|
HC U/S VENOUS IMAGING UP EXT BIL
|
Facility
|
OP
|
$1,716.16
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
1643970
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$189.62 |
| Max. Negotiated Rate |
$1,596.03 |
| Rate for Payer: Aetna Commercial |
$1,448.44
|
| Rate for Payer: Aetna Medicare |
$549.17
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$189.62
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$532.01
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$985.59
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,072.77
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$189.62
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$631.55
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$604.09
|
| Rate for Payer: Cash Price |
$1,029.70
|
| Rate for Payer: Cash Price |
$1,029.70
|
| Rate for Payer: Centivo All Commercial |
$933.59
|
| Rate for Payer: Cigna All Commercial |
$1,481.05
|
| Rate for Payer: CORVEL All Commercial |
$1,596.03
|
| Rate for Payer: Coventry All Commercial |
$1,510.22
|
| Rate for Payer: Encore All Commercial |
$1,579.73
|
| Rate for Payer: Frontpath All Commercial |
$1,578.87
|
| Rate for Payer: Humana ChoiceCare |
$1,482.25
|
| Rate for Payer: Humana Medicare |
$549.17
|
| Rate for Payer: Lucent All Commercial |
$933.59
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,544.54
|
| Rate for Payer: Managed Health Services Medicaid |
$189.62
|
| Rate for Payer: MDWise Medicaid |
$189.62
|
| Rate for Payer: PHCS All Commercial |
$1,287.12
|
| Rate for Payer: PHP All Commercial |
$1,301.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$669.30
|
| Rate for Payer: Sagamore Health Network All Products |
$1,324.88
|
| Rate for Payer: Signature Care EPO |
$1,424.41
|
| Rate for Payer: Signature Care PPO |
$1,510.22
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,458.74
|
| Rate for Payer: United Healthcare Commercial |
$1,352.33
|
| Rate for Payer: United Healthcare Medicare |
$549.17
|
|
|
HC U/S VENOUS IMAGING UP EXT UNI
|
Facility
|
IP
|
$1,026.96
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
1643971
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$770.22 |
| Max. Negotiated Rate |
$955.07 |
| Rate for Payer: Aetna Commercial |
$887.29
|
| Rate for Payer: Cash Price |
$616.18
|
| Rate for Payer: Cigna All Commercial |
$886.27
|
| Rate for Payer: CORVEL All Commercial |
$955.07
|
| Rate for Payer: Coventry All Commercial |
$903.72
|
| Rate for Payer: Encore All Commercial |
$945.32
|
| Rate for Payer: Frontpath All Commercial |
$944.80
|
| Rate for Payer: Humana ChoiceCare |
$886.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$924.26
|
| Rate for Payer: PHCS All Commercial |
$770.22
|
| Rate for Payer: PHP All Commercial |
$778.85
|
| Rate for Payer: Sagamore Health Network All Products |
$792.81
|
| Rate for Payer: Signature Care EPO |
$852.38
|
| Rate for Payer: Signature Care PPO |
$903.72
|
| Rate for Payer: United Healthcare Commercial |
$809.24
|
|
|
HC U/S VENOUS IMAGING UP EXT UNI
|
Facility
|
OP
|
$1,026.96
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
1643971
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$134.85 |
| Max. Negotiated Rate |
$955.07 |
| Rate for Payer: Aetna Commercial |
$866.75
|
| Rate for Payer: Aetna Medicare |
$328.63
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$134.85
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$318.36
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$589.78
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$641.95
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$134.85
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$377.92
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$361.49
|
| Rate for Payer: Cash Price |
$616.18
|
| Rate for Payer: Cash Price |
$616.18
|
| Rate for Payer: Centivo All Commercial |
$558.67
|
| Rate for Payer: Cigna All Commercial |
$886.27
|
| Rate for Payer: CORVEL All Commercial |
$955.07
|
| Rate for Payer: Coventry All Commercial |
$903.72
|
| Rate for Payer: Encore All Commercial |
$945.32
|
| Rate for Payer: Frontpath All Commercial |
$944.80
|
| Rate for Payer: Humana ChoiceCare |
$886.99
|
| Rate for Payer: Humana Medicare |
$328.63
|
| Rate for Payer: Lucent All Commercial |
$558.67
|
| Rate for Payer: Lutheran Preferred All Commercial |
$924.26
|
| Rate for Payer: Managed Health Services Medicaid |
$134.85
|
| Rate for Payer: MDWise Medicaid |
$134.85
|
| Rate for Payer: PHCS All Commercial |
$770.22
|
| Rate for Payer: PHP All Commercial |
$778.85
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$400.51
|
| Rate for Payer: Sagamore Health Network All Products |
$792.81
|
| Rate for Payer: Signature Care EPO |
$852.38
|
| Rate for Payer: Signature Care PPO |
$903.72
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$872.92
|
| Rate for Payer: United Healthcare Commercial |
$809.24
|
| Rate for Payer: United Healthcare Medicare |
$328.63
|
|
|
HC U/S VENOUS REFLUX STUDY
|
Facility
|
IP
|
$912.53
|
|
|
Service Code
|
CPT 93998
|
| Hospital Charge Code |
1643965
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$684.40 |
| Max. Negotiated Rate |
$848.65 |
| Rate for Payer: Aetna Commercial |
$788.43
|
| Rate for Payer: Cash Price |
$547.52
|
| Rate for Payer: Cigna All Commercial |
$787.51
|
| Rate for Payer: CORVEL All Commercial |
$848.65
|
| Rate for Payer: Coventry All Commercial |
$803.03
|
| Rate for Payer: Encore All Commercial |
$839.98
|
| Rate for Payer: Frontpath All Commercial |
$839.53
|
| Rate for Payer: Humana ChoiceCare |
$788.15
|
| Rate for Payer: Lutheran Preferred All Commercial |
$821.28
|
| Rate for Payer: PHCS All Commercial |
$684.40
|
| Rate for Payer: PHP All Commercial |
$692.06
|
| Rate for Payer: Sagamore Health Network All Products |
$704.47
|
| Rate for Payer: Signature Care EPO |
$757.40
|
| Rate for Payer: Signature Care PPO |
$803.03
|
| Rate for Payer: United Healthcare Commercial |
$719.07
|
|
|
HC U/S VENOUS REFLUX STUDY
|
Facility
|
OP
|
$912.53
|
|
|
Service Code
|
CPT 93998
|
| Hospital Charge Code |
1643965
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$136.88 |
| Max. Negotiated Rate |
$848.65 |
| Rate for Payer: Aetna Commercial |
$770.18
|
| Rate for Payer: Aetna Medicare |
$292.01
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$136.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$282.88
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$524.07
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$570.42
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$136.88
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$335.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$321.21
|
| Rate for Payer: Cash Price |
$547.52
|
| Rate for Payer: Centivo All Commercial |
$496.42
|
| Rate for Payer: Cigna All Commercial |
$787.51
|
| Rate for Payer: CORVEL All Commercial |
$848.65
|
| Rate for Payer: Coventry All Commercial |
$803.03
|
| Rate for Payer: Encore All Commercial |
$839.98
|
| Rate for Payer: Frontpath All Commercial |
$839.53
|
| Rate for Payer: Humana ChoiceCare |
$788.15
|
| Rate for Payer: Humana Medicare |
$292.01
|
| Rate for Payer: Lucent All Commercial |
$496.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$821.28
|
| Rate for Payer: Managed Health Services Medicaid |
$136.88
|
| Rate for Payer: MDWise Medicaid |
$136.88
|
| Rate for Payer: PHCS All Commercial |
$684.40
|
| Rate for Payer: PHP All Commercial |
$692.06
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$355.89
|
| Rate for Payer: Sagamore Health Network All Products |
$704.47
|
| Rate for Payer: Signature Care EPO |
$757.40
|
| Rate for Payer: Signature Care PPO |
$803.03
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$775.65
|
| Rate for Payer: United Healthcare Commercial |
$719.07
|
| Rate for Payer: United Healthcare Medicare |
$292.01
|
|
|
HC VACUUM EXTRACTOR
|
Facility
|
IP
|
$175.89
|
|
| Hospital Charge Code |
41602443
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$131.92 |
| Max. Negotiated Rate |
$163.58 |
| Rate for Payer: Aetna Commercial |
$151.97
|
| Rate for Payer: Cash Price |
$105.53
|
| Rate for Payer: Cigna All Commercial |
$151.79
|
| Rate for Payer: CORVEL All Commercial |
$163.58
|
| Rate for Payer: Coventry All Commercial |
$154.78
|
| Rate for Payer: Encore All Commercial |
$161.91
|
| Rate for Payer: Frontpath All Commercial |
$161.82
|
| Rate for Payer: Humana ChoiceCare |
$151.92
|
| Rate for Payer: Lutheran Preferred All Commercial |
$158.30
|
| Rate for Payer: PHCS All Commercial |
$131.92
|
| Rate for Payer: PHP All Commercial |
$133.39
|
| Rate for Payer: Sagamore Health Network All Products |
$135.79
|
| Rate for Payer: Signature Care EPO |
$145.99
|
| Rate for Payer: Signature Care PPO |
$154.78
|
| Rate for Payer: United Healthcare Commercial |
$138.60
|
|
|
HC VACUUM EXTRACTOR
|
Facility
|
OP
|
$175.89
|
|
| Hospital Charge Code |
41602443
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$163.58 |
| Rate for Payer: Aetna Commercial |
$148.45
|
| Rate for Payer: Aetna Medicare |
$56.28
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$54.53
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$101.01
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$109.95
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$64.73
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$61.91
|
| Rate for Payer: Cash Price |
$105.53
|
| Rate for Payer: Cash Price |
$105.53
|
| Rate for Payer: Centivo All Commercial |
$95.68
|
| Rate for Payer: Cigna All Commercial |
$151.79
|
| Rate for Payer: CORVEL All Commercial |
$163.58
|
| Rate for Payer: Coventry All Commercial |
$154.78
|
| Rate for Payer: Encore All Commercial |
$161.91
|
| Rate for Payer: Frontpath All Commercial |
$161.82
|
| Rate for Payer: Humana ChoiceCare |
$151.92
|
| Rate for Payer: Humana Medicare |
$56.28
|
| Rate for Payer: Lucent All Commercial |
$95.68
|
| Rate for Payer: Lutheran Preferred All Commercial |
$158.30
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$131.92
|
| Rate for Payer: PHP All Commercial |
$133.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$68.60
|
| Rate for Payer: Sagamore Health Network All Products |
$135.79
|
| Rate for Payer: Signature Care EPO |
$145.99
|
| Rate for Payer: Signature Care PPO |
$154.78
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$149.51
|
| Rate for Payer: United Healthcare Commercial |
$138.60
|
| Rate for Payer: United Healthcare Medicare |
$56.28
|
|
|
HC VAGINAL DELIVERY-ROUTINE
|
Facility
|
OP
|
$6,470.88
|
|
| Hospital Charge Code |
1223233
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$126.33 |
| Max. Negotiated Rate |
$6,017.92 |
| Rate for Payer: Aetna Commercial |
$5,461.42
|
| Rate for Payer: Aetna Medicare |
$2,070.68
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$126.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$2,005.97
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$3,716.23
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$4,044.95
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$126.33
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$2,381.28
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$2,277.75
|
| Rate for Payer: Cash Price |
$3,882.53
|
| Rate for Payer: Cash Price |
$3,882.53
|
| Rate for Payer: Centivo All Commercial |
$3,520.16
|
| Rate for Payer: Cigna All Commercial |
$5,584.37
|
| Rate for Payer: CORVEL All Commercial |
$6,017.92
|
| Rate for Payer: Coventry All Commercial |
$5,694.37
|
| Rate for Payer: Encore All Commercial |
$5,956.45
|
| Rate for Payer: Frontpath All Commercial |
$5,953.21
|
| Rate for Payer: Humana ChoiceCare |
$5,588.90
|
| Rate for Payer: Humana Medicare |
$2,070.68
|
| Rate for Payer: Lucent All Commercial |
$3,520.16
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,823.79
|
| Rate for Payer: Managed Health Services Medicaid |
$126.33
|
| Rate for Payer: MDWise Medicaid |
$126.33
|
| Rate for Payer: PHCS All Commercial |
$4,853.16
|
| Rate for Payer: PHP All Commercial |
$4,907.52
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$2,523.64
|
| Rate for Payer: Sagamore Health Network All Products |
$4,995.52
|
| Rate for Payer: Signature Care EPO |
$5,370.83
|
| Rate for Payer: Signature Care PPO |
$5,694.37
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$5,500.25
|
| Rate for Payer: United Healthcare Commercial |
$5,099.05
|
| Rate for Payer: United Healthcare Medicare |
$2,070.68
|
|
|
HC VAGINAL DELIVERY-ROUTINE
|
Facility
|
IP
|
$6,470.88
|
|
| Hospital Charge Code |
1223233
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$4,853.16 |
| Max. Negotiated Rate |
$6,017.92 |
| Rate for Payer: Aetna Commercial |
$5,590.84
|
| Rate for Payer: Cash Price |
$3,882.53
|
| Rate for Payer: Cigna All Commercial |
$5,584.37
|
| Rate for Payer: CORVEL All Commercial |
$6,017.92
|
| Rate for Payer: Coventry All Commercial |
$5,694.37
|
| Rate for Payer: Encore All Commercial |
$5,956.45
|
| Rate for Payer: Frontpath All Commercial |
$5,953.21
|
| Rate for Payer: Humana ChoiceCare |
$5,588.90
|
| Rate for Payer: Lutheran Preferred All Commercial |
$5,823.79
|
| Rate for Payer: PHCS All Commercial |
$4,853.16
|
| Rate for Payer: PHP All Commercial |
$4,907.52
|
| Rate for Payer: Sagamore Health Network All Products |
$4,995.52
|
| Rate for Payer: Signature Care EPO |
$5,370.83
|
| Rate for Payer: Signature Care PPO |
$5,694.37
|
| Rate for Payer: United Healthcare Commercial |
$5,099.05
|
|
|
HC VALVE CHEST DRAIN
|
Facility
|
OP
|
$890.80
|
|
| Hospital Charge Code |
41606979
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$828.44 |
| Rate for Payer: Aetna Commercial |
$751.84
|
| Rate for Payer: Aetna Medicare |
$285.06
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$276.15
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$511.59
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$556.84
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$327.81
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$313.56
|
| Rate for Payer: Cash Price |
$534.48
|
| Rate for Payer: Cash Price |
$534.48
|
| Rate for Payer: Centivo All Commercial |
$484.60
|
| Rate for Payer: Cigna All Commercial |
$768.76
|
| Rate for Payer: CORVEL All Commercial |
$828.44
|
| Rate for Payer: Coventry All Commercial |
$783.90
|
| Rate for Payer: Encore All Commercial |
$819.98
|
| Rate for Payer: Frontpath All Commercial |
$819.54
|
| Rate for Payer: Humana ChoiceCare |
$769.38
|
| Rate for Payer: Humana Medicare |
$285.06
|
| Rate for Payer: Lucent All Commercial |
$484.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$801.72
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$668.10
|
| Rate for Payer: PHP All Commercial |
$675.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$347.41
|
| Rate for Payer: Sagamore Health Network All Products |
$687.70
|
| Rate for Payer: Signature Care EPO |
$739.36
|
| Rate for Payer: Signature Care PPO |
$783.90
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$757.18
|
| Rate for Payer: United Healthcare Commercial |
$701.95
|
| Rate for Payer: United Healthcare Medicare |
$285.06
|
|
|
HC VALVE CHEST DRAIN
|
Facility
|
IP
|
$890.80
|
|
| Hospital Charge Code |
41606979
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$668.10 |
| Max. Negotiated Rate |
$828.44 |
| Rate for Payer: Aetna Commercial |
$769.65
|
| Rate for Payer: Cash Price |
$534.48
|
| Rate for Payer: Cigna All Commercial |
$768.76
|
| Rate for Payer: CORVEL All Commercial |
$828.44
|
| Rate for Payer: Coventry All Commercial |
$783.90
|
| Rate for Payer: Encore All Commercial |
$819.98
|
| Rate for Payer: Frontpath All Commercial |
$819.54
|
| Rate for Payer: Humana ChoiceCare |
$769.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$801.72
|
| Rate for Payer: PHCS All Commercial |
$668.10
|
| Rate for Payer: PHP All Commercial |
$675.58
|
| Rate for Payer: Sagamore Health Network All Products |
$687.70
|
| Rate for Payer: Signature Care EPO |
$739.36
|
| Rate for Payer: Signature Care PPO |
$783.90
|
| Rate for Payer: United Healthcare Commercial |
$701.95
|
|
|
HC VANCOMYCIN TR
|
Facility
|
OP
|
$255.82
|
|
|
Service Code
|
CPT 80202
|
| Hospital Charge Code |
63001340
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.54 |
| Max. Negotiated Rate |
$237.91 |
| Rate for Payer: Aetna Commercial |
$215.91
|
| Rate for Payer: Aetna Medicare |
$81.86
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$13.54
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$79.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$117.57
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$117.57
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$13.54
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$94.14
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$90.05
|
| Rate for Payer: Cash Price |
$153.49
|
| Rate for Payer: Cash Price |
$153.49
|
| Rate for Payer: Centivo All Commercial |
$139.17
|
| Rate for Payer: Cigna All Commercial |
$220.77
|
| Rate for Payer: CORVEL All Commercial |
$237.91
|
| Rate for Payer: Coventry All Commercial |
$225.12
|
| Rate for Payer: Encore All Commercial |
$235.48
|
| Rate for Payer: Frontpath All Commercial |
$235.35
|
| Rate for Payer: Humana ChoiceCare |
$220.95
|
| Rate for Payer: Humana Medicare |
$81.86
|
| Rate for Payer: Lucent All Commercial |
$139.17
|
| Rate for Payer: Lutheran Preferred All Commercial |
$230.24
|
| Rate for Payer: Managed Health Services Medicaid |
$13.54
|
| Rate for Payer: MDWise Medicaid |
$13.54
|
| Rate for Payer: PHCS All Commercial |
$191.87
|
| Rate for Payer: PHP All Commercial |
$194.01
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$99.77
|
| Rate for Payer: Sagamore Health Network All Products |
$197.49
|
| Rate for Payer: Signature Care EPO |
$212.33
|
| Rate for Payer: Signature Care PPO |
$225.12
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$217.45
|
| Rate for Payer: United Healthcare Commercial |
$201.59
|
| Rate for Payer: United Healthcare Medicare |
$81.86
|
|
|
HC VANCOMYCIN TR
|
Facility
|
IP
|
$255.82
|
|
|
Service Code
|
CPT 80202
|
| Hospital Charge Code |
63001340
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$191.87 |
| Max. Negotiated Rate |
$237.91 |
| Rate for Payer: Aetna Commercial |
$221.03
|
| Rate for Payer: Cash Price |
$153.49
|
| Rate for Payer: Cigna All Commercial |
$220.77
|
| Rate for Payer: CORVEL All Commercial |
$237.91
|
| Rate for Payer: Coventry All Commercial |
$225.12
|
| Rate for Payer: Encore All Commercial |
$235.48
|
| Rate for Payer: Frontpath All Commercial |
$235.35
|
| Rate for Payer: Humana ChoiceCare |
$220.95
|
| Rate for Payer: Lutheran Preferred All Commercial |
$230.24
|
| Rate for Payer: PHCS All Commercial |
$191.87
|
| Rate for Payer: PHP All Commercial |
$194.01
|
| Rate for Payer: Sagamore Health Network All Products |
$197.49
|
| Rate for Payer: Signature Care EPO |
$212.33
|
| Rate for Payer: Signature Care PPO |
$225.12
|
| Rate for Payer: United Healthcare Commercial |
$201.59
|
|
|
HC VARICELLA ZOSTER IGG
|
Facility
|
IP
|
$150.91
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
63001974
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$113.18 |
| Max. Negotiated Rate |
$140.35 |
| Rate for Payer: Aetna Commercial |
$130.39
|
| Rate for Payer: Cash Price |
$90.55
|
| Rate for Payer: Cigna All Commercial |
$130.24
|
| Rate for Payer: CORVEL All Commercial |
$140.35
|
| Rate for Payer: Coventry All Commercial |
$132.80
|
| Rate for Payer: Encore All Commercial |
$138.91
|
| Rate for Payer: Frontpath All Commercial |
$138.84
|
| Rate for Payer: Humana ChoiceCare |
$130.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$135.82
|
| Rate for Payer: PHCS All Commercial |
$113.18
|
| Rate for Payer: PHP All Commercial |
$114.45
|
| Rate for Payer: Sagamore Health Network All Products |
$116.50
|
| Rate for Payer: Signature Care EPO |
$125.26
|
| Rate for Payer: Signature Care PPO |
$132.80
|
| Rate for Payer: United Healthcare Commercial |
$118.92
|
|
|
HC VARICELLA ZOSTER IGG
|
Facility
|
OP
|
$150.91
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
63001974
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.88 |
| Max. Negotiated Rate |
$140.35 |
| Rate for Payer: Aetna Commercial |
$127.37
|
| Rate for Payer: Aetna Medicare |
$48.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$12.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$46.78
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$69.36
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$69.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$12.88
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$55.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$53.12
|
| Rate for Payer: Cash Price |
$90.55
|
| Rate for Payer: Cash Price |
$90.55
|
| Rate for Payer: Centivo All Commercial |
$82.10
|
| Rate for Payer: Cigna All Commercial |
$130.24
|
| Rate for Payer: CORVEL All Commercial |
$140.35
|
| Rate for Payer: Coventry All Commercial |
$132.80
|
| Rate for Payer: Encore All Commercial |
$138.91
|
| Rate for Payer: Frontpath All Commercial |
$138.84
|
| Rate for Payer: Humana ChoiceCare |
$130.34
|
| Rate for Payer: Humana Medicare |
$48.29
|
| Rate for Payer: Lucent All Commercial |
$82.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$135.82
|
| Rate for Payer: Managed Health Services Medicaid |
$12.88
|
| Rate for Payer: MDWise Medicaid |
$12.88
|
| Rate for Payer: PHCS All Commercial |
$113.18
|
| Rate for Payer: PHP All Commercial |
$114.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$58.85
|
| Rate for Payer: Sagamore Health Network All Products |
$116.50
|
| Rate for Payer: Signature Care EPO |
$125.26
|
| Rate for Payer: Signature Care PPO |
$132.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$128.27
|
| Rate for Payer: United Healthcare Commercial |
$118.92
|
| Rate for Payer: United Healthcare Medicare |
$48.29
|
|
|
HC VARICELLA ZOSTER IGM
|
Facility
|
IP
|
$150.91
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
63001975
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$113.18 |
| Max. Negotiated Rate |
$140.35 |
| Rate for Payer: Aetna Commercial |
$130.39
|
| Rate for Payer: Cash Price |
$90.55
|
| Rate for Payer: Cigna All Commercial |
$130.24
|
| Rate for Payer: CORVEL All Commercial |
$140.35
|
| Rate for Payer: Coventry All Commercial |
$132.80
|
| Rate for Payer: Encore All Commercial |
$138.91
|
| Rate for Payer: Frontpath All Commercial |
$138.84
|
| Rate for Payer: Humana ChoiceCare |
$130.34
|
| Rate for Payer: Lutheran Preferred All Commercial |
$135.82
|
| Rate for Payer: PHCS All Commercial |
$113.18
|
| Rate for Payer: PHP All Commercial |
$114.45
|
| Rate for Payer: Sagamore Health Network All Products |
$116.50
|
| Rate for Payer: Signature Care EPO |
$125.26
|
| Rate for Payer: Signature Care PPO |
$132.80
|
| Rate for Payer: United Healthcare Commercial |
$118.92
|
|
|
HC VARICELLA ZOSTER IGM
|
Facility
|
OP
|
$150.91
|
|
|
Service Code
|
CPT 86787
|
| Hospital Charge Code |
63001975
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.88 |
| Max. Negotiated Rate |
$140.35 |
| Rate for Payer: Aetna Commercial |
$127.37
|
| Rate for Payer: Aetna Medicare |
$48.29
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$12.88
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$46.78
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$69.36
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$69.36
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$12.88
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$55.53
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$53.12
|
| Rate for Payer: Cash Price |
$90.55
|
| Rate for Payer: Cash Price |
$90.55
|
| Rate for Payer: Centivo All Commercial |
$82.10
|
| Rate for Payer: Cigna All Commercial |
$130.24
|
| Rate for Payer: CORVEL All Commercial |
$140.35
|
| Rate for Payer: Coventry All Commercial |
$132.80
|
| Rate for Payer: Encore All Commercial |
$138.91
|
| Rate for Payer: Frontpath All Commercial |
$138.84
|
| Rate for Payer: Humana ChoiceCare |
$130.34
|
| Rate for Payer: Humana Medicare |
$48.29
|
| Rate for Payer: Lucent All Commercial |
$82.10
|
| Rate for Payer: Lutheran Preferred All Commercial |
$135.82
|
| Rate for Payer: Managed Health Services Medicaid |
$12.88
|
| Rate for Payer: MDWise Medicaid |
$12.88
|
| Rate for Payer: PHCS All Commercial |
$113.18
|
| Rate for Payer: PHP All Commercial |
$114.45
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$58.85
|
| Rate for Payer: Sagamore Health Network All Products |
$116.50
|
| Rate for Payer: Signature Care EPO |
$125.26
|
| Rate for Payer: Signature Care PPO |
$132.80
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$128.27
|
| Rate for Payer: United Healthcare Commercial |
$118.92
|
| Rate for Payer: United Healthcare Medicare |
$48.29
|
|
|
HC VASO INTESTINAL PEP
|
Facility
|
IP
|
$617.17
|
|
|
Service Code
|
CPT 84586
|
| Hospital Charge Code |
63001713
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$462.88 |
| Max. Negotiated Rate |
$573.97 |
| Rate for Payer: Aetna Commercial |
$533.23
|
| Rate for Payer: Cash Price |
$370.30
|
| Rate for Payer: Cigna All Commercial |
$532.62
|
| Rate for Payer: CORVEL All Commercial |
$573.97
|
| Rate for Payer: Coventry All Commercial |
$543.11
|
| Rate for Payer: Encore All Commercial |
$568.10
|
| Rate for Payer: Frontpath All Commercial |
$567.80
|
| Rate for Payer: Humana ChoiceCare |
$533.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$555.45
|
| Rate for Payer: PHCS All Commercial |
$462.88
|
| Rate for Payer: PHP All Commercial |
$468.06
|
| Rate for Payer: Sagamore Health Network All Products |
$476.46
|
| Rate for Payer: Signature Care EPO |
$512.25
|
| Rate for Payer: Signature Care PPO |
$543.11
|
| Rate for Payer: United Healthcare Commercial |
$486.33
|
|
|
HC VASO INTESTINAL PEP
|
Facility
|
OP
|
$617.17
|
|
|
Service Code
|
CPT 84586
|
| Hospital Charge Code |
63001713
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$35.33 |
| Max. Negotiated Rate |
$573.97 |
| Rate for Payer: Aetna Commercial |
$520.89
|
| Rate for Payer: Aetna Medicare |
$197.49
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$35.33
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$191.32
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$283.65
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$283.65
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$35.33
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$227.12
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$217.24
|
| Rate for Payer: Cash Price |
$370.30
|
| Rate for Payer: Cash Price |
$370.30
|
| Rate for Payer: Centivo All Commercial |
$335.74
|
| Rate for Payer: Cigna All Commercial |
$532.62
|
| Rate for Payer: CORVEL All Commercial |
$573.97
|
| Rate for Payer: Coventry All Commercial |
$543.11
|
| Rate for Payer: Encore All Commercial |
$568.10
|
| Rate for Payer: Frontpath All Commercial |
$567.80
|
| Rate for Payer: Humana ChoiceCare |
$533.05
|
| Rate for Payer: Humana Medicare |
$197.49
|
| Rate for Payer: Lucent All Commercial |
$335.74
|
| Rate for Payer: Lutheran Preferred All Commercial |
$555.45
|
| Rate for Payer: Managed Health Services Medicaid |
$35.33
|
| Rate for Payer: MDWise Medicaid |
$35.33
|
| Rate for Payer: PHCS All Commercial |
$462.88
|
| Rate for Payer: PHP All Commercial |
$468.06
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$240.70
|
| Rate for Payer: Sagamore Health Network All Products |
$476.46
|
| Rate for Payer: Signature Care EPO |
$512.25
|
| Rate for Payer: Signature Care PPO |
$543.11
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$524.59
|
| Rate for Payer: United Healthcare Commercial |
$486.33
|
| Rate for Payer: United Healthcare Medicare |
$197.49
|
|
|
HC VASOPNEUMATIC DEVICES-PT
|
Facility
|
IP
|
$431.26
|
|
|
Service Code
|
CPT 97016 GP
|
| Hospital Charge Code |
1728088
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$323.44 |
| Max. Negotiated Rate |
$401.07 |
| Rate for Payer: Aetna Commercial |
$372.61
|
| Rate for Payer: Cash Price |
$258.76
|
| Rate for Payer: Cigna All Commercial |
$372.18
|
| Rate for Payer: CORVEL All Commercial |
$401.07
|
| Rate for Payer: Coventry All Commercial |
$379.51
|
| Rate for Payer: Encore All Commercial |
$396.97
|
| Rate for Payer: Frontpath All Commercial |
$396.76
|
| Rate for Payer: Humana ChoiceCare |
$372.48
|
| Rate for Payer: Lutheran Preferred All Commercial |
$388.13
|
| Rate for Payer: PHCS All Commercial |
$323.44
|
| Rate for Payer: PHP All Commercial |
$327.07
|
| Rate for Payer: Sagamore Health Network All Products |
$332.93
|
| Rate for Payer: Signature Care EPO |
$357.95
|
| Rate for Payer: Signature Care PPO |
$379.51
|
| Rate for Payer: United Healthcare Commercial |
$339.83
|
|
|
HC VASOPNEUMATIC DEVICES-PT
|
Facility
|
OP
|
$431.26
|
|
|
Service Code
|
CPT 97016 GP
|
| Hospital Charge Code |
1728088
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$47.81 |
| Max. Negotiated Rate |
$401.07 |
| Rate for Payer: Aetna Commercial |
$363.98
|
| Rate for Payer: Aetna Medicare |
$138.00
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$47.81
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$133.69
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$247.67
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$269.58
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$47.81
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$158.70
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$151.80
|
| Rate for Payer: Cash Price |
$258.76
|
| Rate for Payer: Cash Price |
$258.76
|
| Rate for Payer: Centivo All Commercial |
$234.61
|
| Rate for Payer: Cigna All Commercial |
$372.18
|
| Rate for Payer: CORVEL All Commercial |
$401.07
|
| Rate for Payer: Coventry All Commercial |
$379.51
|
| Rate for Payer: Encore All Commercial |
$396.97
|
| Rate for Payer: Frontpath All Commercial |
$396.76
|
| Rate for Payer: Humana ChoiceCare |
$372.48
|
| Rate for Payer: Humana Medicare |
$138.00
|
| Rate for Payer: Lucent All Commercial |
$234.61
|
| Rate for Payer: Lutheran Preferred All Commercial |
$388.13
|
| Rate for Payer: Managed Health Services Medicaid |
$47.81
|
| Rate for Payer: MDWise Medicaid |
$47.81
|
| Rate for Payer: PHCS All Commercial |
$323.44
|
| Rate for Payer: PHP All Commercial |
$327.07
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$168.19
|
| Rate for Payer: Sagamore Health Network All Products |
$332.93
|
| Rate for Payer: Signature Care EPO |
$357.95
|
| Rate for Payer: Signature Care PPO |
$379.51
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$366.57
|
| Rate for Payer: United Healthcare Commercial |
$339.83
|
| Rate for Payer: United Healthcare Medicare |
$138.00
|
|
|
HC VENIPUNCTURE
|
Facility
|
OP
|
$36.24
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
1263300
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.83 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Aetna Commercial |
$30.59
|
| Rate for Payer: Aetna Medicare |
$11.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$8.83
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$11.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$16.66
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$16.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$8.83
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$13.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$12.76
|
| Rate for Payer: Cash Price |
$21.74
|
| Rate for Payer: Cash Price |
$21.74
|
| Rate for Payer: Centivo All Commercial |
$19.71
|
| Rate for Payer: Cigna All Commercial |
$31.28
|
| Rate for Payer: CORVEL All Commercial |
$33.70
|
| Rate for Payer: Coventry All Commercial |
$31.89
|
| Rate for Payer: Encore All Commercial |
$33.36
|
| Rate for Payer: Frontpath All Commercial |
$33.34
|
| Rate for Payer: Humana ChoiceCare |
$31.30
|
| Rate for Payer: Humana Medicare |
$11.60
|
| Rate for Payer: Lucent All Commercial |
$19.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$32.62
|
| Rate for Payer: Managed Health Services Medicaid |
$8.83
|
| Rate for Payer: MDWise Medicaid |
$8.83
|
| Rate for Payer: PHCS All Commercial |
$27.18
|
| Rate for Payer: PHP All Commercial |
$27.48
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$14.13
|
| Rate for Payer: Sagamore Health Network All Products |
$27.98
|
| Rate for Payer: Signature Care EPO |
$30.08
|
| Rate for Payer: Signature Care PPO |
$31.89
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$30.80
|
| Rate for Payer: United Healthcare Commercial |
$28.56
|
| Rate for Payer: United Healthcare Medicare |
$11.60
|
|
|
HC VENIPUNCTURE
|
Facility
|
OP
|
$36.24
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
1260760
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.83 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Aetna Commercial |
$30.59
|
| Rate for Payer: Aetna Medicare |
$11.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$8.83
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$11.23
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$16.66
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$16.66
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$8.83
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$13.34
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$12.76
|
| Rate for Payer: Cash Price |
$21.74
|
| Rate for Payer: Cash Price |
$21.74
|
| Rate for Payer: Centivo All Commercial |
$19.71
|
| Rate for Payer: Cigna All Commercial |
$31.28
|
| Rate for Payer: CORVEL All Commercial |
$33.70
|
| Rate for Payer: Coventry All Commercial |
$31.89
|
| Rate for Payer: Encore All Commercial |
$33.36
|
| Rate for Payer: Frontpath All Commercial |
$33.34
|
| Rate for Payer: Humana ChoiceCare |
$31.30
|
| Rate for Payer: Humana Medicare |
$11.60
|
| Rate for Payer: Lucent All Commercial |
$19.71
|
| Rate for Payer: Lutheran Preferred All Commercial |
$32.62
|
| Rate for Payer: Managed Health Services Medicaid |
$8.83
|
| Rate for Payer: MDWise Medicaid |
$8.83
|
| Rate for Payer: PHCS All Commercial |
$27.18
|
| Rate for Payer: PHP All Commercial |
$27.48
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$14.13
|
| Rate for Payer: Sagamore Health Network All Products |
$27.98
|
| Rate for Payer: Signature Care EPO |
$30.08
|
| Rate for Payer: Signature Care PPO |
$31.89
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$30.80
|
| Rate for Payer: United Healthcare Commercial |
$28.56
|
| Rate for Payer: United Healthcare Medicare |
$11.60
|
|
|
HC VENIPUNCTURE
|
Facility
|
IP
|
$36.24
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
1263300
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.18 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Aetna Commercial |
$31.31
|
| Rate for Payer: Cash Price |
$21.74
|
| Rate for Payer: Cigna All Commercial |
$31.28
|
| Rate for Payer: CORVEL All Commercial |
$33.70
|
| Rate for Payer: Coventry All Commercial |
$31.89
|
| Rate for Payer: Encore All Commercial |
$33.36
|
| Rate for Payer: Frontpath All Commercial |
$33.34
|
| Rate for Payer: Humana ChoiceCare |
$31.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$32.62
|
| Rate for Payer: PHCS All Commercial |
$27.18
|
| Rate for Payer: PHP All Commercial |
$27.48
|
| Rate for Payer: Sagamore Health Network All Products |
$27.98
|
| Rate for Payer: Signature Care EPO |
$30.08
|
| Rate for Payer: Signature Care PPO |
$31.89
|
| Rate for Payer: United Healthcare Commercial |
$28.56
|
|
|
HC VENIPUNCTURE
|
Facility
|
IP
|
$36.24
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
1260760
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.18 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Aetna Commercial |
$31.31
|
| Rate for Payer: Cash Price |
$21.74
|
| Rate for Payer: Cigna All Commercial |
$31.28
|
| Rate for Payer: CORVEL All Commercial |
$33.70
|
| Rate for Payer: Coventry All Commercial |
$31.89
|
| Rate for Payer: Encore All Commercial |
$33.36
|
| Rate for Payer: Frontpath All Commercial |
$33.34
|
| Rate for Payer: Humana ChoiceCare |
$31.30
|
| Rate for Payer: Lutheran Preferred All Commercial |
$32.62
|
| Rate for Payer: PHCS All Commercial |
$27.18
|
| Rate for Payer: PHP All Commercial |
$27.48
|
| Rate for Payer: Sagamore Health Network All Products |
$27.98
|
| Rate for Payer: Signature Care EPO |
$30.08
|
| Rate for Payer: Signature Care PPO |
$31.89
|
| Rate for Payer: United Healthcare Commercial |
$28.56
|
|
