|
HC SODIUM
|
Facility
|
IP
|
$78.54
|
|
|
Service Code
|
CPT 84295
|
| Hospital Charge Code |
63001109
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$58.91 |
| Max. Negotiated Rate |
$73.04 |
| Rate for Payer: Aetna Commercial |
$67.86
|
| Rate for Payer: Cash Price |
$47.12
|
| Rate for Payer: Cigna All Commercial |
$67.78
|
| Rate for Payer: CORVEL All Commercial |
$73.04
|
| Rate for Payer: Coventry All Commercial |
$69.12
|
| Rate for Payer: Encore All Commercial |
$72.30
|
| Rate for Payer: Frontpath All Commercial |
$72.26
|
| Rate for Payer: Humana ChoiceCare |
$67.83
|
| Rate for Payer: Lutheran Preferred All Commercial |
$70.69
|
| Rate for Payer: PHCS All Commercial |
$58.91
|
| Rate for Payer: PHP All Commercial |
$59.56
|
| Rate for Payer: Sagamore Health Network All Products |
$60.63
|
| Rate for Payer: Signature Care EPO |
$65.19
|
| Rate for Payer: Signature Care PPO |
$69.12
|
| Rate for Payer: United Healthcare Commercial |
$61.89
|
|
|
HC SODIUM URINE
|
Facility
|
IP
|
$99.86
|
|
|
Service Code
|
CPT 84300
|
| Hospital Charge Code |
63001151
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$74.89 |
| Max. Negotiated Rate |
$92.87 |
| Rate for Payer: Aetna Commercial |
$86.28
|
| Rate for Payer: Cash Price |
$59.92
|
| Rate for Payer: Cigna All Commercial |
$86.18
|
| Rate for Payer: CORVEL All Commercial |
$92.87
|
| Rate for Payer: Coventry All Commercial |
$87.88
|
| Rate for Payer: Encore All Commercial |
$91.92
|
| Rate for Payer: Frontpath All Commercial |
$91.87
|
| Rate for Payer: Humana ChoiceCare |
$86.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$89.87
|
| Rate for Payer: PHCS All Commercial |
$74.89
|
| Rate for Payer: PHP All Commercial |
$75.73
|
| Rate for Payer: Sagamore Health Network All Products |
$77.09
|
| Rate for Payer: Signature Care EPO |
$82.88
|
| Rate for Payer: Signature Care PPO |
$87.88
|
| Rate for Payer: United Healthcare Commercial |
$78.69
|
|
|
HC SODIUM URINE
|
Facility
|
OP
|
$99.86
|
|
|
Service Code
|
CPT 84300
|
| Hospital Charge Code |
63001151
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.06 |
| Max. Negotiated Rate |
$92.87 |
| Rate for Payer: Aetna Commercial |
$84.28
|
| Rate for Payer: Aetna Medicare |
$31.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$5.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$30.96
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$45.90
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$45.90
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$5.06
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$36.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$35.15
|
| Rate for Payer: Cash Price |
$59.92
|
| Rate for Payer: Cash Price |
$59.92
|
| Rate for Payer: Centivo All Commercial |
$54.32
|
| Rate for Payer: Cigna All Commercial |
$86.18
|
| Rate for Payer: CORVEL All Commercial |
$92.87
|
| Rate for Payer: Coventry All Commercial |
$87.88
|
| Rate for Payer: Encore All Commercial |
$91.92
|
| Rate for Payer: Frontpath All Commercial |
$91.87
|
| Rate for Payer: Humana ChoiceCare |
$86.25
|
| Rate for Payer: Humana Medicare |
$31.96
|
| Rate for Payer: Lucent All Commercial |
$54.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$89.87
|
| Rate for Payer: Managed Health Services Medicaid |
$5.06
|
| Rate for Payer: MDWise Medicaid |
$5.06
|
| Rate for Payer: PHCS All Commercial |
$74.89
|
| Rate for Payer: PHP All Commercial |
$75.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$38.95
|
| Rate for Payer: Sagamore Health Network All Products |
$77.09
|
| Rate for Payer: Signature Care EPO |
$82.88
|
| Rate for Payer: Signature Care PPO |
$87.88
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$84.88
|
| Rate for Payer: United Healthcare Commercial |
$78.69
|
| Rate for Payer: United Healthcare Medicare |
$31.96
|
|
|
HC SOLUBLE TRANSFERRIN
|
Facility
|
IP
|
$419.63
|
|
|
Service Code
|
CPT 84238
|
| Hospital Charge Code |
63001672
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$314.72 |
| Max. Negotiated Rate |
$390.26 |
| Rate for Payer: Aetna Commercial |
$362.56
|
| Rate for Payer: Cash Price |
$251.78
|
| Rate for Payer: Cigna All Commercial |
$362.14
|
| Rate for Payer: CORVEL All Commercial |
$390.26
|
| Rate for Payer: Coventry All Commercial |
$369.27
|
| Rate for Payer: Encore All Commercial |
$386.27
|
| Rate for Payer: Frontpath All Commercial |
$386.06
|
| Rate for Payer: Humana ChoiceCare |
$362.43
|
| Rate for Payer: Lutheran Preferred All Commercial |
$377.67
|
| Rate for Payer: PHCS All Commercial |
$314.72
|
| Rate for Payer: PHP All Commercial |
$318.25
|
| Rate for Payer: Sagamore Health Network All Products |
$323.95
|
| Rate for Payer: Signature Care EPO |
$348.29
|
| Rate for Payer: Signature Care PPO |
$369.27
|
| Rate for Payer: United Healthcare Commercial |
$330.67
|
|
|
HC SOLUBLE TRANSFERRIN
|
Facility
|
OP
|
$419.63
|
|
|
Service Code
|
CPT 84238
|
| Hospital Charge Code |
63001672
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.57 |
| Max. Negotiated Rate |
$390.26 |
| Rate for Payer: Aetna Commercial |
$354.17
|
| Rate for Payer: Aetna Medicare |
$134.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$36.57
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$130.09
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$192.86
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$192.86
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$36.57
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$154.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$147.71
|
| Rate for Payer: Cash Price |
$251.78
|
| Rate for Payer: Cash Price |
$251.78
|
| Rate for Payer: Centivo All Commercial |
$228.28
|
| Rate for Payer: Cigna All Commercial |
$362.14
|
| Rate for Payer: CORVEL All Commercial |
$390.26
|
| Rate for Payer: Coventry All Commercial |
$369.27
|
| Rate for Payer: Encore All Commercial |
$386.27
|
| Rate for Payer: Frontpath All Commercial |
$386.06
|
| Rate for Payer: Humana ChoiceCare |
$362.43
|
| Rate for Payer: Humana Medicare |
$134.28
|
| Rate for Payer: Lucent All Commercial |
$228.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$377.67
|
| Rate for Payer: Managed Health Services Medicaid |
$36.57
|
| Rate for Payer: MDWise Medicaid |
$36.57
|
| Rate for Payer: PHCS All Commercial |
$314.72
|
| Rate for Payer: PHP All Commercial |
$318.25
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$163.66
|
| Rate for Payer: Sagamore Health Network All Products |
$323.95
|
| Rate for Payer: Signature Care EPO |
$348.29
|
| Rate for Payer: Signature Care PPO |
$369.27
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$356.69
|
| Rate for Payer: United Healthcare Commercial |
$330.67
|
| Rate for Payer: United Healthcare Medicare |
$134.28
|
|
|
HC S PATELLA S31X9 TRI
|
Facility
|
OP
|
$2,808.94
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607498
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$2,612.31 |
| Rate for Payer: Aetna Commercial |
$2,370.75
|
| Rate for Payer: Aetna Medicare |
$898.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$870.77
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,613.17
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,755.87
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,033.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$988.75
|
| Rate for Payer: Cash Price |
$1,685.36
|
| Rate for Payer: Cash Price |
$1,685.36
|
| Rate for Payer: Centivo All Commercial |
$1,528.06
|
| Rate for Payer: Cigna All Commercial |
$2,424.12
|
| Rate for Payer: CORVEL All Commercial |
$2,612.31
|
| Rate for Payer: Coventry All Commercial |
$2,471.87
|
| Rate for Payer: Encore All Commercial |
$2,585.63
|
| Rate for Payer: Frontpath All Commercial |
$2,584.22
|
| Rate for Payer: Humana ChoiceCare |
$2,426.08
|
| Rate for Payer: Humana Medicare |
$898.86
|
| Rate for Payer: Lucent All Commercial |
$1,528.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,528.05
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$2,106.70
|
| Rate for Payer: PHP All Commercial |
$2,130.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,095.49
|
| Rate for Payer: Sagamore Health Network All Products |
$2,168.50
|
| Rate for Payer: Signature Care EPO |
$2,331.42
|
| Rate for Payer: Signature Care PPO |
$2,471.87
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,387.60
|
| Rate for Payer: United Healthcare Commercial |
$2,213.44
|
| Rate for Payer: United Healthcare Medicare |
$898.86
|
|
|
HC S PATELLA S31X9 TRI
|
Facility
|
IP
|
$2,808.94
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607498
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,106.70 |
| Max. Negotiated Rate |
$2,612.31 |
| Rate for Payer: Aetna Commercial |
$2,426.92
|
| Rate for Payer: Cash Price |
$1,685.36
|
| Rate for Payer: Cigna All Commercial |
$2,424.12
|
| Rate for Payer: CORVEL All Commercial |
$2,612.31
|
| Rate for Payer: Coventry All Commercial |
$2,471.87
|
| Rate for Payer: Encore All Commercial |
$2,585.63
|
| Rate for Payer: Frontpath All Commercial |
$2,584.22
|
| Rate for Payer: Humana ChoiceCare |
$2,426.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,528.05
|
| Rate for Payer: PHCS All Commercial |
$2,106.70
|
| Rate for Payer: PHP All Commercial |
$2,130.30
|
| Rate for Payer: Sagamore Health Network All Products |
$2,168.50
|
| Rate for Payer: Signature Care EPO |
$2,331.42
|
| Rate for Payer: Signature Care PPO |
$2,471.87
|
| Rate for Payer: United Healthcare Commercial |
$2,213.44
|
|
|
HC S PATELLA S36X10 SYM TRI E
|
Facility
|
OP
|
$2,808.94
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607459
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$2,612.31 |
| Rate for Payer: Aetna Commercial |
$2,370.75
|
| Rate for Payer: Aetna Medicare |
$898.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$870.77
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,613.17
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,755.87
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,033.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$988.75
|
| Rate for Payer: Cash Price |
$1,685.36
|
| Rate for Payer: Cash Price |
$1,685.36
|
| Rate for Payer: Centivo All Commercial |
$1,528.06
|
| Rate for Payer: Cigna All Commercial |
$2,424.12
|
| Rate for Payer: CORVEL All Commercial |
$2,612.31
|
| Rate for Payer: Coventry All Commercial |
$2,471.87
|
| Rate for Payer: Encore All Commercial |
$2,585.63
|
| Rate for Payer: Frontpath All Commercial |
$2,584.22
|
| Rate for Payer: Humana ChoiceCare |
$2,426.08
|
| Rate for Payer: Humana Medicare |
$898.86
|
| Rate for Payer: Lucent All Commercial |
$1,528.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,528.05
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$2,106.70
|
| Rate for Payer: PHP All Commercial |
$2,130.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,095.49
|
| Rate for Payer: Sagamore Health Network All Products |
$2,168.50
|
| Rate for Payer: Signature Care EPO |
$2,331.42
|
| Rate for Payer: Signature Care PPO |
$2,471.87
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,387.60
|
| Rate for Payer: United Healthcare Commercial |
$2,213.44
|
| Rate for Payer: United Healthcare Medicare |
$898.86
|
|
|
HC S PATELLA S36X10 SYM TRI E
|
Facility
|
IP
|
$2,808.94
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607459
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,106.70 |
| Max. Negotiated Rate |
$2,612.31 |
| Rate for Payer: Aetna Commercial |
$2,426.92
|
| Rate for Payer: Cash Price |
$1,685.36
|
| Rate for Payer: Cigna All Commercial |
$2,424.12
|
| Rate for Payer: CORVEL All Commercial |
$2,612.31
|
| Rate for Payer: Coventry All Commercial |
$2,471.87
|
| Rate for Payer: Encore All Commercial |
$2,585.63
|
| Rate for Payer: Frontpath All Commercial |
$2,584.22
|
| Rate for Payer: Humana ChoiceCare |
$2,426.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,528.05
|
| Rate for Payer: PHCS All Commercial |
$2,106.70
|
| Rate for Payer: PHP All Commercial |
$2,130.30
|
| Rate for Payer: Sagamore Health Network All Products |
$2,168.50
|
| Rate for Payer: Signature Care EPO |
$2,331.42
|
| Rate for Payer: Signature Care PPO |
$2,471.87
|
| Rate for Payer: United Healthcare Commercial |
$2,213.44
|
|
|
HC SPECIAL PHYSICS CONSULT
|
Facility
|
IP
|
$1,591.20
|
|
|
Service Code
|
CPT 77370
|
| Hospital Charge Code |
1547370
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,193.40 |
| Max. Negotiated Rate |
$1,479.82 |
| Rate for Payer: Aetna Commercial |
$1,374.80
|
| Rate for Payer: Cash Price |
$954.72
|
| Rate for Payer: Cigna All Commercial |
$1,373.21
|
| Rate for Payer: CORVEL All Commercial |
$1,479.82
|
| Rate for Payer: Coventry All Commercial |
$1,400.26
|
| Rate for Payer: Encore All Commercial |
$1,464.70
|
| Rate for Payer: Frontpath All Commercial |
$1,463.90
|
| Rate for Payer: Humana ChoiceCare |
$1,374.32
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,432.08
|
| Rate for Payer: PHCS All Commercial |
$1,193.40
|
| Rate for Payer: PHP All Commercial |
$1,206.77
|
| Rate for Payer: Sagamore Health Network All Products |
$1,228.41
|
| Rate for Payer: Signature Care EPO |
$1,320.70
|
| Rate for Payer: Signature Care PPO |
$1,400.26
|
| Rate for Payer: United Healthcare Commercial |
$1,253.87
|
|
|
HC SPECIAL PHYSICS CONSULT
|
Facility
|
OP
|
$1,591.20
|
|
|
Service Code
|
CPT 77370
|
| Hospital Charge Code |
1547370
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$124.89 |
| Max. Negotiated Rate |
$1,479.82 |
| Rate for Payer: Aetna Commercial |
$1,342.97
|
| Rate for Payer: Aetna Medicare |
$509.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$124.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$493.27
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$913.83
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$994.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$124.89
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$585.56
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$560.10
|
| Rate for Payer: Cash Price |
$954.72
|
| Rate for Payer: Cash Price |
$954.72
|
| Rate for Payer: Centivo All Commercial |
$865.61
|
| Rate for Payer: Cigna All Commercial |
$1,373.21
|
| Rate for Payer: CORVEL All Commercial |
$1,479.82
|
| Rate for Payer: Coventry All Commercial |
$1,400.26
|
| Rate for Payer: Encore All Commercial |
$1,464.70
|
| Rate for Payer: Frontpath All Commercial |
$1,463.90
|
| Rate for Payer: Humana ChoiceCare |
$1,374.32
|
| Rate for Payer: Humana Medicare |
$509.18
|
| Rate for Payer: Lucent All Commercial |
$865.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,432.08
|
| Rate for Payer: Managed Health Services Medicaid |
$124.89
|
| Rate for Payer: MDWise Medicaid |
$124.89
|
| Rate for Payer: PHCS All Commercial |
$1,193.40
|
| Rate for Payer: PHP All Commercial |
$1,206.77
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$620.57
|
| Rate for Payer: Sagamore Health Network All Products |
$1,228.41
|
| Rate for Payer: Signature Care EPO |
$1,320.70
|
| Rate for Payer: Signature Care PPO |
$1,400.26
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,352.52
|
| Rate for Payer: United Healthcare Commercial |
$1,253.87
|
| Rate for Payer: United Healthcare Medicare |
$509.18
|
|
|
HC SPECIAL PORT PLAN
|
Facility
|
OP
|
$1,326.00
|
|
|
Service Code
|
CPT 77321
|
| Hospital Charge Code |
1547321
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$29.40 |
| Max. Negotiated Rate |
$1,233.18 |
| Rate for Payer: Aetna Commercial |
$1,119.14
|
| Rate for Payer: Aetna Medicare |
$424.32
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$29.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$411.06
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$761.52
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$828.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$29.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$487.97
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$466.75
|
| Rate for Payer: Cash Price |
$795.60
|
| Rate for Payer: Cash Price |
$795.60
|
| Rate for Payer: Centivo All Commercial |
$721.34
|
| Rate for Payer: Cigna All Commercial |
$1,144.34
|
| Rate for Payer: CORVEL All Commercial |
$1,233.18
|
| Rate for Payer: Coventry All Commercial |
$1,166.88
|
| Rate for Payer: Encore All Commercial |
$1,220.58
|
| Rate for Payer: Frontpath All Commercial |
$1,219.92
|
| Rate for Payer: Humana ChoiceCare |
$1,145.27
|
| Rate for Payer: Humana Medicare |
$424.32
|
| Rate for Payer: Lucent All Commercial |
$721.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,193.40
|
| Rate for Payer: Managed Health Services Medicaid |
$29.40
|
| Rate for Payer: MDWise Medicaid |
$29.40
|
| Rate for Payer: PHCS All Commercial |
$994.50
|
| Rate for Payer: PHP All Commercial |
$1,005.64
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$517.14
|
| Rate for Payer: Sagamore Health Network All Products |
$1,023.67
|
| Rate for Payer: Signature Care EPO |
$1,100.58
|
| Rate for Payer: Signature Care PPO |
$1,166.88
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,127.10
|
| Rate for Payer: United Healthcare Commercial |
$1,044.89
|
| Rate for Payer: United Healthcare Medicare |
$424.32
|
|
|
HC SPECIAL PORT PLAN
|
Facility
|
IP
|
$1,326.00
|
|
|
Service Code
|
CPT 77321
|
| Hospital Charge Code |
1547321
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$994.50 |
| Max. Negotiated Rate |
$1,233.18 |
| Rate for Payer: Aetna Commercial |
$1,145.66
|
| Rate for Payer: Cash Price |
$795.60
|
| Rate for Payer: Cigna All Commercial |
$1,144.34
|
| Rate for Payer: CORVEL All Commercial |
$1,233.18
|
| Rate for Payer: Coventry All Commercial |
$1,166.88
|
| Rate for Payer: Encore All Commercial |
$1,220.58
|
| Rate for Payer: Frontpath All Commercial |
$1,219.92
|
| Rate for Payer: Humana ChoiceCare |
$1,145.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,193.40
|
| Rate for Payer: PHCS All Commercial |
$994.50
|
| Rate for Payer: PHP All Commercial |
$1,005.64
|
| Rate for Payer: Sagamore Health Network All Products |
$1,023.67
|
| Rate for Payer: Signature Care EPO |
$1,100.58
|
| Rate for Payer: Signature Care PPO |
$1,166.88
|
| Rate for Payer: United Healthcare Commercial |
$1,044.89
|
|
|
HC SPECIAL STAIN GROUP 2 EA
|
Facility
|
IP
|
$270.71
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
63001263
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$203.03 |
| Max. Negotiated Rate |
$251.76 |
| Rate for Payer: Aetna Commercial |
$233.89
|
| Rate for Payer: Cash Price |
$162.43
|
| Rate for Payer: Cigna All Commercial |
$233.62
|
| Rate for Payer: CORVEL All Commercial |
$251.76
|
| Rate for Payer: Coventry All Commercial |
$238.22
|
| Rate for Payer: Encore All Commercial |
$249.19
|
| Rate for Payer: Frontpath All Commercial |
$249.05
|
| Rate for Payer: Humana ChoiceCare |
$233.81
|
| Rate for Payer: Lutheran Preferred All Commercial |
$243.64
|
| Rate for Payer: PHCS All Commercial |
$203.03
|
| Rate for Payer: PHP All Commercial |
$205.31
|
| Rate for Payer: Sagamore Health Network All Products |
$208.99
|
| Rate for Payer: Signature Care EPO |
$224.69
|
| Rate for Payer: Signature Care PPO |
$238.22
|
| Rate for Payer: United Healthcare Commercial |
$213.32
|
|
|
HC SPECIAL STAIN GROUP 2 EA
|
Facility
|
OP
|
$270.71
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
63001263
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$8.35 |
| Max. Negotiated Rate |
$251.76 |
| Rate for Payer: Aetna Commercial |
$228.48
|
| Rate for Payer: Aetna Medicare |
$86.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$8.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$83.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$124.42
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$124.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$8.35
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$99.62
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$95.29
|
| Rate for Payer: Cash Price |
$162.43
|
| Rate for Payer: Cash Price |
$162.43
|
| Rate for Payer: Centivo All Commercial |
$147.27
|
| Rate for Payer: Cigna All Commercial |
$233.62
|
| Rate for Payer: CORVEL All Commercial |
$251.76
|
| Rate for Payer: Coventry All Commercial |
$238.22
|
| Rate for Payer: Encore All Commercial |
$249.19
|
| Rate for Payer: Frontpath All Commercial |
$249.05
|
| Rate for Payer: Humana ChoiceCare |
$233.81
|
| Rate for Payer: Humana Medicare |
$86.63
|
| Rate for Payer: Lucent All Commercial |
$147.27
|
| Rate for Payer: Lutheran Preferred All Commercial |
$243.64
|
| Rate for Payer: Managed Health Services Medicaid |
$8.35
|
| Rate for Payer: MDWise Medicaid |
$8.35
|
| Rate for Payer: PHCS All Commercial |
$203.03
|
| Rate for Payer: PHP All Commercial |
$205.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$105.58
|
| Rate for Payer: Sagamore Health Network All Products |
$208.99
|
| Rate for Payer: Signature Care EPO |
$224.69
|
| Rate for Payer: Signature Care PPO |
$238.22
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$230.10
|
| Rate for Payer: United Healthcare Commercial |
$213.32
|
| Rate for Payer: United Healthcare Medicare |
$86.63
|
|
|
HC SPECIAL STAIN GROUP PATH 1 EA
|
Facility
|
IP
|
$291.72
|
|
|
Service Code
|
CPT 88312
|
| Hospital Charge Code |
63001265
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$218.79 |
| Max. Negotiated Rate |
$271.30 |
| Rate for Payer: Aetna Commercial |
$252.05
|
| Rate for Payer: Cash Price |
$175.03
|
| Rate for Payer: Cigna All Commercial |
$251.75
|
| Rate for Payer: CORVEL All Commercial |
$271.30
|
| Rate for Payer: Coventry All Commercial |
$256.71
|
| Rate for Payer: Encore All Commercial |
$268.53
|
| Rate for Payer: Frontpath All Commercial |
$268.38
|
| Rate for Payer: Humana ChoiceCare |
$251.96
|
| Rate for Payer: Lutheran Preferred All Commercial |
$262.55
|
| Rate for Payer: PHCS All Commercial |
$218.79
|
| Rate for Payer: PHP All Commercial |
$221.24
|
| Rate for Payer: Sagamore Health Network All Products |
$225.21
|
| Rate for Payer: Signature Care EPO |
$242.13
|
| Rate for Payer: Signature Care PPO |
$256.71
|
| Rate for Payer: United Healthcare Commercial |
$229.88
|
|
|
HC SPECIAL STAIN GROUP PATH 1 EA
|
Facility
|
OP
|
$291.72
|
|
|
Service Code
|
CPT 88312
|
| Hospital Charge Code |
63001265
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$8.85 |
| Max. Negotiated Rate |
$271.30 |
| Rate for Payer: Aetna Commercial |
$246.21
|
| Rate for Payer: Aetna Medicare |
$93.35
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$8.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$90.43
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$134.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$134.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$8.85
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$107.35
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$102.69
|
| Rate for Payer: Cash Price |
$175.03
|
| Rate for Payer: Cash Price |
$175.03
|
| Rate for Payer: Centivo All Commercial |
$158.70
|
| Rate for Payer: Cigna All Commercial |
$251.75
|
| Rate for Payer: CORVEL All Commercial |
$271.30
|
| Rate for Payer: Coventry All Commercial |
$256.71
|
| Rate for Payer: Encore All Commercial |
$268.53
|
| Rate for Payer: Frontpath All Commercial |
$268.38
|
| Rate for Payer: Humana ChoiceCare |
$251.96
|
| Rate for Payer: Humana Medicare |
$93.35
|
| Rate for Payer: Lucent All Commercial |
$158.70
|
| Rate for Payer: Lutheran Preferred All Commercial |
$262.55
|
| Rate for Payer: Managed Health Services Medicaid |
$8.85
|
| Rate for Payer: MDWise Medicaid |
$8.85
|
| Rate for Payer: PHCS All Commercial |
$218.79
|
| Rate for Payer: PHP All Commercial |
$221.24
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$113.77
|
| Rate for Payer: Sagamore Health Network All Products |
$225.21
|
| Rate for Payer: Signature Care EPO |
$242.13
|
| Rate for Payer: Signature Care PPO |
$256.71
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$247.96
|
| Rate for Payer: United Healthcare Commercial |
$229.88
|
| Rate for Payer: United Healthcare Medicare |
$93.35
|
|
|
HC SPECIAL TREATMENT PROC
|
Facility
|
OP
|
$3,606.72
|
|
|
Service Code
|
CPT 77470
|
| Hospital Charge Code |
1547470
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$32.12 |
| Max. Negotiated Rate |
$3,354.25 |
| Rate for Payer: Aetna Commercial |
$3,044.07
|
| Rate for Payer: Aetna Medicare |
$1,154.15
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$32.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,118.08
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$2,071.34
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$2,254.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$32.12
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,327.27
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,269.57
|
| Rate for Payer: Cash Price |
$2,164.03
|
| Rate for Payer: Cash Price |
$2,164.03
|
| Rate for Payer: Centivo All Commercial |
$1,962.06
|
| Rate for Payer: Cigna All Commercial |
$3,112.60
|
| Rate for Payer: CORVEL All Commercial |
$3,354.25
|
| Rate for Payer: Coventry All Commercial |
$3,173.91
|
| Rate for Payer: Encore All Commercial |
$3,319.99
|
| Rate for Payer: Frontpath All Commercial |
$3,318.18
|
| Rate for Payer: Humana ChoiceCare |
$3,115.12
|
| Rate for Payer: Humana Medicare |
$1,154.15
|
| Rate for Payer: Lucent All Commercial |
$1,962.06
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,246.05
|
| Rate for Payer: Managed Health Services Medicaid |
$32.12
|
| Rate for Payer: MDWise Medicaid |
$32.12
|
| Rate for Payer: PHCS All Commercial |
$2,705.04
|
| Rate for Payer: PHP All Commercial |
$2,735.34
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$1,406.62
|
| Rate for Payer: Sagamore Health Network All Products |
$2,784.39
|
| Rate for Payer: Signature Care EPO |
$2,993.58
|
| Rate for Payer: Signature Care PPO |
$3,173.91
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$3,065.71
|
| Rate for Payer: United Healthcare Commercial |
$2,842.10
|
| Rate for Payer: United Healthcare Medicare |
$1,154.15
|
|
|
HC SPECIAL TREATMENT PROC
|
Facility
|
IP
|
$3,606.72
|
|
|
Service Code
|
CPT 77470
|
| Hospital Charge Code |
1547470
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$2,705.04 |
| Max. Negotiated Rate |
$3,354.25 |
| Rate for Payer: Aetna Commercial |
$3,116.21
|
| Rate for Payer: Cash Price |
$2,164.03
|
| Rate for Payer: Cigna All Commercial |
$3,112.60
|
| Rate for Payer: CORVEL All Commercial |
$3,354.25
|
| Rate for Payer: Coventry All Commercial |
$3,173.91
|
| Rate for Payer: Encore All Commercial |
$3,319.99
|
| Rate for Payer: Frontpath All Commercial |
$3,318.18
|
| Rate for Payer: Humana ChoiceCare |
$3,115.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$3,246.05
|
| Rate for Payer: PHCS All Commercial |
$2,705.04
|
| Rate for Payer: PHP All Commercial |
$2,735.34
|
| Rate for Payer: Sagamore Health Network All Products |
$2,784.39
|
| Rate for Payer: Signature Care EPO |
$2,993.58
|
| Rate for Payer: Signature Care PPO |
$3,173.91
|
| Rate for Payer: United Healthcare Commercial |
$2,842.10
|
|
|
HC SPERM COUNT-POST VAS
|
Facility
|
IP
|
$172.79
|
|
|
Service Code
|
CPT 89321
|
| Hospital Charge Code |
63001247
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$129.59 |
| Max. Negotiated Rate |
$160.69 |
| Rate for Payer: Aetna Commercial |
$149.29
|
| Rate for Payer: Cash Price |
$103.67
|
| Rate for Payer: Cigna All Commercial |
$149.12
|
| Rate for Payer: CORVEL All Commercial |
$160.69
|
| Rate for Payer: Coventry All Commercial |
$152.06
|
| Rate for Payer: Encore All Commercial |
$159.05
|
| Rate for Payer: Frontpath All Commercial |
$158.97
|
| Rate for Payer: Humana ChoiceCare |
$149.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$155.51
|
| Rate for Payer: PHCS All Commercial |
$129.59
|
| Rate for Payer: PHP All Commercial |
$131.04
|
| Rate for Payer: Sagamore Health Network All Products |
$133.39
|
| Rate for Payer: Signature Care EPO |
$143.42
|
| Rate for Payer: Signature Care PPO |
$152.06
|
| Rate for Payer: United Healthcare Commercial |
$136.16
|
|
|
HC SPERM COUNT-POST VAS
|
Facility
|
OP
|
$172.79
|
|
|
Service Code
|
CPT 89321
|
| Hospital Charge Code |
63001247
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.05 |
| Max. Negotiated Rate |
$160.69 |
| Rate for Payer: Aetna Commercial |
$145.83
|
| Rate for Payer: Aetna Medicare |
$55.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$12.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$53.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$79.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$79.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$12.05
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$63.59
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$60.82
|
| Rate for Payer: Cash Price |
$103.67
|
| Rate for Payer: Cash Price |
$103.67
|
| Rate for Payer: Centivo All Commercial |
$94.00
|
| Rate for Payer: Cigna All Commercial |
$149.12
|
| Rate for Payer: CORVEL All Commercial |
$160.69
|
| Rate for Payer: Coventry All Commercial |
$152.06
|
| Rate for Payer: Encore All Commercial |
$159.05
|
| Rate for Payer: Frontpath All Commercial |
$158.97
|
| Rate for Payer: Humana ChoiceCare |
$149.24
|
| Rate for Payer: Humana Medicare |
$55.29
|
| Rate for Payer: Lucent All Commercial |
$94.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$155.51
|
| Rate for Payer: Managed Health Services Medicaid |
$12.05
|
| Rate for Payer: MDWise Medicaid |
$12.05
|
| Rate for Payer: PHCS All Commercial |
$129.59
|
| Rate for Payer: PHP All Commercial |
$131.04
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$67.39
|
| Rate for Payer: Sagamore Health Network All Products |
$133.39
|
| Rate for Payer: Signature Care EPO |
$143.42
|
| Rate for Payer: Signature Care PPO |
$152.06
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$146.87
|
| Rate for Payer: United Healthcare Commercial |
$136.16
|
| Rate for Payer: United Healthcare Medicare |
$55.29
|
|
|
HC SP GEN DEVICE AAC TX
|
Facility
|
OP
|
$369.69
|
|
|
Service Code
|
CPT 92609 GN
|
| Hospital Charge Code |
1742609
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$47.81 |
| Max. Negotiated Rate |
$343.81 |
| Rate for Payer: Aetna Commercial |
$312.02
|
| Rate for Payer: Aetna Medicare |
$118.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$47.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$114.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$212.31
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$231.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$47.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$136.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$130.13
|
| Rate for Payer: Cash Price |
$221.81
|
| Rate for Payer: Cash Price |
$221.81
|
| Rate for Payer: Centivo All Commercial |
$201.11
|
| Rate for Payer: Cigna All Commercial |
$319.04
|
| Rate for Payer: CORVEL All Commercial |
$343.81
|
| Rate for Payer: Coventry All Commercial |
$325.33
|
| Rate for Payer: Encore All Commercial |
$340.30
|
| Rate for Payer: Frontpath All Commercial |
$340.11
|
| Rate for Payer: Humana ChoiceCare |
$319.30
|
| Rate for Payer: Humana Medicare |
$118.30
|
| Rate for Payer: Lucent All Commercial |
$201.11
|
| Rate for Payer: Lutheran Preferred All Commercial |
$332.72
|
| Rate for Payer: Managed Health Services Medicaid |
$47.81
|
| Rate for Payer: MDWise Medicaid |
$47.81
|
| Rate for Payer: PHCS All Commercial |
$277.27
|
| Rate for Payer: PHP All Commercial |
$280.37
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$144.18
|
| Rate for Payer: Sagamore Health Network All Products |
$285.40
|
| Rate for Payer: Signature Care EPO |
$306.84
|
| Rate for Payer: Signature Care PPO |
$325.33
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$314.24
|
| Rate for Payer: United Healthcare Commercial |
$291.32
|
| Rate for Payer: United Healthcare Medicare |
$118.30
|
|
|
HC SP GEN DEVICE AAC TX
|
Facility
|
IP
|
$369.69
|
|
|
Service Code
|
CPT 92609 GN
|
| Hospital Charge Code |
1742609
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$277.27 |
| Max. Negotiated Rate |
$343.81 |
| Rate for Payer: Aetna Commercial |
$319.41
|
| Rate for Payer: Cash Price |
$221.81
|
| Rate for Payer: Cigna All Commercial |
$319.04
|
| Rate for Payer: CORVEL All Commercial |
$343.81
|
| Rate for Payer: Coventry All Commercial |
$325.33
|
| Rate for Payer: Encore All Commercial |
$340.30
|
| Rate for Payer: Frontpath All Commercial |
$340.11
|
| Rate for Payer: Humana ChoiceCare |
$319.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$332.72
|
| Rate for Payer: PHCS All Commercial |
$277.27
|
| Rate for Payer: PHP All Commercial |
$280.37
|
| Rate for Payer: Sagamore Health Network All Products |
$285.40
|
| Rate for Payer: Signature Care EPO |
$306.84
|
| Rate for Payer: Signature Care PPO |
$325.33
|
| Rate for Payer: United Healthcare Commercial |
$291.32
|
|
|
HC S PIN 1.8X3.5 HDLS
|
Facility
|
OP
|
$2,472.50
|
|
| Hospital Charge Code |
41607023
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$2,299.43 |
| Rate for Payer: Aetna Commercial |
$2,086.79
|
| Rate for Payer: Aetna Medicare |
$791.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$766.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,419.96
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,545.56
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$909.88
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$870.32
|
| Rate for Payer: Cash Price |
$1,483.50
|
| Rate for Payer: Cash Price |
$1,483.50
|
| Rate for Payer: Centivo All Commercial |
$1,345.04
|
| Rate for Payer: Cigna All Commercial |
$2,133.77
|
| Rate for Payer: CORVEL All Commercial |
$2,299.43
|
| Rate for Payer: Coventry All Commercial |
$2,175.80
|
| Rate for Payer: Encore All Commercial |
$2,275.94
|
| Rate for Payer: Frontpath All Commercial |
$2,274.70
|
| Rate for Payer: Humana ChoiceCare |
$2,135.50
|
| Rate for Payer: Humana Medicare |
$791.20
|
| Rate for Payer: Lucent All Commercial |
$1,345.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,225.25
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$1,854.38
|
| Rate for Payer: PHP All Commercial |
$1,875.14
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$964.27
|
| Rate for Payer: Sagamore Health Network All Products |
$1,908.77
|
| Rate for Payer: Signature Care EPO |
$2,052.18
|
| Rate for Payer: Signature Care PPO |
$2,175.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$2,101.62
|
| Rate for Payer: United Healthcare Commercial |
$1,948.33
|
| Rate for Payer: United Healthcare Medicare |
$791.20
|
|
|
HC S PIN 1.8X3.5 HDLS
|
Facility
|
IP
|
$2,472.50
|
|
| Hospital Charge Code |
41607023
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,854.38 |
| Max. Negotiated Rate |
$2,299.43 |
| Rate for Payer: Aetna Commercial |
$2,136.24
|
| Rate for Payer: Cash Price |
$1,483.50
|
| Rate for Payer: Cigna All Commercial |
$2,133.77
|
| Rate for Payer: CORVEL All Commercial |
$2,299.43
|
| Rate for Payer: Coventry All Commercial |
$2,175.80
|
| Rate for Payer: Encore All Commercial |
$2,275.94
|
| Rate for Payer: Frontpath All Commercial |
$2,274.70
|
| Rate for Payer: Humana ChoiceCare |
$2,135.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,225.25
|
| Rate for Payer: PHCS All Commercial |
$1,854.38
|
| Rate for Payer: PHP All Commercial |
$1,875.14
|
| Rate for Payer: Sagamore Health Network All Products |
$1,908.77
|
| Rate for Payer: Signature Care EPO |
$2,052.18
|
| Rate for Payer: Signature Care PPO |
$2,175.80
|
| Rate for Payer: United Healthcare Commercial |
$1,948.33
|
|
