|
HC OXIMETER SINGLE DETERMINATION
|
Facility
OP
|
$94.20
|
|
|
Service Code
|
CPT 94760
|
| Hospital Charge Code |
01709887
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$31.09 |
| Max. Negotiated Rate |
$186.46 |
| Rate for Payer: Aetna Commercial |
$79.50
|
| Rate for Payer: Aetna Medicare |
$31.09
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$31.09
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$54.10
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$58.88
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$186.46
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$35.75
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$34.19
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Centivo All Commercial |
$48.04
|
| Rate for Payer: Cigna All Commercial |
$81.29
|
| Rate for Payer: CORVEL All Commercial |
$87.60
|
| Rate for Payer: Coventry All Commercial |
$82.89
|
| Rate for Payer: Encore All Commercial |
$86.71
|
| Rate for Payer: Frontpath All Commercial |
$86.66
|
| Rate for Payer: Humana ChoiceCare |
$81.36
|
| Rate for Payer: Humana Medicare |
$48.04
|
| Rate for Payer: Lucent All Commercial |
$48.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$84.78
|
| Rate for Payer: Managed Health Services Medicaid |
$186.46
|
| Rate for Payer: MDWise Medicaid |
$186.46
|
| Rate for Payer: PHCS All Commercial |
$70.65
|
| Rate for Payer: PHP All Commercial |
$71.44
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$36.74
|
| Rate for Payer: Sagamore Health Network All Products |
$72.72
|
| Rate for Payer: Signature Care EPO |
$78.18
|
| Rate for Payer: Signature Care PPO |
$82.89
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$80.07
|
| Rate for Payer: United Healthcare Commercial |
$74.23
|
| Rate for Payer: United Healthcare Medicare |
$31.09
|
|
|
HC OXIMETER SINGLE DETERMINATION
|
Facility
IP
|
$94.20
|
|
|
Service Code
|
CPT 94760
|
| Hospital Charge Code |
01709887
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$70.65 |
| Max. Negotiated Rate |
$87.60 |
| Rate for Payer: Aetna Commercial |
$81.39
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cigna All Commercial |
$81.29
|
| Rate for Payer: CORVEL All Commercial |
$87.60
|
| Rate for Payer: Coventry All Commercial |
$82.89
|
| Rate for Payer: Encore All Commercial |
$86.71
|
| Rate for Payer: Frontpath All Commercial |
$86.66
|
| Rate for Payer: Humana ChoiceCare |
$81.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$84.78
|
| Rate for Payer: PHCS All Commercial |
$70.65
|
| Rate for Payer: PHP All Commercial |
$71.44
|
| Rate for Payer: Sagamore Health Network All Products |
$72.72
|
| Rate for Payer: Signature Care EPO |
$78.18
|
| Rate for Payer: Signature Care PPO |
$82.89
|
| Rate for Payer: United Healthcare Commercial |
$74.23
|
|
|
HC OXYCARB METAB-TRILEP
|
Facility
OP
|
$271.52
|
|
|
Service Code
|
CPT 80183
|
| Hospital Charge Code |
63001376
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.25 |
| Max. Negotiated Rate |
$252.52 |
| Rate for Payer: Aetna Commercial |
$229.17
|
| Rate for Payer: Aetna Medicare |
$89.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$89.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$155.94
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$169.73
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$13.25
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$103.04
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$98.56
|
| Rate for Payer: Cash Price |
$168.35
|
| Rate for Payer: Cash Price |
$168.35
|
| Rate for Payer: Centivo All Commercial |
$138.48
|
| Rate for Payer: Cigna All Commercial |
$234.33
|
| Rate for Payer: CORVEL All Commercial |
$252.52
|
| Rate for Payer: Coventry All Commercial |
$238.94
|
| Rate for Payer: Encore All Commercial |
$249.94
|
| Rate for Payer: Frontpath All Commercial |
$249.80
|
| Rate for Payer: Humana ChoiceCare |
$234.52
|
| Rate for Payer: Humana Medicare |
$138.48
|
| Rate for Payer: Lucent All Commercial |
$138.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$244.37
|
| Rate for Payer: Managed Health Services Medicaid |
$13.25
|
| Rate for Payer: MDWise Medicaid |
$13.25
|
| Rate for Payer: PHCS All Commercial |
$203.64
|
| Rate for Payer: PHP All Commercial |
$205.92
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$105.89
|
| Rate for Payer: Sagamore Health Network All Products |
$209.62
|
| Rate for Payer: Signature Care EPO |
$225.36
|
| Rate for Payer: Signature Care PPO |
$238.94
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$230.80
|
| Rate for Payer: United Healthcare Commercial |
$213.96
|
| Rate for Payer: United Healthcare Medicare |
$89.60
|
|
|
HC OXYCARB METAB-TRILEP
|
Facility
IP
|
$271.52
|
|
|
Service Code
|
CPT 80183
|
| Hospital Charge Code |
63001376
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$203.64 |
| Max. Negotiated Rate |
$252.52 |
| Rate for Payer: Aetna Commercial |
$234.60
|
| Rate for Payer: Cash Price |
$168.35
|
| Rate for Payer: Cigna All Commercial |
$234.33
|
| Rate for Payer: CORVEL All Commercial |
$252.52
|
| Rate for Payer: Coventry All Commercial |
$238.94
|
| Rate for Payer: Encore All Commercial |
$249.94
|
| Rate for Payer: Frontpath All Commercial |
$249.80
|
| Rate for Payer: Humana ChoiceCare |
$234.52
|
| Rate for Payer: Lutheran Preferred All Commercial |
$244.37
|
| Rate for Payer: PHCS All Commercial |
$203.64
|
| Rate for Payer: PHP All Commercial |
$205.92
|
| Rate for Payer: Sagamore Health Network All Products |
$209.62
|
| Rate for Payer: Signature Care EPO |
$225.36
|
| Rate for Payer: Signature Care PPO |
$238.94
|
| Rate for Payer: United Healthcare Commercial |
$213.96
|
|
|
HC OXYGEN PER DAY
|
Facility
IP
|
$360.86
|
|
| Hospital Charge Code |
01700501
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$270.64 |
| Max. Negotiated Rate |
$335.60 |
| Rate for Payer: Aetna Commercial |
$311.78
|
| Rate for Payer: Cash Price |
$223.73
|
| Rate for Payer: Cigna All Commercial |
$311.42
|
| Rate for Payer: CORVEL All Commercial |
$335.60
|
| Rate for Payer: Coventry All Commercial |
$317.55
|
| Rate for Payer: Encore All Commercial |
$332.17
|
| Rate for Payer: Frontpath All Commercial |
$331.99
|
| Rate for Payer: Humana ChoiceCare |
$311.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$324.77
|
| Rate for Payer: PHCS All Commercial |
$270.64
|
| Rate for Payer: PHP All Commercial |
$273.67
|
| Rate for Payer: Sagamore Health Network All Products |
$278.58
|
| Rate for Payer: Signature Care EPO |
$299.51
|
| Rate for Payer: Signature Care PPO |
$317.55
|
| Rate for Payer: United Healthcare Commercial |
$284.35
|
|
|
HC OXYGEN PER DAY
|
Facility
OP
|
$360.86
|
|
| Hospital Charge Code |
01700501
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$81.94 |
| Max. Negotiated Rate |
$335.60 |
| Rate for Payer: Aetna Commercial |
$304.56
|
| Rate for Payer: Aetna Medicare |
$119.08
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$119.08
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$207.24
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$225.57
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$81.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$136.94
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$130.99
|
| Rate for Payer: Cash Price |
$223.73
|
| Rate for Payer: Cash Price |
$223.73
|
| Rate for Payer: Centivo All Commercial |
$184.04
|
| Rate for Payer: Cigna All Commercial |
$311.42
|
| Rate for Payer: CORVEL All Commercial |
$335.60
|
| Rate for Payer: Coventry All Commercial |
$317.55
|
| Rate for Payer: Encore All Commercial |
$332.17
|
| Rate for Payer: Frontpath All Commercial |
$331.99
|
| Rate for Payer: Humana ChoiceCare |
$311.67
|
| Rate for Payer: Humana Medicare |
$184.04
|
| Rate for Payer: Lucent All Commercial |
$184.04
|
| Rate for Payer: Lutheran Preferred All Commercial |
$324.77
|
| Rate for Payer: Managed Health Services Medicaid |
$81.94
|
| Rate for Payer: MDWise Medicaid |
$81.94
|
| Rate for Payer: PHCS All Commercial |
$270.64
|
| Rate for Payer: PHP All Commercial |
$273.67
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$140.73
|
| Rate for Payer: Sagamore Health Network All Products |
$278.58
|
| Rate for Payer: Signature Care EPO |
$299.51
|
| Rate for Payer: Signature Care PPO |
$317.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$306.73
|
| Rate for Payer: United Healthcare Commercial |
$284.35
|
| Rate for Payer: United Healthcare Medicare |
$119.08
|
|
|
HC PACEMAKER DC ACCOLADE DR
|
Facility
OP
|
$14,062.50
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
41607170
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$13,078.12 |
| Rate for Payer: Aetna Commercial |
$11,868.75
|
| Rate for Payer: Aetna Medicare |
$4,640.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,640.62
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$8,076.09
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$8,790.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,336.72
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,104.69
|
| Rate for Payer: Cash Price |
$8,718.75
|
| Rate for Payer: Cash Price |
$8,718.75
|
| Rate for Payer: Centivo All Commercial |
$7,171.88
|
| Rate for Payer: Cigna All Commercial |
$12,135.94
|
| Rate for Payer: CORVEL All Commercial |
$13,078.12
|
| Rate for Payer: Coventry All Commercial |
$12,375.00
|
| Rate for Payer: Encore All Commercial |
$12,944.53
|
| Rate for Payer: Frontpath All Commercial |
$12,937.50
|
| Rate for Payer: Humana ChoiceCare |
$12,145.78
|
| Rate for Payer: Humana Medicare |
$7,171.88
|
| Rate for Payer: Lucent All Commercial |
$7,171.88
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12,656.25
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$10,546.88
|
| Rate for Payer: PHP All Commercial |
$10,665.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,484.38
|
| Rate for Payer: Sagamore Health Network All Products |
$10,856.25
|
| Rate for Payer: Signature Care EPO |
$11,671.88
|
| Rate for Payer: Signature Care PPO |
$12,375.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,953.12
|
| Rate for Payer: United Healthcare Commercial |
$11,081.25
|
| Rate for Payer: United Healthcare Medicare |
$4,640.62
|
|
|
HC PACEMAKER DC ACCOLADE DR
|
Facility
IP
|
$14,062.50
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
41607170
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$10,546.88 |
| Max. Negotiated Rate |
$13,078.12 |
| Rate for Payer: Aetna Commercial |
$12,150.00
|
| Rate for Payer: Cash Price |
$8,718.75
|
| Rate for Payer: Cigna All Commercial |
$12,135.94
|
| Rate for Payer: CORVEL All Commercial |
$13,078.12
|
| Rate for Payer: Coventry All Commercial |
$12,375.00
|
| Rate for Payer: Encore All Commercial |
$12,944.53
|
| Rate for Payer: Frontpath All Commercial |
$12,937.50
|
| Rate for Payer: Humana ChoiceCare |
$12,145.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$12,656.25
|
| Rate for Payer: PHCS All Commercial |
$10,546.88
|
| Rate for Payer: PHP All Commercial |
$10,665.00
|
| Rate for Payer: Sagamore Health Network All Products |
$10,856.25
|
| Rate for Payer: Signature Care EPO |
$11,671.88
|
| Rate for Payer: Signature Care PPO |
$12,375.00
|
| Rate for Payer: United Healthcare Commercial |
$11,081.25
|
|
|
HC PACEMAKER DC ACCOLADE DR EL
|
Facility
OP
|
$14,812.50
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
41607169
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$13,775.62 |
| Rate for Payer: Aetna Commercial |
$12,501.75
|
| Rate for Payer: Aetna Medicare |
$4,888.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,888.12
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$8,506.82
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,259.29
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$5,621.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,376.94
|
| Rate for Payer: Cash Price |
$9,183.75
|
| Rate for Payer: Cash Price |
$9,183.75
|
| Rate for Payer: Centivo All Commercial |
$7,554.38
|
| Rate for Payer: Cigna All Commercial |
$12,783.19
|
| Rate for Payer: CORVEL All Commercial |
$13,775.62
|
| Rate for Payer: Coventry All Commercial |
$13,035.00
|
| Rate for Payer: Encore All Commercial |
$13,634.91
|
| Rate for Payer: Frontpath All Commercial |
$13,627.50
|
| Rate for Payer: Humana ChoiceCare |
$12,793.56
|
| Rate for Payer: Humana Medicare |
$7,554.38
|
| Rate for Payer: Lucent All Commercial |
$7,554.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,331.25
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$11,109.38
|
| Rate for Payer: PHP All Commercial |
$11,233.80
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,776.88
|
| Rate for Payer: Sagamore Health Network All Products |
$11,435.25
|
| Rate for Payer: Signature Care EPO |
$12,294.38
|
| Rate for Payer: Signature Care PPO |
$13,035.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$12,590.62
|
| Rate for Payer: United Healthcare Commercial |
$11,672.25
|
| Rate for Payer: United Healthcare Medicare |
$4,888.12
|
|
|
HC PACEMAKER DC ACCOLADE DR EL
|
Facility
IP
|
$14,812.50
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
41607169
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$11,109.38 |
| Max. Negotiated Rate |
$13,775.62 |
| Rate for Payer: Aetna Commercial |
$12,798.00
|
| Rate for Payer: Cash Price |
$9,183.75
|
| Rate for Payer: Cigna All Commercial |
$12,783.19
|
| Rate for Payer: CORVEL All Commercial |
$13,775.62
|
| Rate for Payer: Coventry All Commercial |
$13,035.00
|
| Rate for Payer: Encore All Commercial |
$13,634.91
|
| Rate for Payer: Frontpath All Commercial |
$13,627.50
|
| Rate for Payer: Humana ChoiceCare |
$12,793.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$13,331.25
|
| Rate for Payer: PHCS All Commercial |
$11,109.38
|
| Rate for Payer: PHP All Commercial |
$11,233.80
|
| Rate for Payer: Sagamore Health Network All Products |
$11,435.25
|
| Rate for Payer: Signature Care EPO |
$12,294.38
|
| Rate for Payer: Signature Care PPO |
$13,035.00
|
| Rate for Payer: United Healthcare Commercial |
$11,672.25
|
|
|
HC PACEMAKER DC ACCOLADE MRI DR
|
Facility
OP
|
$15,937.50
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
41607168
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$14,821.88 |
| Rate for Payer: Aetna Commercial |
$13,451.25
|
| Rate for Payer: Aetna Medicare |
$5,259.38
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5,259.38
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$9,152.91
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,962.53
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6,048.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,785.31
|
| Rate for Payer: Cash Price |
$9,881.25
|
| Rate for Payer: Cash Price |
$9,881.25
|
| Rate for Payer: Centivo All Commercial |
$8,128.12
|
| Rate for Payer: Cigna All Commercial |
$13,754.06
|
| Rate for Payer: CORVEL All Commercial |
$14,821.88
|
| Rate for Payer: Coventry All Commercial |
$14,025.00
|
| Rate for Payer: Encore All Commercial |
$14,670.47
|
| Rate for Payer: Frontpath All Commercial |
$14,662.50
|
| Rate for Payer: Humana ChoiceCare |
$13,765.22
|
| Rate for Payer: Humana Medicare |
$8,128.12
|
| Rate for Payer: Lucent All Commercial |
$8,128.12
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14,343.75
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$11,953.12
|
| Rate for Payer: PHP All Commercial |
$12,087.00
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$6,215.62
|
| Rate for Payer: Sagamore Health Network All Products |
$12,303.75
|
| Rate for Payer: Signature Care EPO |
$13,228.12
|
| Rate for Payer: Signature Care PPO |
$14,025.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,546.88
|
| Rate for Payer: United Healthcare Commercial |
$12,558.75
|
| Rate for Payer: United Healthcare Medicare |
$5,259.38
|
|
|
HC PACEMAKER DC ACCOLADE MRI DR
|
Facility
IP
|
$15,937.50
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
41607168
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$11,953.12 |
| Max. Negotiated Rate |
$14,821.88 |
| Rate for Payer: Aetna Commercial |
$13,770.00
|
| Rate for Payer: Cash Price |
$9,881.25
|
| Rate for Payer: Cigna All Commercial |
$13,754.06
|
| Rate for Payer: CORVEL All Commercial |
$14,821.88
|
| Rate for Payer: Coventry All Commercial |
$14,025.00
|
| Rate for Payer: Encore All Commercial |
$14,670.47
|
| Rate for Payer: Frontpath All Commercial |
$14,662.50
|
| Rate for Payer: Humana ChoiceCare |
$13,765.22
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14,343.75
|
| Rate for Payer: PHCS All Commercial |
$11,953.12
|
| Rate for Payer: PHP All Commercial |
$12,087.00
|
| Rate for Payer: Sagamore Health Network All Products |
$12,303.75
|
| Rate for Payer: Signature Care EPO |
$13,228.12
|
| Rate for Payer: Signature Care PPO |
$14,025.00
|
| Rate for Payer: United Healthcare Commercial |
$12,558.75
|
|
|
HC PACEMAKER DC ACCOLAD MRI DR EL
|
Facility
OP
|
$16,687.50
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
41607167
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$15,519.38 |
| Rate for Payer: Aetna Commercial |
$14,084.25
|
| Rate for Payer: Aetna Medicare |
$5,506.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5,506.88
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$9,583.63
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$10,431.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6,332.91
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$6,057.56
|
| Rate for Payer: Cash Price |
$10,346.25
|
| Rate for Payer: Cash Price |
$10,346.25
|
| Rate for Payer: Centivo All Commercial |
$8,510.62
|
| Rate for Payer: Cigna All Commercial |
$14,401.31
|
| Rate for Payer: CORVEL All Commercial |
$15,519.38
|
| Rate for Payer: Coventry All Commercial |
$14,685.00
|
| Rate for Payer: Encore All Commercial |
$15,360.84
|
| Rate for Payer: Frontpath All Commercial |
$15,352.50
|
| Rate for Payer: Humana ChoiceCare |
$14,412.99
|
| Rate for Payer: Humana Medicare |
$8,510.62
|
| Rate for Payer: Lucent All Commercial |
$8,510.62
|
| Rate for Payer: Lutheran Preferred All Commercial |
$15,018.75
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$12,515.62
|
| Rate for Payer: PHP All Commercial |
$12,655.80
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$6,508.12
|
| Rate for Payer: Sagamore Health Network All Products |
$12,882.75
|
| Rate for Payer: Signature Care EPO |
$13,850.62
|
| Rate for Payer: Signature Care PPO |
$14,685.00
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$14,184.38
|
| Rate for Payer: United Healthcare Commercial |
$13,149.75
|
| Rate for Payer: United Healthcare Medicare |
$5,506.88
|
|
|
HC PACEMAKER DC ACCOLAD MRI DR EL
|
Facility
IP
|
$16,687.50
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
41607167
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$12,515.62 |
| Max. Negotiated Rate |
$15,519.38 |
| Rate for Payer: Aetna Commercial |
$14,418.00
|
| Rate for Payer: Cash Price |
$10,346.25
|
| Rate for Payer: Cigna All Commercial |
$14,401.31
|
| Rate for Payer: CORVEL All Commercial |
$15,519.38
|
| Rate for Payer: Coventry All Commercial |
$14,685.00
|
| Rate for Payer: Encore All Commercial |
$15,360.84
|
| Rate for Payer: Frontpath All Commercial |
$15,352.50
|
| Rate for Payer: Humana ChoiceCare |
$14,412.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$15,018.75
|
| Rate for Payer: PHCS All Commercial |
$12,515.62
|
| Rate for Payer: PHP All Commercial |
$12,655.80
|
| Rate for Payer: Sagamore Health Network All Products |
$12,882.75
|
| Rate for Payer: Signature Care EPO |
$13,850.62
|
| Rate for Payer: Signature Care PPO |
$14,685.00
|
| Rate for Payer: United Healthcare Commercial |
$13,149.75
|
|
|
HC PACEMAKER DC ASSURIT MRI DR RF
|
Facility
IP
|
$16,098.75
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
41607533
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$12,074.06 |
| Max. Negotiated Rate |
$14,971.84 |
| Rate for Payer: Aetna Commercial |
$13,909.32
|
| Rate for Payer: Cash Price |
$9,981.23
|
| Rate for Payer: Cigna All Commercial |
$13,893.22
|
| Rate for Payer: CORVEL All Commercial |
$14,971.84
|
| Rate for Payer: Coventry All Commercial |
$14,166.90
|
| Rate for Payer: Encore All Commercial |
$14,818.90
|
| Rate for Payer: Frontpath All Commercial |
$14,810.85
|
| Rate for Payer: Humana ChoiceCare |
$13,904.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14,488.88
|
| Rate for Payer: PHCS All Commercial |
$12,074.06
|
| Rate for Payer: PHP All Commercial |
$12,209.29
|
| Rate for Payer: Sagamore Health Network All Products |
$12,428.24
|
| Rate for Payer: Signature Care EPO |
$13,361.96
|
| Rate for Payer: Signature Care PPO |
$14,166.90
|
| Rate for Payer: United Healthcare Commercial |
$12,685.82
|
|
|
HC PACEMAKER DC ASSURIT MRI DR RF
|
Facility
OP
|
$16,098.75
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
41607533
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$14,971.84 |
| Rate for Payer: Aetna Commercial |
$13,587.34
|
| Rate for Payer: Aetna Medicare |
$5,312.59
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5,312.59
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$9,245.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$10,063.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6,109.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,843.85
|
| Rate for Payer: Cash Price |
$9,981.23
|
| Rate for Payer: Cash Price |
$9,981.23
|
| Rate for Payer: Centivo All Commercial |
$8,210.36
|
| Rate for Payer: Cigna All Commercial |
$13,893.22
|
| Rate for Payer: CORVEL All Commercial |
$14,971.84
|
| Rate for Payer: Coventry All Commercial |
$14,166.90
|
| Rate for Payer: Encore All Commercial |
$14,818.90
|
| Rate for Payer: Frontpath All Commercial |
$14,810.85
|
| Rate for Payer: Humana ChoiceCare |
$13,904.49
|
| Rate for Payer: Humana Medicare |
$8,210.36
|
| Rate for Payer: Lucent All Commercial |
$8,210.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14,488.88
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$12,074.06
|
| Rate for Payer: PHP All Commercial |
$12,209.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$6,278.51
|
| Rate for Payer: Sagamore Health Network All Products |
$12,428.24
|
| Rate for Payer: Signature Care EPO |
$13,361.96
|
| Rate for Payer: Signature Care PPO |
$14,166.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,683.94
|
| Rate for Payer: United Healthcare Commercial |
$12,685.82
|
| Rate for Payer: United Healthcare Medicare |
$5,312.59
|
|
|
HC PACEMAKER DC ASSURITY DR RF
|
Facility
OP
|
$16,098.75
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
41607534
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$14,971.84 |
| Rate for Payer: Aetna Commercial |
$13,587.34
|
| Rate for Payer: Aetna Medicare |
$5,312.59
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5,312.59
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$9,245.51
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$10,063.33
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6,109.48
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,843.85
|
| Rate for Payer: Cash Price |
$9,981.23
|
| Rate for Payer: Cash Price |
$9,981.23
|
| Rate for Payer: Centivo All Commercial |
$8,210.36
|
| Rate for Payer: Cigna All Commercial |
$13,893.22
|
| Rate for Payer: CORVEL All Commercial |
$14,971.84
|
| Rate for Payer: Coventry All Commercial |
$14,166.90
|
| Rate for Payer: Encore All Commercial |
$14,818.90
|
| Rate for Payer: Frontpath All Commercial |
$14,810.85
|
| Rate for Payer: Humana ChoiceCare |
$13,904.49
|
| Rate for Payer: Humana Medicare |
$8,210.36
|
| Rate for Payer: Lucent All Commercial |
$8,210.36
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14,488.88
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$12,074.06
|
| Rate for Payer: PHP All Commercial |
$12,209.29
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$6,278.51
|
| Rate for Payer: Sagamore Health Network All Products |
$12,428.24
|
| Rate for Payer: Signature Care EPO |
$13,361.96
|
| Rate for Payer: Signature Care PPO |
$14,166.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,683.94
|
| Rate for Payer: United Healthcare Commercial |
$12,685.82
|
| Rate for Payer: United Healthcare Medicare |
$5,312.59
|
|
|
HC PACEMAKER DC ASSURITY DR RF
|
Facility
IP
|
$16,098.75
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
41607534
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$12,074.06 |
| Max. Negotiated Rate |
$14,971.84 |
| Rate for Payer: Aetna Commercial |
$13,909.32
|
| Rate for Payer: Cash Price |
$9,981.23
|
| Rate for Payer: Cigna All Commercial |
$13,893.22
|
| Rate for Payer: CORVEL All Commercial |
$14,971.84
|
| Rate for Payer: Coventry All Commercial |
$14,166.90
|
| Rate for Payer: Encore All Commercial |
$14,818.90
|
| Rate for Payer: Frontpath All Commercial |
$14,810.85
|
| Rate for Payer: Humana ChoiceCare |
$13,904.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14,488.88
|
| Rate for Payer: PHCS All Commercial |
$12,074.06
|
| Rate for Payer: PHP All Commercial |
$12,209.29
|
| Rate for Payer: Sagamore Health Network All Products |
$12,428.24
|
| Rate for Payer: Signature Care EPO |
$13,361.96
|
| Rate for Payer: Signature Care PPO |
$14,166.90
|
| Rate for Payer: United Healthcare Commercial |
$12,685.82
|
|
|
HC PACEMAKER DC AZURE S DR MRI
|
Facility
IP
|
$15,836.25
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
41607336
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$11,877.19 |
| Max. Negotiated Rate |
$14,727.71 |
| Rate for Payer: Aetna Commercial |
$13,682.52
|
| Rate for Payer: Cash Price |
$9,818.48
|
| Rate for Payer: Cigna All Commercial |
$13,666.68
|
| Rate for Payer: CORVEL All Commercial |
$14,727.71
|
| Rate for Payer: Coventry All Commercial |
$13,935.90
|
| Rate for Payer: Encore All Commercial |
$14,577.27
|
| Rate for Payer: Frontpath All Commercial |
$14,569.35
|
| Rate for Payer: Humana ChoiceCare |
$13,677.77
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14,252.62
|
| Rate for Payer: PHCS All Commercial |
$11,877.19
|
| Rate for Payer: PHP All Commercial |
$12,010.21
|
| Rate for Payer: Sagamore Health Network All Products |
$12,225.58
|
| Rate for Payer: Signature Care EPO |
$13,144.09
|
| Rate for Payer: Signature Care PPO |
$13,935.90
|
| Rate for Payer: United Healthcare Commercial |
$12,478.96
|
|
|
HC PACEMAKER DC AZURE S DR MRI
|
Facility
OP
|
$15,836.25
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
41607336
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$14,727.71 |
| Rate for Payer: Aetna Commercial |
$13,365.80
|
| Rate for Payer: Aetna Medicare |
$5,225.96
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5,225.96
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$9,094.76
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$9,899.24
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6,009.86
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$5,748.56
|
| Rate for Payer: Cash Price |
$9,818.48
|
| Rate for Payer: Cash Price |
$9,818.48
|
| Rate for Payer: Centivo All Commercial |
$8,076.49
|
| Rate for Payer: Cigna All Commercial |
$13,666.68
|
| Rate for Payer: CORVEL All Commercial |
$14,727.71
|
| Rate for Payer: Coventry All Commercial |
$13,935.90
|
| Rate for Payer: Encore All Commercial |
$14,577.27
|
| Rate for Payer: Frontpath All Commercial |
$14,569.35
|
| Rate for Payer: Humana ChoiceCare |
$13,677.77
|
| Rate for Payer: Humana Medicare |
$8,076.49
|
| Rate for Payer: Lucent All Commercial |
$8,076.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$14,252.62
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$11,877.19
|
| Rate for Payer: PHP All Commercial |
$12,010.21
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$6,176.14
|
| Rate for Payer: Sagamore Health Network All Products |
$12,225.58
|
| Rate for Payer: Signature Care EPO |
$13,144.09
|
| Rate for Payer: Signature Care PPO |
$13,935.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$13,460.81
|
| Rate for Payer: United Healthcare Commercial |
$12,478.96
|
| Rate for Payer: United Healthcare Medicare |
$5,225.96
|
|
|
HC PACEMAKER DC AZURE XT DR MRI
|
Facility
OP
|
$17,991.53
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
41607335
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$16,732.12 |
| Rate for Payer: Aetna Commercial |
$15,184.85
|
| Rate for Payer: Aetna Medicare |
$5,937.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5,937.20
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$10,332.54
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$11,246.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6,827.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$6,530.93
|
| Rate for Payer: Cash Price |
$11,154.75
|
| Rate for Payer: Cash Price |
$11,154.75
|
| Rate for Payer: Centivo All Commercial |
$9,175.68
|
| Rate for Payer: Cigna All Commercial |
$15,526.69
|
| Rate for Payer: CORVEL All Commercial |
$16,732.12
|
| Rate for Payer: Coventry All Commercial |
$15,832.55
|
| Rate for Payer: Encore All Commercial |
$16,561.20
|
| Rate for Payer: Frontpath All Commercial |
$16,552.21
|
| Rate for Payer: Humana ChoiceCare |
$15,539.28
|
| Rate for Payer: Humana Medicare |
$9,175.68
|
| Rate for Payer: Lucent All Commercial |
$9,175.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$16,192.38
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$13,493.65
|
| Rate for Payer: PHP All Commercial |
$13,644.78
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$7,016.70
|
| Rate for Payer: Sagamore Health Network All Products |
$13,889.46
|
| Rate for Payer: Signature Care EPO |
$14,932.97
|
| Rate for Payer: Signature Care PPO |
$15,832.55
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$15,292.80
|
| Rate for Payer: United Healthcare Commercial |
$14,177.33
|
| Rate for Payer: United Healthcare Medicare |
$5,937.20
|
|
|
HC PACEMAKER DC AZURE XT DR MRI
|
Facility
IP
|
$17,991.53
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
41607335
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$13,493.65 |
| Max. Negotiated Rate |
$16,732.12 |
| Rate for Payer: Aetna Commercial |
$15,544.68
|
| Rate for Payer: Cash Price |
$11,154.75
|
| Rate for Payer: Cigna All Commercial |
$15,526.69
|
| Rate for Payer: CORVEL All Commercial |
$16,732.12
|
| Rate for Payer: Coventry All Commercial |
$15,832.55
|
| Rate for Payer: Encore All Commercial |
$16,561.20
|
| Rate for Payer: Frontpath All Commercial |
$16,552.21
|
| Rate for Payer: Humana ChoiceCare |
$15,539.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$16,192.38
|
| Rate for Payer: PHCS All Commercial |
$13,493.65
|
| Rate for Payer: PHP All Commercial |
$13,644.78
|
| Rate for Payer: Sagamore Health Network All Products |
$13,889.46
|
| Rate for Payer: Signature Care EPO |
$14,932.97
|
| Rate for Payer: Signature Care PPO |
$15,832.55
|
| Rate for Payer: United Healthcare Commercial |
$14,177.33
|
|
|
HC PACEMAKER DC ENDURITY DR
|
Facility
OP
|
$13,061.25
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
41607535
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$12,146.96 |
| Rate for Payer: Aetna Commercial |
$11,023.70
|
| Rate for Payer: Aetna Medicare |
$4,310.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$4,310.21
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$7,501.08
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$8,164.59
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4,956.74
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$4,741.23
|
| Rate for Payer: Cash Price |
$8,097.98
|
| Rate for Payer: Cash Price |
$8,097.98
|
| Rate for Payer: Centivo All Commercial |
$6,661.24
|
| Rate for Payer: Cigna All Commercial |
$11,271.86
|
| Rate for Payer: CORVEL All Commercial |
$12,146.96
|
| Rate for Payer: Coventry All Commercial |
$11,493.90
|
| Rate for Payer: Encore All Commercial |
$12,022.88
|
| Rate for Payer: Frontpath All Commercial |
$12,016.35
|
| Rate for Payer: Humana ChoiceCare |
$11,281.00
|
| Rate for Payer: Humana Medicare |
$6,661.24
|
| Rate for Payer: Lucent All Commercial |
$6,661.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,755.12
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$9,795.94
|
| Rate for Payer: PHP All Commercial |
$9,905.65
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$5,093.89
|
| Rate for Payer: Sagamore Health Network All Products |
$10,083.28
|
| Rate for Payer: Signature Care EPO |
$10,840.84
|
| Rate for Payer: Signature Care PPO |
$11,493.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$11,102.06
|
| Rate for Payer: United Healthcare Commercial |
$10,292.26
|
| Rate for Payer: United Healthcare Medicare |
$4,310.21
|
|
|
HC PACEMAKER DC ENDURITY DR
|
Facility
IP
|
$13,061.25
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
41607535
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$9,795.94 |
| Max. Negotiated Rate |
$12,146.96 |
| Rate for Payer: Aetna Commercial |
$11,284.92
|
| Rate for Payer: Cash Price |
$8,097.98
|
| Rate for Payer: Cigna All Commercial |
$11,271.86
|
| Rate for Payer: CORVEL All Commercial |
$12,146.96
|
| Rate for Payer: Coventry All Commercial |
$11,493.90
|
| Rate for Payer: Encore All Commercial |
$12,022.88
|
| Rate for Payer: Frontpath All Commercial |
$12,016.35
|
| Rate for Payer: Humana ChoiceCare |
$11,281.00
|
| Rate for Payer: Lutheran Preferred All Commercial |
$11,755.12
|
| Rate for Payer: PHCS All Commercial |
$9,795.94
|
| Rate for Payer: PHP All Commercial |
$9,905.65
|
| Rate for Payer: Sagamore Health Network All Products |
$10,083.28
|
| Rate for Payer: Signature Care EPO |
$10,840.84
|
| Rate for Payer: Signature Care PPO |
$11,493.90
|
| Rate for Payer: United Healthcare Commercial |
$10,292.26
|
|
|
HC PACEMAKER DC ZEPHYR DR
|
Facility
OP
|
$17,820.00
|
|
|
Service Code
|
CPT C1785
|
| Hospital Charge Code |
41607537
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$82.84 |
| Max. Negotiated Rate |
$16,572.60 |
| Rate for Payer: Aetna Commercial |
$15,040.08
|
| Rate for Payer: Aetna Medicare |
$5,880.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$5,880.60
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Exchange |
$10,234.03
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$11,139.28
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$82.84
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$6,762.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$6,468.66
|
| Rate for Payer: Cash Price |
$11,048.40
|
| Rate for Payer: Cash Price |
$11,048.40
|
| Rate for Payer: Centivo All Commercial |
$9,088.20
|
| Rate for Payer: Cigna All Commercial |
$15,378.66
|
| Rate for Payer: CORVEL All Commercial |
$16,572.60
|
| Rate for Payer: Coventry All Commercial |
$15,681.60
|
| Rate for Payer: Encore All Commercial |
$16,403.31
|
| Rate for Payer: Frontpath All Commercial |
$16,394.40
|
| Rate for Payer: Humana ChoiceCare |
$15,391.13
|
| Rate for Payer: Humana Medicare |
$9,088.20
|
| Rate for Payer: Lucent All Commercial |
$9,088.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$16,038.00
|
| Rate for Payer: Managed Health Services Medicaid |
$82.84
|
| Rate for Payer: MDWise Medicaid |
$82.84
|
| Rate for Payer: PHCS All Commercial |
$13,365.00
|
| Rate for Payer: PHP All Commercial |
$13,514.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$6,949.80
|
| Rate for Payer: Sagamore Health Network All Products |
$13,757.04
|
| Rate for Payer: Signature Care EPO |
$14,790.60
|
| Rate for Payer: Signature Care PPO |
$15,681.60
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$15,147.00
|
| Rate for Payer: United Healthcare Commercial |
$14,042.16
|
| Rate for Payer: United Healthcare Medicare |
$5,880.60
|
|
