|
HC TELEMETRY MONITORING PER DAY
|
Facility
|
OP
|
$254.59
|
|
| Hospital Charge Code |
1950195
|
|
Hospital Revenue Code
|
732
|
| Min. Negotiated Rate |
$60.48 |
| Max. Negotiated Rate |
$236.77 |
| Rate for Payer: Aetna Commercial |
$214.87
|
| Rate for Payer: Aetna Medicare |
$81.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$60.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$78.92
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$146.21
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$159.14
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$60.48
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$93.69
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$89.62
|
| Rate for Payer: Cash Price |
$152.75
|
| Rate for Payer: Cash Price |
$152.75
|
| Rate for Payer: Centivo All Commercial |
$138.50
|
| Rate for Payer: Cigna All Commercial |
$219.71
|
| Rate for Payer: CORVEL All Commercial |
$236.77
|
| Rate for Payer: Coventry All Commercial |
$224.04
|
| Rate for Payer: Encore All Commercial |
$234.35
|
| Rate for Payer: Frontpath All Commercial |
$234.22
|
| Rate for Payer: Humana ChoiceCare |
$219.89
|
| Rate for Payer: Humana Medicare |
$81.47
|
| Rate for Payer: Lucent All Commercial |
$138.50
|
| Rate for Payer: Lutheran Preferred All Commercial |
$229.13
|
| Rate for Payer: Managed Health Services Medicaid |
$60.48
|
| Rate for Payer: MDWise Medicaid |
$60.48
|
| Rate for Payer: PHCS All Commercial |
$190.94
|
| Rate for Payer: PHP All Commercial |
$193.08
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$99.29
|
| Rate for Payer: Sagamore Health Network All Products |
$196.54
|
| Rate for Payer: Signature Care EPO |
$211.31
|
| Rate for Payer: Signature Care PPO |
$224.04
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$216.40
|
| Rate for Payer: United Healthcare Commercial |
$200.62
|
| Rate for Payer: United Healthcare Medicare |
$81.47
|
|
|
HC TEMP SKIN SENSOR ADULT
|
Facility
|
IP
|
$11.05
|
|
| Hospital Charge Code |
41607464
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.29 |
| Max. Negotiated Rate |
$10.28 |
| Rate for Payer: Aetna Commercial |
$9.55
|
| Rate for Payer: Cash Price |
$6.63
|
| Rate for Payer: Cigna All Commercial |
$9.54
|
| Rate for Payer: CORVEL All Commercial |
$10.28
|
| Rate for Payer: Coventry All Commercial |
$9.72
|
| Rate for Payer: Encore All Commercial |
$10.17
|
| Rate for Payer: Frontpath All Commercial |
$10.17
|
| Rate for Payer: Humana ChoiceCare |
$9.54
|
| Rate for Payer: Lutheran Preferred All Commercial |
$9.95
|
| Rate for Payer: PHCS All Commercial |
$8.29
|
| Rate for Payer: PHP All Commercial |
$8.38
|
| Rate for Payer: Sagamore Health Network All Products |
$8.53
|
| Rate for Payer: Signature Care EPO |
$9.17
|
| Rate for Payer: Signature Care PPO |
$9.72
|
| Rate for Payer: United Healthcare Commercial |
$8.71
|
|
|
HC TEMP SKIN SENSOR ADULT
|
Facility
|
OP
|
$11.05
|
|
| Hospital Charge Code |
41607464
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.43 |
| Max. Negotiated Rate |
$31.20 |
| Rate for Payer: Aetna Commercial |
$9.33
|
| Rate for Payer: Aetna Medicare |
$3.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$3.43
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$6.35
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$6.91
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$4.07
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$3.89
|
| Rate for Payer: Cash Price |
$6.63
|
| Rate for Payer: Cash Price |
$6.63
|
| Rate for Payer: Centivo All Commercial |
$6.01
|
| Rate for Payer: Cigna All Commercial |
$9.54
|
| Rate for Payer: CORVEL All Commercial |
$10.28
|
| Rate for Payer: Coventry All Commercial |
$9.72
|
| Rate for Payer: Encore All Commercial |
$10.17
|
| Rate for Payer: Frontpath All Commercial |
$10.17
|
| Rate for Payer: Humana ChoiceCare |
$9.54
|
| Rate for Payer: Humana Medicare |
$3.54
|
| Rate for Payer: Lucent All Commercial |
$6.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$9.95
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$8.29
|
| Rate for Payer: PHP All Commercial |
$8.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$4.31
|
| Rate for Payer: Sagamore Health Network All Products |
$8.53
|
| Rate for Payer: Signature Care EPO |
$9.17
|
| Rate for Payer: Signature Care PPO |
$9.72
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$9.39
|
| Rate for Payer: United Healthcare Commercial |
$8.71
|
| Rate for Payer: United Healthcare Medicare |
$3.54
|
|
|
HC TESTOSTERONE FREE
|
Facility
|
IP
|
$218.47
|
|
|
Service Code
|
CPT 84402
|
| Hospital Charge Code |
63001682
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$163.85 |
| Max. Negotiated Rate |
$203.18 |
| Rate for Payer: Aetna Commercial |
$188.76
|
| Rate for Payer: Cash Price |
$131.08
|
| Rate for Payer: Cigna All Commercial |
$188.54
|
| Rate for Payer: CORVEL All Commercial |
$203.18
|
| Rate for Payer: Coventry All Commercial |
$192.25
|
| Rate for Payer: Encore All Commercial |
$201.10
|
| Rate for Payer: Frontpath All Commercial |
$200.99
|
| Rate for Payer: Humana ChoiceCare |
$188.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$196.62
|
| Rate for Payer: PHCS All Commercial |
$163.85
|
| Rate for Payer: PHP All Commercial |
$165.69
|
| Rate for Payer: Sagamore Health Network All Products |
$168.66
|
| Rate for Payer: Signature Care EPO |
$181.33
|
| Rate for Payer: Signature Care PPO |
$192.25
|
| Rate for Payer: United Healthcare Commercial |
$172.15
|
|
|
HC TESTOSTERONE FREE
|
Facility
|
OP
|
$218.47
|
|
|
Service Code
|
CPT 84402
|
| Hospital Charge Code |
63001682
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.47 |
| Max. Negotiated Rate |
$203.18 |
| Rate for Payer: Aetna Commercial |
$184.39
|
| Rate for Payer: Aetna Medicare |
$69.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$25.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$67.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$100.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$100.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$25.47
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$80.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$76.90
|
| Rate for Payer: Cash Price |
$131.08
|
| Rate for Payer: Cash Price |
$131.08
|
| Rate for Payer: Centivo All Commercial |
$118.85
|
| Rate for Payer: Cigna All Commercial |
$188.54
|
| Rate for Payer: CORVEL All Commercial |
$203.18
|
| Rate for Payer: Coventry All Commercial |
$192.25
|
| Rate for Payer: Encore All Commercial |
$201.10
|
| Rate for Payer: Frontpath All Commercial |
$200.99
|
| Rate for Payer: Humana ChoiceCare |
$188.69
|
| Rate for Payer: Humana Medicare |
$69.91
|
| Rate for Payer: Lucent All Commercial |
$118.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$196.62
|
| Rate for Payer: Managed Health Services Medicaid |
$25.47
|
| Rate for Payer: MDWise Medicaid |
$25.47
|
| Rate for Payer: PHCS All Commercial |
$163.85
|
| Rate for Payer: PHP All Commercial |
$165.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$85.20
|
| Rate for Payer: Sagamore Health Network All Products |
$168.66
|
| Rate for Payer: Signature Care EPO |
$181.33
|
| Rate for Payer: Signature Care PPO |
$192.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$185.70
|
| Rate for Payer: United Healthcare Commercial |
$172.15
|
| Rate for Payer: United Healthcare Medicare |
$69.91
|
|
|
HC TESTOSTERONE FREE-LC-MS/MS(FEMALE/CHILD)
|
Facility
|
IP
|
$218.47
|
|
|
Service Code
|
CPT 84402
|
| Hospital Charge Code |
63001683
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$163.85 |
| Max. Negotiated Rate |
$203.18 |
| Rate for Payer: Aetna Commercial |
$188.76
|
| Rate for Payer: Cash Price |
$131.08
|
| Rate for Payer: Cigna All Commercial |
$188.54
|
| Rate for Payer: CORVEL All Commercial |
$203.18
|
| Rate for Payer: Coventry All Commercial |
$192.25
|
| Rate for Payer: Encore All Commercial |
$201.10
|
| Rate for Payer: Frontpath All Commercial |
$200.99
|
| Rate for Payer: Humana ChoiceCare |
$188.69
|
| Rate for Payer: Lutheran Preferred All Commercial |
$196.62
|
| Rate for Payer: PHCS All Commercial |
$163.85
|
| Rate for Payer: PHP All Commercial |
$165.69
|
| Rate for Payer: Sagamore Health Network All Products |
$168.66
|
| Rate for Payer: Signature Care EPO |
$181.33
|
| Rate for Payer: Signature Care PPO |
$192.25
|
| Rate for Payer: United Healthcare Commercial |
$172.15
|
|
|
HC TESTOSTERONE FREE-LC-MS/MS(FEMALE/CHILD)
|
Facility
|
OP
|
$218.47
|
|
|
Service Code
|
CPT 84402
|
| Hospital Charge Code |
63001683
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.47 |
| Max. Negotiated Rate |
$203.18 |
| Rate for Payer: Aetna Commercial |
$184.39
|
| Rate for Payer: Aetna Medicare |
$69.91
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$25.47
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$67.73
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$100.41
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$100.41
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$25.47
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$80.40
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$76.90
|
| Rate for Payer: Cash Price |
$131.08
|
| Rate for Payer: Cash Price |
$131.08
|
| Rate for Payer: Centivo All Commercial |
$118.85
|
| Rate for Payer: Cigna All Commercial |
$188.54
|
| Rate for Payer: CORVEL All Commercial |
$203.18
|
| Rate for Payer: Coventry All Commercial |
$192.25
|
| Rate for Payer: Encore All Commercial |
$201.10
|
| Rate for Payer: Frontpath All Commercial |
$200.99
|
| Rate for Payer: Humana ChoiceCare |
$188.69
|
| Rate for Payer: Humana Medicare |
$69.91
|
| Rate for Payer: Lucent All Commercial |
$118.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$196.62
|
| Rate for Payer: Managed Health Services Medicaid |
$25.47
|
| Rate for Payer: MDWise Medicaid |
$25.47
|
| Rate for Payer: PHCS All Commercial |
$163.85
|
| Rate for Payer: PHP All Commercial |
$165.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$85.20
|
| Rate for Payer: Sagamore Health Network All Products |
$168.66
|
| Rate for Payer: Signature Care EPO |
$181.33
|
| Rate for Payer: Signature Care PPO |
$192.25
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$185.70
|
| Rate for Payer: United Healthcare Commercial |
$172.15
|
| Rate for Payer: United Healthcare Medicare |
$69.91
|
|
|
HC TESTOSTERONE TOTAL
|
Facility
|
IP
|
$277.40
|
|
|
Service Code
|
CPT 84403
|
| Hospital Charge Code |
63001161
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$208.05 |
| Max. Negotiated Rate |
$257.98 |
| Rate for Payer: Aetna Commercial |
$239.67
|
| Rate for Payer: Cash Price |
$166.44
|
| Rate for Payer: Cigna All Commercial |
$239.40
|
| Rate for Payer: CORVEL All Commercial |
$257.98
|
| Rate for Payer: Coventry All Commercial |
$244.11
|
| Rate for Payer: Encore All Commercial |
$255.35
|
| Rate for Payer: Frontpath All Commercial |
$255.21
|
| Rate for Payer: Humana ChoiceCare |
$239.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$249.66
|
| Rate for Payer: PHCS All Commercial |
$208.05
|
| Rate for Payer: PHP All Commercial |
$210.38
|
| Rate for Payer: Sagamore Health Network All Products |
$214.15
|
| Rate for Payer: Signature Care EPO |
$230.24
|
| Rate for Payer: Signature Care PPO |
$244.11
|
| Rate for Payer: United Healthcare Commercial |
$218.59
|
|
|
HC TESTOSTERONE TOTAL
|
Facility
|
OP
|
$277.40
|
|
|
Service Code
|
CPT 84403
|
| Hospital Charge Code |
63001161
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.81 |
| Max. Negotiated Rate |
$257.98 |
| Rate for Payer: Aetna Commercial |
$234.13
|
| Rate for Payer: Aetna Medicare |
$88.77
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$25.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$85.99
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$127.49
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$127.49
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$25.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$102.08
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$97.64
|
| Rate for Payer: Cash Price |
$166.44
|
| Rate for Payer: Cash Price |
$166.44
|
| Rate for Payer: Centivo All Commercial |
$150.91
|
| Rate for Payer: Cigna All Commercial |
$239.40
|
| Rate for Payer: CORVEL All Commercial |
$257.98
|
| Rate for Payer: Coventry All Commercial |
$244.11
|
| Rate for Payer: Encore All Commercial |
$255.35
|
| Rate for Payer: Frontpath All Commercial |
$255.21
|
| Rate for Payer: Humana ChoiceCare |
$239.59
|
| Rate for Payer: Humana Medicare |
$88.77
|
| Rate for Payer: Lucent All Commercial |
$150.91
|
| Rate for Payer: Lutheran Preferred All Commercial |
$249.66
|
| Rate for Payer: Managed Health Services Medicaid |
$25.81
|
| Rate for Payer: MDWise Medicaid |
$25.81
|
| Rate for Payer: PHCS All Commercial |
$208.05
|
| Rate for Payer: PHP All Commercial |
$210.38
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$108.19
|
| Rate for Payer: Sagamore Health Network All Products |
$214.15
|
| Rate for Payer: Signature Care EPO |
$230.24
|
| Rate for Payer: Signature Care PPO |
$244.11
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$235.79
|
| Rate for Payer: United Healthcare Commercial |
$218.59
|
| Rate for Payer: United Healthcare Medicare |
$88.77
|
|
|
HC TETANUS/DIPHTHERIA ANTIBODY PROFILE
|
Facility
|
IP
|
$57.38
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
63044041
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$43.03 |
| Max. Negotiated Rate |
$53.36 |
| Rate for Payer: Aetna Commercial |
$49.58
|
| Rate for Payer: Cash Price |
$34.43
|
| Rate for Payer: Cigna All Commercial |
$49.52
|
| Rate for Payer: CORVEL All Commercial |
$53.36
|
| Rate for Payer: Coventry All Commercial |
$50.49
|
| Rate for Payer: Encore All Commercial |
$52.82
|
| Rate for Payer: Frontpath All Commercial |
$52.79
|
| Rate for Payer: Humana ChoiceCare |
$49.56
|
| Rate for Payer: Lutheran Preferred All Commercial |
$51.64
|
| Rate for Payer: PHCS All Commercial |
$43.03
|
| Rate for Payer: PHP All Commercial |
$43.52
|
| Rate for Payer: Sagamore Health Network All Products |
$44.30
|
| Rate for Payer: Signature Care EPO |
$47.63
|
| Rate for Payer: Signature Care PPO |
$50.49
|
| Rate for Payer: United Healthcare Commercial |
$45.22
|
|
|
HC TETANUS/DIPHTHERIA ANTIBODY PROFILE
|
Facility
|
OP
|
$57.38
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
63044041
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.99 |
| Max. Negotiated Rate |
$53.36 |
| Rate for Payer: Aetna Commercial |
$48.43
|
| Rate for Payer: Aetna Medicare |
$18.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$14.99
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$17.79
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$26.37
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$26.37
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$14.99
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$21.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$20.20
|
| Rate for Payer: Cash Price |
$34.43
|
| Rate for Payer: Cash Price |
$34.43
|
| Rate for Payer: Centivo All Commercial |
$31.21
|
| Rate for Payer: Cigna All Commercial |
$49.52
|
| Rate for Payer: CORVEL All Commercial |
$53.36
|
| Rate for Payer: Coventry All Commercial |
$50.49
|
| Rate for Payer: Encore All Commercial |
$52.82
|
| Rate for Payer: Frontpath All Commercial |
$52.79
|
| Rate for Payer: Humana ChoiceCare |
$49.56
|
| Rate for Payer: Humana Medicare |
$18.36
|
| Rate for Payer: Lucent All Commercial |
$31.21
|
| Rate for Payer: Lutheran Preferred All Commercial |
$51.64
|
| Rate for Payer: Managed Health Services Medicaid |
$14.99
|
| Rate for Payer: MDWise Medicaid |
$14.99
|
| Rate for Payer: PHCS All Commercial |
$43.03
|
| Rate for Payer: PHP All Commercial |
$43.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$22.38
|
| Rate for Payer: Sagamore Health Network All Products |
$44.30
|
| Rate for Payer: Signature Care EPO |
$47.63
|
| Rate for Payer: Signature Care PPO |
$50.49
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$48.77
|
| Rate for Payer: United Healthcare Commercial |
$45.22
|
| Rate for Payer: United Healthcare Medicare |
$18.36
|
|
|
HC TETANUS IGG ANTIBODY
|
Facility
|
IP
|
$420.55
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
63001047
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$315.41 |
| Max. Negotiated Rate |
$391.11 |
| Rate for Payer: Aetna Commercial |
$363.36
|
| Rate for Payer: Cash Price |
$252.33
|
| Rate for Payer: Cigna All Commercial |
$362.93
|
| Rate for Payer: CORVEL All Commercial |
$391.11
|
| Rate for Payer: Coventry All Commercial |
$370.08
|
| Rate for Payer: Encore All Commercial |
$387.12
|
| Rate for Payer: Frontpath All Commercial |
$386.91
|
| Rate for Payer: Humana ChoiceCare |
$363.23
|
| Rate for Payer: Lutheran Preferred All Commercial |
$378.50
|
| Rate for Payer: PHCS All Commercial |
$315.41
|
| Rate for Payer: PHP All Commercial |
$318.95
|
| Rate for Payer: Sagamore Health Network All Products |
$324.66
|
| Rate for Payer: Signature Care EPO |
$349.06
|
| Rate for Payer: Signature Care PPO |
$370.08
|
| Rate for Payer: United Healthcare Commercial |
$331.39
|
|
|
HC TETANUS IGG ANTIBODY
|
Facility
|
OP
|
$420.55
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
63001047
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.99 |
| Max. Negotiated Rate |
$391.11 |
| Rate for Payer: Aetna Commercial |
$354.94
|
| Rate for Payer: Aetna Medicare |
$134.58
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$14.99
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$130.37
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$193.28
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$193.28
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$14.99
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$154.76
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$148.03
|
| Rate for Payer: Cash Price |
$252.33
|
| Rate for Payer: Cash Price |
$252.33
|
| Rate for Payer: Centivo All Commercial |
$228.78
|
| Rate for Payer: Cigna All Commercial |
$362.93
|
| Rate for Payer: CORVEL All Commercial |
$391.11
|
| Rate for Payer: Coventry All Commercial |
$370.08
|
| Rate for Payer: Encore All Commercial |
$387.12
|
| Rate for Payer: Frontpath All Commercial |
$386.91
|
| Rate for Payer: Humana ChoiceCare |
$363.23
|
| Rate for Payer: Humana Medicare |
$134.58
|
| Rate for Payer: Lucent All Commercial |
$228.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$378.50
|
| Rate for Payer: Managed Health Services Medicaid |
$14.99
|
| Rate for Payer: MDWise Medicaid |
$14.99
|
| Rate for Payer: PHCS All Commercial |
$315.41
|
| Rate for Payer: PHP All Commercial |
$318.95
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$164.01
|
| Rate for Payer: Sagamore Health Network All Products |
$324.66
|
| Rate for Payer: Signature Care EPO |
$349.06
|
| Rate for Payer: Signature Care PPO |
$370.08
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$357.47
|
| Rate for Payer: United Healthcare Commercial |
$331.39
|
| Rate for Payer: United Healthcare Medicare |
$134.58
|
|
|
HC THER ACTIVITIES/15 MIN-OT
|
Facility
|
OP
|
$140.00
|
|
|
Service Code
|
CPT 97530 GO
|
| Hospital Charge Code |
1738087
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$130.20 |
| Rate for Payer: Aetna Commercial |
$118.16
|
| Rate for Payer: Aetna Medicare |
$44.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$47.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$43.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$80.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$87.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$47.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$51.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$49.28
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Centivo All Commercial |
$76.16
|
| Rate for Payer: Cigna All Commercial |
$120.82
|
| Rate for Payer: CORVEL All Commercial |
$130.20
|
| Rate for Payer: Coventry All Commercial |
$123.20
|
| Rate for Payer: Encore All Commercial |
$128.87
|
| Rate for Payer: Frontpath All Commercial |
$128.80
|
| Rate for Payer: Humana ChoiceCare |
$120.92
|
| Rate for Payer: Humana Medicare |
$44.80
|
| Rate for Payer: Lucent All Commercial |
$76.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$126.00
|
| Rate for Payer: Managed Health Services Medicaid |
$47.81
|
| Rate for Payer: MDWise Medicaid |
$47.81
|
| Rate for Payer: PHCS All Commercial |
$105.00
|
| Rate for Payer: PHP All Commercial |
$106.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$54.60
|
| Rate for Payer: Sagamore Health Network All Products |
$108.08
|
| Rate for Payer: Signature Care EPO |
$116.20
|
| Rate for Payer: Signature Care PPO |
$123.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$119.00
|
| Rate for Payer: United Healthcare Commercial |
$110.32
|
| Rate for Payer: United Healthcare Medicare |
$44.80
|
|
|
HC THER ACTIVITIES/15 MIN-OT
|
Facility
|
IP
|
$140.00
|
|
|
Service Code
|
CPT 97530 GO
|
| Hospital Charge Code |
1738087
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$105.00 |
| Max. Negotiated Rate |
$130.20 |
| Rate for Payer: Aetna Commercial |
$120.96
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cigna All Commercial |
$120.82
|
| Rate for Payer: CORVEL All Commercial |
$130.20
|
| Rate for Payer: Coventry All Commercial |
$123.20
|
| Rate for Payer: Encore All Commercial |
$128.87
|
| Rate for Payer: Frontpath All Commercial |
$128.80
|
| Rate for Payer: Humana ChoiceCare |
$120.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$126.00
|
| Rate for Payer: PHCS All Commercial |
$105.00
|
| Rate for Payer: PHP All Commercial |
$106.18
|
| Rate for Payer: Sagamore Health Network All Products |
$108.08
|
| Rate for Payer: Signature Care EPO |
$116.20
|
| Rate for Payer: Signature Care PPO |
$123.20
|
| Rate for Payer: United Healthcare Commercial |
$110.32
|
|
|
HC THERAPEUTIC ACTIV/15 MIN-PT
|
Facility
|
IP
|
$137.53
|
|
|
Service Code
|
CPT 97530 GP
|
| Hospital Charge Code |
1728077
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$103.15 |
| Max. Negotiated Rate |
$127.90 |
| Rate for Payer: Aetna Commercial |
$118.83
|
| Rate for Payer: Cash Price |
$82.52
|
| Rate for Payer: Cigna All Commercial |
$118.69
|
| Rate for Payer: CORVEL All Commercial |
$127.90
|
| Rate for Payer: Coventry All Commercial |
$121.03
|
| Rate for Payer: Encore All Commercial |
$126.60
|
| Rate for Payer: Frontpath All Commercial |
$126.53
|
| Rate for Payer: Humana ChoiceCare |
$118.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$123.78
|
| Rate for Payer: PHCS All Commercial |
$103.15
|
| Rate for Payer: PHP All Commercial |
$104.30
|
| Rate for Payer: Sagamore Health Network All Products |
$106.17
|
| Rate for Payer: Signature Care EPO |
$114.15
|
| Rate for Payer: Signature Care PPO |
$121.03
|
| Rate for Payer: United Healthcare Commercial |
$108.37
|
|
|
HC THERAPEUTIC ACTIV/15 MIN-PT
|
Facility
|
OP
|
$137.53
|
|
|
Service Code
|
CPT 97530 GP
|
| Hospital Charge Code |
1728077
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$42.63 |
| Max. Negotiated Rate |
$127.90 |
| Rate for Payer: Aetna Commercial |
$116.08
|
| Rate for Payer: Aetna Medicare |
$44.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$47.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$42.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$78.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$85.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$47.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$50.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$48.41
|
| Rate for Payer: Cash Price |
$82.52
|
| Rate for Payer: Cash Price |
$82.52
|
| Rate for Payer: Centivo All Commercial |
$74.82
|
| Rate for Payer: Cigna All Commercial |
$118.69
|
| Rate for Payer: CORVEL All Commercial |
$127.90
|
| Rate for Payer: Coventry All Commercial |
$121.03
|
| Rate for Payer: Encore All Commercial |
$126.60
|
| Rate for Payer: Frontpath All Commercial |
$126.53
|
| Rate for Payer: Humana ChoiceCare |
$118.78
|
| Rate for Payer: Humana Medicare |
$44.01
|
| Rate for Payer: Lucent All Commercial |
$74.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$123.78
|
| Rate for Payer: Managed Health Services Medicaid |
$47.81
|
| Rate for Payer: MDWise Medicaid |
$47.81
|
| Rate for Payer: PHCS All Commercial |
$103.15
|
| Rate for Payer: PHP All Commercial |
$104.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$53.64
|
| Rate for Payer: Sagamore Health Network All Products |
$106.17
|
| Rate for Payer: Signature Care EPO |
$114.15
|
| Rate for Payer: Signature Care PPO |
$121.03
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$116.90
|
| Rate for Payer: United Healthcare Commercial |
$108.37
|
| Rate for Payer: United Healthcare Medicare |
$44.01
|
|
|
HC THERAPEUTIC PHLEBOTOMY
|
Facility
|
IP
|
$264.07
|
|
|
Service Code
|
CPT 99195
|
| Hospital Charge Code |
529195
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$198.05 |
| Max. Negotiated Rate |
$245.59 |
| Rate for Payer: Aetna Commercial |
$228.16
|
| Rate for Payer: Cash Price |
$158.44
|
| Rate for Payer: Cigna All Commercial |
$227.89
|
| Rate for Payer: CORVEL All Commercial |
$245.59
|
| Rate for Payer: Coventry All Commercial |
$232.38
|
| Rate for Payer: Encore All Commercial |
$243.08
|
| Rate for Payer: Frontpath All Commercial |
$242.94
|
| Rate for Payer: Humana ChoiceCare |
$228.08
|
| Rate for Payer: Lutheran Preferred All Commercial |
$237.66
|
| Rate for Payer: PHCS All Commercial |
$198.05
|
| Rate for Payer: PHP All Commercial |
$200.27
|
| Rate for Payer: Sagamore Health Network All Products |
$203.86
|
| Rate for Payer: Signature Care EPO |
$219.18
|
| Rate for Payer: Signature Care PPO |
$232.38
|
| Rate for Payer: United Healthcare Commercial |
$208.09
|
|
|
HC THERAPEUTIC PHLEBOTOMY
|
Facility
|
OP
|
$264.07
|
|
|
Service Code
|
CPT 99195
|
| Hospital Charge Code |
529195
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$81.86 |
| Max. Negotiated Rate |
$245.59 |
| Rate for Payer: Aetna Commercial |
$222.88
|
| Rate for Payer: Aetna Medicare |
$84.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$105.04
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$81.86
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$151.66
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$165.07
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$105.04
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$97.18
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$92.95
|
| Rate for Payer: Cash Price |
$158.44
|
| Rate for Payer: Cash Price |
$158.44
|
| Rate for Payer: Centivo All Commercial |
$143.65
|
| Rate for Payer: Cigna All Commercial |
$227.89
|
| Rate for Payer: CORVEL All Commercial |
$245.59
|
| Rate for Payer: Coventry All Commercial |
$232.38
|
| Rate for Payer: Encore All Commercial |
$243.08
|
| Rate for Payer: Frontpath All Commercial |
$242.94
|
| Rate for Payer: Humana ChoiceCare |
$228.08
|
| Rate for Payer: Humana Medicare |
$84.50
|
| Rate for Payer: Lucent All Commercial |
$143.65
|
| Rate for Payer: Lutheran Preferred All Commercial |
$237.66
|
| Rate for Payer: Managed Health Services Medicaid |
$105.04
|
| Rate for Payer: MDWise Medicaid |
$105.04
|
| Rate for Payer: PHCS All Commercial |
$198.05
|
| Rate for Payer: PHP All Commercial |
$200.27
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$102.99
|
| Rate for Payer: Sagamore Health Network All Products |
$203.86
|
| Rate for Payer: Signature Care EPO |
$219.18
|
| Rate for Payer: Signature Care PPO |
$232.38
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$224.46
|
| Rate for Payer: United Healthcare Commercial |
$208.09
|
| Rate for Payer: United Healthcare Medicare |
$84.50
|
|
|
HC THER EXERCISE/15 MIN-OT
|
Facility
|
IP
|
$140.00
|
|
|
Service Code
|
CPT 97110 GO
|
| Hospital Charge Code |
1738080
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$105.00 |
| Max. Negotiated Rate |
$130.20 |
| Rate for Payer: Aetna Commercial |
$120.96
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cigna All Commercial |
$120.82
|
| Rate for Payer: CORVEL All Commercial |
$130.20
|
| Rate for Payer: Coventry All Commercial |
$123.20
|
| Rate for Payer: Encore All Commercial |
$128.87
|
| Rate for Payer: Frontpath All Commercial |
$128.80
|
| Rate for Payer: Humana ChoiceCare |
$120.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$126.00
|
| Rate for Payer: PHCS All Commercial |
$105.00
|
| Rate for Payer: PHP All Commercial |
$106.18
|
| Rate for Payer: Sagamore Health Network All Products |
$108.08
|
| Rate for Payer: Signature Care EPO |
$116.20
|
| Rate for Payer: Signature Care PPO |
$123.20
|
| Rate for Payer: United Healthcare Commercial |
$110.32
|
|
|
HC THER EXERCISE/15 MIN-OT
|
Facility
|
OP
|
$140.00
|
|
|
Service Code
|
CPT 97110 GO
|
| Hospital Charge Code |
1738080
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$130.20 |
| Rate for Payer: Aetna Commercial |
$118.16
|
| Rate for Payer: Aetna Medicare |
$44.80
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$47.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$43.40
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$80.40
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$87.51
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$47.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$51.52
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$49.28
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Centivo All Commercial |
$76.16
|
| Rate for Payer: Cigna All Commercial |
$120.82
|
| Rate for Payer: CORVEL All Commercial |
$130.20
|
| Rate for Payer: Coventry All Commercial |
$123.20
|
| Rate for Payer: Encore All Commercial |
$128.87
|
| Rate for Payer: Frontpath All Commercial |
$128.80
|
| Rate for Payer: Humana ChoiceCare |
$120.92
|
| Rate for Payer: Humana Medicare |
$44.80
|
| Rate for Payer: Lucent All Commercial |
$76.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$126.00
|
| Rate for Payer: Managed Health Services Medicaid |
$47.81
|
| Rate for Payer: MDWise Medicaid |
$47.81
|
| Rate for Payer: PHCS All Commercial |
$105.00
|
| Rate for Payer: PHP All Commercial |
$106.18
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$54.60
|
| Rate for Payer: Sagamore Health Network All Products |
$108.08
|
| Rate for Payer: Signature Care EPO |
$116.20
|
| Rate for Payer: Signature Care PPO |
$123.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$119.00
|
| Rate for Payer: United Healthcare Commercial |
$110.32
|
| Rate for Payer: United Healthcare Medicare |
$44.80
|
|
|
HC THER EXERCISE/15 MIN-PT
|
Facility
|
OP
|
$137.53
|
|
|
Service Code
|
CPT 97110 GP
|
| Hospital Charge Code |
1728078
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$42.63 |
| Max. Negotiated Rate |
$127.90 |
| Rate for Payer: Aetna Commercial |
$116.08
|
| Rate for Payer: Aetna Medicare |
$44.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$47.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$42.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$78.98
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$85.97
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$47.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$50.61
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$48.41
|
| Rate for Payer: Cash Price |
$82.52
|
| Rate for Payer: Cash Price |
$82.52
|
| Rate for Payer: Centivo All Commercial |
$74.82
|
| Rate for Payer: Cigna All Commercial |
$118.69
|
| Rate for Payer: CORVEL All Commercial |
$127.90
|
| Rate for Payer: Coventry All Commercial |
$121.03
|
| Rate for Payer: Encore All Commercial |
$126.60
|
| Rate for Payer: Frontpath All Commercial |
$126.53
|
| Rate for Payer: Humana ChoiceCare |
$118.78
|
| Rate for Payer: Humana Medicare |
$44.01
|
| Rate for Payer: Lucent All Commercial |
$74.82
|
| Rate for Payer: Lutheran Preferred All Commercial |
$123.78
|
| Rate for Payer: Managed Health Services Medicaid |
$47.81
|
| Rate for Payer: MDWise Medicaid |
$47.81
|
| Rate for Payer: PHCS All Commercial |
$103.15
|
| Rate for Payer: PHP All Commercial |
$104.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$53.64
|
| Rate for Payer: Sagamore Health Network All Products |
$106.17
|
| Rate for Payer: Signature Care EPO |
$114.15
|
| Rate for Payer: Signature Care PPO |
$121.03
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$116.90
|
| Rate for Payer: United Healthcare Commercial |
$108.37
|
| Rate for Payer: United Healthcare Medicare |
$44.01
|
|
|
HC THER EXERCISE/15 MIN-PT
|
Facility
|
IP
|
$137.53
|
|
|
Service Code
|
CPT 97110 GP
|
| Hospital Charge Code |
1728078
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$103.15 |
| Max. Negotiated Rate |
$127.90 |
| Rate for Payer: Aetna Commercial |
$118.83
|
| Rate for Payer: Cash Price |
$82.52
|
| Rate for Payer: Cigna All Commercial |
$118.69
|
| Rate for Payer: CORVEL All Commercial |
$127.90
|
| Rate for Payer: Coventry All Commercial |
$121.03
|
| Rate for Payer: Encore All Commercial |
$126.60
|
| Rate for Payer: Frontpath All Commercial |
$126.53
|
| Rate for Payer: Humana ChoiceCare |
$118.78
|
| Rate for Payer: Lutheran Preferred All Commercial |
$123.78
|
| Rate for Payer: PHCS All Commercial |
$103.15
|
| Rate for Payer: PHP All Commercial |
$104.30
|
| Rate for Payer: Sagamore Health Network All Products |
$106.17
|
| Rate for Payer: Signature Care EPO |
$114.15
|
| Rate for Payer: Signature Care PPO |
$121.03
|
| Rate for Payer: United Healthcare Commercial |
$108.37
|
|
|
HC THER IVNTJ COG FUNCJ CNTCT 1ST 15 MIN - OT
|
Facility
|
OP
|
$164.24
|
|
|
Service Code
|
CPT 97129 GO
|
| Hospital Charge Code |
1737129
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$47.81 |
| Max. Negotiated Rate |
$152.74 |
| Rate for Payer: Aetna Commercial |
$138.62
|
| Rate for Payer: Aetna Medicare |
$52.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$47.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$50.91
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$94.32
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$102.67
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$47.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$60.44
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$57.81
|
| Rate for Payer: Cash Price |
$98.54
|
| Rate for Payer: Cash Price |
$98.54
|
| Rate for Payer: Centivo All Commercial |
$89.35
|
| Rate for Payer: Cigna All Commercial |
$141.74
|
| Rate for Payer: CORVEL All Commercial |
$152.74
|
| Rate for Payer: Coventry All Commercial |
$144.53
|
| Rate for Payer: Encore All Commercial |
$151.18
|
| Rate for Payer: Frontpath All Commercial |
$151.10
|
| Rate for Payer: Humana ChoiceCare |
$141.85
|
| Rate for Payer: Humana Medicare |
$52.56
|
| Rate for Payer: Lucent All Commercial |
$89.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$147.82
|
| Rate for Payer: Managed Health Services Medicaid |
$47.81
|
| Rate for Payer: MDWise Medicaid |
$47.81
|
| Rate for Payer: PHCS All Commercial |
$123.18
|
| Rate for Payer: PHP All Commercial |
$124.56
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$64.05
|
| Rate for Payer: Sagamore Health Network All Products |
$126.79
|
| Rate for Payer: Signature Care EPO |
$136.32
|
| Rate for Payer: Signature Care PPO |
$144.53
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$139.60
|
| Rate for Payer: United Healthcare Commercial |
$129.42
|
| Rate for Payer: United Healthcare Medicare |
$52.56
|
|
|
HC THER IVNTJ COG FUNCJ CNTCT 1ST 15 MIN - OT
|
Facility
|
IP
|
$164.24
|
|
|
Service Code
|
CPT 97129 GO
|
| Hospital Charge Code |
1737129
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$123.18 |
| Max. Negotiated Rate |
$152.74 |
| Rate for Payer: Aetna Commercial |
$141.90
|
| Rate for Payer: Cash Price |
$98.54
|
| Rate for Payer: Cigna All Commercial |
$141.74
|
| Rate for Payer: CORVEL All Commercial |
$152.74
|
| Rate for Payer: Coventry All Commercial |
$144.53
|
| Rate for Payer: Encore All Commercial |
$151.18
|
| Rate for Payer: Frontpath All Commercial |
$151.10
|
| Rate for Payer: Humana ChoiceCare |
$141.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$147.82
|
| Rate for Payer: PHCS All Commercial |
$123.18
|
| Rate for Payer: PHP All Commercial |
$124.56
|
| Rate for Payer: Sagamore Health Network All Products |
$126.79
|
| Rate for Payer: Signature Care EPO |
$136.32
|
| Rate for Payer: Signature Care PPO |
$144.53
|
| Rate for Payer: United Healthcare Commercial |
$129.42
|
|
