|
HC SPYGLASS RETRIEVAL BASKET
|
Facility
|
IP
|
$1,236.00
|
|
| Hospital Charge Code |
41608363
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$927.00 |
| Max. Negotiated Rate |
$1,149.48 |
| Rate for Payer: Aetna Commercial |
$1,067.90
|
| Rate for Payer: Cash Price |
$741.60
|
| Rate for Payer: Cigna All Commercial |
$1,066.67
|
| Rate for Payer: CORVEL All Commercial |
$1,149.48
|
| Rate for Payer: Coventry All Commercial |
$1,087.68
|
| Rate for Payer: Encore All Commercial |
$1,137.74
|
| Rate for Payer: Frontpath All Commercial |
$1,137.12
|
| Rate for Payer: Humana ChoiceCare |
$1,067.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,112.40
|
| Rate for Payer: PHCS All Commercial |
$927.00
|
| Rate for Payer: PHP All Commercial |
$937.38
|
| Rate for Payer: Sagamore Health Network All Products |
$954.19
|
| Rate for Payer: Signature Care EPO |
$1,025.88
|
| Rate for Payer: Signature Care PPO |
$1,087.68
|
| Rate for Payer: United Healthcare Commercial |
$973.97
|
|
|
HC SPYGLASS RETRIEVAL BASKET
|
Facility
|
OP
|
$1,236.00
|
|
| Hospital Charge Code |
41608363
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$1,149.48 |
| Rate for Payer: Aetna Commercial |
$1,043.18
|
| Rate for Payer: Aetna Medicare |
$395.52
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$383.16
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$709.83
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$772.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$454.85
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$435.07
|
| Rate for Payer: Cash Price |
$741.60
|
| Rate for Payer: Cash Price |
$741.60
|
| Rate for Payer: Centivo All Commercial |
$672.38
|
| Rate for Payer: Cigna All Commercial |
$1,066.67
|
| Rate for Payer: CORVEL All Commercial |
$1,149.48
|
| Rate for Payer: Coventry All Commercial |
$1,087.68
|
| Rate for Payer: Encore All Commercial |
$1,137.74
|
| Rate for Payer: Frontpath All Commercial |
$1,137.12
|
| Rate for Payer: Humana ChoiceCare |
$1,067.53
|
| Rate for Payer: Humana Medicare |
$395.52
|
| Rate for Payer: Lucent All Commercial |
$672.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,112.40
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$927.00
|
| Rate for Payer: PHP All Commercial |
$937.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$482.04
|
| Rate for Payer: Sagamore Health Network All Products |
$954.19
|
| Rate for Payer: Signature Care EPO |
$1,025.88
|
| Rate for Payer: Signature Care PPO |
$1,087.68
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,050.60
|
| Rate for Payer: United Healthcare Commercial |
$973.97
|
| Rate for Payer: United Healthcare Medicare |
$395.52
|
|
|
HC SQ/IM INJECTION
|
Facility
|
IP
|
$106.08
|
|
|
Service Code
|
CPT 96372
|
| Hospital Charge Code |
1689113
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$79.56 |
| Max. Negotiated Rate |
$98.65 |
| Rate for Payer: Aetna Commercial |
$91.65
|
| Rate for Payer: Cash Price |
$63.65
|
| Rate for Payer: Cigna All Commercial |
$91.55
|
| Rate for Payer: CORVEL All Commercial |
$98.65
|
| Rate for Payer: Coventry All Commercial |
$93.35
|
| Rate for Payer: Encore All Commercial |
$97.65
|
| Rate for Payer: Frontpath All Commercial |
$97.59
|
| Rate for Payer: Humana ChoiceCare |
$91.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$95.47
|
| Rate for Payer: PHCS All Commercial |
$79.56
|
| Rate for Payer: PHP All Commercial |
$80.45
|
| Rate for Payer: Sagamore Health Network All Products |
$81.89
|
| Rate for Payer: Signature Care EPO |
$88.05
|
| Rate for Payer: Signature Care PPO |
$93.35
|
| Rate for Payer: United Healthcare Commercial |
$83.59
|
|
|
HC SQ/IM INJECTION
|
Facility
|
OP
|
$106.08
|
|
|
Service Code
|
CPT 96372
|
| Hospital Charge Code |
1689113
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$18.90 |
| Max. Negotiated Rate |
$98.65 |
| Rate for Payer: Aetna Commercial |
$89.53
|
| Rate for Payer: Aetna Medicare |
$33.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$18.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$32.88
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$60.92
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$66.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$18.90
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$39.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$37.34
|
| Rate for Payer: Cash Price |
$63.65
|
| Rate for Payer: Cash Price |
$63.65
|
| Rate for Payer: Centivo All Commercial |
$57.71
|
| Rate for Payer: Cigna All Commercial |
$91.55
|
| Rate for Payer: CORVEL All Commercial |
$98.65
|
| Rate for Payer: Coventry All Commercial |
$93.35
|
| Rate for Payer: Encore All Commercial |
$97.65
|
| Rate for Payer: Frontpath All Commercial |
$97.59
|
| Rate for Payer: Humana ChoiceCare |
$91.62
|
| Rate for Payer: Humana Medicare |
$33.95
|
| Rate for Payer: Lucent All Commercial |
$57.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$95.47
|
| Rate for Payer: Managed Health Services Medicaid |
$18.90
|
| Rate for Payer: MDWise Medicaid |
$18.90
|
| Rate for Payer: PHCS All Commercial |
$79.56
|
| Rate for Payer: PHP All Commercial |
$80.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$41.37
|
| Rate for Payer: Sagamore Health Network All Products |
$81.89
|
| Rate for Payer: Signature Care EPO |
$88.05
|
| Rate for Payer: Signature Care PPO |
$93.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$90.17
|
| Rate for Payer: United Healthcare Commercial |
$83.59
|
| Rate for Payer: United Healthcare Medicare |
$33.95
|
|
|
HC SQ/IM INJECTION
|
Facility
|
IP
|
$106.08
|
|
|
Service Code
|
CPT 96372
|
| Hospital Charge Code |
1291372
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$79.56 |
| Max. Negotiated Rate |
$98.65 |
| Rate for Payer: Aetna Commercial |
$91.65
|
| Rate for Payer: Cash Price |
$63.65
|
| Rate for Payer: Cigna All Commercial |
$91.55
|
| Rate for Payer: CORVEL All Commercial |
$98.65
|
| Rate for Payer: Coventry All Commercial |
$93.35
|
| Rate for Payer: Encore All Commercial |
$97.65
|
| Rate for Payer: Frontpath All Commercial |
$97.59
|
| Rate for Payer: Humana ChoiceCare |
$91.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$95.47
|
| Rate for Payer: PHCS All Commercial |
$79.56
|
| Rate for Payer: PHP All Commercial |
$80.45
|
| Rate for Payer: Sagamore Health Network All Products |
$81.89
|
| Rate for Payer: Signature Care EPO |
$88.05
|
| Rate for Payer: Signature Care PPO |
$93.35
|
| Rate for Payer: United Healthcare Commercial |
$83.59
|
|
|
HC SQ/IM INJECTION
|
Facility
|
OP
|
$106.08
|
|
|
Service Code
|
CPT 96372
|
| Hospital Charge Code |
1291372
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$18.90 |
| Max. Negotiated Rate |
$98.65 |
| Rate for Payer: Aetna Commercial |
$89.53
|
| Rate for Payer: Aetna Medicare |
$33.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$18.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$32.88
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$60.92
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$66.31
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$18.90
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$39.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$37.34
|
| Rate for Payer: Cash Price |
$63.65
|
| Rate for Payer: Cash Price |
$63.65
|
| Rate for Payer: Centivo All Commercial |
$57.71
|
| Rate for Payer: Cigna All Commercial |
$91.55
|
| Rate for Payer: CORVEL All Commercial |
$98.65
|
| Rate for Payer: Coventry All Commercial |
$93.35
|
| Rate for Payer: Encore All Commercial |
$97.65
|
| Rate for Payer: Frontpath All Commercial |
$97.59
|
| Rate for Payer: Humana ChoiceCare |
$91.62
|
| Rate for Payer: Humana Medicare |
$33.95
|
| Rate for Payer: Lucent All Commercial |
$57.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$95.47
|
| Rate for Payer: Managed Health Services Medicaid |
$18.90
|
| Rate for Payer: MDWise Medicaid |
$18.90
|
| Rate for Payer: PHCS All Commercial |
$79.56
|
| Rate for Payer: PHP All Commercial |
$80.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$41.37
|
| Rate for Payer: Sagamore Health Network All Products |
$81.89
|
| Rate for Payer: Signature Care EPO |
$88.05
|
| Rate for Payer: Signature Care PPO |
$93.35
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$90.17
|
| Rate for Payer: United Healthcare Commercial |
$83.59
|
| Rate for Payer: United Healthcare Medicare |
$33.95
|
|
|
HC S RASP LG 14X7
|
Facility
|
OP
|
$859.32
|
|
| Hospital Charge Code |
41606538
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$799.17 |
| Rate for Payer: Aetna Commercial |
$725.27
|
| Rate for Payer: Aetna Medicare |
$274.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$266.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$493.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$537.16
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$316.23
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$302.48
|
| Rate for Payer: Cash Price |
$515.59
|
| Rate for Payer: Cash Price |
$515.59
|
| Rate for Payer: Centivo All Commercial |
$467.47
|
| Rate for Payer: Cigna All Commercial |
$741.59
|
| Rate for Payer: CORVEL All Commercial |
$799.17
|
| Rate for Payer: Coventry All Commercial |
$756.20
|
| Rate for Payer: Encore All Commercial |
$791.00
|
| Rate for Payer: Frontpath All Commercial |
$790.57
|
| Rate for Payer: Humana ChoiceCare |
$742.19
|
| Rate for Payer: Humana Medicare |
$274.98
|
| Rate for Payer: Lucent All Commercial |
$467.47
|
| Rate for Payer: Lutheran Preferred All Commercial |
$773.39
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$644.49
|
| Rate for Payer: PHP All Commercial |
$651.71
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$335.13
|
| Rate for Payer: Sagamore Health Network All Products |
$663.40
|
| Rate for Payer: Signature Care EPO |
$713.24
|
| Rate for Payer: Signature Care PPO |
$756.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$730.42
|
| Rate for Payer: United Healthcare Commercial |
$677.14
|
| Rate for Payer: United Healthcare Medicare |
$274.98
|
|
|
HC S RASP LG 14X7
|
Facility
|
IP
|
$859.32
|
|
| Hospital Charge Code |
41606538
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$644.49 |
| Max. Negotiated Rate |
$799.17 |
| Rate for Payer: Aetna Commercial |
$742.45
|
| Rate for Payer: Cash Price |
$515.59
|
| Rate for Payer: Cigna All Commercial |
$741.59
|
| Rate for Payer: CORVEL All Commercial |
$799.17
|
| Rate for Payer: Coventry All Commercial |
$756.20
|
| Rate for Payer: Encore All Commercial |
$791.00
|
| Rate for Payer: Frontpath All Commercial |
$790.57
|
| Rate for Payer: Humana ChoiceCare |
$742.19
|
| Rate for Payer: Lutheran Preferred All Commercial |
$773.39
|
| Rate for Payer: PHCS All Commercial |
$644.49
|
| Rate for Payer: PHP All Commercial |
$651.71
|
| Rate for Payer: Sagamore Health Network All Products |
$663.40
|
| Rate for Payer: Signature Care EPO |
$713.24
|
| Rate for Payer: Signature Care PPO |
$756.20
|
| Rate for Payer: United Healthcare Commercial |
$677.14
|
|
|
HC SSA(RO) AB IGG
|
Facility
|
OP
|
$128.52
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
63001883
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.93 |
| Max. Negotiated Rate |
$119.52 |
| Rate for Payer: Aetna Commercial |
$108.47
|
| Rate for Payer: Aetna Medicare |
$41.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$17.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$39.84
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$59.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$59.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$17.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$47.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$45.24
|
| Rate for Payer: Cash Price |
$77.11
|
| Rate for Payer: Cash Price |
$77.11
|
| Rate for Payer: Centivo All Commercial |
$69.91
|
| Rate for Payer: Cigna All Commercial |
$110.91
|
| Rate for Payer: CORVEL All Commercial |
$119.52
|
| Rate for Payer: Coventry All Commercial |
$113.10
|
| Rate for Payer: Encore All Commercial |
$118.30
|
| Rate for Payer: Frontpath All Commercial |
$118.24
|
| Rate for Payer: Humana ChoiceCare |
$111.00
|
| Rate for Payer: Humana Medicare |
$41.13
|
| Rate for Payer: Lucent All Commercial |
$69.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$115.67
|
| Rate for Payer: Managed Health Services Medicaid |
$17.93
|
| Rate for Payer: MDWise Medicaid |
$17.93
|
| Rate for Payer: PHCS All Commercial |
$96.39
|
| Rate for Payer: PHP All Commercial |
$97.47
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$50.12
|
| Rate for Payer: Sagamore Health Network All Products |
$99.22
|
| Rate for Payer: Signature Care EPO |
$106.67
|
| Rate for Payer: Signature Care PPO |
$113.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$109.24
|
| Rate for Payer: United Healthcare Commercial |
$101.27
|
| Rate for Payer: United Healthcare Medicare |
$41.13
|
|
|
HC SSA(RO) AB IGG
|
Facility
|
IP
|
$128.52
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
63001883
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$96.39 |
| Max. Negotiated Rate |
$119.52 |
| Rate for Payer: Aetna Commercial |
$111.04
|
| Rate for Payer: Cash Price |
$77.11
|
| Rate for Payer: Cigna All Commercial |
$110.91
|
| Rate for Payer: CORVEL All Commercial |
$119.52
|
| Rate for Payer: Coventry All Commercial |
$113.10
|
| Rate for Payer: Encore All Commercial |
$118.30
|
| Rate for Payer: Frontpath All Commercial |
$118.24
|
| Rate for Payer: Humana ChoiceCare |
$111.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$115.67
|
| Rate for Payer: PHCS All Commercial |
$96.39
|
| Rate for Payer: PHP All Commercial |
$97.47
|
| Rate for Payer: Sagamore Health Network All Products |
$99.22
|
| Rate for Payer: Signature Care EPO |
$106.67
|
| Rate for Payer: Signature Care PPO |
$113.10
|
| Rate for Payer: United Healthcare Commercial |
$101.27
|
|
|
HC SSB(LA) AB IGG
|
Facility
|
OP
|
$128.52
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
63001884
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$17.93 |
| Max. Negotiated Rate |
$119.52 |
| Rate for Payer: Aetna Commercial |
$108.47
|
| Rate for Payer: Aetna Medicare |
$41.13
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$17.93
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$39.84
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$59.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$59.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$17.93
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$47.30
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$45.24
|
| Rate for Payer: Cash Price |
$77.11
|
| Rate for Payer: Cash Price |
$77.11
|
| Rate for Payer: Centivo All Commercial |
$69.91
|
| Rate for Payer: Cigna All Commercial |
$110.91
|
| Rate for Payer: CORVEL All Commercial |
$119.52
|
| Rate for Payer: Coventry All Commercial |
$113.10
|
| Rate for Payer: Encore All Commercial |
$118.30
|
| Rate for Payer: Frontpath All Commercial |
$118.24
|
| Rate for Payer: Humana ChoiceCare |
$111.00
|
| Rate for Payer: Humana Medicare |
$41.13
|
| Rate for Payer: Lucent All Commercial |
$69.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$115.67
|
| Rate for Payer: Managed Health Services Medicaid |
$17.93
|
| Rate for Payer: MDWise Medicaid |
$17.93
|
| Rate for Payer: PHCS All Commercial |
$96.39
|
| Rate for Payer: PHP All Commercial |
$97.47
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$50.12
|
| Rate for Payer: Sagamore Health Network All Products |
$99.22
|
| Rate for Payer: Signature Care EPO |
$106.67
|
| Rate for Payer: Signature Care PPO |
$113.10
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$109.24
|
| Rate for Payer: United Healthcare Commercial |
$101.27
|
| Rate for Payer: United Healthcare Medicare |
$41.13
|
|
|
HC SSB(LA) AB IGG
|
Facility
|
IP
|
$128.52
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
63001884
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$96.39 |
| Max. Negotiated Rate |
$119.52 |
| Rate for Payer: Aetna Commercial |
$111.04
|
| Rate for Payer: Cash Price |
$77.11
|
| Rate for Payer: Cigna All Commercial |
$110.91
|
| Rate for Payer: CORVEL All Commercial |
$119.52
|
| Rate for Payer: Coventry All Commercial |
$113.10
|
| Rate for Payer: Encore All Commercial |
$118.30
|
| Rate for Payer: Frontpath All Commercial |
$118.24
|
| Rate for Payer: Humana ChoiceCare |
$111.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$115.67
|
| Rate for Payer: PHCS All Commercial |
$96.39
|
| Rate for Payer: PHP All Commercial |
$97.47
|
| Rate for Payer: Sagamore Health Network All Products |
$99.22
|
| Rate for Payer: Signature Care EPO |
$106.67
|
| Rate for Payer: Signature Care PPO |
$113.10
|
| Rate for Payer: United Healthcare Commercial |
$101.27
|
|
|
HC STAPLE ENDO 65 4.8
|
Facility
|
OP
|
$970.00
|
|
| Hospital Charge Code |
41602093
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.83 |
| Max. Negotiated Rate |
$902.10 |
| Rate for Payer: Aetna Commercial |
$818.68
|
| Rate for Payer: Aetna Medicare |
$310.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$24.83
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$300.70
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$557.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$606.35
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$24.83
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$356.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$341.44
|
| Rate for Payer: Cash Price |
$582.00
|
| Rate for Payer: Cash Price |
$582.00
|
| Rate for Payer: Centivo All Commercial |
$527.68
|
| Rate for Payer: Cigna All Commercial |
$837.11
|
| Rate for Payer: CORVEL All Commercial |
$902.10
|
| Rate for Payer: Coventry All Commercial |
$853.60
|
| Rate for Payer: Encore All Commercial |
$892.88
|
| Rate for Payer: Frontpath All Commercial |
$892.40
|
| Rate for Payer: Humana ChoiceCare |
$837.79
|
| Rate for Payer: Humana Medicare |
$310.40
|
| Rate for Payer: Lucent All Commercial |
$527.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$873.00
|
| Rate for Payer: Managed Health Services Medicaid |
$24.83
|
| Rate for Payer: MDWise Medicaid |
$24.83
|
| Rate for Payer: PHCS All Commercial |
$727.50
|
| Rate for Payer: PHP All Commercial |
$735.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$378.30
|
| Rate for Payer: Sagamore Health Network All Products |
$748.84
|
| Rate for Payer: Signature Care EPO |
$805.10
|
| Rate for Payer: Signature Care PPO |
$853.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$824.50
|
| Rate for Payer: United Healthcare Commercial |
$764.36
|
| Rate for Payer: United Healthcare Medicare |
$310.40
|
|
|
HC STAPLE ENDO 65 4.8
|
Facility
|
IP
|
$970.00
|
|
| Hospital Charge Code |
41602093
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$727.50 |
| Max. Negotiated Rate |
$902.10 |
| Rate for Payer: Aetna Commercial |
$838.08
|
| Rate for Payer: Cash Price |
$582.00
|
| Rate for Payer: Cigna All Commercial |
$837.11
|
| Rate for Payer: CORVEL All Commercial |
$902.10
|
| Rate for Payer: Coventry All Commercial |
$853.60
|
| Rate for Payer: Encore All Commercial |
$892.88
|
| Rate for Payer: Frontpath All Commercial |
$892.40
|
| Rate for Payer: Humana ChoiceCare |
$837.79
|
| Rate for Payer: Lutheran Preferred All Commercial |
$873.00
|
| Rate for Payer: PHCS All Commercial |
$727.50
|
| Rate for Payer: PHP All Commercial |
$735.65
|
| Rate for Payer: Sagamore Health Network All Products |
$748.84
|
| Rate for Payer: Signature Care EPO |
$805.10
|
| Rate for Payer: Signature Care PPO |
$853.60
|
| Rate for Payer: United Healthcare Commercial |
$764.36
|
|
|
HC STAPLER 45 MM ECHELON 340MM
|
Facility
|
OP
|
$1,682.45
|
|
| Hospital Charge Code |
41607896
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$1,564.68 |
| Rate for Payer: Aetna Commercial |
$1,419.99
|
| Rate for Payer: Aetna Medicare |
$538.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$521.56
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$966.23
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,051.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$619.14
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$592.22
|
| Rate for Payer: Cash Price |
$1,009.47
|
| Rate for Payer: Cash Price |
$1,009.47
|
| Rate for Payer: Centivo All Commercial |
$915.25
|
| Rate for Payer: Cigna All Commercial |
$1,451.95
|
| Rate for Payer: CORVEL All Commercial |
$1,564.68
|
| Rate for Payer: Coventry All Commercial |
$1,480.56
|
| Rate for Payer: Encore All Commercial |
$1,548.70
|
| Rate for Payer: Frontpath All Commercial |
$1,547.85
|
| Rate for Payer: Humana ChoiceCare |
$1,453.13
|
| Rate for Payer: Humana Medicare |
$538.38
|
| Rate for Payer: Lucent All Commercial |
$915.25
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,514.20
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$1,261.84
|
| Rate for Payer: PHP All Commercial |
$1,275.97
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$656.16
|
| Rate for Payer: Sagamore Health Network All Products |
$1,298.85
|
| Rate for Payer: Signature Care EPO |
$1,396.43
|
| Rate for Payer: Signature Care PPO |
$1,480.56
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,430.08
|
| Rate for Payer: United Healthcare Commercial |
$1,325.77
|
| Rate for Payer: United Healthcare Medicare |
$538.38
|
|
|
HC STAPLER 45 MM ECHELON 340MM
|
Facility
|
IP
|
$1,682.45
|
|
| Hospital Charge Code |
41607896
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,261.84 |
| Max. Negotiated Rate |
$1,564.68 |
| Rate for Payer: Aetna Commercial |
$1,453.64
|
| Rate for Payer: Cash Price |
$1,009.47
|
| Rate for Payer: Cigna All Commercial |
$1,451.95
|
| Rate for Payer: CORVEL All Commercial |
$1,564.68
|
| Rate for Payer: Coventry All Commercial |
$1,480.56
|
| Rate for Payer: Encore All Commercial |
$1,548.70
|
| Rate for Payer: Frontpath All Commercial |
$1,547.85
|
| Rate for Payer: Humana ChoiceCare |
$1,453.13
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,514.20
|
| Rate for Payer: PHCS All Commercial |
$1,261.84
|
| Rate for Payer: PHP All Commercial |
$1,275.97
|
| Rate for Payer: Sagamore Health Network All Products |
$1,298.85
|
| Rate for Payer: Signature Care EPO |
$1,396.43
|
| Rate for Payer: Signature Care PPO |
$1,480.56
|
| Rate for Payer: United Healthcare Commercial |
$1,325.77
|
|
|
HC STAPLER 60MM ECHELON 340MM
|
Facility
|
IP
|
$2,018.93
|
|
| Hospital Charge Code |
41607897
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,514.20 |
| Max. Negotiated Rate |
$1,877.60 |
| Rate for Payer: Aetna Commercial |
$1,744.36
|
| Rate for Payer: Cash Price |
$1,211.36
|
| Rate for Payer: Cigna All Commercial |
$1,742.34
|
| Rate for Payer: CORVEL All Commercial |
$1,877.60
|
| Rate for Payer: Coventry All Commercial |
$1,776.66
|
| Rate for Payer: Encore All Commercial |
$1,858.43
|
| Rate for Payer: Frontpath All Commercial |
$1,857.42
|
| Rate for Payer: Humana ChoiceCare |
$1,743.75
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,817.04
|
| Rate for Payer: PHCS All Commercial |
$1,514.20
|
| Rate for Payer: PHP All Commercial |
$1,531.16
|
| Rate for Payer: Sagamore Health Network All Products |
$1,558.61
|
| Rate for Payer: Signature Care EPO |
$1,675.71
|
| Rate for Payer: Signature Care PPO |
$1,776.66
|
| Rate for Payer: United Healthcare Commercial |
$1,590.92
|
|
|
HC STAPLER 60MM ECHELON 340MM
|
Facility
|
OP
|
$2,018.93
|
|
| Hospital Charge Code |
41607897
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$1,877.60 |
| Rate for Payer: Aetna Commercial |
$1,703.98
|
| Rate for Payer: Aetna Medicare |
$646.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$625.87
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,159.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,262.03
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$742.97
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$710.66
|
| Rate for Payer: Cash Price |
$1,211.36
|
| Rate for Payer: Cash Price |
$1,211.36
|
| Rate for Payer: Centivo All Commercial |
$1,098.30
|
| Rate for Payer: Cigna All Commercial |
$1,742.34
|
| Rate for Payer: CORVEL All Commercial |
$1,877.60
|
| Rate for Payer: Coventry All Commercial |
$1,776.66
|
| Rate for Payer: Encore All Commercial |
$1,858.43
|
| Rate for Payer: Frontpath All Commercial |
$1,857.42
|
| Rate for Payer: Humana ChoiceCare |
$1,743.75
|
| Rate for Payer: Humana Medicare |
$646.06
|
| Rate for Payer: Lucent All Commercial |
$1,098.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,817.04
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$1,514.20
|
| Rate for Payer: PHP All Commercial |
$1,531.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$787.38
|
| Rate for Payer: Sagamore Health Network All Products |
$1,558.61
|
| Rate for Payer: Signature Care EPO |
$1,675.71
|
| Rate for Payer: Signature Care PPO |
$1,776.66
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,716.09
|
| Rate for Payer: United Healthcare Commercial |
$1,590.92
|
| Rate for Payer: United Healthcare Medicare |
$646.06
|
|
|
HC STAPLER CIRCULAR 25 CM
|
Facility
|
OP
|
$2,327.63
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607057
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$2,164.70 |
| Rate for Payer: Aetna Commercial |
$1,964.52
|
| Rate for Payer: Aetna Medicare |
$744.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$721.57
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,336.76
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,455.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$856.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$819.33
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Centivo All Commercial |
$1,266.23
|
| Rate for Payer: Cigna All Commercial |
$2,008.74
|
| Rate for Payer: CORVEL All Commercial |
$2,164.70
|
| Rate for Payer: Coventry All Commercial |
$2,048.31
|
| Rate for Payer: Encore All Commercial |
$2,142.58
|
| Rate for Payer: Frontpath All Commercial |
$2,141.42
|
| Rate for Payer: Humana ChoiceCare |
$2,010.37
|
| Rate for Payer: Humana Medicare |
$744.84
|
| Rate for Payer: Lucent All Commercial |
$1,266.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,094.87
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$1,745.72
|
| Rate for Payer: PHP All Commercial |
$1,765.27
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$907.78
|
| Rate for Payer: Sagamore Health Network All Products |
$1,796.93
|
| Rate for Payer: Signature Care EPO |
$1,931.93
|
| Rate for Payer: Signature Care PPO |
$2,048.31
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,978.49
|
| Rate for Payer: United Healthcare Commercial |
$1,834.17
|
| Rate for Payer: United Healthcare Medicare |
$744.84
|
|
|
HC STAPLER CIRCULAR 25 CM
|
Facility
|
IP
|
$2,327.63
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607057
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,745.72 |
| Max. Negotiated Rate |
$2,164.70 |
| Rate for Payer: Aetna Commercial |
$2,011.07
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cigna All Commercial |
$2,008.74
|
| Rate for Payer: CORVEL All Commercial |
$2,164.70
|
| Rate for Payer: Coventry All Commercial |
$2,048.31
|
| Rate for Payer: Encore All Commercial |
$2,142.58
|
| Rate for Payer: Frontpath All Commercial |
$2,141.42
|
| Rate for Payer: Humana ChoiceCare |
$2,010.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,094.87
|
| Rate for Payer: PHCS All Commercial |
$1,745.72
|
| Rate for Payer: PHP All Commercial |
$1,765.27
|
| Rate for Payer: Sagamore Health Network All Products |
$1,796.93
|
| Rate for Payer: Signature Care EPO |
$1,931.93
|
| Rate for Payer: Signature Care PPO |
$2,048.31
|
| Rate for Payer: United Healthcare Commercial |
$1,834.17
|
|
|
HC STAPLER CIRCULAR 29 CM
|
Facility
|
IP
|
$2,327.63
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607058
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,745.72 |
| Max. Negotiated Rate |
$2,164.70 |
| Rate for Payer: Aetna Commercial |
$2,011.07
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cigna All Commercial |
$2,008.74
|
| Rate for Payer: CORVEL All Commercial |
$2,164.70
|
| Rate for Payer: Coventry All Commercial |
$2,048.31
|
| Rate for Payer: Encore All Commercial |
$2,142.58
|
| Rate for Payer: Frontpath All Commercial |
$2,141.42
|
| Rate for Payer: Humana ChoiceCare |
$2,010.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,094.87
|
| Rate for Payer: PHCS All Commercial |
$1,745.72
|
| Rate for Payer: PHP All Commercial |
$1,765.27
|
| Rate for Payer: Sagamore Health Network All Products |
$1,796.93
|
| Rate for Payer: Signature Care EPO |
$1,931.93
|
| Rate for Payer: Signature Care PPO |
$2,048.31
|
| Rate for Payer: United Healthcare Commercial |
$1,834.17
|
|
|
HC STAPLER CIRCULAR 29 CM
|
Facility
|
OP
|
$2,327.63
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607058
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$2,164.70 |
| Rate for Payer: Aetna Commercial |
$1,964.52
|
| Rate for Payer: Aetna Medicare |
$744.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$721.57
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,336.76
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,455.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$856.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$819.33
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Centivo All Commercial |
$1,266.23
|
| Rate for Payer: Cigna All Commercial |
$2,008.74
|
| Rate for Payer: CORVEL All Commercial |
$2,164.70
|
| Rate for Payer: Coventry All Commercial |
$2,048.31
|
| Rate for Payer: Encore All Commercial |
$2,142.58
|
| Rate for Payer: Frontpath All Commercial |
$2,141.42
|
| Rate for Payer: Humana ChoiceCare |
$2,010.37
|
| Rate for Payer: Humana Medicare |
$744.84
|
| Rate for Payer: Lucent All Commercial |
$1,266.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,094.87
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$1,745.72
|
| Rate for Payer: PHP All Commercial |
$1,765.27
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$907.78
|
| Rate for Payer: Sagamore Health Network All Products |
$1,796.93
|
| Rate for Payer: Signature Care EPO |
$1,931.93
|
| Rate for Payer: Signature Care PPO |
$2,048.31
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,978.49
|
| Rate for Payer: United Healthcare Commercial |
$1,834.17
|
| Rate for Payer: United Healthcare Medicare |
$744.84
|
|
|
HC STAPLER CIRCULAR 31 CM
|
Facility
|
OP
|
$2,327.63
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$2,164.70 |
| Rate for Payer: Aetna Commercial |
$1,964.52
|
| Rate for Payer: Aetna Medicare |
$744.84
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$721.57
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,336.76
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,455.00
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$856.57
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$819.33
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Centivo All Commercial |
$1,266.23
|
| Rate for Payer: Cigna All Commercial |
$2,008.74
|
| Rate for Payer: CORVEL All Commercial |
$2,164.70
|
| Rate for Payer: Coventry All Commercial |
$2,048.31
|
| Rate for Payer: Encore All Commercial |
$2,142.58
|
| Rate for Payer: Frontpath All Commercial |
$2,141.42
|
| Rate for Payer: Humana ChoiceCare |
$2,010.37
|
| Rate for Payer: Humana Medicare |
$744.84
|
| Rate for Payer: Lucent All Commercial |
$1,266.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,094.87
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$1,745.72
|
| Rate for Payer: PHP All Commercial |
$1,765.27
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$907.78
|
| Rate for Payer: Sagamore Health Network All Products |
$1,796.93
|
| Rate for Payer: Signature Care EPO |
$1,931.93
|
| Rate for Payer: Signature Care PPO |
$2,048.31
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,978.49
|
| Rate for Payer: United Healthcare Commercial |
$1,834.17
|
| Rate for Payer: United Healthcare Medicare |
$744.84
|
|
|
HC STAPLER CIRCULAR 31 CM
|
Facility
|
IP
|
$2,327.63
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41607059
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,745.72 |
| Max. Negotiated Rate |
$2,164.70 |
| Rate for Payer: Aetna Commercial |
$2,011.07
|
| Rate for Payer: Cash Price |
$1,396.58
|
| Rate for Payer: Cigna All Commercial |
$2,008.74
|
| Rate for Payer: CORVEL All Commercial |
$2,164.70
|
| Rate for Payer: Coventry All Commercial |
$2,048.31
|
| Rate for Payer: Encore All Commercial |
$2,142.58
|
| Rate for Payer: Frontpath All Commercial |
$2,141.42
|
| Rate for Payer: Humana ChoiceCare |
$2,010.37
|
| Rate for Payer: Lutheran Preferred All Commercial |
$2,094.87
|
| Rate for Payer: PHCS All Commercial |
$1,745.72
|
| Rate for Payer: PHP All Commercial |
$1,765.27
|
| Rate for Payer: Sagamore Health Network All Products |
$1,796.93
|
| Rate for Payer: Signature Care EPO |
$1,931.93
|
| Rate for Payer: Signature Care PPO |
$2,048.31
|
| Rate for Payer: United Healthcare Commercial |
$1,834.17
|
|
|
HC STAPLER ENDO GIA
|
Facility
|
OP
|
$349.07
|
|
| Hospital Charge Code |
41602049
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$324.64 |
| Rate for Payer: Aetna Commercial |
$294.62
|
| Rate for Payer: Aetna Medicare |
$111.70
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$108.21
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$200.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$218.20
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$128.46
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$122.87
|
| Rate for Payer: Cash Price |
$209.44
|
| Rate for Payer: Cash Price |
$209.44
|
| Rate for Payer: Centivo All Commercial |
$189.89
|
| Rate for Payer: Cigna All Commercial |
$301.25
|
| Rate for Payer: CORVEL All Commercial |
$324.64
|
| Rate for Payer: Coventry All Commercial |
$307.18
|
| Rate for Payer: Encore All Commercial |
$321.32
|
| Rate for Payer: Frontpath All Commercial |
$321.14
|
| Rate for Payer: Humana ChoiceCare |
$301.49
|
| Rate for Payer: Humana Medicare |
$111.70
|
| Rate for Payer: Lucent All Commercial |
$189.89
|
| Rate for Payer: Lutheran Preferred All Commercial |
$314.16
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$261.80
|
| Rate for Payer: PHP All Commercial |
$264.73
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$136.14
|
| Rate for Payer: Sagamore Health Network All Products |
$269.48
|
| Rate for Payer: Signature Care EPO |
$289.73
|
| Rate for Payer: Signature Care PPO |
$307.18
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$296.71
|
| Rate for Payer: United Healthcare Commercial |
$275.07
|
| Rate for Payer: United Healthcare Medicare |
$111.70
|
|
