|
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
|
|
|
HC PAD REHAB PER SESSION; 1-36
|
Facility
|
OP
|
$238.68
|
|
|
Service Code
|
CPT 93668
|
| Hospital Charge Code |
1603668
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$73.99 |
| Max. Negotiated Rate |
$221.97 |
| Rate for Payer: Aetna Commercial |
$201.45
|
| Rate for Payer: Aetna Medicare |
$76.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$166.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$73.99
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$137.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$149.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$166.32
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$87.83
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$84.02
|
| Rate for Payer: Cash Price |
$143.21
|
| Rate for Payer: Cash Price |
$143.21
|
| Rate for Payer: Centivo All Commercial |
$129.84
|
| Rate for Payer: Cigna All Commercial |
$205.98
|
| Rate for Payer: CORVEL All Commercial |
$221.97
|
| Rate for Payer: Coventry All Commercial |
$210.04
|
| Rate for Payer: Encore All Commercial |
$219.70
|
| Rate for Payer: Frontpath All Commercial |
$219.59
|
| Rate for Payer: Humana ChoiceCare |
$206.15
|
| Rate for Payer: Humana Medicare |
$76.38
|
| Rate for Payer: Lucent All Commercial |
$129.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$214.81
|
| Rate for Payer: Managed Health Services Medicaid |
$166.32
|
| Rate for Payer: MDWise Medicaid |
$166.32
|
| Rate for Payer: PHCS All Commercial |
$179.01
|
| Rate for Payer: PHP All Commercial |
$181.01
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$93.09
|
| Rate for Payer: Sagamore Health Network All Products |
$184.26
|
| Rate for Payer: Signature Care EPO |
$198.10
|
| Rate for Payer: Signature Care PPO |
$210.04
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$202.88
|
| Rate for Payer: United Healthcare Commercial |
$188.08
|
| Rate for Payer: United Healthcare Medicare |
$76.38
|
|
|
HC PAD REHAB PER SESSION; 1-36
|
Facility
|
IP
|
$238.68
|
|
|
Service Code
|
CPT 93668
|
| Hospital Charge Code |
1603668
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$179.01 |
| Max. Negotiated Rate |
$221.97 |
| Rate for Payer: Aetna Commercial |
$206.22
|
| Rate for Payer: Cash Price |
$143.21
|
| Rate for Payer: Cigna All Commercial |
$205.98
|
| Rate for Payer: CORVEL All Commercial |
$221.97
|
| Rate for Payer: Coventry All Commercial |
$210.04
|
| Rate for Payer: Encore All Commercial |
$219.70
|
| Rate for Payer: Frontpath All Commercial |
$219.59
|
| Rate for Payer: Humana ChoiceCare |
$206.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$214.81
|
| Rate for Payer: PHCS All Commercial |
$179.01
|
| Rate for Payer: PHP All Commercial |
$181.01
|
| Rate for Payer: Sagamore Health Network All Products |
$184.26
|
| Rate for Payer: Signature Care EPO |
$198.10
|
| Rate for Payer: Signature Care PPO |
$210.04
|
| Rate for Payer: United Healthcare Commercial |
$188.08
|
|
|
HC PAIN MANAGEMENT CHARGE CLASS B
|
Facility
|
IP
|
$186.89
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
63001398
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$140.17 |
| Max. Negotiated Rate |
$173.81 |
| Rate for Payer: Aetna Commercial |
$161.47
|
| Rate for Payer: Cash Price |
$112.13
|
| Rate for Payer: Cigna All Commercial |
$161.29
|
| Rate for Payer: CORVEL All Commercial |
$173.81
|
| Rate for Payer: Coventry All Commercial |
$164.46
|
| Rate for Payer: Encore All Commercial |
$172.03
|
| Rate for Payer: Frontpath All Commercial |
$171.94
|
| Rate for Payer: Humana ChoiceCare |
$161.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$168.20
|
| Rate for Payer: PHCS All Commercial |
$140.17
|
| Rate for Payer: PHP All Commercial |
$141.74
|
| Rate for Payer: Sagamore Health Network All Products |
$144.28
|
| Rate for Payer: Signature Care EPO |
$155.12
|
| Rate for Payer: Signature Care PPO |
$164.46
|
| Rate for Payer: United Healthcare Commercial |
$147.27
|
|
|
HC PAIN MANAGEMENT CHARGE CLASS B
|
Facility
|
OP
|
$186.89
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
63001398
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$57.94 |
| Max. Negotiated Rate |
$173.81 |
| Rate for Payer: Aetna Commercial |
$157.74
|
| Rate for Payer: Aetna Medicare |
$59.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$62.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$57.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$85.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$85.89
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$62.14
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$68.78
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$65.79
|
| Rate for Payer: Cash Price |
$112.13
|
| Rate for Payer: Cash Price |
$112.13
|
| Rate for Payer: Centivo All Commercial |
$101.67
|
| Rate for Payer: Cigna All Commercial |
$161.29
|
| Rate for Payer: CORVEL All Commercial |
$173.81
|
| Rate for Payer: Coventry All Commercial |
$164.46
|
| Rate for Payer: Encore All Commercial |
$172.03
|
| Rate for Payer: Frontpath All Commercial |
$171.94
|
| Rate for Payer: Humana ChoiceCare |
$161.42
|
| Rate for Payer: Humana Medicare |
$59.80
|
| Rate for Payer: Lucent All Commercial |
$101.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$168.20
|
| Rate for Payer: Managed Health Services Medicaid |
$62.14
|
| Rate for Payer: MDWise Medicaid |
$62.14
|
| Rate for Payer: PHCS All Commercial |
$140.17
|
| Rate for Payer: PHP All Commercial |
$141.74
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$72.89
|
| Rate for Payer: Sagamore Health Network All Products |
$144.28
|
| Rate for Payer: Signature Care EPO |
$155.12
|
| Rate for Payer: Signature Care PPO |
$164.46
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$158.86
|
| Rate for Payer: United Healthcare Commercial |
$147.27
|
| Rate for Payer: United Healthcare Medicare |
$59.80
|
|
|
HC PAIN MANAGEMENT CHARGE CLASS EA
|
Facility
|
IP
|
$186.89
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
63001393
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$140.17 |
| Max. Negotiated Rate |
$173.81 |
| Rate for Payer: Aetna Commercial |
$161.47
|
| Rate for Payer: Cash Price |
$112.13
|
| Rate for Payer: Cigna All Commercial |
$161.29
|
| Rate for Payer: CORVEL All Commercial |
$173.81
|
| Rate for Payer: Coventry All Commercial |
$164.46
|
| Rate for Payer: Encore All Commercial |
$172.03
|
| Rate for Payer: Frontpath All Commercial |
$171.94
|
| Rate for Payer: Humana ChoiceCare |
$161.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$168.20
|
| Rate for Payer: PHCS All Commercial |
$140.17
|
| Rate for Payer: PHP All Commercial |
$141.74
|
| Rate for Payer: Sagamore Health Network All Products |
$144.28
|
| Rate for Payer: Signature Care EPO |
$155.12
|
| Rate for Payer: Signature Care PPO |
$164.46
|
| Rate for Payer: United Healthcare Commercial |
$147.27
|
|
|
HC PAIN MANAGEMENT CHARGE CLASS EA
|
Facility
|
OP
|
$186.89
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
63001393
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$57.94 |
| Max. Negotiated Rate |
$173.81 |
| Rate for Payer: Aetna Commercial |
$157.74
|
| Rate for Payer: Aetna Medicare |
$59.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$62.14
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$57.94
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$85.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$85.89
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$62.14
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$68.78
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$65.79
|
| Rate for Payer: Cash Price |
$112.13
|
| Rate for Payer: Cash Price |
$112.13
|
| Rate for Payer: Centivo All Commercial |
$101.67
|
| Rate for Payer: Cigna All Commercial |
$161.29
|
| Rate for Payer: CORVEL All Commercial |
$173.81
|
| Rate for Payer: Coventry All Commercial |
$164.46
|
| Rate for Payer: Encore All Commercial |
$172.03
|
| Rate for Payer: Frontpath All Commercial |
$171.94
|
| Rate for Payer: Humana ChoiceCare |
$161.42
|
| Rate for Payer: Humana Medicare |
$59.80
|
| Rate for Payer: Lucent All Commercial |
$101.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$168.20
|
| Rate for Payer: Managed Health Services Medicaid |
$62.14
|
| Rate for Payer: MDWise Medicaid |
$62.14
|
| Rate for Payer: PHCS All Commercial |
$140.17
|
| Rate for Payer: PHP All Commercial |
$141.74
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$72.89
|
| Rate for Payer: Sagamore Health Network All Products |
$144.28
|
| Rate for Payer: Signature Care EPO |
$155.12
|
| Rate for Payer: Signature Care PPO |
$164.46
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$158.86
|
| Rate for Payer: United Healthcare Commercial |
$147.27
|
| Rate for Payer: United Healthcare Medicare |
$59.80
|
|
|
HC PANCREATIC ELASTASE-FECE
|
Facility
|
IP
|
$330.47
|
|
|
Service Code
|
CPT 82653
|
| Hospital Charge Code |
63001531
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$247.85 |
| Max. Negotiated Rate |
$307.34 |
| Rate for Payer: Aetna Commercial |
$285.53
|
| Rate for Payer: Cash Price |
$198.28
|
| Rate for Payer: Cigna All Commercial |
$285.20
|
| Rate for Payer: CORVEL All Commercial |
$307.34
|
| Rate for Payer: Coventry All Commercial |
$290.81
|
| Rate for Payer: Encore All Commercial |
$304.20
|
| Rate for Payer: Frontpath All Commercial |
$304.03
|
| Rate for Payer: Humana ChoiceCare |
$285.43
|
| Rate for Payer: Lutheran Preferred All Commercial |
$297.42
|
| Rate for Payer: PHCS All Commercial |
$247.85
|
| Rate for Payer: PHP All Commercial |
$250.63
|
| Rate for Payer: Sagamore Health Network All Products |
$255.12
|
| Rate for Payer: Signature Care EPO |
$274.29
|
| Rate for Payer: Signature Care PPO |
$290.81
|
| Rate for Payer: United Healthcare Commercial |
$260.41
|
|
|
HC PANCREATIC ELASTASE-FECE
|
Facility
|
OP
|
$330.47
|
|
|
Service Code
|
CPT 82653
|
| Hospital Charge Code |
63001531
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.97 |
| Max. Negotiated Rate |
$307.34 |
| Rate for Payer: Aetna Commercial |
$278.92
|
| Rate for Payer: Aetna Medicare |
$105.75
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$22.97
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$102.45
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$151.88
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$151.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$22.97
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$121.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$116.33
|
| Rate for Payer: Cash Price |
$198.28
|
| Rate for Payer: Cash Price |
$198.28
|
| Rate for Payer: Centivo All Commercial |
$179.78
|
| Rate for Payer: Cigna All Commercial |
$285.20
|
| Rate for Payer: CORVEL All Commercial |
$307.34
|
| Rate for Payer: Coventry All Commercial |
$290.81
|
| Rate for Payer: Encore All Commercial |
$304.20
|
| Rate for Payer: Frontpath All Commercial |
$304.03
|
| Rate for Payer: Humana ChoiceCare |
$285.43
|
| Rate for Payer: Humana Medicare |
$105.75
|
| Rate for Payer: Lucent All Commercial |
$179.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$297.42
|
| Rate for Payer: Managed Health Services Medicaid |
$22.97
|
| Rate for Payer: MDWise Medicaid |
$22.97
|
| Rate for Payer: PHCS All Commercial |
$247.85
|
| Rate for Payer: PHP All Commercial |
$250.63
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$128.88
|
| Rate for Payer: Sagamore Health Network All Products |
$255.12
|
| Rate for Payer: Signature Care EPO |
$274.29
|
| Rate for Payer: Signature Care PPO |
$290.81
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$280.90
|
| Rate for Payer: United Healthcare Commercial |
$260.41
|
| Rate for Payer: United Healthcare Medicare |
$105.75
|
|
|
HC PAP SCREENING SUREPATH W/HPV 24206
|
Facility
|
IP
|
$196.89
|
|
|
Service Code
|
CPT 88142
|
| Hospital Charge Code |
63044000
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$147.67 |
| Max. Negotiated Rate |
$183.11 |
| Rate for Payer: Aetna Commercial |
$170.11
|
| Rate for Payer: Cash Price |
$118.13
|
| Rate for Payer: Cigna All Commercial |
$169.92
|
| Rate for Payer: CORVEL All Commercial |
$183.11
|
| Rate for Payer: Coventry All Commercial |
$173.26
|
| Rate for Payer: Encore All Commercial |
$181.24
|
| Rate for Payer: Frontpath All Commercial |
$181.14
|
| Rate for Payer: Humana ChoiceCare |
$170.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$177.20
|
| Rate for Payer: PHCS All Commercial |
$147.67
|
| Rate for Payer: PHP All Commercial |
$149.32
|
| Rate for Payer: Sagamore Health Network All Products |
$152.00
|
| Rate for Payer: Signature Care EPO |
$163.42
|
| Rate for Payer: Signature Care PPO |
$173.26
|
| Rate for Payer: United Healthcare Commercial |
$155.15
|
|
|
HC PAP SCREENING SUREPATH W/HPV 24206
|
Facility
|
OP
|
$196.89
|
|
|
Service Code
|
CPT 88142
|
| Hospital Charge Code |
63044000
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$20.26 |
| Max. Negotiated Rate |
$183.11 |
| Rate for Payer: Aetna Commercial |
$166.18
|
| Rate for Payer: Aetna Medicare |
$63.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$20.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$61.04
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$90.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$90.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$20.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$72.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$69.31
|
| Rate for Payer: Cash Price |
$118.13
|
| Rate for Payer: Cash Price |
$118.13
|
| Rate for Payer: Centivo All Commercial |
$107.11
|
| Rate for Payer: Cigna All Commercial |
$169.92
|
| Rate for Payer: CORVEL All Commercial |
$183.11
|
| Rate for Payer: Coventry All Commercial |
$173.26
|
| Rate for Payer: Encore All Commercial |
$181.24
|
| Rate for Payer: Frontpath All Commercial |
$181.14
|
| Rate for Payer: Humana ChoiceCare |
$170.05
|
| Rate for Payer: Humana Medicare |
$63.00
|
| Rate for Payer: Lucent All Commercial |
$107.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$177.20
|
| Rate for Payer: Managed Health Services Medicaid |
$20.26
|
| Rate for Payer: MDWise Medicaid |
$20.26
|
| Rate for Payer: PHCS All Commercial |
$147.67
|
| Rate for Payer: PHP All Commercial |
$149.32
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$76.79
|
| Rate for Payer: Sagamore Health Network All Products |
$152.00
|
| Rate for Payer: Signature Care EPO |
$163.42
|
| Rate for Payer: Signature Care PPO |
$173.26
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$167.36
|
| Rate for Payer: United Healthcare Commercial |
$155.15
|
| Rate for Payer: United Healthcare Medicare |
$63.00
|
|
|
HC PAP TEST
|
Facility
|
IP
|
$73.44
|
|
|
Service Code
|
CPT 88142
|
| Hospital Charge Code |
63087802
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$55.08 |
| Max. Negotiated Rate |
$68.30 |
| Rate for Payer: Aetna Commercial |
$63.45
|
| Rate for Payer: Cash Price |
$44.06
|
| Rate for Payer: Cigna All Commercial |
$63.38
|
| Rate for Payer: CORVEL All Commercial |
$68.30
|
| Rate for Payer: Coventry All Commercial |
$64.63
|
| Rate for Payer: Encore All Commercial |
$67.60
|
| Rate for Payer: Frontpath All Commercial |
$67.56
|
| Rate for Payer: Humana ChoiceCare |
$63.43
|
| Rate for Payer: Lutheran Preferred All Commercial |
$66.10
|
| Rate for Payer: PHCS All Commercial |
$55.08
|
| Rate for Payer: PHP All Commercial |
$55.70
|
| Rate for Payer: Sagamore Health Network All Products |
$56.70
|
| Rate for Payer: Signature Care EPO |
$60.96
|
| Rate for Payer: Signature Care PPO |
$64.63
|
| Rate for Payer: United Healthcare Commercial |
$57.87
|
|
|
HC PAP TEST
|
Facility
|
OP
|
$73.44
|
|
|
Service Code
|
CPT 88142
|
| Hospital Charge Code |
63087802
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$20.26 |
| Max. Negotiated Rate |
$68.30 |
| Rate for Payer: Aetna Commercial |
$61.98
|
| Rate for Payer: Aetna Medicare |
$23.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$20.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$22.77
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$33.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$33.75
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$20.26
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$27.03
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$25.85
|
| Rate for Payer: Cash Price |
$44.06
|
| Rate for Payer: Cash Price |
$44.06
|
| Rate for Payer: Centivo All Commercial |
$39.95
|
| Rate for Payer: Cigna All Commercial |
$63.38
|
| Rate for Payer: CORVEL All Commercial |
$68.30
|
| Rate for Payer: Coventry All Commercial |
$64.63
|
| Rate for Payer: Encore All Commercial |
$67.60
|
| Rate for Payer: Frontpath All Commercial |
$67.56
|
| Rate for Payer: Humana ChoiceCare |
$63.43
|
| Rate for Payer: Humana Medicare |
$23.50
|
| Rate for Payer: Lucent All Commercial |
$39.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$66.10
|
| Rate for Payer: Managed Health Services Medicaid |
$20.26
|
| Rate for Payer: MDWise Medicaid |
$20.26
|
| Rate for Payer: PHCS All Commercial |
$55.08
|
| Rate for Payer: PHP All Commercial |
$55.70
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$28.64
|
| Rate for Payer: Sagamore Health Network All Products |
$56.70
|
| Rate for Payer: Signature Care EPO |
$60.96
|
| Rate for Payer: Signature Care PPO |
$64.63
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$62.42
|
| Rate for Payer: United Healthcare Commercial |
$57.87
|
| Rate for Payer: United Healthcare Medicare |
$23.50
|
|
|
HC PARACENTESIS
|
Facility
|
IP
|
$937.48
|
|
| Hospital Charge Code |
1682014
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$703.11 |
| Max. Negotiated Rate |
$871.86 |
| Rate for Payer: Aetna Commercial |
$809.98
|
| Rate for Payer: Cash Price |
$562.49
|
| Rate for Payer: Cigna All Commercial |
$809.05
|
| Rate for Payer: CORVEL All Commercial |
$871.86
|
| Rate for Payer: Coventry All Commercial |
$824.98
|
| Rate for Payer: Encore All Commercial |
$862.95
|
| Rate for Payer: Frontpath All Commercial |
$862.48
|
| Rate for Payer: Humana ChoiceCare |
$809.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$843.73
|
| Rate for Payer: PHCS All Commercial |
$703.11
|
| Rate for Payer: PHP All Commercial |
$710.98
|
| Rate for Payer: Sagamore Health Network All Products |
$723.73
|
| Rate for Payer: Signature Care EPO |
$778.11
|
| Rate for Payer: Signature Care PPO |
$824.98
|
| Rate for Payer: United Healthcare Commercial |
$738.73
|
|
|
HC PARACENTESIS
|
Facility
|
OP
|
$937.48
|
|
| Hospital Charge Code |
1682014
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$290.62 |
| Max. Negotiated Rate |
$871.86 |
| Rate for Payer: Aetna Commercial |
$791.23
|
| Rate for Payer: Aetna Medicare |
$299.99
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$290.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$538.39
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$586.02
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$344.99
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$329.99
|
| Rate for Payer: Cash Price |
$562.49
|
| Rate for Payer: Centivo All Commercial |
$509.99
|
| Rate for Payer: Cigna All Commercial |
$809.05
|
| Rate for Payer: CORVEL All Commercial |
$871.86
|
| Rate for Payer: Coventry All Commercial |
$824.98
|
| Rate for Payer: Encore All Commercial |
$862.95
|
| Rate for Payer: Frontpath All Commercial |
$862.48
|
| Rate for Payer: Humana ChoiceCare |
$809.70
|
| Rate for Payer: Humana Medicare |
$299.99
|
| Rate for Payer: Lucent All Commercial |
$509.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$843.73
|
| Rate for Payer: PHCS All Commercial |
$703.11
|
| Rate for Payer: PHP All Commercial |
$710.98
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$365.62
|
| Rate for Payer: Sagamore Health Network All Products |
$723.73
|
| Rate for Payer: Signature Care EPO |
$778.11
|
| Rate for Payer: Signature Care PPO |
$824.98
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$796.86
|
| Rate for Payer: United Healthcare Commercial |
$738.73
|
| Rate for Payer: United Healthcare Medicare |
$299.99
|
|
|
HC PARAFFIN BATH-OT
|
Facility
|
OP
|
$115.33
|
|
|
Service Code
|
CPT 97018 GO
|
| Hospital Charge Code |
1738060
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$35.75 |
| Max. Negotiated Rate |
$107.26 |
| Rate for Payer: Aetna Commercial |
$97.34
|
| Rate for Payer: Aetna Medicare |
$36.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$47.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$35.75
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$66.23
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$72.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$47.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$42.44
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$40.60
|
| Rate for Payer: Cash Price |
$69.20
|
| Rate for Payer: Cash Price |
$69.20
|
| Rate for Payer: Centivo All Commercial |
$62.74
|
| Rate for Payer: Cigna All Commercial |
$99.53
|
| Rate for Payer: CORVEL All Commercial |
$107.26
|
| Rate for Payer: Coventry All Commercial |
$101.49
|
| Rate for Payer: Encore All Commercial |
$106.16
|
| Rate for Payer: Frontpath All Commercial |
$106.10
|
| Rate for Payer: Humana ChoiceCare |
$99.61
|
| Rate for Payer: Humana Medicare |
$36.91
|
| Rate for Payer: Lucent All Commercial |
$62.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$103.80
|
| Rate for Payer: Managed Health Services Medicaid |
$47.81
|
| Rate for Payer: MDWise Medicaid |
$47.81
|
| Rate for Payer: PHCS All Commercial |
$86.50
|
| Rate for Payer: PHP All Commercial |
$87.47
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$44.98
|
| Rate for Payer: Sagamore Health Network All Products |
$89.03
|
| Rate for Payer: Signature Care EPO |
$95.72
|
| Rate for Payer: Signature Care PPO |
$101.49
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$98.03
|
| Rate for Payer: United Healthcare Commercial |
$90.88
|
| Rate for Payer: United Healthcare Medicare |
$36.91
|
|
|
HC PARAFFIN BATH-OT
|
Facility
|
IP
|
$115.33
|
|
|
Service Code
|
CPT 97018 GO
|
| Hospital Charge Code |
1738060
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$86.50 |
| Max. Negotiated Rate |
$107.26 |
| Rate for Payer: Aetna Commercial |
$99.65
|
| Rate for Payer: Cash Price |
$69.20
|
| Rate for Payer: Cigna All Commercial |
$99.53
|
| Rate for Payer: CORVEL All Commercial |
$107.26
|
| Rate for Payer: Coventry All Commercial |
$101.49
|
| Rate for Payer: Encore All Commercial |
$106.16
|
| Rate for Payer: Frontpath All Commercial |
$106.10
|
| Rate for Payer: Humana ChoiceCare |
$99.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$103.80
|
| Rate for Payer: PHCS All Commercial |
$86.50
|
| Rate for Payer: PHP All Commercial |
$87.47
|
| Rate for Payer: Sagamore Health Network All Products |
$89.03
|
| Rate for Payer: Signature Care EPO |
$95.72
|
| Rate for Payer: Signature Care PPO |
$101.49
|
| Rate for Payer: United Healthcare Commercial |
$90.88
|
|
|
HC PARASITE EXAM BLOOD
|
Facility
|
OP
|
$34.57
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
63002016
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$32.15 |
| Rate for Payer: Aetna Commercial |
$29.18
|
| Rate for Payer: Aetna Medicare |
$11.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$5.99
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$10.72
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$15.89
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$15.89
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$5.99
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$12.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$12.17
|
| Rate for Payer: Cash Price |
$20.74
|
| Rate for Payer: Cash Price |
$20.74
|
| Rate for Payer: Centivo All Commercial |
$18.81
|
| Rate for Payer: Cigna All Commercial |
$29.83
|
| Rate for Payer: CORVEL All Commercial |
$32.15
|
| Rate for Payer: Coventry All Commercial |
$30.42
|
| Rate for Payer: Encore All Commercial |
$31.82
|
| Rate for Payer: Frontpath All Commercial |
$31.80
|
| Rate for Payer: Humana ChoiceCare |
$29.86
|
| Rate for Payer: Humana Medicare |
$11.06
|
| Rate for Payer: Lucent All Commercial |
$18.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$31.11
|
| Rate for Payer: Managed Health Services Medicaid |
$5.99
|
| Rate for Payer: MDWise Medicaid |
$5.99
|
| Rate for Payer: PHCS All Commercial |
$25.93
|
| Rate for Payer: PHP All Commercial |
$26.22
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$13.48
|
| Rate for Payer: Sagamore Health Network All Products |
$26.69
|
| Rate for Payer: Signature Care EPO |
$28.69
|
| Rate for Payer: Signature Care PPO |
$30.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$29.38
|
| Rate for Payer: United Healthcare Commercial |
$27.24
|
| Rate for Payer: United Healthcare Medicare |
$11.06
|
|
|
HC PARASITE EXAM BLOOD
|
Facility
|
IP
|
$34.57
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
63002016
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.93 |
| Max. Negotiated Rate |
$32.15 |
| Rate for Payer: Aetna Commercial |
$29.87
|
| Rate for Payer: Cash Price |
$20.74
|
| Rate for Payer: Cigna All Commercial |
$29.83
|
| Rate for Payer: CORVEL All Commercial |
$32.15
|
| Rate for Payer: Coventry All Commercial |
$30.42
|
| Rate for Payer: Encore All Commercial |
$31.82
|
| Rate for Payer: Frontpath All Commercial |
$31.80
|
| Rate for Payer: Humana ChoiceCare |
$29.86
|
| Rate for Payer: Lutheran Preferred All Commercial |
$31.11
|
| Rate for Payer: PHCS All Commercial |
$25.93
|
| Rate for Payer: PHP All Commercial |
$26.22
|
| Rate for Payer: Sagamore Health Network All Products |
$26.69
|
| Rate for Payer: Signature Care EPO |
$28.69
|
| Rate for Payer: Signature Care PPO |
$30.42
|
| Rate for Payer: United Healthcare Commercial |
$27.24
|
|
|
HC PARASITE ID
|
Facility
|
IP
|
$138.69
|
|
|
Service Code
|
CPT 87169
|
| Hospital Charge Code |
63001080
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$104.02 |
| Max. Negotiated Rate |
$128.98 |
| Rate for Payer: Aetna Commercial |
$119.83
|
| Rate for Payer: Cash Price |
$83.21
|
| Rate for Payer: Cigna All Commercial |
$119.69
|
| Rate for Payer: CORVEL All Commercial |
$128.98
|
| Rate for Payer: Coventry All Commercial |
$122.05
|
| Rate for Payer: Encore All Commercial |
$127.66
|
| Rate for Payer: Frontpath All Commercial |
$127.59
|
| Rate for Payer: Humana ChoiceCare |
$119.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$124.82
|
| Rate for Payer: PHCS All Commercial |
$104.02
|
| Rate for Payer: PHP All Commercial |
$105.18
|
| Rate for Payer: Sagamore Health Network All Products |
$107.07
|
| Rate for Payer: Signature Care EPO |
$115.11
|
| Rate for Payer: Signature Care PPO |
$122.05
|
| Rate for Payer: United Healthcare Commercial |
$109.29
|
|
|
HC PARASITE ID
|
Facility
|
OP
|
$138.69
|
|
|
Service Code
|
CPT 87169
|
| Hospital Charge Code |
63001080
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.31 |
| Max. Negotiated Rate |
$128.98 |
| Rate for Payer: Aetna Commercial |
$117.05
|
| Rate for Payer: Aetna Medicare |
$44.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$4.31
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$42.99
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$63.74
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$63.74
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$4.31
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$51.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$48.82
|
| Rate for Payer: Cash Price |
$83.21
|
| Rate for Payer: Cash Price |
$83.21
|
| Rate for Payer: Centivo All Commercial |
$75.45
|
| Rate for Payer: Cigna All Commercial |
$119.69
|
| Rate for Payer: CORVEL All Commercial |
$128.98
|
| Rate for Payer: Coventry All Commercial |
$122.05
|
| Rate for Payer: Encore All Commercial |
$127.66
|
| Rate for Payer: Frontpath All Commercial |
$127.59
|
| Rate for Payer: Humana ChoiceCare |
$119.79
|
| Rate for Payer: Humana Medicare |
$44.38
|
| Rate for Payer: Lucent All Commercial |
$75.45
|
| Rate for Payer: Lutheran Preferred All Commercial |
$124.82
|
| Rate for Payer: Managed Health Services Medicaid |
$4.31
|
| Rate for Payer: MDWise Medicaid |
$4.31
|
| Rate for Payer: PHCS All Commercial |
$104.02
|
| Rate for Payer: PHP All Commercial |
$105.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$54.09
|
| Rate for Payer: Sagamore Health Network All Products |
$107.07
|
| Rate for Payer: Signature Care EPO |
$115.11
|
| Rate for Payer: Signature Care PPO |
$122.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$117.89
|
| Rate for Payer: United Healthcare Commercial |
$109.29
|
| Rate for Payer: United Healthcare Medicare |
$44.38
|
|
|
HC PARATHYRD PLANAR W/WO SUBTRJ W SPECT
|
Facility
|
OP
|
$1,536.19
|
|
|
Service Code
|
CPT 78071
|
| Hospital Charge Code |
1638071
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$205.60 |
| Max. Negotiated Rate |
$1,428.66 |
| Rate for Payer: Aetna Commercial |
$1,296.54
|
| Rate for Payer: Aetna Medicare |
$491.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$205.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$476.22
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$882.23
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$960.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$205.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$565.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$540.74
|
| Rate for Payer: Cash Price |
$921.71
|
| Rate for Payer: Cash Price |
$921.71
|
| Rate for Payer: Centivo All Commercial |
$835.69
|
| Rate for Payer: Cigna All Commercial |
$1,325.73
|
| Rate for Payer: CORVEL All Commercial |
$1,428.66
|
| Rate for Payer: Coventry All Commercial |
$1,351.85
|
| Rate for Payer: Encore All Commercial |
$1,414.06
|
| Rate for Payer: Frontpath All Commercial |
$1,413.29
|
| Rate for Payer: Humana ChoiceCare |
$1,326.81
|
| Rate for Payer: Humana Medicare |
$491.58
|
| Rate for Payer: Lucent All Commercial |
$835.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,382.57
|
| Rate for Payer: Managed Health Services Medicaid |
$205.60
|
| Rate for Payer: MDWise Medicaid |
$205.60
|
| Rate for Payer: PHCS All Commercial |
$1,152.14
|
| Rate for Payer: PHP All Commercial |
$1,165.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$599.11
|
| Rate for Payer: Sagamore Health Network All Products |
$1,185.94
|
| Rate for Payer: Signature Care EPO |
$1,275.04
|
| Rate for Payer: Signature Care PPO |
$1,351.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,305.76
|
| Rate for Payer: United Healthcare Commercial |
$1,210.52
|
| Rate for Payer: United Healthcare Medicare |
$491.58
|
|
|
HC PARATHYRD PLANAR W/WO SUBTRJ W SPECT
|
Facility
|
IP
|
$1,536.19
|
|
|
Service Code
|
CPT 78071
|
| Hospital Charge Code |
1638071
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,152.14 |
| Max. Negotiated Rate |
$1,428.66 |
| Rate for Payer: Aetna Commercial |
$1,327.27
|
| Rate for Payer: Cash Price |
$921.71
|
| Rate for Payer: Cigna All Commercial |
$1,325.73
|
| Rate for Payer: CORVEL All Commercial |
$1,428.66
|
| Rate for Payer: Coventry All Commercial |
$1,351.85
|
| Rate for Payer: Encore All Commercial |
$1,414.06
|
| Rate for Payer: Frontpath All Commercial |
$1,413.29
|
| Rate for Payer: Humana ChoiceCare |
$1,326.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,382.57
|
| Rate for Payer: PHCS All Commercial |
$1,152.14
|
| Rate for Payer: PHP All Commercial |
$1,165.05
|
| Rate for Payer: Sagamore Health Network All Products |
$1,185.94
|
| Rate for Payer: Signature Care EPO |
$1,275.04
|
| Rate for Payer: Signature Care PPO |
$1,351.85
|
| Rate for Payer: United Healthcare Commercial |
$1,210.52
|
|
|
HC PARATHYROID PLANAR IMAGING
|
Facility
|
OP
|
$1,536.19
|
|
|
Service Code
|
CPT 78070
|
| Hospital Charge Code |
1638070
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$182.57 |
| Max. Negotiated Rate |
$1,428.66 |
| Rate for Payer: Aetna Commercial |
$1,296.54
|
| Rate for Payer: Aetna Medicare |
$491.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$182.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$476.22
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$882.23
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$960.27
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$182.57
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$565.32
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$540.74
|
| Rate for Payer: Cash Price |
$921.71
|
| Rate for Payer: Cash Price |
$921.71
|
| Rate for Payer: Centivo All Commercial |
$835.69
|
| Rate for Payer: Cigna All Commercial |
$1,325.73
|
| Rate for Payer: CORVEL All Commercial |
$1,428.66
|
| Rate for Payer: Coventry All Commercial |
$1,351.85
|
| Rate for Payer: Encore All Commercial |
$1,414.06
|
| Rate for Payer: Frontpath All Commercial |
$1,413.29
|
| Rate for Payer: Humana ChoiceCare |
$1,326.81
|
| Rate for Payer: Humana Medicare |
$491.58
|
| Rate for Payer: Lucent All Commercial |
$835.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,382.57
|
| Rate for Payer: Managed Health Services Medicaid |
$182.57
|
| Rate for Payer: MDWise Medicaid |
$182.57
|
| Rate for Payer: PHCS All Commercial |
$1,152.14
|
| Rate for Payer: PHP All Commercial |
$1,165.05
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$599.11
|
| Rate for Payer: Sagamore Health Network All Products |
$1,185.94
|
| Rate for Payer: Signature Care EPO |
$1,275.04
|
| Rate for Payer: Signature Care PPO |
$1,351.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,305.76
|
| Rate for Payer: United Healthcare Commercial |
$1,210.52
|
| Rate for Payer: United Healthcare Medicare |
$491.58
|
|
|
HC PARATHYROID PLANAR IMAGING
|
Facility
|
IP
|
$1,536.19
|
|
|
Service Code
|
CPT 78070
|
| Hospital Charge Code |
1638070
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,152.14 |
| Max. Negotiated Rate |
$1,428.66 |
| Rate for Payer: Aetna Commercial |
$1,327.27
|
| Rate for Payer: Cash Price |
$921.71
|
| Rate for Payer: Cigna All Commercial |
$1,325.73
|
| Rate for Payer: CORVEL All Commercial |
$1,428.66
|
| Rate for Payer: Coventry All Commercial |
$1,351.85
|
| Rate for Payer: Encore All Commercial |
$1,414.06
|
| Rate for Payer: Frontpath All Commercial |
$1,413.29
|
| Rate for Payer: Humana ChoiceCare |
$1,326.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,382.57
|
| Rate for Payer: PHCS All Commercial |
$1,152.14
|
| Rate for Payer: PHP All Commercial |
$1,165.05
|
| Rate for Payer: Sagamore Health Network All Products |
$1,185.94
|
| Rate for Payer: Signature Care EPO |
$1,275.04
|
| Rate for Payer: Signature Care PPO |
$1,351.85
|
| Rate for Payer: United Healthcare Commercial |
$1,210.52
|
|
