|
HC S TIBIAL COMP 5 TRI
|
Facility
|
IP
|
$5,838.55
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607026
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,378.91 |
| Max. Negotiated Rate |
$5,429.85 |
| Rate for Payer: Aetna Commercial |
$5,044.51
|
| Rate for Payer: Cash Price |
$3,503.13
|
| Rate for Payer: Cigna All Commercial |
$5,038.67
|
| Rate for Payer: CORVEL All Commercial |
$5,429.85
|
| Rate for Payer: Coventry All Commercial |
$5,137.92
|
| Rate for Payer: Encore All Commercial |
$5,374.39
|
| Rate for Payer: Frontpath All Commercial |
$5,371.47
|
| Rate for Payer: Humana ChoiceCare |
$5,042.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,254.69
|
| Rate for Payer: PHCS All Commercial |
$4,378.91
|
| Rate for Payer: PHP All Commercial |
$4,427.96
|
| Rate for Payer: Sagamore Health Network All Products |
$4,507.36
|
| Rate for Payer: Signature Care EPO |
$4,846.00
|
| Rate for Payer: Signature Care PPO |
$5,137.92
|
| Rate for Payer: United Healthcare Commercial |
$4,600.78
|
|
|
HC S TIBIAL COMP 5 TRI
|
Facility
|
OP
|
$5,838.55
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607026
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$5,429.85 |
| Rate for Payer: Aetna Commercial |
$4,927.74
|
| Rate for Payer: Aetna Medicare |
$1,868.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,809.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$3,353.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,649.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,148.59
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,055.17
|
| Rate for Payer: Cash Price |
$3,503.13
|
| Rate for Payer: Cash Price |
$3,503.13
|
| Rate for Payer: Centivo All Commercial |
$3,176.17
|
| Rate for Payer: Cigna All Commercial |
$5,038.67
|
| Rate for Payer: CORVEL All Commercial |
$5,429.85
|
| Rate for Payer: Coventry All Commercial |
$5,137.92
|
| Rate for Payer: Encore All Commercial |
$5,374.39
|
| Rate for Payer: Frontpath All Commercial |
$5,371.47
|
| Rate for Payer: Humana ChoiceCare |
$5,042.76
|
| Rate for Payer: Humana Medicare |
$1,868.34
|
| Rate for Payer: Lucent All Commercial |
$3,176.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,254.69
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$4,378.91
|
| Rate for Payer: PHP All Commercial |
$4,427.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,277.03
|
| Rate for Payer: Sagamore Health Network All Products |
$4,507.36
|
| Rate for Payer: Signature Care EPO |
$4,846.00
|
| Rate for Payer: Signature Care PPO |
$5,137.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,962.77
|
| Rate for Payer: United Healthcare Commercial |
$4,600.78
|
| Rate for Payer: United Healthcare Medicare |
$1,868.34
|
|
|
HC S TIBIAL COMP 7 TRI
|
Facility
|
OP
|
$5,838.55
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607908
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$5,429.85 |
| Rate for Payer: Aetna Commercial |
$4,927.74
|
| Rate for Payer: Aetna Medicare |
$1,868.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,809.95
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$3,353.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,649.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,148.59
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,055.17
|
| Rate for Payer: Cash Price |
$3,503.13
|
| Rate for Payer: Cash Price |
$3,503.13
|
| Rate for Payer: Centivo All Commercial |
$3,176.17
|
| Rate for Payer: Cigna All Commercial |
$5,038.67
|
| Rate for Payer: CORVEL All Commercial |
$5,429.85
|
| Rate for Payer: Coventry All Commercial |
$5,137.92
|
| Rate for Payer: Encore All Commercial |
$5,374.39
|
| Rate for Payer: Frontpath All Commercial |
$5,371.47
|
| Rate for Payer: Humana ChoiceCare |
$5,042.76
|
| Rate for Payer: Humana Medicare |
$1,868.34
|
| Rate for Payer: Lucent All Commercial |
$3,176.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,254.69
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$4,378.91
|
| Rate for Payer: PHP All Commercial |
$4,427.96
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,277.03
|
| Rate for Payer: Sagamore Health Network All Products |
$4,507.36
|
| Rate for Payer: Signature Care EPO |
$4,846.00
|
| Rate for Payer: Signature Care PPO |
$5,137.92
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,962.77
|
| Rate for Payer: United Healthcare Commercial |
$4,600.78
|
| Rate for Payer: United Healthcare Medicare |
$1,868.34
|
|
|
HC S TIBIAL COMP 7 TRI
|
Facility
|
IP
|
$5,838.55
|
|
|
Service Code
|
CPT C1776
|
| Hospital Charge Code |
41607908
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,378.91 |
| Max. Negotiated Rate |
$5,429.85 |
| Rate for Payer: Aetna Commercial |
$5,044.51
|
| Rate for Payer: Cash Price |
$3,503.13
|
| Rate for Payer: Cigna All Commercial |
$5,038.67
|
| Rate for Payer: CORVEL All Commercial |
$5,429.85
|
| Rate for Payer: Coventry All Commercial |
$5,137.92
|
| Rate for Payer: Encore All Commercial |
$5,374.39
|
| Rate for Payer: Frontpath All Commercial |
$5,371.47
|
| Rate for Payer: Humana ChoiceCare |
$5,042.76
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,254.69
|
| Rate for Payer: PHCS All Commercial |
$4,378.91
|
| Rate for Payer: PHP All Commercial |
$4,427.96
|
| Rate for Payer: Sagamore Health Network All Products |
$4,507.36
|
| Rate for Payer: Signature Care EPO |
$4,846.00
|
| Rate for Payer: Signature Care PPO |
$5,137.92
|
| Rate for Payer: United Healthcare Commercial |
$4,600.78
|
|
|
HC STIMULAN RAPID CURE
|
Facility
|
IP
|
$5,220.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606900
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,915.00 |
| Max. Negotiated Rate |
$4,854.60 |
| Rate for Payer: Aetna Commercial |
$4,510.08
|
| Rate for Payer: Cash Price |
$3,132.00
|
| Rate for Payer: Cigna All Commercial |
$4,504.86
|
| Rate for Payer: CORVEL All Commercial |
$4,854.60
|
| Rate for Payer: Coventry All Commercial |
$4,593.60
|
| Rate for Payer: Encore All Commercial |
$4,805.01
|
| Rate for Payer: Frontpath All Commercial |
$4,802.40
|
| Rate for Payer: Humana ChoiceCare |
$4,508.51
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,698.00
|
| Rate for Payer: PHCS All Commercial |
$3,915.00
|
| Rate for Payer: PHP All Commercial |
$3,958.85
|
| Rate for Payer: Sagamore Health Network All Products |
$4,029.84
|
| Rate for Payer: Signature Care EPO |
$4,332.60
|
| Rate for Payer: Signature Care PPO |
$4,593.60
|
| Rate for Payer: United Healthcare Commercial |
$4,113.36
|
|
|
HC STIMULAN RAPID CURE
|
Facility
|
OP
|
$5,220.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
41606900
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$4,854.60 |
| Rate for Payer: Aetna Commercial |
$4,405.68
|
| Rate for Payer: Aetna Medicare |
$1,670.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.40
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$1,618.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$2,997.85
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$3,263.02
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.40
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$1,920.96
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$1,837.44
|
| Rate for Payer: Cash Price |
$3,132.00
|
| Rate for Payer: Cash Price |
$3,132.00
|
| Rate for Payer: Centivo All Commercial |
$2,839.68
|
| Rate for Payer: Cigna All Commercial |
$4,504.86
|
| Rate for Payer: CORVEL All Commercial |
$4,854.60
|
| Rate for Payer: Coventry All Commercial |
$4,593.60
|
| Rate for Payer: Encore All Commercial |
$4,805.01
|
| Rate for Payer: Frontpath All Commercial |
$4,802.40
|
| Rate for Payer: Humana ChoiceCare |
$4,508.51
|
| Rate for Payer: Humana Medicare |
$1,670.40
|
| Rate for Payer: Lucent All Commercial |
$2,839.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$4,698.00
|
| Rate for Payer: Managed Health Services Medicaid |
$134.40
|
| Rate for Payer: MDWise Medicaid |
$134.40
|
| Rate for Payer: PHCS All Commercial |
$3,915.00
|
| Rate for Payer: PHP All Commercial |
$3,958.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,035.80
|
| Rate for Payer: Sagamore Health Network All Products |
$4,029.84
|
| Rate for Payer: Signature Care EPO |
$4,332.60
|
| Rate for Payer: Signature Care PPO |
$4,593.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$4,437.00
|
| Rate for Payer: United Healthcare Commercial |
$4,113.36
|
| Rate for Payer: United Healthcare Medicare |
$1,670.40
|
|
|
HC STOCKING KNEE LARGE/LONG
|
Facility
|
IP
|
$24.93
|
|
| Hospital Charge Code |
41601101
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$18.70 |
| Max. Negotiated Rate |
$23.18 |
| Rate for Payer: Aetna Commercial |
$21.54
|
| Rate for Payer: Cash Price |
$14.96
|
| Rate for Payer: Cigna All Commercial |
$21.51
|
| Rate for Payer: CORVEL All Commercial |
$23.18
|
| Rate for Payer: Coventry All Commercial |
$21.94
|
| Rate for Payer: Encore All Commercial |
$22.95
|
| Rate for Payer: Frontpath All Commercial |
$22.94
|
| Rate for Payer: Humana ChoiceCare |
$21.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$22.44
|
| Rate for Payer: PHCS All Commercial |
$18.70
|
| Rate for Payer: PHP All Commercial |
$18.91
|
| Rate for Payer: Sagamore Health Network All Products |
$19.25
|
| Rate for Payer: Signature Care EPO |
$20.69
|
| Rate for Payer: Signature Care PPO |
$21.94
|
| Rate for Payer: United Healthcare Commercial |
$19.64
|
|
|
HC STOCKING KNEE LARGE/LONG
|
Facility
|
OP
|
$24.93
|
|
| Hospital Charge Code |
41601101
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.73 |
| Max. Negotiated Rate |
$23.18 |
| Rate for Payer: Aetna Commercial |
$21.04
|
| Rate for Payer: Aetna Medicare |
$7.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$21.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$7.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$14.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$15.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$21.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$9.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$8.78
|
| Rate for Payer: Cash Price |
$14.96
|
| Rate for Payer: Cash Price |
$14.96
|
| Rate for Payer: Centivo All Commercial |
$13.56
|
| Rate for Payer: Cigna All Commercial |
$21.51
|
| Rate for Payer: CORVEL All Commercial |
$23.18
|
| Rate for Payer: Coventry All Commercial |
$21.94
|
| Rate for Payer: Encore All Commercial |
$22.95
|
| Rate for Payer: Frontpath All Commercial |
$22.94
|
| Rate for Payer: Humana ChoiceCare |
$21.53
|
| Rate for Payer: Humana Medicare |
$7.98
|
| Rate for Payer: Lucent All Commercial |
$13.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$22.44
|
| Rate for Payer: Managed Health Services Medicaid |
$21.01
|
| Rate for Payer: MDWise Medicaid |
$21.01
|
| Rate for Payer: PHCS All Commercial |
$18.70
|
| Rate for Payer: PHP All Commercial |
$18.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$9.72
|
| Rate for Payer: Sagamore Health Network All Products |
$19.25
|
| Rate for Payer: Signature Care EPO |
$20.69
|
| Rate for Payer: Signature Care PPO |
$21.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$21.19
|
| Rate for Payer: United Healthcare Commercial |
$19.64
|
| Rate for Payer: United Healthcare Medicare |
$7.98
|
|
|
HC STOCKING KNEE LARGE/REGULAR
|
Facility
|
OP
|
$33.74
|
|
| Hospital Charge Code |
41601102
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$10.46 |
| Max. Negotiated Rate |
$31.38 |
| Rate for Payer: Aetna Commercial |
$28.48
|
| Rate for Payer: Aetna Medicare |
$10.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$21.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$10.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$19.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$21.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$21.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$12.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$11.88
|
| Rate for Payer: Cash Price |
$20.24
|
| Rate for Payer: Cash Price |
$20.24
|
| Rate for Payer: Centivo All Commercial |
$18.35
|
| Rate for Payer: Cigna All Commercial |
$29.12
|
| Rate for Payer: CORVEL All Commercial |
$31.38
|
| Rate for Payer: Coventry All Commercial |
$29.69
|
| Rate for Payer: Encore All Commercial |
$31.06
|
| Rate for Payer: Frontpath All Commercial |
$31.04
|
| Rate for Payer: Humana ChoiceCare |
$29.14
|
| Rate for Payer: Humana Medicare |
$10.80
|
| Rate for Payer: Lucent All Commercial |
$18.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$30.37
|
| Rate for Payer: Managed Health Services Medicaid |
$21.01
|
| Rate for Payer: MDWise Medicaid |
$21.01
|
| Rate for Payer: PHCS All Commercial |
$25.30
|
| Rate for Payer: PHP All Commercial |
$25.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$13.16
|
| Rate for Payer: Sagamore Health Network All Products |
$26.05
|
| Rate for Payer: Signature Care EPO |
$28.00
|
| Rate for Payer: Signature Care PPO |
$29.69
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$28.68
|
| Rate for Payer: United Healthcare Commercial |
$26.59
|
| Rate for Payer: United Healthcare Medicare |
$10.80
|
|
|
HC STOCKING KNEE LARGE/REGULAR
|
Facility
|
IP
|
$33.74
|
|
| Hospital Charge Code |
41601102
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$25.30 |
| Max. Negotiated Rate |
$31.38 |
| Rate for Payer: Aetna Commercial |
$29.15
|
| Rate for Payer: Cash Price |
$20.24
|
| Rate for Payer: Cigna All Commercial |
$29.12
|
| Rate for Payer: CORVEL All Commercial |
$31.38
|
| Rate for Payer: Coventry All Commercial |
$29.69
|
| Rate for Payer: Encore All Commercial |
$31.06
|
| Rate for Payer: Frontpath All Commercial |
$31.04
|
| Rate for Payer: Humana ChoiceCare |
$29.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$30.37
|
| Rate for Payer: PHCS All Commercial |
$25.30
|
| Rate for Payer: PHP All Commercial |
$25.59
|
| Rate for Payer: Sagamore Health Network All Products |
$26.05
|
| Rate for Payer: Signature Care EPO |
$28.00
|
| Rate for Payer: Signature Care PPO |
$29.69
|
| Rate for Payer: United Healthcare Commercial |
$26.59
|
|
|
HC STOCKING KNEE MEDIUM/LONG
|
Facility
|
OP
|
$24.93
|
|
| Hospital Charge Code |
41601103
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.73 |
| Max. Negotiated Rate |
$23.18 |
| Rate for Payer: Aetna Commercial |
$21.04
|
| Rate for Payer: Aetna Medicare |
$7.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$21.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$7.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$14.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$15.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$21.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$9.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$8.78
|
| Rate for Payer: Cash Price |
$14.96
|
| Rate for Payer: Cash Price |
$14.96
|
| Rate for Payer: Centivo All Commercial |
$13.56
|
| Rate for Payer: Cigna All Commercial |
$21.51
|
| Rate for Payer: CORVEL All Commercial |
$23.18
|
| Rate for Payer: Coventry All Commercial |
$21.94
|
| Rate for Payer: Encore All Commercial |
$22.95
|
| Rate for Payer: Frontpath All Commercial |
$22.94
|
| Rate for Payer: Humana ChoiceCare |
$21.53
|
| Rate for Payer: Humana Medicare |
$7.98
|
| Rate for Payer: Lucent All Commercial |
$13.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$22.44
|
| Rate for Payer: Managed Health Services Medicaid |
$21.01
|
| Rate for Payer: MDWise Medicaid |
$21.01
|
| Rate for Payer: PHCS All Commercial |
$18.70
|
| Rate for Payer: PHP All Commercial |
$18.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$9.72
|
| Rate for Payer: Sagamore Health Network All Products |
$19.25
|
| Rate for Payer: Signature Care EPO |
$20.69
|
| Rate for Payer: Signature Care PPO |
$21.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$21.19
|
| Rate for Payer: United Healthcare Commercial |
$19.64
|
| Rate for Payer: United Healthcare Medicare |
$7.98
|
|
|
HC STOCKING KNEE MEDIUM/LONG
|
Facility
|
IP
|
$24.93
|
|
| Hospital Charge Code |
41601103
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$18.70 |
| Max. Negotiated Rate |
$23.18 |
| Rate for Payer: Aetna Commercial |
$21.54
|
| Rate for Payer: Cash Price |
$14.96
|
| Rate for Payer: Cigna All Commercial |
$21.51
|
| Rate for Payer: CORVEL All Commercial |
$23.18
|
| Rate for Payer: Coventry All Commercial |
$21.94
|
| Rate for Payer: Encore All Commercial |
$22.95
|
| Rate for Payer: Frontpath All Commercial |
$22.94
|
| Rate for Payer: Humana ChoiceCare |
$21.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$22.44
|
| Rate for Payer: PHCS All Commercial |
$18.70
|
| Rate for Payer: PHP All Commercial |
$18.91
|
| Rate for Payer: Sagamore Health Network All Products |
$19.25
|
| Rate for Payer: Signature Care EPO |
$20.69
|
| Rate for Payer: Signature Care PPO |
$21.94
|
| Rate for Payer: United Healthcare Commercial |
$19.64
|
|
|
HC STOCKING KNEE MEDIUM/REGULAR
|
Facility
|
IP
|
$33.74
|
|
| Hospital Charge Code |
41601104
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$25.30 |
| Max. Negotiated Rate |
$31.38 |
| Rate for Payer: Aetna Commercial |
$29.15
|
| Rate for Payer: Cash Price |
$20.24
|
| Rate for Payer: Cigna All Commercial |
$29.12
|
| Rate for Payer: CORVEL All Commercial |
$31.38
|
| Rate for Payer: Coventry All Commercial |
$29.69
|
| Rate for Payer: Encore All Commercial |
$31.06
|
| Rate for Payer: Frontpath All Commercial |
$31.04
|
| Rate for Payer: Humana ChoiceCare |
$29.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$30.37
|
| Rate for Payer: PHCS All Commercial |
$25.30
|
| Rate for Payer: PHP All Commercial |
$25.59
|
| Rate for Payer: Sagamore Health Network All Products |
$26.05
|
| Rate for Payer: Signature Care EPO |
$28.00
|
| Rate for Payer: Signature Care PPO |
$29.69
|
| Rate for Payer: United Healthcare Commercial |
$26.59
|
|
|
HC STOCKING KNEE MEDIUM/REGULAR
|
Facility
|
OP
|
$33.74
|
|
| Hospital Charge Code |
41601104
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$10.46 |
| Max. Negotiated Rate |
$31.38 |
| Rate for Payer: Aetna Commercial |
$28.48
|
| Rate for Payer: Aetna Medicare |
$10.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$21.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$10.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$19.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$21.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$21.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$12.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$11.88
|
| Rate for Payer: Cash Price |
$20.24
|
| Rate for Payer: Cash Price |
$20.24
|
| Rate for Payer: Centivo All Commercial |
$18.35
|
| Rate for Payer: Cigna All Commercial |
$29.12
|
| Rate for Payer: CORVEL All Commercial |
$31.38
|
| Rate for Payer: Coventry All Commercial |
$29.69
|
| Rate for Payer: Encore All Commercial |
$31.06
|
| Rate for Payer: Frontpath All Commercial |
$31.04
|
| Rate for Payer: Humana ChoiceCare |
$29.14
|
| Rate for Payer: Humana Medicare |
$10.80
|
| Rate for Payer: Lucent All Commercial |
$18.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$30.37
|
| Rate for Payer: Managed Health Services Medicaid |
$21.01
|
| Rate for Payer: MDWise Medicaid |
$21.01
|
| Rate for Payer: PHCS All Commercial |
$25.30
|
| Rate for Payer: PHP All Commercial |
$25.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$13.16
|
| Rate for Payer: Sagamore Health Network All Products |
$26.05
|
| Rate for Payer: Signature Care EPO |
$28.00
|
| Rate for Payer: Signature Care PPO |
$29.69
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$28.68
|
| Rate for Payer: United Healthcare Commercial |
$26.59
|
| Rate for Payer: United Healthcare Medicare |
$10.80
|
|
|
HC STOCKING KNEE SMALL/LONG
|
Facility
|
IP
|
$33.74
|
|
| Hospital Charge Code |
41601105
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$25.30 |
| Max. Negotiated Rate |
$31.38 |
| Rate for Payer: Aetna Commercial |
$29.15
|
| Rate for Payer: Cash Price |
$20.24
|
| Rate for Payer: Cigna All Commercial |
$29.12
|
| Rate for Payer: CORVEL All Commercial |
$31.38
|
| Rate for Payer: Coventry All Commercial |
$29.69
|
| Rate for Payer: Encore All Commercial |
$31.06
|
| Rate for Payer: Frontpath All Commercial |
$31.04
|
| Rate for Payer: Humana ChoiceCare |
$29.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$30.37
|
| Rate for Payer: PHCS All Commercial |
$25.30
|
| Rate for Payer: PHP All Commercial |
$25.59
|
| Rate for Payer: Sagamore Health Network All Products |
$26.05
|
| Rate for Payer: Signature Care EPO |
$28.00
|
| Rate for Payer: Signature Care PPO |
$29.69
|
| Rate for Payer: United Healthcare Commercial |
$26.59
|
|
|
HC STOCKING KNEE SMALL/LONG
|
Facility
|
OP
|
$33.74
|
|
| Hospital Charge Code |
41601105
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$10.46 |
| Max. Negotiated Rate |
$31.38 |
| Rate for Payer: Aetna Commercial |
$28.48
|
| Rate for Payer: Aetna Medicare |
$10.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$21.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$10.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$19.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$21.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$21.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$12.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$11.88
|
| Rate for Payer: Cash Price |
$20.24
|
| Rate for Payer: Cash Price |
$20.24
|
| Rate for Payer: Centivo All Commercial |
$18.35
|
| Rate for Payer: Cigna All Commercial |
$29.12
|
| Rate for Payer: CORVEL All Commercial |
$31.38
|
| Rate for Payer: Coventry All Commercial |
$29.69
|
| Rate for Payer: Encore All Commercial |
$31.06
|
| Rate for Payer: Frontpath All Commercial |
$31.04
|
| Rate for Payer: Humana ChoiceCare |
$29.14
|
| Rate for Payer: Humana Medicare |
$10.80
|
| Rate for Payer: Lucent All Commercial |
$18.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$30.37
|
| Rate for Payer: Managed Health Services Medicaid |
$21.01
|
| Rate for Payer: MDWise Medicaid |
$21.01
|
| Rate for Payer: PHCS All Commercial |
$25.30
|
| Rate for Payer: PHP All Commercial |
$25.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$13.16
|
| Rate for Payer: Sagamore Health Network All Products |
$26.05
|
| Rate for Payer: Signature Care EPO |
$28.00
|
| Rate for Payer: Signature Care PPO |
$29.69
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$28.68
|
| Rate for Payer: United Healthcare Commercial |
$26.59
|
| Rate for Payer: United Healthcare Medicare |
$10.80
|
|
|
HC STOCKING KNEE SMALL/REGULAR
|
Facility
|
OP
|
$33.74
|
|
| Hospital Charge Code |
41601106
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$10.46 |
| Max. Negotiated Rate |
$31.38 |
| Rate for Payer: Aetna Commercial |
$28.48
|
| Rate for Payer: Aetna Medicare |
$10.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$21.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$10.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$19.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$21.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$21.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$12.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$11.88
|
| Rate for Payer: Cash Price |
$20.24
|
| Rate for Payer: Cash Price |
$20.24
|
| Rate for Payer: Centivo All Commercial |
$18.35
|
| Rate for Payer: Cigna All Commercial |
$29.12
|
| Rate for Payer: CORVEL All Commercial |
$31.38
|
| Rate for Payer: Coventry All Commercial |
$29.69
|
| Rate for Payer: Encore All Commercial |
$31.06
|
| Rate for Payer: Frontpath All Commercial |
$31.04
|
| Rate for Payer: Humana ChoiceCare |
$29.14
|
| Rate for Payer: Humana Medicare |
$10.80
|
| Rate for Payer: Lucent All Commercial |
$18.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$30.37
|
| Rate for Payer: Managed Health Services Medicaid |
$21.01
|
| Rate for Payer: MDWise Medicaid |
$21.01
|
| Rate for Payer: PHCS All Commercial |
$25.30
|
| Rate for Payer: PHP All Commercial |
$25.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$13.16
|
| Rate for Payer: Sagamore Health Network All Products |
$26.05
|
| Rate for Payer: Signature Care EPO |
$28.00
|
| Rate for Payer: Signature Care PPO |
$29.69
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$28.68
|
| Rate for Payer: United Healthcare Commercial |
$26.59
|
| Rate for Payer: United Healthcare Medicare |
$10.80
|
|
|
HC STOCKING KNEE SMALL/REGULAR
|
Facility
|
IP
|
$33.74
|
|
| Hospital Charge Code |
41601106
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$25.30 |
| Max. Negotiated Rate |
$31.38 |
| Rate for Payer: Aetna Commercial |
$29.15
|
| Rate for Payer: Cash Price |
$20.24
|
| Rate for Payer: Cigna All Commercial |
$29.12
|
| Rate for Payer: CORVEL All Commercial |
$31.38
|
| Rate for Payer: Coventry All Commercial |
$29.69
|
| Rate for Payer: Encore All Commercial |
$31.06
|
| Rate for Payer: Frontpath All Commercial |
$31.04
|
| Rate for Payer: Humana ChoiceCare |
$29.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$30.37
|
| Rate for Payer: PHCS All Commercial |
$25.30
|
| Rate for Payer: PHP All Commercial |
$25.59
|
| Rate for Payer: Sagamore Health Network All Products |
$26.05
|
| Rate for Payer: Signature Care EPO |
$28.00
|
| Rate for Payer: Signature Care PPO |
$29.69
|
| Rate for Payer: United Healthcare Commercial |
$26.59
|
|
|
HC STOCKING KNEE X LARGE/LONG
|
Facility
|
IP
|
$24.93
|
|
| Hospital Charge Code |
41601107
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$18.70 |
| Max. Negotiated Rate |
$23.18 |
| Rate for Payer: Aetna Commercial |
$21.54
|
| Rate for Payer: Cash Price |
$14.96
|
| Rate for Payer: Cigna All Commercial |
$21.51
|
| Rate for Payer: CORVEL All Commercial |
$23.18
|
| Rate for Payer: Coventry All Commercial |
$21.94
|
| Rate for Payer: Encore All Commercial |
$22.95
|
| Rate for Payer: Frontpath All Commercial |
$22.94
|
| Rate for Payer: Humana ChoiceCare |
$21.53
|
| Rate for Payer: Lutheran Preferred All Commercial |
$22.44
|
| Rate for Payer: PHCS All Commercial |
$18.70
|
| Rate for Payer: PHP All Commercial |
$18.91
|
| Rate for Payer: Sagamore Health Network All Products |
$19.25
|
| Rate for Payer: Signature Care EPO |
$20.69
|
| Rate for Payer: Signature Care PPO |
$21.94
|
| Rate for Payer: United Healthcare Commercial |
$19.64
|
|
|
HC STOCKING KNEE X LARGE/LONG
|
Facility
|
OP
|
$24.93
|
|
| Hospital Charge Code |
41601107
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.73 |
| Max. Negotiated Rate |
$23.18 |
| Rate for Payer: Aetna Commercial |
$21.04
|
| Rate for Payer: Aetna Medicare |
$7.98
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$21.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$7.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$14.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$15.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$21.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$9.17
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$8.78
|
| Rate for Payer: Cash Price |
$14.96
|
| Rate for Payer: Cash Price |
$14.96
|
| Rate for Payer: Centivo All Commercial |
$13.56
|
| Rate for Payer: Cigna All Commercial |
$21.51
|
| Rate for Payer: CORVEL All Commercial |
$23.18
|
| Rate for Payer: Coventry All Commercial |
$21.94
|
| Rate for Payer: Encore All Commercial |
$22.95
|
| Rate for Payer: Frontpath All Commercial |
$22.94
|
| Rate for Payer: Humana ChoiceCare |
$21.53
|
| Rate for Payer: Humana Medicare |
$7.98
|
| Rate for Payer: Lucent All Commercial |
$13.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$22.44
|
| Rate for Payer: Managed Health Services Medicaid |
$21.01
|
| Rate for Payer: MDWise Medicaid |
$21.01
|
| Rate for Payer: PHCS All Commercial |
$18.70
|
| Rate for Payer: PHP All Commercial |
$18.91
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$9.72
|
| Rate for Payer: Sagamore Health Network All Products |
$19.25
|
| Rate for Payer: Signature Care EPO |
$20.69
|
| Rate for Payer: Signature Care PPO |
$21.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$21.19
|
| Rate for Payer: United Healthcare Commercial |
$19.64
|
| Rate for Payer: United Healthcare Medicare |
$7.98
|
|
|
HC STOCKING KNEE X LARGE/REGULAR
|
Facility
|
OP
|
$33.74
|
|
| Hospital Charge Code |
41601108
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$10.46 |
| Max. Negotiated Rate |
$31.38 |
| Rate for Payer: Aetna Commercial |
$28.48
|
| Rate for Payer: Aetna Medicare |
$10.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$21.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$10.46
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$19.38
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$21.09
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$21.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$12.42
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$11.88
|
| Rate for Payer: Cash Price |
$20.24
|
| Rate for Payer: Cash Price |
$20.24
|
| Rate for Payer: Centivo All Commercial |
$18.35
|
| Rate for Payer: Cigna All Commercial |
$29.12
|
| Rate for Payer: CORVEL All Commercial |
$31.38
|
| Rate for Payer: Coventry All Commercial |
$29.69
|
| Rate for Payer: Encore All Commercial |
$31.06
|
| Rate for Payer: Frontpath All Commercial |
$31.04
|
| Rate for Payer: Humana ChoiceCare |
$29.14
|
| Rate for Payer: Humana Medicare |
$10.80
|
| Rate for Payer: Lucent All Commercial |
$18.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$30.37
|
| Rate for Payer: Managed Health Services Medicaid |
$21.01
|
| Rate for Payer: MDWise Medicaid |
$21.01
|
| Rate for Payer: PHCS All Commercial |
$25.30
|
| Rate for Payer: PHP All Commercial |
$25.59
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$13.16
|
| Rate for Payer: Sagamore Health Network All Products |
$26.05
|
| Rate for Payer: Signature Care EPO |
$28.00
|
| Rate for Payer: Signature Care PPO |
$29.69
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$28.68
|
| Rate for Payer: United Healthcare Commercial |
$26.59
|
| Rate for Payer: United Healthcare Medicare |
$10.80
|
|
|
HC STOCKING KNEE X LARGE/REGULAR
|
Facility
|
IP
|
$33.74
|
|
| Hospital Charge Code |
41601108
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$25.30 |
| Max. Negotiated Rate |
$31.38 |
| Rate for Payer: Aetna Commercial |
$29.15
|
| Rate for Payer: Cash Price |
$20.24
|
| Rate for Payer: Cigna All Commercial |
$29.12
|
| Rate for Payer: CORVEL All Commercial |
$31.38
|
| Rate for Payer: Coventry All Commercial |
$29.69
|
| Rate for Payer: Encore All Commercial |
$31.06
|
| Rate for Payer: Frontpath All Commercial |
$31.04
|
| Rate for Payer: Humana ChoiceCare |
$29.14
|
| Rate for Payer: Lutheran Preferred All Commercial |
$30.37
|
| Rate for Payer: PHCS All Commercial |
$25.30
|
| Rate for Payer: PHP All Commercial |
$25.59
|
| Rate for Payer: Sagamore Health Network All Products |
$26.05
|
| Rate for Payer: Signature Care EPO |
$28.00
|
| Rate for Payer: Signature Care PPO |
$29.69
|
| Rate for Payer: United Healthcare Commercial |
$26.59
|
|
|
HC STOCKING KNEE XX LARGE/LONG
|
Facility
|
IP
|
$20.32
|
|
| Hospital Charge Code |
41601109
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$15.24 |
| Max. Negotiated Rate |
$18.90 |
| Rate for Payer: Aetna Commercial |
$17.56
|
| Rate for Payer: Cash Price |
$12.19
|
| Rate for Payer: Cigna All Commercial |
$17.54
|
| Rate for Payer: CORVEL All Commercial |
$18.90
|
| Rate for Payer: Coventry All Commercial |
$17.88
|
| Rate for Payer: Encore All Commercial |
$18.70
|
| Rate for Payer: Frontpath All Commercial |
$18.69
|
| Rate for Payer: Humana ChoiceCare |
$17.55
|
| Rate for Payer: Lutheran Preferred All Commercial |
$18.29
|
| Rate for Payer: PHCS All Commercial |
$15.24
|
| Rate for Payer: PHP All Commercial |
$15.41
|
| Rate for Payer: Sagamore Health Network All Products |
$15.69
|
| Rate for Payer: Signature Care EPO |
$16.87
|
| Rate for Payer: Signature Care PPO |
$17.88
|
| Rate for Payer: United Healthcare Commercial |
$16.01
|
|
|
HC STOCKING KNEE XX LARGE/LONG
|
Facility
|
OP
|
$20.32
|
|
| Hospital Charge Code |
41601109
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$21.01 |
| Rate for Payer: Aetna Commercial |
$17.15
|
| Rate for Payer: Aetna Medicare |
$6.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$21.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$6.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$11.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$12.70
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$21.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$7.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$7.15
|
| Rate for Payer: Cash Price |
$12.19
|
| Rate for Payer: Cash Price |
$12.19
|
| Rate for Payer: Centivo All Commercial |
$11.05
|
| Rate for Payer: Cigna All Commercial |
$17.54
|
| Rate for Payer: CORVEL All Commercial |
$18.90
|
| Rate for Payer: Coventry All Commercial |
$17.88
|
| Rate for Payer: Encore All Commercial |
$18.70
|
| Rate for Payer: Frontpath All Commercial |
$18.69
|
| Rate for Payer: Humana ChoiceCare |
$17.55
|
| Rate for Payer: Humana Medicare |
$6.50
|
| Rate for Payer: Lucent All Commercial |
$11.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$18.29
|
| Rate for Payer: Managed Health Services Medicaid |
$21.01
|
| Rate for Payer: MDWise Medicaid |
$21.01
|
| Rate for Payer: PHCS All Commercial |
$15.24
|
| Rate for Payer: PHP All Commercial |
$15.41
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$7.92
|
| Rate for Payer: Sagamore Health Network All Products |
$15.69
|
| Rate for Payer: Signature Care EPO |
$16.87
|
| Rate for Payer: Signature Care PPO |
$17.88
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$17.27
|
| Rate for Payer: United Healthcare Commercial |
$16.01
|
| Rate for Payer: United Healthcare Medicare |
$6.50
|
|
|
HC STOCKING KNEE XX LARGE/REGULAR
|
Facility
|
OP
|
$43.72
|
|
| Hospital Charge Code |
41601110
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$13.55 |
| Max. Negotiated Rate |
$40.66 |
| Rate for Payer: Aetna Commercial |
$36.90
|
| Rate for Payer: Aetna Medicare |
$13.99
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$21.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$13.55
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$25.11
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$27.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$21.01
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$16.09
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$15.39
|
| Rate for Payer: Cash Price |
$26.23
|
| Rate for Payer: Cash Price |
$26.23
|
| Rate for Payer: Centivo All Commercial |
$23.78
|
| Rate for Payer: Cigna All Commercial |
$37.73
|
| Rate for Payer: CORVEL All Commercial |
$40.66
|
| Rate for Payer: Coventry All Commercial |
$38.47
|
| Rate for Payer: Encore All Commercial |
$40.24
|
| Rate for Payer: Frontpath All Commercial |
$40.22
|
| Rate for Payer: Humana ChoiceCare |
$37.76
|
| Rate for Payer: Humana Medicare |
$13.99
|
| Rate for Payer: Lucent All Commercial |
$23.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$39.35
|
| Rate for Payer: Managed Health Services Medicaid |
$21.01
|
| Rate for Payer: MDWise Medicaid |
$21.01
|
| Rate for Payer: PHCS All Commercial |
$32.79
|
| Rate for Payer: PHP All Commercial |
$33.16
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$17.05
|
| Rate for Payer: Sagamore Health Network All Products |
$33.75
|
| Rate for Payer: Signature Care EPO |
$36.29
|
| Rate for Payer: Signature Care PPO |
$38.47
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$37.16
|
| Rate for Payer: United Healthcare Commercial |
$34.45
|
| Rate for Payer: United Healthcare Medicare |
$13.99
|
|
