|
HC OT RE-EVAL EST PLAN CARE
|
Facility
|
OP
|
$295.80
|
|
|
Service Code
|
CPT 97168 GO
|
| Hospital Charge Code |
1737168
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$47.81 |
| Max. Negotiated Rate |
$275.09 |
| Rate for Payer: Aetna Commercial |
$249.66
|
| Rate for Payer: Aetna Medicare |
$94.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$47.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$91.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$169.88
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$184.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$47.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$108.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$104.12
|
| Rate for Payer: Cash Price |
$177.48
|
| Rate for Payer: Cash Price |
$177.48
|
| Rate for Payer: Centivo All Commercial |
$160.92
|
| Rate for Payer: Cigna All Commercial |
$255.28
|
| Rate for Payer: CORVEL All Commercial |
$275.09
|
| Rate for Payer: Coventry All Commercial |
$260.30
|
| Rate for Payer: Encore All Commercial |
$272.28
|
| Rate for Payer: Frontpath All Commercial |
$272.14
|
| Rate for Payer: Humana ChoiceCare |
$255.48
|
| Rate for Payer: Humana Medicare |
$94.66
|
| Rate for Payer: Lucent All Commercial |
$160.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$266.22
|
| Rate for Payer: Managed Health Services Medicaid |
$47.81
|
| Rate for Payer: MDWise Medicaid |
$47.81
|
| Rate for Payer: PHCS All Commercial |
$221.85
|
| Rate for Payer: PHP All Commercial |
$224.33
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$115.36
|
| Rate for Payer: Sagamore Health Network All Products |
$228.36
|
| Rate for Payer: Signature Care EPO |
$245.51
|
| Rate for Payer: Signature Care PPO |
$260.30
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$251.43
|
| Rate for Payer: United Healthcare Commercial |
$233.09
|
| Rate for Payer: United Healthcare Medicare |
$94.66
|
|
|
HC OT RE-EVAL EST PLAN CARE
|
Facility
|
IP
|
$295.80
|
|
|
Service Code
|
CPT 97168 GO
|
| Hospital Charge Code |
1737168
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$221.85 |
| Max. Negotiated Rate |
$275.09 |
| Rate for Payer: Aetna Commercial |
$255.57
|
| Rate for Payer: Cash Price |
$177.48
|
| Rate for Payer: Cigna All Commercial |
$255.28
|
| Rate for Payer: CORVEL All Commercial |
$275.09
|
| Rate for Payer: Coventry All Commercial |
$260.30
|
| Rate for Payer: Encore All Commercial |
$272.28
|
| Rate for Payer: Frontpath All Commercial |
$272.14
|
| Rate for Payer: Humana ChoiceCare |
$255.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$266.22
|
| Rate for Payer: PHCS All Commercial |
$221.85
|
| Rate for Payer: PHP All Commercial |
$224.33
|
| Rate for Payer: Sagamore Health Network All Products |
$228.36
|
| Rate for Payer: Signature Care EPO |
$245.51
|
| Rate for Payer: Signature Care PPO |
$260.30
|
| Rate for Payer: United Healthcare Commercial |
$233.09
|
|
|
HC OXALATE
|
Facility
|
OP
|
$225.63
|
|
|
Service Code
|
CPT 83945
|
| Hospital Charge Code |
63001647
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.45 |
| Max. Negotiated Rate |
$209.84 |
| Rate for Payer: Aetna Commercial |
$190.43
|
| Rate for Payer: Aetna Medicare |
$72.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$14.45
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$69.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$103.70
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$103.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$14.45
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$83.03
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$79.42
|
| Rate for Payer: Cash Price |
$135.38
|
| Rate for Payer: Cash Price |
$135.38
|
| Rate for Payer: Centivo All Commercial |
$122.74
|
| Rate for Payer: Cigna All Commercial |
$194.72
|
| Rate for Payer: CORVEL All Commercial |
$209.84
|
| Rate for Payer: Coventry All Commercial |
$198.55
|
| Rate for Payer: Encore All Commercial |
$207.69
|
| Rate for Payer: Frontpath All Commercial |
$207.58
|
| Rate for Payer: Humana ChoiceCare |
$194.88
|
| Rate for Payer: Humana Medicare |
$72.20
|
| Rate for Payer: Lucent All Commercial |
$122.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$203.07
|
| Rate for Payer: Managed Health Services Medicaid |
$14.45
|
| Rate for Payer: MDWise Medicaid |
$14.45
|
| Rate for Payer: PHCS All Commercial |
$169.22
|
| Rate for Payer: PHP All Commercial |
$171.12
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$88.00
|
| Rate for Payer: Sagamore Health Network All Products |
$174.19
|
| Rate for Payer: Signature Care EPO |
$187.27
|
| Rate for Payer: Signature Care PPO |
$198.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$191.79
|
| Rate for Payer: United Healthcare Commercial |
$177.80
|
| Rate for Payer: United Healthcare Medicare |
$72.20
|
|
|
HC OXALATE
|
Facility
|
IP
|
$225.63
|
|
|
Service Code
|
CPT 83945
|
| Hospital Charge Code |
63001647
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$169.22 |
| Max. Negotiated Rate |
$209.84 |
| Rate for Payer: Aetna Commercial |
$194.94
|
| Rate for Payer: Cash Price |
$135.38
|
| Rate for Payer: Cigna All Commercial |
$194.72
|
| Rate for Payer: CORVEL All Commercial |
$209.84
|
| Rate for Payer: Coventry All Commercial |
$198.55
|
| Rate for Payer: Encore All Commercial |
$207.69
|
| Rate for Payer: Frontpath All Commercial |
$207.58
|
| Rate for Payer: Humana ChoiceCare |
$194.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$203.07
|
| Rate for Payer: PHCS All Commercial |
$169.22
|
| Rate for Payer: PHP All Commercial |
$171.12
|
| Rate for Payer: Sagamore Health Network All Products |
$174.19
|
| Rate for Payer: Signature Care EPO |
$187.27
|
| Rate for Payer: Signature Care PPO |
$198.55
|
| Rate for Payer: United Healthcare Commercial |
$177.80
|
|
|
HC OXIMETER MULTI DETERMINATION
|
Facility
|
IP
|
$277.44
|
|
|
Service Code
|
CPT 94761
|
| Hospital Charge Code |
1704761
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$208.08 |
| Max. Negotiated Rate |
$258.02 |
| Rate for Payer: Aetna Commercial |
$239.71
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cigna All Commercial |
$239.43
|
| Rate for Payer: CORVEL All Commercial |
$258.02
|
| Rate for Payer: Coventry All Commercial |
$244.15
|
| Rate for Payer: Encore All Commercial |
$255.38
|
| Rate for Payer: Frontpath All Commercial |
$255.24
|
| Rate for Payer: Humana ChoiceCare |
$239.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$249.70
|
| Rate for Payer: PHCS All Commercial |
$208.08
|
| Rate for Payer: PHP All Commercial |
$210.41
|
| Rate for Payer: Sagamore Health Network All Products |
$214.18
|
| Rate for Payer: Signature Care EPO |
$230.28
|
| Rate for Payer: Signature Care PPO |
$244.15
|
| Rate for Payer: United Healthcare Commercial |
$218.62
|
|
|
HC OXIMETER MULTI DETERMINATION
|
Facility
|
OP
|
$277.44
|
|
|
Service Code
|
CPT 94761
|
| Hospital Charge Code |
1704761
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$36.37 |
| Max. Negotiated Rate |
$258.02 |
| Rate for Payer: Aetna Commercial |
$234.16
|
| Rate for Payer: Aetna Medicare |
$88.78
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$36.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$86.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$159.33
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$173.43
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$36.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$102.10
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$97.66
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Centivo All Commercial |
$150.93
|
| Rate for Payer: Cigna All Commercial |
$239.43
|
| Rate for Payer: CORVEL All Commercial |
$258.02
|
| Rate for Payer: Coventry All Commercial |
$244.15
|
| Rate for Payer: Encore All Commercial |
$255.38
|
| Rate for Payer: Frontpath All Commercial |
$255.24
|
| Rate for Payer: Humana ChoiceCare |
$239.62
|
| Rate for Payer: Humana Medicare |
$88.78
|
| Rate for Payer: Lucent All Commercial |
$150.93
|
| Rate for Payer: Lutheran Preferred All Commercial |
$249.70
|
| Rate for Payer: Managed Health Services Medicaid |
$36.37
|
| Rate for Payer: MDWise Medicaid |
$36.37
|
| Rate for Payer: PHCS All Commercial |
$208.08
|
| Rate for Payer: PHP All Commercial |
$210.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$108.20
|
| Rate for Payer: Sagamore Health Network All Products |
$214.18
|
| Rate for Payer: Signature Care EPO |
$230.28
|
| Rate for Payer: Signature Care PPO |
$244.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$235.82
|
| Rate for Payer: United Healthcare Commercial |
$218.62
|
| Rate for Payer: United Healthcare Medicare |
$88.78
|
|
|
HC OXIMETER OVERNIGHT
|
Facility
|
OP
|
$296.38
|
|
|
Service Code
|
CPT 94762
|
| Hospital Charge Code |
1701408
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$36.37 |
| Max. Negotiated Rate |
$275.63 |
| Rate for Payer: Aetna Commercial |
$250.14
|
| Rate for Payer: Aetna Medicare |
$94.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$36.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$91.88
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$170.21
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$185.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$36.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$109.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$104.33
|
| Rate for Payer: Cash Price |
$177.83
|
| Rate for Payer: Cash Price |
$177.83
|
| Rate for Payer: Centivo All Commercial |
$161.23
|
| Rate for Payer: Cigna All Commercial |
$255.78
|
| Rate for Payer: CORVEL All Commercial |
$275.63
|
| Rate for Payer: Coventry All Commercial |
$260.81
|
| Rate for Payer: Encore All Commercial |
$272.82
|
| Rate for Payer: Frontpath All Commercial |
$272.67
|
| Rate for Payer: Humana ChoiceCare |
$255.98
|
| Rate for Payer: Humana Medicare |
$94.84
|
| Rate for Payer: Lucent All Commercial |
$161.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$266.74
|
| Rate for Payer: Managed Health Services Medicaid |
$36.37
|
| Rate for Payer: MDWise Medicaid |
$36.37
|
| Rate for Payer: PHCS All Commercial |
$222.28
|
| Rate for Payer: PHP All Commercial |
$224.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$115.59
|
| Rate for Payer: Sagamore Health Network All Products |
$228.81
|
| Rate for Payer: Signature Care EPO |
$246.00
|
| Rate for Payer: Signature Care PPO |
$260.81
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$251.92
|
| Rate for Payer: United Healthcare Commercial |
$233.55
|
| Rate for Payer: United Healthcare Medicare |
$94.84
|
|
|
HC OXIMETER OVERNIGHT
|
Facility
|
IP
|
$296.38
|
|
|
Service Code
|
CPT 94762
|
| Hospital Charge Code |
1701408
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$222.28 |
| Max. Negotiated Rate |
$275.63 |
| Rate for Payer: Aetna Commercial |
$256.07
|
| Rate for Payer: Cash Price |
$177.83
|
| Rate for Payer: Cigna All Commercial |
$255.78
|
| Rate for Payer: CORVEL All Commercial |
$275.63
|
| Rate for Payer: Coventry All Commercial |
$260.81
|
| Rate for Payer: Encore All Commercial |
$272.82
|
| Rate for Payer: Frontpath All Commercial |
$272.67
|
| Rate for Payer: Humana ChoiceCare |
$255.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$266.74
|
| Rate for Payer: PHCS All Commercial |
$222.28
|
| Rate for Payer: PHP All Commercial |
$224.77
|
| Rate for Payer: Sagamore Health Network All Products |
$228.81
|
| Rate for Payer: Signature Care EPO |
$246.00
|
| Rate for Payer: Signature Care PPO |
$260.81
|
| Rate for Payer: United Healthcare Commercial |
$233.55
|
|
|
HC OXIMETER SINGLE
|
Facility
|
IP
|
$94.20
|
|
|
Service Code
|
CPT 94760
|
| Hospital Charge Code |
1706011
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$70.65 |
| Max. Negotiated Rate |
$87.61 |
| Rate for Payer: Aetna Commercial |
$81.39
|
| Rate for Payer: Cash Price |
$56.52
|
| Rate for Payer: Cigna All Commercial |
$81.29
|
| Rate for Payer: CORVEL All Commercial |
$87.61
|
| Rate for Payer: Coventry All Commercial |
$82.90
|
| Rate for Payer: Encore All Commercial |
$86.71
|
| Rate for Payer: Frontpath All Commercial |
$86.66
|
| Rate for Payer: Humana ChoiceCare |
$81.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$84.78
|
| Rate for Payer: PHCS All Commercial |
$70.65
|
| Rate for Payer: PHP All Commercial |
$71.44
|
| Rate for Payer: Sagamore Health Network All Products |
$72.72
|
| Rate for Payer: Signature Care EPO |
$78.19
|
| Rate for Payer: Signature Care PPO |
$82.90
|
| Rate for Payer: United Healthcare Commercial |
$74.23
|
|
|
HC OXIMETER SINGLE
|
Facility
|
OP
|
$94.20
|
|
|
Service Code
|
CPT 94760
|
| Hospital Charge Code |
1706011
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$29.20 |
| Max. Negotiated Rate |
$87.61 |
| Rate for Payer: Aetna Commercial |
$79.50
|
| Rate for Payer: Aetna Medicare |
$30.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$36.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$29.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$54.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$58.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$36.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$34.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$33.16
|
| Rate for Payer: Cash Price |
$56.52
|
| Rate for Payer: Cash Price |
$56.52
|
| Rate for Payer: Centivo All Commercial |
$51.24
|
| Rate for Payer: Cigna All Commercial |
$81.29
|
| Rate for Payer: CORVEL All Commercial |
$87.61
|
| Rate for Payer: Coventry All Commercial |
$82.90
|
| Rate for Payer: Encore All Commercial |
$86.71
|
| Rate for Payer: Frontpath All Commercial |
$86.66
|
| Rate for Payer: Humana ChoiceCare |
$81.36
|
| Rate for Payer: Humana Medicare |
$30.14
|
| Rate for Payer: Lucent All Commercial |
$51.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$84.78
|
| Rate for Payer: Managed Health Services Medicaid |
$36.37
|
| Rate for Payer: MDWise Medicaid |
$36.37
|
| Rate for Payer: PHCS All Commercial |
$70.65
|
| Rate for Payer: PHP All Commercial |
$71.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$36.74
|
| Rate for Payer: Sagamore Health Network All Products |
$72.72
|
| Rate for Payer: Signature Care EPO |
$78.19
|
| Rate for Payer: Signature Care PPO |
$82.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$80.07
|
| Rate for Payer: United Healthcare Commercial |
$74.23
|
| Rate for Payer: United Healthcare Medicare |
$30.14
|
|
|
HC OXIMETER SINGLE DETERMINATION
|
Facility
|
OP
|
$94.20
|
|
|
Service Code
|
CPT 94760
|
| Hospital Charge Code |
1709887
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$29.20 |
| Max. Negotiated Rate |
$87.61 |
| Rate for Payer: Aetna Commercial |
$79.50
|
| Rate for Payer: Aetna Medicare |
$30.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$36.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$29.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$54.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$58.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$36.37
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$34.67
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$33.16
|
| Rate for Payer: Cash Price |
$56.52
|
| Rate for Payer: Cash Price |
$56.52
|
| Rate for Payer: Centivo All Commercial |
$51.24
|
| Rate for Payer: Cigna All Commercial |
$81.29
|
| Rate for Payer: CORVEL All Commercial |
$87.61
|
| Rate for Payer: Coventry All Commercial |
$82.90
|
| Rate for Payer: Encore All Commercial |
$86.71
|
| Rate for Payer: Frontpath All Commercial |
$86.66
|
| Rate for Payer: Humana ChoiceCare |
$81.36
|
| Rate for Payer: Humana Medicare |
$30.14
|
| Rate for Payer: Lucent All Commercial |
$51.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$84.78
|
| Rate for Payer: Managed Health Services Medicaid |
$36.37
|
| Rate for Payer: MDWise Medicaid |
$36.37
|
| Rate for Payer: PHCS All Commercial |
$70.65
|
| Rate for Payer: PHP All Commercial |
$71.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$36.74
|
| Rate for Payer: Sagamore Health Network All Products |
$72.72
|
| Rate for Payer: Signature Care EPO |
$78.19
|
| Rate for Payer: Signature Care PPO |
$82.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$80.07
|
| Rate for Payer: United Healthcare Commercial |
$74.23
|
| Rate for Payer: United Healthcare Medicare |
$30.14
|
|
|
HC OXIMETER SINGLE DETERMINATION
|
Facility
|
IP
|
$94.20
|
|
|
Service Code
|
CPT 94760
|
| Hospital Charge Code |
1709887
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$70.65 |
| Max. Negotiated Rate |
$87.61 |
| Rate for Payer: Aetna Commercial |
$81.39
|
| Rate for Payer: Cash Price |
$56.52
|
| Rate for Payer: Cigna All Commercial |
$81.29
|
| Rate for Payer: CORVEL All Commercial |
$87.61
|
| Rate for Payer: Coventry All Commercial |
$82.90
|
| Rate for Payer: Encore All Commercial |
$86.71
|
| Rate for Payer: Frontpath All Commercial |
$86.66
|
| Rate for Payer: Humana ChoiceCare |
$81.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$84.78
|
| Rate for Payer: PHCS All Commercial |
$70.65
|
| Rate for Payer: PHP All Commercial |
$71.44
|
| Rate for Payer: Sagamore Health Network All Products |
$72.72
|
| Rate for Payer: Signature Care EPO |
$78.19
|
| Rate for Payer: Signature Care PPO |
$82.90
|
| Rate for Payer: United Healthcare Commercial |
$74.23
|
|
|
HC OXYCARB METAB-TRILEP
|
Facility
|
OP
|
$271.52
|
|
|
Service Code
|
CPT 80183
|
| Hospital Charge Code |
63001376
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.25 |
| Max. Negotiated Rate |
$252.51 |
| Rate for Payer: Aetna Commercial |
$229.16
|
| Rate for Payer: Aetna Medicare |
$86.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$13.25
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$84.17
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$124.79
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$124.79
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$13.25
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$99.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$95.58
|
| Rate for Payer: Cash Price |
$162.91
|
| Rate for Payer: Cash Price |
$162.91
|
| Rate for Payer: Centivo All Commercial |
$147.71
|
| Rate for Payer: Cigna All Commercial |
$234.32
|
| Rate for Payer: CORVEL All Commercial |
$252.51
|
| Rate for Payer: Coventry All Commercial |
$238.94
|
| Rate for Payer: Encore All Commercial |
$249.93
|
| Rate for Payer: Frontpath All Commercial |
$249.80
|
| Rate for Payer: Humana ChoiceCare |
$234.51
|
| Rate for Payer: Humana Medicare |
$86.89
|
| Rate for Payer: Lucent All Commercial |
$147.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$244.37
|
| Rate for Payer: Managed Health Services Medicaid |
$13.25
|
| Rate for Payer: MDWise Medicaid |
$13.25
|
| Rate for Payer: PHCS All Commercial |
$203.64
|
| Rate for Payer: PHP All Commercial |
$205.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$105.89
|
| Rate for Payer: Sagamore Health Network All Products |
$209.61
|
| Rate for Payer: Signature Care EPO |
$225.36
|
| Rate for Payer: Signature Care PPO |
$238.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$230.79
|
| Rate for Payer: United Healthcare Commercial |
$213.96
|
| Rate for Payer: United Healthcare Medicare |
$86.89
|
|
|
HC OXYCARB METAB-TRILEP
|
Facility
|
IP
|
$271.52
|
|
|
Service Code
|
CPT 80183
|
| Hospital Charge Code |
63001376
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$203.64 |
| Max. Negotiated Rate |
$252.51 |
| Rate for Payer: Aetna Commercial |
$234.59
|
| Rate for Payer: Cash Price |
$162.91
|
| Rate for Payer: Cigna All Commercial |
$234.32
|
| Rate for Payer: CORVEL All Commercial |
$252.51
|
| Rate for Payer: Coventry All Commercial |
$238.94
|
| Rate for Payer: Encore All Commercial |
$249.93
|
| Rate for Payer: Frontpath All Commercial |
$249.80
|
| Rate for Payer: Humana ChoiceCare |
$234.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$244.37
|
| Rate for Payer: PHCS All Commercial |
$203.64
|
| Rate for Payer: PHP All Commercial |
$205.92
|
| Rate for Payer: Sagamore Health Network All Products |
$209.61
|
| Rate for Payer: Signature Care EPO |
$225.36
|
| Rate for Payer: Signature Care PPO |
$238.94
|
| Rate for Payer: United Healthcare Commercial |
$213.96
|
|
|
HC OXYGEN PER DAY
|
Facility
|
IP
|
$360.86
|
|
| Hospital Charge Code |
1700501
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$270.64 |
| Max. Negotiated Rate |
$335.60 |
| Rate for Payer: Aetna Commercial |
$311.78
|
| Rate for Payer: Cash Price |
$216.52
|
| Rate for Payer: Cigna All Commercial |
$311.42
|
| Rate for Payer: CORVEL All Commercial |
$335.60
|
| Rate for Payer: Coventry All Commercial |
$317.56
|
| Rate for Payer: Encore All Commercial |
$332.17
|
| Rate for Payer: Frontpath All Commercial |
$331.99
|
| Rate for Payer: Humana ChoiceCare |
$311.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$324.77
|
| Rate for Payer: PHCS All Commercial |
$270.64
|
| Rate for Payer: PHP All Commercial |
$273.68
|
| Rate for Payer: Sagamore Health Network All Products |
$278.58
|
| Rate for Payer: Signature Care EPO |
$299.51
|
| Rate for Payer: Signature Care PPO |
$317.56
|
| Rate for Payer: United Healthcare Commercial |
$284.36
|
|
|
HC OXYGEN PER DAY
|
Facility
|
OP
|
$360.86
|
|
| Hospital Charge Code |
1700501
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$21.01 |
| Max. Negotiated Rate |
$335.60 |
| Rate for Payer: Aetna Commercial |
$304.57
|
| Rate for Payer: Aetna Medicare |
$115.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$21.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$111.87
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$207.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$225.57
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$21.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$132.80
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$127.02
|
| Rate for Payer: Cash Price |
$216.52
|
| Rate for Payer: Cash Price |
$216.52
|
| Rate for Payer: Centivo All Commercial |
$196.31
|
| Rate for Payer: Cigna All Commercial |
$311.42
|
| Rate for Payer: CORVEL All Commercial |
$335.60
|
| Rate for Payer: Coventry All Commercial |
$317.56
|
| Rate for Payer: Encore All Commercial |
$332.17
|
| Rate for Payer: Frontpath All Commercial |
$331.99
|
| Rate for Payer: Humana ChoiceCare |
$311.67
|
| Rate for Payer: Humana Medicare |
$115.48
|
| Rate for Payer: Lucent All Commercial |
$196.31
|
| Rate for Payer: Lutheran Preferred All Commercial |
$324.77
|
| Rate for Payer: Managed Health Services Medicaid |
$21.01
|
| Rate for Payer: MDWise Medicaid |
$21.01
|
| Rate for Payer: PHCS All Commercial |
$270.64
|
| Rate for Payer: PHP All Commercial |
$273.68
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$140.74
|
| Rate for Payer: Sagamore Health Network All Products |
$278.58
|
| Rate for Payer: Signature Care EPO |
$299.51
|
| Rate for Payer: Signature Care PPO |
$317.56
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$306.73
|
| Rate for Payer: United Healthcare Commercial |
$284.36
|
| Rate for Payer: United Healthcare Medicare |
$115.48
|
|
|
HC PACEMAKER DC AZURE XT DR MRI
|
Facility
|
OP
|
$17,271.86
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
41607335
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$21.24 |
| Max. Negotiated Rate |
$16,062.83 |
| Rate for Payer: Aetna Commercial |
$14,577.45
|
| Rate for Payer: Aetna Medicare |
$5,527.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$21.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5,354.28
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$9,919.23
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$10,796.64
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$21.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6,356.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$6,079.69
|
| Rate for Payer: Cash Price |
$10,363.12
|
| Rate for Payer: Cash Price |
$10,363.12
|
| Rate for Payer: Centivo All Commercial |
$9,395.89
|
| Rate for Payer: Cigna All Commercial |
$14,905.62
|
| Rate for Payer: CORVEL All Commercial |
$16,062.83
|
| Rate for Payer: Coventry All Commercial |
$15,199.24
|
| Rate for Payer: Encore All Commercial |
$15,898.75
|
| Rate for Payer: Frontpath All Commercial |
$15,890.11
|
| Rate for Payer: Humana ChoiceCare |
$14,917.71
|
| Rate for Payer: Humana Medicare |
$5,527.00
|
| Rate for Payer: Lucent All Commercial |
$9,395.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$15,544.67
|
| Rate for Payer: Managed Health Services Medicaid |
$21.24
|
| Rate for Payer: MDWise Medicaid |
$21.24
|
| Rate for Payer: PHCS All Commercial |
$12,953.90
|
| Rate for Payer: PHP All Commercial |
$13,098.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$6,736.03
|
| Rate for Payer: Sagamore Health Network All Products |
$13,333.88
|
| Rate for Payer: Signature Care EPO |
$14,335.64
|
| Rate for Payer: Signature Care PPO |
$15,199.24
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,681.08
|
| Rate for Payer: United Healthcare Commercial |
$13,610.23
|
| Rate for Payer: United Healthcare Medicare |
$5,527.00
|
|
|
HC PACEMAKER DC AZURE XT DR MRI
|
Facility
|
IP
|
$17,271.86
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
41607335
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$12,953.90 |
| Max. Negotiated Rate |
$16,062.83 |
| Rate for Payer: Aetna Commercial |
$14,922.89
|
| Rate for Payer: Cash Price |
$10,363.12
|
| Rate for Payer: Cigna All Commercial |
$14,905.62
|
| Rate for Payer: CORVEL All Commercial |
$16,062.83
|
| Rate for Payer: Coventry All Commercial |
$15,199.24
|
| Rate for Payer: Encore All Commercial |
$15,898.75
|
| Rate for Payer: Frontpath All Commercial |
$15,890.11
|
| Rate for Payer: Humana ChoiceCare |
$14,917.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$15,544.67
|
| Rate for Payer: PHCS All Commercial |
$12,953.90
|
| Rate for Payer: PHP All Commercial |
$13,098.98
|
| Rate for Payer: Sagamore Health Network All Products |
$13,333.88
|
| Rate for Payer: Signature Care EPO |
$14,335.64
|
| Rate for Payer: Signature Care PPO |
$15,199.24
|
| Rate for Payer: United Healthcare Commercial |
$13,610.23
|
|
|
HC PACEMAKER SC ACCOLADE DR
|
Facility
|
OP
|
$12,060.00
|
|
|
Service Code
|
CPT C1786
|
| Hospital Charge Code |
41607172
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$21.24 |
| Max. Negotiated Rate |
$11,215.80 |
| Rate for Payer: Aetna Commercial |
$10,178.64
|
| Rate for Payer: Aetna Medicare |
$3,859.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$21.24
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$3,738.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$6,926.06
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$7,538.71
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$21.24
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,438.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,245.12
|
| Rate for Payer: Cash Price |
$7,236.00
|
| Rate for Payer: Cash Price |
$7,236.00
|
| Rate for Payer: Centivo All Commercial |
$6,560.64
|
| Rate for Payer: Cigna All Commercial |
$10,407.78
|
| Rate for Payer: CORVEL All Commercial |
$11,215.80
|
| Rate for Payer: Coventry All Commercial |
$10,612.80
|
| Rate for Payer: Encore All Commercial |
$11,101.23
|
| Rate for Payer: Frontpath All Commercial |
$11,095.20
|
| Rate for Payer: Humana ChoiceCare |
$10,416.22
|
| Rate for Payer: Humana Medicare |
$3,859.20
|
| Rate for Payer: Lucent All Commercial |
$6,560.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,854.00
|
| Rate for Payer: Managed Health Services Medicaid |
$21.24
|
| Rate for Payer: MDWise Medicaid |
$21.24
|
| Rate for Payer: PHCS All Commercial |
$9,045.00
|
| Rate for Payer: PHP All Commercial |
$9,146.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4,703.40
|
| Rate for Payer: Sagamore Health Network All Products |
$9,310.32
|
| Rate for Payer: Signature Care EPO |
$10,009.80
|
| Rate for Payer: Signature Care PPO |
$10,612.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$10,251.00
|
| Rate for Payer: United Healthcare Commercial |
$9,503.28
|
| Rate for Payer: United Healthcare Medicare |
$3,859.20
|
|
|
HC PACEMAKER SC ACCOLADE DR
|
Facility
|
IP
|
$12,060.00
|
|
|
Service Code
|
CPT C1786
|
| Hospital Charge Code |
41607172
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$9,045.00 |
| Max. Negotiated Rate |
$11,215.80 |
| Rate for Payer: Aetna Commercial |
$10,419.84
|
| Rate for Payer: Cash Price |
$7,236.00
|
| Rate for Payer: Cigna All Commercial |
$10,407.78
|
| Rate for Payer: CORVEL All Commercial |
$11,215.80
|
| Rate for Payer: Coventry All Commercial |
$10,612.80
|
| Rate for Payer: Encore All Commercial |
$11,101.23
|
| Rate for Payer: Frontpath All Commercial |
$11,095.20
|
| Rate for Payer: Humana ChoiceCare |
$10,416.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$10,854.00
|
| Rate for Payer: PHCS All Commercial |
$9,045.00
|
| Rate for Payer: PHP All Commercial |
$9,146.30
|
| Rate for Payer: Sagamore Health Network All Products |
$9,310.32
|
| Rate for Payer: Signature Care EPO |
$10,009.80
|
| Rate for Payer: Signature Care PPO |
$10,612.80
|
| Rate for Payer: United Healthcare Commercial |
$9,503.28
|
|
|
HC PACKED RBC LR CMV NEGATIVE
|
Facility
|
OP
|
$2,615.07
|
|
|
Service Code
|
CPT P9051
|
| Hospital Charge Code |
1371000
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$71.47 |
| Max. Negotiated Rate |
$2,432.02 |
| Rate for Payer: Aetna Commercial |
$2,207.12
|
| Rate for Payer: Aetna Medicare |
$836.82
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$71.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$810.67
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,501.83
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,634.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$71.47
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$962.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$920.50
|
| Rate for Payer: Cash Price |
$1,569.04
|
| Rate for Payer: Cash Price |
$1,569.04
|
| Rate for Payer: Centivo All Commercial |
$1,422.60
|
| Rate for Payer: Cigna All Commercial |
$2,256.81
|
| Rate for Payer: CORVEL All Commercial |
$2,432.02
|
| Rate for Payer: Coventry All Commercial |
$2,301.26
|
| Rate for Payer: Encore All Commercial |
$2,407.17
|
| Rate for Payer: Frontpath All Commercial |
$2,405.86
|
| Rate for Payer: Humana ChoiceCare |
$2,258.64
|
| Rate for Payer: Humana Medicare |
$836.82
|
| Rate for Payer: Lucent All Commercial |
$1,422.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,353.56
|
| Rate for Payer: Managed Health Services Medicaid |
$71.47
|
| Rate for Payer: MDWise Medicaid |
$71.47
|
| Rate for Payer: PHCS All Commercial |
$1,961.30
|
| Rate for Payer: PHP All Commercial |
$1,983.27
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,019.88
|
| Rate for Payer: Sagamore Health Network All Products |
$2,018.83
|
| Rate for Payer: Signature Care EPO |
$2,170.51
|
| Rate for Payer: Signature Care PPO |
$2,301.26
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,222.81
|
| Rate for Payer: United Healthcare Commercial |
$2,060.68
|
| Rate for Payer: United Healthcare Medicare |
$836.82
|
|
|
HC PACKED RBC LR CMV NEGATIVE
|
Facility
|
IP
|
$2,615.07
|
|
|
Service Code
|
CPT P9051
|
| Hospital Charge Code |
1371000
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,961.30 |
| Max. Negotiated Rate |
$2,432.02 |
| Rate for Payer: Aetna Commercial |
$2,259.42
|
| Rate for Payer: Cash Price |
$1,569.04
|
| Rate for Payer: Cigna All Commercial |
$2,256.81
|
| Rate for Payer: CORVEL All Commercial |
$2,432.02
|
| Rate for Payer: Coventry All Commercial |
$2,301.26
|
| Rate for Payer: Encore All Commercial |
$2,407.17
|
| Rate for Payer: Frontpath All Commercial |
$2,405.86
|
| Rate for Payer: Humana ChoiceCare |
$2,258.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,353.56
|
| Rate for Payer: PHCS All Commercial |
$1,961.30
|
| Rate for Payer: PHP All Commercial |
$1,983.27
|
| Rate for Payer: Sagamore Health Network All Products |
$2,018.83
|
| Rate for Payer: Signature Care EPO |
$2,170.51
|
| Rate for Payer: Signature Care PPO |
$2,301.26
|
| Rate for Payer: United Healthcare Commercial |
$2,060.68
|
|
|
HC PACKED RBC LR IRRAD
|
Facility
|
IP
|
$1,567.74
|
|
|
Service Code
|
CPT P9040
|
| Hospital Charge Code |
1371009
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,175.81 |
| Max. Negotiated Rate |
$1,458.00 |
| Rate for Payer: Aetna Commercial |
$1,354.53
|
| Rate for Payer: Cash Price |
$940.64
|
| Rate for Payer: Cigna All Commercial |
$1,352.96
|
| Rate for Payer: CORVEL All Commercial |
$1,458.00
|
| Rate for Payer: Coventry All Commercial |
$1,379.61
|
| Rate for Payer: Encore All Commercial |
$1,443.10
|
| Rate for Payer: Frontpath All Commercial |
$1,442.32
|
| Rate for Payer: Humana ChoiceCare |
$1,354.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,410.97
|
| Rate for Payer: PHCS All Commercial |
$1,175.81
|
| Rate for Payer: PHP All Commercial |
$1,188.97
|
| Rate for Payer: Sagamore Health Network All Products |
$1,210.30
|
| Rate for Payer: Signature Care EPO |
$1,301.22
|
| Rate for Payer: Signature Care PPO |
$1,379.61
|
| Rate for Payer: United Healthcare Commercial |
$1,235.38
|
|
|
HC PACKED RBC LR IRRAD
|
Facility
|
OP
|
$1,567.74
|
|
|
Service Code
|
CPT P9040
|
| Hospital Charge Code |
1371009
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$71.47 |
| Max. Negotiated Rate |
$1,458.00 |
| Rate for Payer: Aetna Commercial |
$1,323.17
|
| Rate for Payer: Aetna Medicare |
$501.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$71.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$486.00
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$900.35
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$979.99
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$71.47
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$576.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$551.84
|
| Rate for Payer: Cash Price |
$940.64
|
| Rate for Payer: Cash Price |
$940.64
|
| Rate for Payer: Centivo All Commercial |
$852.85
|
| Rate for Payer: Cigna All Commercial |
$1,352.96
|
| Rate for Payer: CORVEL All Commercial |
$1,458.00
|
| Rate for Payer: Coventry All Commercial |
$1,379.61
|
| Rate for Payer: Encore All Commercial |
$1,443.10
|
| Rate for Payer: Frontpath All Commercial |
$1,442.32
|
| Rate for Payer: Humana ChoiceCare |
$1,354.06
|
| Rate for Payer: Humana Medicare |
$501.68
|
| Rate for Payer: Lucent All Commercial |
$852.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,410.97
|
| Rate for Payer: Managed Health Services Medicaid |
$71.47
|
| Rate for Payer: MDWise Medicaid |
$71.47
|
| Rate for Payer: PHCS All Commercial |
$1,175.81
|
| Rate for Payer: PHP All Commercial |
$1,188.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$611.42
|
| Rate for Payer: Sagamore Health Network All Products |
$1,210.30
|
| Rate for Payer: Signature Care EPO |
$1,301.22
|
| Rate for Payer: Signature Care PPO |
$1,379.61
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,332.58
|
| Rate for Payer: United Healthcare Commercial |
$1,235.38
|
| Rate for Payer: United Healthcare Medicare |
$501.68
|
|
|
HC PACKED RBC LR IRRAD CMV NEG
|
Facility
|
OP
|
$1,888.58
|
|
|
Service Code
|
CPT P9058
|
| Hospital Charge Code |
1371014
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$71.47 |
| Max. Negotiated Rate |
$1,756.38 |
| Rate for Payer: Aetna Commercial |
$1,593.96
|
| Rate for Payer: Aetna Medicare |
$604.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$71.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$585.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,084.61
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,180.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$71.47
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$695.00
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$664.78
|
| Rate for Payer: Cash Price |
$1,133.15
|
| Rate for Payer: Cash Price |
$1,133.15
|
| Rate for Payer: Centivo All Commercial |
$1,027.39
|
| Rate for Payer: Cigna All Commercial |
$1,629.84
|
| Rate for Payer: CORVEL All Commercial |
$1,756.38
|
| Rate for Payer: Coventry All Commercial |
$1,661.95
|
| Rate for Payer: Encore All Commercial |
$1,738.44
|
| Rate for Payer: Frontpath All Commercial |
$1,737.49
|
| Rate for Payer: Humana ChoiceCare |
$1,631.17
|
| Rate for Payer: Humana Medicare |
$604.35
|
| Rate for Payer: Lucent All Commercial |
$1,027.39
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,699.72
|
| Rate for Payer: Managed Health Services Medicaid |
$71.47
|
| Rate for Payer: MDWise Medicaid |
$71.47
|
| Rate for Payer: PHCS All Commercial |
$1,416.43
|
| Rate for Payer: PHP All Commercial |
$1,432.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$736.55
|
| Rate for Payer: Sagamore Health Network All Products |
$1,457.98
|
| Rate for Payer: Signature Care EPO |
$1,567.52
|
| Rate for Payer: Signature Care PPO |
$1,661.95
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,605.29
|
| Rate for Payer: United Healthcare Commercial |
$1,488.20
|
| Rate for Payer: United Healthcare Medicare |
$604.35
|
|
