|
HC RADIAL JAW 4 JUMBO
|
Facility
|
IP
|
$134.15
|
|
| Hospital Charge Code |
41608237
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$100.61 |
| Max. Negotiated Rate |
$124.76 |
| Rate for Payer: Aetna Commercial |
$115.91
|
| Rate for Payer: Cash Price |
$80.49
|
| Rate for Payer: Cigna All Commercial |
$115.77
|
| Rate for Payer: CORVEL All Commercial |
$124.76
|
| Rate for Payer: Coventry All Commercial |
$118.05
|
| Rate for Payer: Encore All Commercial |
$123.49
|
| Rate for Payer: Frontpath All Commercial |
$123.42
|
| Rate for Payer: Humana ChoiceCare |
$115.87
|
| Rate for Payer: Lutheran Preferred All Commercial |
$120.73
|
| Rate for Payer: PHCS All Commercial |
$100.61
|
| Rate for Payer: PHP All Commercial |
$101.74
|
| Rate for Payer: Sagamore Health Network All Products |
$103.56
|
| Rate for Payer: Signature Care EPO |
$111.34
|
| Rate for Payer: Signature Care PPO |
$118.05
|
| Rate for Payer: United Healthcare Commercial |
$105.71
|
|
|
HC RADIAL JAW 4 JUMBO
|
Facility
|
OP
|
$134.15
|
|
| Hospital Charge Code |
41608237
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$124.76 |
| Rate for Payer: Aetna Commercial |
$113.22
|
| Rate for Payer: Aetna Medicare |
$42.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$41.59
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$77.04
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$83.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$49.37
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$47.22
|
| Rate for Payer: Cash Price |
$80.49
|
| Rate for Payer: Cash Price |
$80.49
|
| Rate for Payer: Centivo All Commercial |
$72.98
|
| Rate for Payer: Cigna All Commercial |
$115.77
|
| Rate for Payer: CORVEL All Commercial |
$124.76
|
| Rate for Payer: Coventry All Commercial |
$118.05
|
| Rate for Payer: Encore All Commercial |
$123.49
|
| Rate for Payer: Frontpath All Commercial |
$123.42
|
| Rate for Payer: Humana ChoiceCare |
$115.87
|
| Rate for Payer: Humana Medicare |
$42.93
|
| Rate for Payer: Lucent All Commercial |
$72.98
|
| Rate for Payer: Lutheran Preferred All Commercial |
$120.73
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$100.61
|
| Rate for Payer: PHP All Commercial |
$101.74
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$52.32
|
| Rate for Payer: Sagamore Health Network All Products |
$103.56
|
| Rate for Payer: Signature Care EPO |
$111.34
|
| Rate for Payer: Signature Care PPO |
$118.05
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$114.03
|
| Rate for Payer: United Healthcare Commercial |
$105.71
|
| Rate for Payer: United Healthcare Medicare |
$42.93
|
|
|
HC RADIATION TREATMENT DELIVERY, >1MEV; COMPLEX
|
Facility
|
OP
|
$1,166.88
|
|
|
Service Code
|
CPT 77412
|
| Hospital Charge Code |
1547412
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$193.17 |
| Max. Negotiated Rate |
$1,085.20 |
| Rate for Payer: Aetna Commercial |
$984.85
|
| Rate for Payer: Aetna Medicare |
$373.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$193.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$361.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$670.14
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$729.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$193.17
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$429.41
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$410.74
|
| Rate for Payer: Cash Price |
$700.13
|
| Rate for Payer: Cash Price |
$700.13
|
| Rate for Payer: Centivo All Commercial |
$634.78
|
| Rate for Payer: Cigna All Commercial |
$1,007.02
|
| Rate for Payer: CORVEL All Commercial |
$1,085.20
|
| Rate for Payer: Coventry All Commercial |
$1,026.85
|
| Rate for Payer: Encore All Commercial |
$1,074.11
|
| Rate for Payer: Frontpath All Commercial |
$1,073.53
|
| Rate for Payer: Humana ChoiceCare |
$1,007.83
|
| Rate for Payer: Humana Medicare |
$373.40
|
| Rate for Payer: Lucent All Commercial |
$634.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,050.19
|
| Rate for Payer: Managed Health Services Medicaid |
$193.17
|
| Rate for Payer: MDWise Medicaid |
$193.17
|
| Rate for Payer: PHCS All Commercial |
$875.16
|
| Rate for Payer: PHP All Commercial |
$884.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$455.08
|
| Rate for Payer: Sagamore Health Network All Products |
$900.83
|
| Rate for Payer: Signature Care EPO |
$968.51
|
| Rate for Payer: Signature Care PPO |
$1,026.85
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$991.85
|
| Rate for Payer: United Healthcare Commercial |
$919.50
|
| Rate for Payer: United Healthcare Medicare |
$373.40
|
|
|
HC RADIATION TREATMENT DELIVERY, >1MEV; COMPLEX
|
Facility
|
IP
|
$1,166.88
|
|
|
Service Code
|
CPT 77412
|
| Hospital Charge Code |
1547412
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$875.16 |
| Max. Negotiated Rate |
$1,085.20 |
| Rate for Payer: Aetna Commercial |
$1,008.18
|
| Rate for Payer: Cash Price |
$700.13
|
| Rate for Payer: Cigna All Commercial |
$1,007.02
|
| Rate for Payer: CORVEL All Commercial |
$1,085.20
|
| Rate for Payer: Coventry All Commercial |
$1,026.85
|
| Rate for Payer: Encore All Commercial |
$1,074.11
|
| Rate for Payer: Frontpath All Commercial |
$1,073.53
|
| Rate for Payer: Humana ChoiceCare |
$1,007.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,050.19
|
| Rate for Payer: PHCS All Commercial |
$875.16
|
| Rate for Payer: PHP All Commercial |
$884.96
|
| Rate for Payer: Sagamore Health Network All Products |
$900.83
|
| Rate for Payer: Signature Care EPO |
$968.51
|
| Rate for Payer: Signature Care PPO |
$1,026.85
|
| Rate for Payer: United Healthcare Commercial |
$919.50
|
|
|
HC RADIATION TREATMENT DELIVERY, >1MEV; INTERMEDIATE
|
Facility
|
OP
|
$954.72
|
|
|
Service Code
|
CPT 77407
|
| Hospital Charge Code |
1547407
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$100.09 |
| Max. Negotiated Rate |
$887.89 |
| Rate for Payer: Aetna Commercial |
$805.78
|
| Rate for Payer: Aetna Medicare |
$305.51
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$100.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$295.96
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$548.30
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$596.80
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$100.09
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$351.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$336.06
|
| Rate for Payer: Cash Price |
$572.83
|
| Rate for Payer: Cash Price |
$572.83
|
| Rate for Payer: Centivo All Commercial |
$519.37
|
| Rate for Payer: Cigna All Commercial |
$823.92
|
| Rate for Payer: CORVEL All Commercial |
$887.89
|
| Rate for Payer: Coventry All Commercial |
$840.15
|
| Rate for Payer: Encore All Commercial |
$878.82
|
| Rate for Payer: Frontpath All Commercial |
$878.34
|
| Rate for Payer: Humana ChoiceCare |
$824.59
|
| Rate for Payer: Humana Medicare |
$305.51
|
| Rate for Payer: Lucent All Commercial |
$519.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$859.25
|
| Rate for Payer: Managed Health Services Medicaid |
$100.09
|
| Rate for Payer: MDWise Medicaid |
$100.09
|
| Rate for Payer: PHCS All Commercial |
$716.04
|
| Rate for Payer: PHP All Commercial |
$724.06
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$372.34
|
| Rate for Payer: Sagamore Health Network All Products |
$737.04
|
| Rate for Payer: Signature Care EPO |
$792.42
|
| Rate for Payer: Signature Care PPO |
$840.15
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$811.51
|
| Rate for Payer: United Healthcare Commercial |
$752.32
|
| Rate for Payer: United Healthcare Medicare |
$305.51
|
|
|
HC RADIATION TREATMENT DELIVERY, >1MEV; INTERMEDIATE
|
Facility
|
IP
|
$954.72
|
|
|
Service Code
|
CPT 77407
|
| Hospital Charge Code |
1547407
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$716.04 |
| Max. Negotiated Rate |
$887.89 |
| Rate for Payer: Aetna Commercial |
$824.88
|
| Rate for Payer: Cash Price |
$572.83
|
| Rate for Payer: Cigna All Commercial |
$823.92
|
| Rate for Payer: CORVEL All Commercial |
$887.89
|
| Rate for Payer: Coventry All Commercial |
$840.15
|
| Rate for Payer: Encore All Commercial |
$878.82
|
| Rate for Payer: Frontpath All Commercial |
$878.34
|
| Rate for Payer: Humana ChoiceCare |
$824.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$859.25
|
| Rate for Payer: PHCS All Commercial |
$716.04
|
| Rate for Payer: PHP All Commercial |
$724.06
|
| Rate for Payer: Sagamore Health Network All Products |
$737.04
|
| Rate for Payer: Signature Care EPO |
$792.42
|
| Rate for Payer: Signature Care PPO |
$840.15
|
| Rate for Payer: United Healthcare Commercial |
$752.32
|
|
|
HC RADIATION TREATMENT DELIVERY, >1MEV; SIMPLE
|
Facility
|
IP
|
$742.56
|
|
|
Service Code
|
CPT 77402
|
| Hospital Charge Code |
1547402
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$556.92 |
| Max. Negotiated Rate |
$690.58 |
| Rate for Payer: Aetna Commercial |
$641.57
|
| Rate for Payer: Cash Price |
$445.54
|
| Rate for Payer: Cigna All Commercial |
$640.83
|
| Rate for Payer: CORVEL All Commercial |
$690.58
|
| Rate for Payer: Coventry All Commercial |
$653.45
|
| Rate for Payer: Encore All Commercial |
$683.53
|
| Rate for Payer: Frontpath All Commercial |
$683.16
|
| Rate for Payer: Humana ChoiceCare |
$641.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$668.30
|
| Rate for Payer: PHCS All Commercial |
$556.92
|
| Rate for Payer: PHP All Commercial |
$563.16
|
| Rate for Payer: Sagamore Health Network All Products |
$573.26
|
| Rate for Payer: Signature Care EPO |
$616.32
|
| Rate for Payer: Signature Care PPO |
$653.45
|
| Rate for Payer: United Healthcare Commercial |
$585.14
|
|
|
HC RADIATION TREATMENT DELIVERY, >1MEV; SIMPLE
|
Facility
|
OP
|
$742.56
|
|
|
Service Code
|
CPT 77402
|
| Hospital Charge Code |
1547402
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$100.09 |
| Max. Negotiated Rate |
$690.58 |
| Rate for Payer: Aetna Commercial |
$626.72
|
| Rate for Payer: Aetna Medicare |
$237.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$100.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$230.19
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$426.45
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$464.17
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$100.09
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$273.26
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$261.38
|
| Rate for Payer: Cash Price |
$445.54
|
| Rate for Payer: Cash Price |
$445.54
|
| Rate for Payer: Centivo All Commercial |
$403.95
|
| Rate for Payer: Cigna All Commercial |
$640.83
|
| Rate for Payer: CORVEL All Commercial |
$690.58
|
| Rate for Payer: Coventry All Commercial |
$653.45
|
| Rate for Payer: Encore All Commercial |
$683.53
|
| Rate for Payer: Frontpath All Commercial |
$683.16
|
| Rate for Payer: Humana ChoiceCare |
$641.35
|
| Rate for Payer: Humana Medicare |
$237.62
|
| Rate for Payer: Lucent All Commercial |
$403.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$668.30
|
| Rate for Payer: Managed Health Services Medicaid |
$100.09
|
| Rate for Payer: MDWise Medicaid |
$100.09
|
| Rate for Payer: PHCS All Commercial |
$556.92
|
| Rate for Payer: PHP All Commercial |
$563.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$289.60
|
| Rate for Payer: Sagamore Health Network All Products |
$573.26
|
| Rate for Payer: Signature Care EPO |
$616.32
|
| Rate for Payer: Signature Care PPO |
$653.45
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$631.18
|
| Rate for Payer: United Healthcare Commercial |
$585.14
|
| Rate for Payer: United Healthcare Medicare |
$237.62
|
|
|
HC RAD JAW 4 LG/NEEDLE
|
Facility
|
IP
|
$65.25
|
|
| Hospital Charge Code |
41608208
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.94 |
| Max. Negotiated Rate |
$60.68 |
| Rate for Payer: Aetna Commercial |
$56.38
|
| Rate for Payer: Cash Price |
$39.15
|
| Rate for Payer: Cigna All Commercial |
$56.31
|
| Rate for Payer: CORVEL All Commercial |
$60.68
|
| Rate for Payer: Coventry All Commercial |
$57.42
|
| Rate for Payer: Encore All Commercial |
$60.06
|
| Rate for Payer: Frontpath All Commercial |
$60.03
|
| Rate for Payer: Humana ChoiceCare |
$56.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$58.73
|
| Rate for Payer: PHCS All Commercial |
$48.94
|
| Rate for Payer: PHP All Commercial |
$49.49
|
| Rate for Payer: Sagamore Health Network All Products |
$50.37
|
| Rate for Payer: Signature Care EPO |
$54.16
|
| Rate for Payer: Signature Care PPO |
$57.42
|
| Rate for Payer: United Healthcare Commercial |
$51.42
|
|
|
HC RAD JAW 4 LG/NEEDLE
|
Facility
|
OP
|
$65.25
|
|
| Hospital Charge Code |
41608208
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.23 |
| Max. Negotiated Rate |
$60.68 |
| Rate for Payer: Aetna Commercial |
$55.07
|
| Rate for Payer: Aetna Medicare |
$20.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$20.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$37.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$40.79
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$24.01
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$22.97
|
| Rate for Payer: Cash Price |
$39.15
|
| Rate for Payer: Cash Price |
$39.15
|
| Rate for Payer: Centivo All Commercial |
$35.50
|
| Rate for Payer: Cigna All Commercial |
$56.31
|
| Rate for Payer: CORVEL All Commercial |
$60.68
|
| Rate for Payer: Coventry All Commercial |
$57.42
|
| Rate for Payer: Encore All Commercial |
$60.06
|
| Rate for Payer: Frontpath All Commercial |
$60.03
|
| Rate for Payer: Humana ChoiceCare |
$56.36
|
| Rate for Payer: Humana Medicare |
$20.88
|
| Rate for Payer: Lucent All Commercial |
$35.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$58.73
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$48.94
|
| Rate for Payer: PHP All Commercial |
$49.49
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$25.45
|
| Rate for Payer: Sagamore Health Network All Products |
$50.37
|
| Rate for Payer: Signature Care EPO |
$54.16
|
| Rate for Payer: Signature Care PPO |
$57.42
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$55.46
|
| Rate for Payer: United Healthcare Commercial |
$51.42
|
| Rate for Payer: United Healthcare Medicare |
$20.88
|
|
|
HC RAPTOR GRASPING DEVICE
|
Facility
|
OP
|
$910.00
|
|
| Hospital Charge Code |
41601220
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$846.30 |
| Rate for Payer: Aetna Commercial |
$768.04
|
| Rate for Payer: Aetna Medicare |
$291.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$282.10
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$522.61
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$568.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$334.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$320.32
|
| Rate for Payer: Cash Price |
$546.00
|
| Rate for Payer: Cash Price |
$546.00
|
| Rate for Payer: Centivo All Commercial |
$495.04
|
| Rate for Payer: Cigna All Commercial |
$785.33
|
| Rate for Payer: CORVEL All Commercial |
$846.30
|
| Rate for Payer: Coventry All Commercial |
$800.80
|
| Rate for Payer: Encore All Commercial |
$837.65
|
| Rate for Payer: Frontpath All Commercial |
$837.20
|
| Rate for Payer: Humana ChoiceCare |
$785.97
|
| Rate for Payer: Humana Medicare |
$291.20
|
| Rate for Payer: Lucent All Commercial |
$495.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$819.00
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$682.50
|
| Rate for Payer: PHP All Commercial |
$690.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$354.90
|
| Rate for Payer: Sagamore Health Network All Products |
$702.52
|
| Rate for Payer: Signature Care EPO |
$755.30
|
| Rate for Payer: Signature Care PPO |
$800.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$773.50
|
| Rate for Payer: United Healthcare Commercial |
$717.08
|
| Rate for Payer: United Healthcare Medicare |
$291.20
|
|
|
HC RAPTOR GRASPING DEVICE
|
Facility
|
IP
|
$910.00
|
|
| Hospital Charge Code |
41601220
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$682.50 |
| Max. Negotiated Rate |
$846.30 |
| Rate for Payer: Aetna Commercial |
$786.24
|
| Rate for Payer: Cash Price |
$546.00
|
| Rate for Payer: Cigna All Commercial |
$785.33
|
| Rate for Payer: CORVEL All Commercial |
$846.30
|
| Rate for Payer: Coventry All Commercial |
$800.80
|
| Rate for Payer: Encore All Commercial |
$837.65
|
| Rate for Payer: Frontpath All Commercial |
$837.20
|
| Rate for Payer: Humana ChoiceCare |
$785.97
|
| Rate for Payer: Lutheran Preferred All Commercial |
$819.00
|
| Rate for Payer: PHCS All Commercial |
$682.50
|
| Rate for Payer: PHP All Commercial |
$690.14
|
| Rate for Payer: Sagamore Health Network All Products |
$702.52
|
| Rate for Payer: Signature Care EPO |
$755.30
|
| Rate for Payer: Signature Care PPO |
$800.80
|
| Rate for Payer: United Healthcare Commercial |
$717.08
|
|
|
HC RA QUANT
|
Facility
|
IP
|
$61.04
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
63001915
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$45.78 |
| Max. Negotiated Rate |
$56.77 |
| Rate for Payer: Aetna Commercial |
$52.74
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cigna All Commercial |
$52.68
|
| Rate for Payer: CORVEL All Commercial |
$56.77
|
| Rate for Payer: Coventry All Commercial |
$53.72
|
| Rate for Payer: Encore All Commercial |
$56.19
|
| Rate for Payer: Frontpath All Commercial |
$56.16
|
| Rate for Payer: Humana ChoiceCare |
$52.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$54.94
|
| Rate for Payer: PHCS All Commercial |
$45.78
|
| Rate for Payer: PHP All Commercial |
$46.29
|
| Rate for Payer: Sagamore Health Network All Products |
$47.12
|
| Rate for Payer: Signature Care EPO |
$50.66
|
| Rate for Payer: Signature Care PPO |
$53.72
|
| Rate for Payer: United Healthcare Commercial |
$48.10
|
|
|
HC RA QUANT
|
Facility
|
OP
|
$61.04
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
63001915
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.67 |
| Max. Negotiated Rate |
$56.77 |
| Rate for Payer: Aetna Commercial |
$51.52
|
| Rate for Payer: Aetna Medicare |
$19.53
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$5.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$18.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$28.05
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$28.05
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$5.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$22.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$21.49
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Centivo All Commercial |
$33.21
|
| Rate for Payer: Cigna All Commercial |
$52.68
|
| Rate for Payer: CORVEL All Commercial |
$56.77
|
| Rate for Payer: Coventry All Commercial |
$53.72
|
| Rate for Payer: Encore All Commercial |
$56.19
|
| Rate for Payer: Frontpath All Commercial |
$56.16
|
| Rate for Payer: Humana ChoiceCare |
$52.72
|
| Rate for Payer: Humana Medicare |
$19.53
|
| Rate for Payer: Lucent All Commercial |
$33.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$54.94
|
| Rate for Payer: Managed Health Services Medicaid |
$5.67
|
| Rate for Payer: MDWise Medicaid |
$5.67
|
| Rate for Payer: PHCS All Commercial |
$45.78
|
| Rate for Payer: PHP All Commercial |
$46.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$23.81
|
| Rate for Payer: Sagamore Health Network All Products |
$47.12
|
| Rate for Payer: Signature Care EPO |
$50.66
|
| Rate for Payer: Signature Care PPO |
$53.72
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$51.88
|
| Rate for Payer: United Healthcare Commercial |
$48.10
|
| Rate for Payer: United Healthcare Medicare |
$19.53
|
|
|
HC RA TITER
|
Facility
|
OP
|
$69.56
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
63001288
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.67 |
| Max. Negotiated Rate |
$64.69 |
| Rate for Payer: Aetna Commercial |
$58.71
|
| Rate for Payer: Aetna Medicare |
$22.26
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$5.67
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$21.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$31.97
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$31.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$5.67
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$25.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$24.49
|
| Rate for Payer: Cash Price |
$41.74
|
| Rate for Payer: Cash Price |
$41.74
|
| Rate for Payer: Centivo All Commercial |
$37.84
|
| Rate for Payer: Cigna All Commercial |
$60.03
|
| Rate for Payer: CORVEL All Commercial |
$64.69
|
| Rate for Payer: Coventry All Commercial |
$61.21
|
| Rate for Payer: Encore All Commercial |
$64.03
|
| Rate for Payer: Frontpath All Commercial |
$64.00
|
| Rate for Payer: Humana ChoiceCare |
$60.08
|
| Rate for Payer: Humana Medicare |
$22.26
|
| Rate for Payer: Lucent All Commercial |
$37.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$62.60
|
| Rate for Payer: Managed Health Services Medicaid |
$5.67
|
| Rate for Payer: MDWise Medicaid |
$5.67
|
| Rate for Payer: PHCS All Commercial |
$52.17
|
| Rate for Payer: PHP All Commercial |
$52.75
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$27.13
|
| Rate for Payer: Sagamore Health Network All Products |
$53.70
|
| Rate for Payer: Signature Care EPO |
$57.73
|
| Rate for Payer: Signature Care PPO |
$61.21
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$59.13
|
| Rate for Payer: United Healthcare Commercial |
$54.81
|
| Rate for Payer: United Healthcare Medicare |
$22.26
|
|
|
HC RA TITER
|
Facility
|
IP
|
$69.56
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
63001288
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$52.17 |
| Max. Negotiated Rate |
$64.69 |
| Rate for Payer: Aetna Commercial |
$60.10
|
| Rate for Payer: Cash Price |
$41.74
|
| Rate for Payer: Cigna All Commercial |
$60.03
|
| Rate for Payer: CORVEL All Commercial |
$64.69
|
| Rate for Payer: Coventry All Commercial |
$61.21
|
| Rate for Payer: Encore All Commercial |
$64.03
|
| Rate for Payer: Frontpath All Commercial |
$64.00
|
| Rate for Payer: Humana ChoiceCare |
$60.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$62.60
|
| Rate for Payer: PHCS All Commercial |
$52.17
|
| Rate for Payer: PHP All Commercial |
$52.75
|
| Rate for Payer: Sagamore Health Network All Products |
$53.70
|
| Rate for Payer: Signature Care EPO |
$57.73
|
| Rate for Payer: Signature Care PPO |
$61.21
|
| Rate for Payer: United Healthcare Commercial |
$54.81
|
|
|
HC RECOVERY PHASE 1 EA ADD MIN
|
Facility
|
OP
|
$49.47
|
|
| Hospital Charge Code |
1216651
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$15.34 |
| Max. Negotiated Rate |
$103.04 |
| Rate for Payer: Aetna Commercial |
$41.75
|
| Rate for Payer: Aetna Medicare |
$15.83
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$103.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$15.34
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$28.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$30.92
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$103.04
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$18.20
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$17.41
|
| Rate for Payer: Cash Price |
$29.68
|
| Rate for Payer: Cash Price |
$29.68
|
| Rate for Payer: Centivo All Commercial |
$26.91
|
| Rate for Payer: Cigna All Commercial |
$42.69
|
| Rate for Payer: CORVEL All Commercial |
$46.01
|
| Rate for Payer: Coventry All Commercial |
$43.53
|
| Rate for Payer: Encore All Commercial |
$45.54
|
| Rate for Payer: Frontpath All Commercial |
$45.51
|
| Rate for Payer: Humana ChoiceCare |
$42.73
|
| Rate for Payer: Humana Medicare |
$15.83
|
| Rate for Payer: Lucent All Commercial |
$26.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$44.52
|
| Rate for Payer: Managed Health Services Medicaid |
$103.04
|
| Rate for Payer: MDWise Medicaid |
$103.04
|
| Rate for Payer: PHCS All Commercial |
$37.10
|
| Rate for Payer: PHP All Commercial |
$37.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$19.29
|
| Rate for Payer: Sagamore Health Network All Products |
$38.19
|
| Rate for Payer: Signature Care EPO |
$41.06
|
| Rate for Payer: Signature Care PPO |
$43.53
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$42.05
|
| Rate for Payer: United Healthcare Commercial |
$38.98
|
| Rate for Payer: United Healthcare Medicare |
$15.83
|
|
|
HC RECOVERY PHASE 1 EA ADD MIN
|
Facility
|
IP
|
$49.47
|
|
| Hospital Charge Code |
1216651
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$37.10 |
| Max. Negotiated Rate |
$46.01 |
| Rate for Payer: Aetna Commercial |
$42.74
|
| Rate for Payer: Cash Price |
$29.68
|
| Rate for Payer: Cigna All Commercial |
$42.69
|
| Rate for Payer: CORVEL All Commercial |
$46.01
|
| Rate for Payer: Coventry All Commercial |
$43.53
|
| Rate for Payer: Encore All Commercial |
$45.54
|
| Rate for Payer: Frontpath All Commercial |
$45.51
|
| Rate for Payer: Humana ChoiceCare |
$42.73
|
| Rate for Payer: Lutheran Preferred All Commercial |
$44.52
|
| Rate for Payer: PHCS All Commercial |
$37.10
|
| Rate for Payer: PHP All Commercial |
$37.52
|
| Rate for Payer: Sagamore Health Network All Products |
$38.19
|
| Rate for Payer: Signature Care EPO |
$41.06
|
| Rate for Payer: Signature Care PPO |
$43.53
|
| Rate for Payer: United Healthcare Commercial |
$38.98
|
|
|
HC RECOVERY PHASE 1 INITIAL 30 MIN
|
Facility
|
OP
|
$1,280.18
|
|
| Hospital Charge Code |
1216650
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$103.04 |
| Max. Negotiated Rate |
$1,190.57 |
| Rate for Payer: Aetna Commercial |
$1,080.47
|
| Rate for Payer: Aetna Medicare |
$409.66
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$103.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$396.86
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$735.21
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$800.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$103.04
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$471.11
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$450.62
|
| Rate for Payer: Cash Price |
$768.11
|
| Rate for Payer: Cash Price |
$768.11
|
| Rate for Payer: Centivo All Commercial |
$696.42
|
| Rate for Payer: Cigna All Commercial |
$1,104.80
|
| Rate for Payer: CORVEL All Commercial |
$1,190.57
|
| Rate for Payer: Coventry All Commercial |
$1,126.56
|
| Rate for Payer: Encore All Commercial |
$1,178.41
|
| Rate for Payer: Frontpath All Commercial |
$1,177.77
|
| Rate for Payer: Humana ChoiceCare |
$1,105.69
|
| Rate for Payer: Humana Medicare |
$409.66
|
| Rate for Payer: Lucent All Commercial |
$696.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,152.16
|
| Rate for Payer: Managed Health Services Medicaid |
$103.04
|
| Rate for Payer: MDWise Medicaid |
$103.04
|
| Rate for Payer: PHCS All Commercial |
$960.13
|
| Rate for Payer: PHP All Commercial |
$970.89
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$499.27
|
| Rate for Payer: Sagamore Health Network All Products |
$988.30
|
| Rate for Payer: Signature Care EPO |
$1,062.55
|
| Rate for Payer: Signature Care PPO |
$1,126.56
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,088.15
|
| Rate for Payer: United Healthcare Commercial |
$1,008.78
|
| Rate for Payer: United Healthcare Medicare |
$409.66
|
|
|
HC RECOVERY PHASE 1 INITIAL 30 MIN
|
Facility
|
IP
|
$1,280.18
|
|
| Hospital Charge Code |
1216650
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$960.13 |
| Max. Negotiated Rate |
$1,190.57 |
| Rate for Payer: Aetna Commercial |
$1,106.08
|
| Rate for Payer: Cash Price |
$768.11
|
| Rate for Payer: Cigna All Commercial |
$1,104.80
|
| Rate for Payer: CORVEL All Commercial |
$1,190.57
|
| Rate for Payer: Coventry All Commercial |
$1,126.56
|
| Rate for Payer: Encore All Commercial |
$1,178.41
|
| Rate for Payer: Frontpath All Commercial |
$1,177.77
|
| Rate for Payer: Humana ChoiceCare |
$1,105.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,152.16
|
| Rate for Payer: PHCS All Commercial |
$960.13
|
| Rate for Payer: PHP All Commercial |
$970.89
|
| Rate for Payer: Sagamore Health Network All Products |
$988.30
|
| Rate for Payer: Signature Care EPO |
$1,062.55
|
| Rate for Payer: Signature Care PPO |
$1,126.56
|
| Rate for Payer: United Healthcare Commercial |
$1,008.78
|
|
|
HC RECOVERY PHASE 2 EA ADD MIN
|
Facility
|
IP
|
$17.81
|
|
| Hospital Charge Code |
1216653
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$13.36 |
| Max. Negotiated Rate |
$16.56 |
| Rate for Payer: Aetna Commercial |
$15.39
|
| Rate for Payer: Cash Price |
$10.69
|
| Rate for Payer: Cigna All Commercial |
$15.37
|
| Rate for Payer: CORVEL All Commercial |
$16.56
|
| Rate for Payer: Coventry All Commercial |
$15.67
|
| Rate for Payer: Encore All Commercial |
$16.39
|
| Rate for Payer: Frontpath All Commercial |
$16.39
|
| Rate for Payer: Humana ChoiceCare |
$15.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$16.03
|
| Rate for Payer: PHCS All Commercial |
$13.36
|
| Rate for Payer: PHP All Commercial |
$13.51
|
| Rate for Payer: Sagamore Health Network All Products |
$13.75
|
| Rate for Payer: Signature Care EPO |
$14.78
|
| Rate for Payer: Signature Care PPO |
$15.67
|
| Rate for Payer: United Healthcare Commercial |
$14.03
|
|
|
HC RECOVERY PHASE 2 EA ADD MIN
|
Facility
|
OP
|
$17.81
|
|
| Hospital Charge Code |
1216653
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$5.52 |
| Max. Negotiated Rate |
$103.04 |
| Rate for Payer: Aetna Commercial |
$15.03
|
| Rate for Payer: Aetna Medicare |
$5.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$103.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5.52
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$10.23
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$11.13
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$103.04
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$6.27
|
| Rate for Payer: Cash Price |
$10.69
|
| Rate for Payer: Cash Price |
$10.69
|
| Rate for Payer: Centivo All Commercial |
$9.69
|
| Rate for Payer: Cigna All Commercial |
$15.37
|
| Rate for Payer: CORVEL All Commercial |
$16.56
|
| Rate for Payer: Coventry All Commercial |
$15.67
|
| Rate for Payer: Encore All Commercial |
$16.39
|
| Rate for Payer: Frontpath All Commercial |
$16.39
|
| Rate for Payer: Humana ChoiceCare |
$15.38
|
| Rate for Payer: Humana Medicare |
$5.70
|
| Rate for Payer: Lucent All Commercial |
$9.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$16.03
|
| Rate for Payer: Managed Health Services Medicaid |
$103.04
|
| Rate for Payer: MDWise Medicaid |
$103.04
|
| Rate for Payer: PHCS All Commercial |
$13.36
|
| Rate for Payer: PHP All Commercial |
$13.51
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$6.95
|
| Rate for Payer: Sagamore Health Network All Products |
$13.75
|
| Rate for Payer: Signature Care EPO |
$14.78
|
| Rate for Payer: Signature Care PPO |
$15.67
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$15.14
|
| Rate for Payer: United Healthcare Commercial |
$14.03
|
| Rate for Payer: United Healthcare Medicare |
$5.70
|
|
|
HC RECOVERY PHASE 2 INITIAL 30 MIN
|
Facility
|
OP
|
$460.87
|
|
| Hospital Charge Code |
1216652
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$103.04 |
| Max. Negotiated Rate |
$428.61 |
| Rate for Payer: Aetna Commercial |
$388.97
|
| Rate for Payer: Aetna Medicare |
$147.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$103.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$142.87
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$264.68
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$288.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$103.04
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$169.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$162.23
|
| Rate for Payer: Cash Price |
$276.52
|
| Rate for Payer: Cash Price |
$276.52
|
| Rate for Payer: Centivo All Commercial |
$250.71
|
| Rate for Payer: Cigna All Commercial |
$397.73
|
| Rate for Payer: CORVEL All Commercial |
$428.61
|
| Rate for Payer: Coventry All Commercial |
$405.57
|
| Rate for Payer: Encore All Commercial |
$424.23
|
| Rate for Payer: Frontpath All Commercial |
$424.00
|
| Rate for Payer: Humana ChoiceCare |
$398.05
|
| Rate for Payer: Humana Medicare |
$147.48
|
| Rate for Payer: Lucent All Commercial |
$250.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$414.78
|
| Rate for Payer: Managed Health Services Medicaid |
$103.04
|
| Rate for Payer: MDWise Medicaid |
$103.04
|
| Rate for Payer: PHCS All Commercial |
$345.65
|
| Rate for Payer: PHP All Commercial |
$349.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$179.74
|
| Rate for Payer: Sagamore Health Network All Products |
$355.79
|
| Rate for Payer: Signature Care EPO |
$382.52
|
| Rate for Payer: Signature Care PPO |
$405.57
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$391.74
|
| Rate for Payer: United Healthcare Commercial |
$363.17
|
| Rate for Payer: United Healthcare Medicare |
$147.48
|
|
|
HC RECOVERY PHASE 2 INITIAL 30 MIN
|
Facility
|
IP
|
$460.87
|
|
| Hospital Charge Code |
1216652
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$345.65 |
| Max. Negotiated Rate |
$428.61 |
| Rate for Payer: Aetna Commercial |
$398.19
|
| Rate for Payer: Cash Price |
$276.52
|
| Rate for Payer: Cigna All Commercial |
$397.73
|
| Rate for Payer: CORVEL All Commercial |
$428.61
|
| Rate for Payer: Coventry All Commercial |
$405.57
|
| Rate for Payer: Encore All Commercial |
$424.23
|
| Rate for Payer: Frontpath All Commercial |
$424.00
|
| Rate for Payer: Humana ChoiceCare |
$398.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$414.78
|
| Rate for Payer: PHCS All Commercial |
$345.65
|
| Rate for Payer: PHP All Commercial |
$349.52
|
| Rate for Payer: Sagamore Health Network All Products |
$355.79
|
| Rate for Payer: Signature Care EPO |
$382.52
|
| Rate for Payer: Signature Care PPO |
$405.57
|
| Rate for Payer: United Healthcare Commercial |
$363.17
|
|
|
HC RED CELL - LEUKOREDUCED
|
Facility
|
OP
|
$1,219.92
|
|
|
Service Code
|
CPT P9016
|
| Hospital Charge Code |
1370017
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$71.47 |
| Max. Negotiated Rate |
$1,134.53 |
| Rate for Payer: Aetna Commercial |
$1,029.61
|
| Rate for Payer: Aetna Medicare |
$390.37
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$71.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$378.18
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$700.60
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$762.57
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$71.47
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$448.93
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$429.41
|
| Rate for Payer: Cash Price |
$731.95
|
| Rate for Payer: Cash Price |
$731.95
|
| Rate for Payer: Centivo All Commercial |
$663.64
|
| Rate for Payer: Cigna All Commercial |
$1,052.79
|
| Rate for Payer: CORVEL All Commercial |
$1,134.53
|
| Rate for Payer: Coventry All Commercial |
$1,073.53
|
| Rate for Payer: Encore All Commercial |
$1,122.94
|
| Rate for Payer: Frontpath All Commercial |
$1,122.33
|
| Rate for Payer: Humana ChoiceCare |
$1,053.64
|
| Rate for Payer: Humana Medicare |
$390.37
|
| Rate for Payer: Lucent All Commercial |
$663.64
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,097.93
|
| Rate for Payer: Managed Health Services Medicaid |
$71.47
|
| Rate for Payer: MDWise Medicaid |
$71.47
|
| Rate for Payer: PHCS All Commercial |
$914.94
|
| Rate for Payer: PHP All Commercial |
$925.19
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$475.77
|
| Rate for Payer: Sagamore Health Network All Products |
$941.78
|
| Rate for Payer: Signature Care EPO |
$1,012.53
|
| Rate for Payer: Signature Care PPO |
$1,073.53
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,036.93
|
| Rate for Payer: United Healthcare Commercial |
$961.30
|
| Rate for Payer: United Healthcare Medicare |
$390.37
|
|
