Max. Negotiated Rate |
$99.06 |
| Rate for Payer: Aetna Commercial |
$92.03
|
| Rate for Payer: Cash Price |
$66.04
|
| Rate for Payer: Cigna All Commercial |
$91.93
|
| Rate for Payer: CORVEL All Commercial |
$99.06
|
| Rate for Payer: Coventry All Commercial |
$93.74
|
| Rate for Payer: Encore All Commercial |
$98.05
|
| Rate for Payer: Frontpath All Commercial |
$98.00
|
| Rate for Payer: Humana ChoiceCare |
$92.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$95.87
|
| Rate for Payer: PHCS All Commercial |
$79.89
|
| Rate for Payer: PHP All Commercial |
$80.78
|
| Rate for Payer: Sagamore Health Network All Products |
$82.23
|
| Rate for Payer: Signature Care EPO |
$88.41
|
| Rate for Payer: Signature Care PPO |
$93.74
|
| Rate for Payer: United Healthcare Commercial |
$83.94
|
|
|
HC METANEPHRINES, PHEOCHROMOCYTOMA EVALUATION-B
|
Facility
OP
|
$307.43
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
63044065
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.94 |
| Max. Negotiated Rate |
$285.91 |
| Rate for Payer: Aetna Commercial |
$259.47
|
| Rate for Payer: Aetna Medicare |
$101.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$101.45
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$141.29
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$141.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$16.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$116.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$111.60
|
| Rate for Payer: Cash Price |
$190.61
|
| Rate for Payer: Cash Price |
$190.61
|
| Rate for Payer: Centivo All Commercial |
$156.79
|
| Rate for Payer: Cigna All Commercial |
$265.31
|
| Rate for Payer: CORVEL All Commercial |
$285.91
|
| Rate for Payer: Coventry All Commercial |
$270.54
|
| Rate for Payer: Encore All Commercial |
$282.99
|
| Rate for Payer: Frontpath All Commercial |
$282.83
|
| Rate for Payer: Humana ChoiceCare |
$265.53
|
| Rate for Payer: Humana Medicare |
$156.79
|
| Rate for Payer: Lucent All Commercial |
$156.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$276.69
|
| Rate for Payer: Managed Health Services Medicaid |
$16.94
|
| Rate for Payer: MDWise Medicaid |
$16.94
|
| Rate for Payer: PHCS All Commercial |
$230.57
|
| Rate for Payer: PHP All Commercial |
$233.15
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$119.90
|
| Rate for Payer: Sagamore Health Network All Products |
$237.33
|
| Rate for Payer: Signature Care EPO |
$255.17
|
| Rate for Payer: Signature Care PPO |
$270.54
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$261.31
|
| Rate for Payer: United Healthcare Commercial |
$242.25
|
| Rate for Payer: United Healthcare Medicare |
$101.45
|
|
|
HC METANEPHRINES, PHEOCHROMOCYTOMA EVALUATION-B
|
Facility
IP
|
$307.43
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
63044065
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$230.57 |
| Max. Negotiated Rate |
$285.91 |
| Rate for Payer: Aetna Commercial |
$265.62
|
| Rate for Payer: Cash Price |
$190.61
|
| Rate for Payer: Cigna All Commercial |
$265.31
|
| Rate for Payer: CORVEL All Commercial |
$285.91
|
| Rate for Payer: Coventry All Commercial |
$270.54
|
| Rate for Payer: Encore All Commercial |
$282.99
|
| Rate for Payer: Frontpath All Commercial |
$282.83
|
| Rate for Payer: Humana ChoiceCare |
$265.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$276.69
|
| Rate for Payer: PHCS All Commercial |
$230.57
|
| Rate for Payer: PHP All Commercial |
$233.15
|
| Rate for Payer: Sagamore Health Network All Products |
$237.33
|
| Rate for Payer: Signature Care EPO |
$255.17
|
| Rate for Payer: Signature Care PPO |
$270.54
|
| Rate for Payer: United Healthcare Commercial |
$242.25
|
|
|
HC METANEPHRINES U
|
Facility
OP
|
$258.06
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
63001638
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.94 |
| Max. Negotiated Rate |
$240.00 |
| Rate for Payer: Aetna Commercial |
$217.80
|
| Rate for Payer: Aetna Medicare |
$85.16
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$85.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$118.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$118.60
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$16.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$97.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$93.68
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Centivo All Commercial |
$131.61
|
| Rate for Payer: Cigna All Commercial |
$222.71
|
| Rate for Payer: CORVEL All Commercial |
$240.00
|
| Rate for Payer: Coventry All Commercial |
$227.09
|
| Rate for Payer: Encore All Commercial |
$237.54
|
| Rate for Payer: Frontpath All Commercial |
$237.42
|
| Rate for Payer: Humana ChoiceCare |
$222.89
|
| Rate for Payer: Humana Medicare |
$131.61
|
| Rate for Payer: Lucent All Commercial |
$131.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$232.25
|
| Rate for Payer: Managed Health Services Medicaid |
$16.94
|
| Rate for Payer: MDWise Medicaid |
$16.94
|
| Rate for Payer: PHCS All Commercial |
$193.54
|
| Rate for Payer: PHP All Commercial |
$195.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$100.64
|
| Rate for Payer: Sagamore Health Network All Products |
$199.22
|
| Rate for Payer: Signature Care EPO |
$214.19
|
| Rate for Payer: Signature Care PPO |
$227.09
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$219.35
|
| Rate for Payer: United Healthcare Commercial |
$203.35
|
| Rate for Payer: United Healthcare Medicare |
$85.16
|
|
|
HC METANEPHRINES U
|
Facility
IP
|
$258.06
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
63001638
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$193.54 |
| Max. Negotiated Rate |
$240.00 |
| Rate for Payer: Aetna Commercial |
$222.96
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cigna All Commercial |
$222.71
|
| Rate for Payer: CORVEL All Commercial |
$240.00
|
| Rate for Payer: Coventry All Commercial |
$227.09
|
| Rate for Payer: Encore All Commercial |
$237.54
|
| Rate for Payer: Frontpath All Commercial |
$237.42
|
| Rate for Payer: Humana ChoiceCare |
$222.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$232.25
|
| Rate for Payer: PHCS All Commercial |
$193.54
|
| Rate for Payer: PHP All Commercial |
$195.71
|
| Rate for Payer: Sagamore Health Network All Products |
$199.22
|
| Rate for Payer: Signature Care EPO |
$214.19
|
| Rate for Payer: Signature Care PPO |
$227.09
|
| Rate for Payer: United Healthcare Commercial |
$203.35
|
|
|
HC METERED DOSE INHALER
|
Facility
OP
|
$169.33
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
01701292
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$24.84 |
| Max. Negotiated Rate |
$157.48 |
| Rate for Payer: Aetna Commercial |
$142.91
|
| Rate for Payer: Aetna Medicare |
$55.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$55.88
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$97.25
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$105.85
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$24.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$64.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$61.47
|
| Rate for Payer: Cash Price |
$104.99
|
| Rate for Payer: Cash Price |
$104.99
|
| Rate for Payer: Centivo All Commercial |
$86.36
|
| Rate for Payer: Cigna All Commercial |
$146.13
|
| Rate for Payer: CORVEL All Commercial |
$157.48
|
| Rate for Payer: Coventry All Commercial |
$149.01
|
| Rate for Payer: Encore All Commercial |
$155.87
|
| Rate for Payer: Frontpath All Commercial |
$155.78
|
| Rate for Payer: Humana ChoiceCare |
$146.25
|
| Rate for Payer: Humana Medicare |
$86.36
|
| Rate for Payer: Lucent All Commercial |
$86.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$152.40
|
| Rate for Payer: Managed Health Services Medicaid |
$24.84
|
| Rate for Payer: MDWise Medicaid |
$24.84
|
| Rate for Payer: PHCS All Commercial |
$127.00
|
| Rate for Payer: PHP All Commercial |
$128.42
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$66.04
|
| Rate for Payer: Sagamore Health Network All Products |
$130.72
|
| Rate for Payer: Signature Care EPO |
$140.54
|
| Rate for Payer: Signature Care PPO |
$149.01
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$143.93
|
| Rate for Payer: United Healthcare Commercial |
$133.43
|
| Rate for Payer: United Healthcare Medicare |
$55.88
|
|
