|
HC VITAMIN C
|
Facility
|
OP
|
$160.45
|
|
|
Service Code
|
CPT 82180
|
| Hospital Charge Code |
63044083
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.89 |
| Max. Negotiated Rate |
$149.22 |
| Rate for Payer: Aetna Commercial |
$135.42
|
| Rate for Payer: Aetna Medicare |
$51.34
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$9.89
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$49.74
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$73.74
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$73.74
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$9.89
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$59.05
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$56.48
|
| Rate for Payer: Cash Price |
$96.27
|
| Rate for Payer: Cash Price |
$96.27
|
| Rate for Payer: Centivo All Commercial |
$87.28
|
| Rate for Payer: Cigna All Commercial |
$138.47
|
| Rate for Payer: CORVEL All Commercial |
$149.22
|
| Rate for Payer: Coventry All Commercial |
$141.20
|
| Rate for Payer: Encore All Commercial |
$147.69
|
| Rate for Payer: Frontpath All Commercial |
$147.61
|
| Rate for Payer: Humana ChoiceCare |
$138.58
|
| Rate for Payer: Humana Medicare |
$51.34
|
| Rate for Payer: Lucent All Commercial |
$87.28
|
| Rate for Payer: Lutheran Preferred All Commercial |
$144.41
|
| Rate for Payer: Managed Health Services Medicaid |
$9.89
|
| Rate for Payer: MDWise Medicaid |
$9.89
|
| Rate for Payer: PHCS All Commercial |
$120.34
|
| Rate for Payer: PHP All Commercial |
$121.69
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$62.58
|
| Rate for Payer: Sagamore Health Network All Products |
$123.87
|
| Rate for Payer: Signature Care EPO |
$133.17
|
| Rate for Payer: Signature Care PPO |
$141.20
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$136.38
|
| Rate for Payer: United Healthcare Commercial |
$126.43
|
| Rate for Payer: United Healthcare Medicare |
$51.34
|
|
|
HC VITAMIN D,25-HYDROXY
|
Facility
|
IP
|
$225.59
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
63001127
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$169.19 |
| Max. Negotiated Rate |
$209.80 |
| Rate for Payer: Aetna Commercial |
$194.91
|
| Rate for Payer: Cash Price |
$135.35
|
| Rate for Payer: Cigna All Commercial |
$194.68
|
| Rate for Payer: CORVEL All Commercial |
$209.80
|
| Rate for Payer: Coventry All Commercial |
$198.52
|
| Rate for Payer: Encore All Commercial |
$207.66
|
| Rate for Payer: Frontpath All Commercial |
$207.54
|
| Rate for Payer: Humana ChoiceCare |
$194.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$203.03
|
| Rate for Payer: PHCS All Commercial |
$169.19
|
| Rate for Payer: PHP All Commercial |
$171.09
|
| Rate for Payer: Sagamore Health Network All Products |
$174.16
|
| Rate for Payer: Signature Care EPO |
$187.24
|
| Rate for Payer: Signature Care PPO |
$198.52
|
| Rate for Payer: United Healthcare Commercial |
$177.76
|
|
|
HC VITAMIN D,25-HYDROXY
|
Facility
|
OP
|
$225.59
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
63001127
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$29.60 |
| Max. Negotiated Rate |
$209.80 |
| Rate for Payer: Aetna Commercial |
$190.40
|
| Rate for Payer: Aetna Medicare |
$72.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$29.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$69.93
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$103.68
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$103.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$29.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$83.02
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$79.41
|
| Rate for Payer: Cash Price |
$135.35
|
| Rate for Payer: Cash Price |
$135.35
|
| Rate for Payer: Centivo All Commercial |
$122.72
|
| Rate for Payer: Cigna All Commercial |
$194.68
|
| Rate for Payer: CORVEL All Commercial |
$209.80
|
| Rate for Payer: Coventry All Commercial |
$198.52
|
| Rate for Payer: Encore All Commercial |
$207.66
|
| Rate for Payer: Frontpath All Commercial |
$207.54
|
| Rate for Payer: Humana ChoiceCare |
$194.84
|
| Rate for Payer: Humana Medicare |
$72.19
|
| Rate for Payer: Lucent All Commercial |
$122.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$203.03
|
| Rate for Payer: Managed Health Services Medicaid |
$29.60
|
| Rate for Payer: MDWise Medicaid |
$29.60
|
| Rate for Payer: PHCS All Commercial |
$169.19
|
| Rate for Payer: PHP All Commercial |
$171.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$87.98
|
| Rate for Payer: Sagamore Health Network All Products |
$174.16
|
| Rate for Payer: Signature Care EPO |
$187.24
|
| Rate for Payer: Signature Care PPO |
$198.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$191.75
|
| Rate for Payer: United Healthcare Commercial |
$177.76
|
| Rate for Payer: United Healthcare Medicare |
$72.19
|
|
|
HC VITAMIN D2&D3 25 HYDROXY
|
Facility
|
OP
|
$225.59
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
63001473
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$29.60 |
| Max. Negotiated Rate |
$209.80 |
| Rate for Payer: Aetna Commercial |
$190.40
|
| Rate for Payer: Aetna Medicare |
$72.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$29.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$69.93
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$103.68
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$103.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$29.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$83.02
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$79.41
|
| Rate for Payer: Cash Price |
$135.35
|
| Rate for Payer: Cash Price |
$135.35
|
| Rate for Payer: Centivo All Commercial |
$122.72
|
| Rate for Payer: Cigna All Commercial |
$194.68
|
| Rate for Payer: CORVEL All Commercial |
$209.80
|
| Rate for Payer: Coventry All Commercial |
$198.52
|
| Rate for Payer: Encore All Commercial |
$207.66
|
| Rate for Payer: Frontpath All Commercial |
$207.54
|
| Rate for Payer: Humana ChoiceCare |
$194.84
|
| Rate for Payer: Humana Medicare |
$72.19
|
| Rate for Payer: Lucent All Commercial |
$122.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$203.03
|
| Rate for Payer: Managed Health Services Medicaid |
$29.60
|
| Rate for Payer: MDWise Medicaid |
$29.60
|
| Rate for Payer: PHCS All Commercial |
$169.19
|
| Rate for Payer: PHP All Commercial |
$171.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$87.98
|
| Rate for Payer: Sagamore Health Network All Products |
$174.16
|
| Rate for Payer: Signature Care EPO |
$187.24
|
| Rate for Payer: Signature Care PPO |
$198.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$191.75
|
| Rate for Payer: United Healthcare Commercial |
$177.76
|
| Rate for Payer: United Healthcare Medicare |
$72.19
|
|
|
HC VITAMIN D2&D3 25 HYDROXY
|
Facility
|
IP
|
$225.59
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
63001473
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$169.19 |
| Max. Negotiated Rate |
$209.80 |
| Rate for Payer: Aetna Commercial |
$194.91
|
| Rate for Payer: Cash Price |
$135.35
|
| Rate for Payer: Cigna All Commercial |
$194.68
|
| Rate for Payer: CORVEL All Commercial |
$209.80
|
| Rate for Payer: Coventry All Commercial |
$198.52
|
| Rate for Payer: Encore All Commercial |
$207.66
|
| Rate for Payer: Frontpath All Commercial |
$207.54
|
| Rate for Payer: Humana ChoiceCare |
$194.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$203.03
|
| Rate for Payer: PHCS All Commercial |
$169.19
|
| Rate for Payer: PHP All Commercial |
$171.09
|
| Rate for Payer: Sagamore Health Network All Products |
$174.16
|
| Rate for Payer: Signature Care EPO |
$187.24
|
| Rate for Payer: Signature Care PPO |
$198.52
|
| Rate for Payer: United Healthcare Commercial |
$177.76
|
|
|
HC VITAMIN E
|
Facility
|
IP
|
$166.55
|
|
|
Service Code
|
CPT 84446
|
| Hospital Charge Code |
63001695
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$124.91 |
| Max. Negotiated Rate |
$154.89 |
| Rate for Payer: Aetna Commercial |
$143.90
|
| Rate for Payer: Cash Price |
$99.93
|
| Rate for Payer: Cigna All Commercial |
$143.73
|
| Rate for Payer: CORVEL All Commercial |
$154.89
|
| Rate for Payer: Coventry All Commercial |
$146.56
|
| Rate for Payer: Encore All Commercial |
$153.31
|
| Rate for Payer: Frontpath All Commercial |
$153.23
|
| Rate for Payer: Humana ChoiceCare |
$143.85
|
| Rate for Payer: Lutheran Preferred All Commercial |
$149.90
|
| Rate for Payer: PHCS All Commercial |
$124.91
|
| Rate for Payer: PHP All Commercial |
$126.31
|
| Rate for Payer: Sagamore Health Network All Products |
$128.58
|
| Rate for Payer: Signature Care EPO |
$138.24
|
| Rate for Payer: Signature Care PPO |
$146.56
|
| Rate for Payer: United Healthcare Commercial |
$131.24
|
|
|
HC VITAMIN E
|
Facility
|
OP
|
$166.55
|
|
|
Service Code
|
CPT 84446
|
| Hospital Charge Code |
63001695
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.18 |
| Max. Negotiated Rate |
$154.89 |
| Rate for Payer: Aetna Commercial |
$140.57
|
| Rate for Payer: Aetna Medicare |
$53.30
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$14.18
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$51.63
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$76.55
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$76.55
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$14.18
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$61.29
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$58.63
|
| Rate for Payer: Cash Price |
$99.93
|
| Rate for Payer: Cash Price |
$99.93
|
| Rate for Payer: Centivo All Commercial |
$90.60
|
| Rate for Payer: Cigna All Commercial |
$143.73
|
| Rate for Payer: CORVEL All Commercial |
$154.89
|
| Rate for Payer: Coventry All Commercial |
$146.56
|
| Rate for Payer: Encore All Commercial |
$153.31
|
| Rate for Payer: Frontpath All Commercial |
$153.23
|
| Rate for Payer: Humana ChoiceCare |
$143.85
|
| Rate for Payer: Humana Medicare |
$53.30
|
| Rate for Payer: Lucent All Commercial |
$90.60
|
| Rate for Payer: Lutheran Preferred All Commercial |
$149.90
|
| Rate for Payer: Managed Health Services Medicaid |
$14.18
|
| Rate for Payer: MDWise Medicaid |
$14.18
|
| Rate for Payer: PHCS All Commercial |
$124.91
|
| Rate for Payer: PHP All Commercial |
$126.31
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$64.95
|
| Rate for Payer: Sagamore Health Network All Products |
$128.58
|
| Rate for Payer: Signature Care EPO |
$138.24
|
| Rate for Payer: Signature Care PPO |
$146.56
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$141.57
|
| Rate for Payer: United Healthcare Commercial |
$131.24
|
| Rate for Payer: United Healthcare Medicare |
$53.30
|
|
|
HC VITAMIN K
|
Facility
|
OP
|
$417.38
|
|
|
Service Code
|
CPT 84597
|
| Hospital Charge Code |
63001717
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.72 |
| Max. Negotiated Rate |
$388.16 |
| Rate for Payer: Aetna Commercial |
$352.27
|
| Rate for Payer: Aetna Medicare |
$133.56
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$13.72
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$129.39
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$191.83
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$191.83
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$13.72
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$153.60
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$146.92
|
| Rate for Payer: Cash Price |
$250.43
|
| Rate for Payer: Cash Price |
$250.43
|
| Rate for Payer: Centivo All Commercial |
$227.05
|
| Rate for Payer: Cigna All Commercial |
$360.20
|
| Rate for Payer: CORVEL All Commercial |
$388.16
|
| Rate for Payer: Coventry All Commercial |
$367.29
|
| Rate for Payer: Encore All Commercial |
$384.20
|
| Rate for Payer: Frontpath All Commercial |
$383.99
|
| Rate for Payer: Humana ChoiceCare |
$360.49
|
| Rate for Payer: Humana Medicare |
$133.56
|
| Rate for Payer: Lucent All Commercial |
$227.05
|
| Rate for Payer: Lutheran Preferred All Commercial |
$375.64
|
| Rate for Payer: Managed Health Services Medicaid |
$13.72
|
| Rate for Payer: MDWise Medicaid |
$13.72
|
| Rate for Payer: PHCS All Commercial |
$313.04
|
| Rate for Payer: PHP All Commercial |
$316.54
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$162.78
|
| Rate for Payer: Sagamore Health Network All Products |
$322.22
|
| Rate for Payer: Signature Care EPO |
$346.43
|
| Rate for Payer: Signature Care PPO |
$367.29
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$354.77
|
| Rate for Payer: United Healthcare Commercial |
$328.90
|
| Rate for Payer: United Healthcare Medicare |
$133.56
|
|
|
HC VITAMIN K
|
Facility
|
IP
|
$417.38
|
|
|
Service Code
|
CPT 84597
|
| Hospital Charge Code |
63001717
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$313.04 |
| Max. Negotiated Rate |
$388.16 |
| Rate for Payer: Aetna Commercial |
$360.62
|
| Rate for Payer: Cash Price |
$250.43
|
| Rate for Payer: Cigna All Commercial |
$360.20
|
| Rate for Payer: CORVEL All Commercial |
$388.16
|
| Rate for Payer: Coventry All Commercial |
$367.29
|
| Rate for Payer: Encore All Commercial |
$384.20
|
| Rate for Payer: Frontpath All Commercial |
$383.99
|
| Rate for Payer: Humana ChoiceCare |
$360.49
|
| Rate for Payer: Lutheran Preferred All Commercial |
$375.64
|
| Rate for Payer: PHCS All Commercial |
$313.04
|
| Rate for Payer: PHP All Commercial |
$316.54
|
| Rate for Payer: Sagamore Health Network All Products |
$322.22
|
| Rate for Payer: Signature Care EPO |
$346.43
|
| Rate for Payer: Signature Care PPO |
$367.29
|
| Rate for Payer: United Healthcare Commercial |
$328.90
|
|
|
HC VIT D 1 25
|
Facility
|
OP
|
$303.79
|
|
|
Service Code
|
CPT 82652
|
| Hospital Charge Code |
63001530
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$38.50 |
| Max. Negotiated Rate |
$282.52 |
| Rate for Payer: Aetna Commercial |
$256.40
|
| Rate for Payer: Aetna Medicare |
$97.21
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$38.50
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$94.17
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$139.62
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$139.62
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$38.50
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$111.79
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$106.93
|
| Rate for Payer: Cash Price |
$182.27
|
| Rate for Payer: Cash Price |
$182.27
|
| Rate for Payer: Centivo All Commercial |
$165.26
|
| Rate for Payer: Cigna All Commercial |
$262.17
|
| Rate for Payer: CORVEL All Commercial |
$282.52
|
| Rate for Payer: Coventry All Commercial |
$267.34
|
| Rate for Payer: Encore All Commercial |
$279.64
|
| Rate for Payer: Frontpath All Commercial |
$279.49
|
| Rate for Payer: Humana ChoiceCare |
$262.38
|
| Rate for Payer: Humana Medicare |
$97.21
|
| Rate for Payer: Lucent All Commercial |
$165.26
|
| Rate for Payer: Lutheran Preferred All Commercial |
$273.41
|
| Rate for Payer: Managed Health Services Medicaid |
$38.50
|
| Rate for Payer: MDWise Medicaid |
$38.50
|
| Rate for Payer: PHCS All Commercial |
$227.84
|
| Rate for Payer: PHP All Commercial |
$230.39
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$118.48
|
| Rate for Payer: Sagamore Health Network All Products |
$234.53
|
| Rate for Payer: Signature Care EPO |
$252.15
|
| Rate for Payer: Signature Care PPO |
$267.34
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$258.22
|
| Rate for Payer: United Healthcare Commercial |
$239.39
|
| Rate for Payer: United Healthcare Medicare |
$97.21
|
|
|
HC VIT D 1 25
|
Facility
|
IP
|
$303.79
|
|
|
Service Code
|
CPT 82652
|
| Hospital Charge Code |
63001530
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$227.84 |
| Max. Negotiated Rate |
$282.52 |
| Rate for Payer: Aetna Commercial |
$262.47
|
| Rate for Payer: Cash Price |
$182.27
|
| Rate for Payer: Cigna All Commercial |
$262.17
|
| Rate for Payer: CORVEL All Commercial |
$282.52
|
| Rate for Payer: Coventry All Commercial |
$267.34
|
| Rate for Payer: Encore All Commercial |
$279.64
|
| Rate for Payer: Frontpath All Commercial |
$279.49
|
| Rate for Payer: Humana ChoiceCare |
$262.38
|
| Rate for Payer: Lutheran Preferred All Commercial |
$273.41
|
| Rate for Payer: PHCS All Commercial |
$227.84
|
| Rate for Payer: PHP All Commercial |
$230.39
|
| Rate for Payer: Sagamore Health Network All Products |
$234.53
|
| Rate for Payer: Signature Care EPO |
$252.15
|
| Rate for Payer: Signature Care PPO |
$267.34
|
| Rate for Payer: United Healthcare Commercial |
$239.39
|
|
|
HC VIT D 25 HYDROXYQ
|
Facility
|
OP
|
$225.59
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
63001126
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$29.60 |
| Max. Negotiated Rate |
$209.80 |
| Rate for Payer: Aetna Commercial |
$190.40
|
| Rate for Payer: Aetna Medicare |
$72.19
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$29.60
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$69.93
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$103.68
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$103.68
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$29.60
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$83.02
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$79.41
|
| Rate for Payer: Cash Price |
$135.35
|
| Rate for Payer: Cash Price |
$135.35
|
| Rate for Payer: Centivo All Commercial |
$122.72
|
| Rate for Payer: Cigna All Commercial |
$194.68
|
| Rate for Payer: CORVEL All Commercial |
$209.80
|
| Rate for Payer: Coventry All Commercial |
$198.52
|
| Rate for Payer: Encore All Commercial |
$207.66
|
| Rate for Payer: Frontpath All Commercial |
$207.54
|
| Rate for Payer: Humana ChoiceCare |
$194.84
|
| Rate for Payer: Humana Medicare |
$72.19
|
| Rate for Payer: Lucent All Commercial |
$122.72
|
| Rate for Payer: Lutheran Preferred All Commercial |
$203.03
|
| Rate for Payer: Managed Health Services Medicaid |
$29.60
|
| Rate for Payer: MDWise Medicaid |
$29.60
|
| Rate for Payer: PHCS All Commercial |
$169.19
|
| Rate for Payer: PHP All Commercial |
$171.09
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$87.98
|
| Rate for Payer: Sagamore Health Network All Products |
$174.16
|
| Rate for Payer: Signature Care EPO |
$187.24
|
| Rate for Payer: Signature Care PPO |
$198.52
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$191.75
|
| Rate for Payer: United Healthcare Commercial |
$177.76
|
| Rate for Payer: United Healthcare Medicare |
$72.19
|
|
|
HC VIT D 25 HYDROXYQ
|
Facility
|
IP
|
$225.59
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
63001126
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$169.19 |
| Max. Negotiated Rate |
$209.80 |
| Rate for Payer: Aetna Commercial |
$194.91
|
| Rate for Payer: Cash Price |
$135.35
|
| Rate for Payer: Cigna All Commercial |
$194.68
|
| Rate for Payer: CORVEL All Commercial |
$209.80
|
| Rate for Payer: Coventry All Commercial |
$198.52
|
| Rate for Payer: Encore All Commercial |
$207.66
|
| Rate for Payer: Frontpath All Commercial |
$207.54
|
| Rate for Payer: Humana ChoiceCare |
$194.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$203.03
|
| Rate for Payer: PHCS All Commercial |
$169.19
|
| Rate for Payer: PHP All Commercial |
$171.09
|
| Rate for Payer: Sagamore Health Network All Products |
$174.16
|
| Rate for Payer: Signature Care EPO |
$187.24
|
| Rate for Payer: Signature Care PPO |
$198.52
|
| Rate for Payer: United Healthcare Commercial |
$177.76
|
|
|
HC VOIDING CYSTOGRAM
|
Facility
|
OP
|
$1,288.63
|
|
|
Service Code
|
CPT 74455
|
| Hospital Charge Code |
1614456
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$47.48 |
| Max. Negotiated Rate |
$1,198.43 |
| Rate for Payer: Aetna Commercial |
$1,087.60
|
| Rate for Payer: Aetna Medicare |
$412.36
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$47.48
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$399.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$740.06
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$805.52
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$47.48
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$474.22
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$453.60
|
| Rate for Payer: Cash Price |
$773.18
|
| Rate for Payer: Cash Price |
$773.18
|
| Rate for Payer: Centivo All Commercial |
$701.01
|
| Rate for Payer: Cigna All Commercial |
$1,112.09
|
| Rate for Payer: CORVEL All Commercial |
$1,198.43
|
| Rate for Payer: Coventry All Commercial |
$1,133.99
|
| Rate for Payer: Encore All Commercial |
$1,186.18
|
| Rate for Payer: Frontpath All Commercial |
$1,185.54
|
| Rate for Payer: Humana ChoiceCare |
$1,112.99
|
| Rate for Payer: Humana Medicare |
$412.36
|
| Rate for Payer: Lucent All Commercial |
$701.01
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,159.77
|
| Rate for Payer: Managed Health Services Medicaid |
$47.48
|
| Rate for Payer: MDWise Medicaid |
$47.48
|
| Rate for Payer: PHCS All Commercial |
$966.47
|
| Rate for Payer: PHP All Commercial |
$977.30
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$502.57
|
| Rate for Payer: Sagamore Health Network All Products |
$994.82
|
| Rate for Payer: Signature Care EPO |
$1,069.56
|
| Rate for Payer: Signature Care PPO |
$1,133.99
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,095.34
|
| Rate for Payer: United Healthcare Commercial |
$1,015.44
|
| Rate for Payer: United Healthcare Medicare |
$412.36
|
|
|
HC VOIDING CYSTOGRAM
|
Facility
|
IP
|
$1,288.63
|
|
|
Service Code
|
CPT 74455
|
| Hospital Charge Code |
1614456
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$966.47 |
| Max. Negotiated Rate |
$1,198.43 |
| Rate for Payer: Aetna Commercial |
$1,113.38
|
| Rate for Payer: Cash Price |
$773.18
|
| Rate for Payer: Cigna All Commercial |
$1,112.09
|
| Rate for Payer: CORVEL All Commercial |
$1,198.43
|
| Rate for Payer: Coventry All Commercial |
$1,133.99
|
| Rate for Payer: Encore All Commercial |
$1,186.18
|
| Rate for Payer: Frontpath All Commercial |
$1,185.54
|
| Rate for Payer: Humana ChoiceCare |
$1,112.99
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,159.77
|
| Rate for Payer: PHCS All Commercial |
$966.47
|
| Rate for Payer: PHP All Commercial |
$977.30
|
| Rate for Payer: Sagamore Health Network All Products |
$994.82
|
| Rate for Payer: Signature Care EPO |
$1,069.56
|
| Rate for Payer: Signature Care PPO |
$1,133.99
|
| Rate for Payer: United Healthcare Commercial |
$1,015.44
|
|
|
HC VON WILLEBRAND FACTOR AG
|
Facility
|
OP
|
$281.62
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
63001737
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.94 |
| Max. Negotiated Rate |
$261.91 |
| Rate for Payer: Aetna Commercial |
$237.69
|
| Rate for Payer: Aetna Medicare |
$90.12
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$22.94
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$87.30
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$129.43
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$129.43
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$22.94
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$103.64
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$99.13
|
| Rate for Payer: Cash Price |
$168.97
|
| Rate for Payer: Cash Price |
$168.97
|
| Rate for Payer: Centivo All Commercial |
$153.20
|
| Rate for Payer: Cigna All Commercial |
$243.04
|
| Rate for Payer: CORVEL All Commercial |
$261.91
|
| Rate for Payer: Coventry All Commercial |
$247.83
|
| Rate for Payer: Encore All Commercial |
$259.23
|
| Rate for Payer: Frontpath All Commercial |
$259.09
|
| Rate for Payer: Humana ChoiceCare |
$243.24
|
| Rate for Payer: Humana Medicare |
$90.12
|
| Rate for Payer: Lucent All Commercial |
$153.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$253.46
|
| Rate for Payer: Managed Health Services Medicaid |
$22.94
|
| Rate for Payer: MDWise Medicaid |
$22.94
|
| Rate for Payer: PHCS All Commercial |
$211.22
|
| Rate for Payer: PHP All Commercial |
$213.58
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$109.83
|
| Rate for Payer: Sagamore Health Network All Products |
$217.41
|
| Rate for Payer: Signature Care EPO |
$233.74
|
| Rate for Payer: Signature Care PPO |
$247.83
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$239.38
|
| Rate for Payer: United Healthcare Commercial |
$221.92
|
| Rate for Payer: United Healthcare Medicare |
$90.12
|
|
|
HC VON WILLEBRAND FACTOR AG
|
Facility
|
IP
|
$281.62
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
63001737
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$211.22 |
| Max. Negotiated Rate |
$261.91 |
| Rate for Payer: Aetna Commercial |
$243.32
|
| Rate for Payer: Cash Price |
$168.97
|
| Rate for Payer: Cigna All Commercial |
$243.04
|
| Rate for Payer: CORVEL All Commercial |
$261.91
|
| Rate for Payer: Coventry All Commercial |
$247.83
|
| Rate for Payer: Encore All Commercial |
$259.23
|
| Rate for Payer: Frontpath All Commercial |
$259.09
|
| Rate for Payer: Humana ChoiceCare |
$243.24
|
| Rate for Payer: Lutheran Preferred All Commercial |
$253.46
|
| Rate for Payer: PHCS All Commercial |
$211.22
|
| Rate for Payer: PHP All Commercial |
$213.58
|
| Rate for Payer: Sagamore Health Network All Products |
$217.41
|
| Rate for Payer: Signature Care EPO |
$233.74
|
| Rate for Payer: Signature Care PPO |
$247.83
|
| Rate for Payer: United Healthcare Commercial |
$221.92
|
|
|
HC VP CANDIDA DNA DIR PROBE
|
Facility
|
OP
|
$46.72
|
|
|
Service Code
|
CPT 87480
|
| Hospital Charge Code |
63087804
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$43.45 |
| Rate for Payer: Aetna Commercial |
$39.43
|
| Rate for Payer: Aetna Medicare |
$14.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$20.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$14.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$21.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$21.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$20.05
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$17.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$16.45
|
| Rate for Payer: Cash Price |
$28.03
|
| Rate for Payer: Cash Price |
$28.03
|
| Rate for Payer: Centivo All Commercial |
$25.42
|
| Rate for Payer: Cigna All Commercial |
$40.32
|
| Rate for Payer: CORVEL All Commercial |
$43.45
|
| Rate for Payer: Coventry All Commercial |
$41.11
|
| Rate for Payer: Encore All Commercial |
$43.01
|
| Rate for Payer: Frontpath All Commercial |
$42.98
|
| Rate for Payer: Humana ChoiceCare |
$40.35
|
| Rate for Payer: Humana Medicare |
$14.95
|
| Rate for Payer: Lucent All Commercial |
$25.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$42.05
|
| Rate for Payer: Managed Health Services Medicaid |
$20.05
|
| Rate for Payer: MDWise Medicaid |
$20.05
|
| Rate for Payer: PHCS All Commercial |
$35.04
|
| Rate for Payer: PHP All Commercial |
$35.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$18.22
|
| Rate for Payer: Sagamore Health Network All Products |
$36.07
|
| Rate for Payer: Signature Care EPO |
$38.78
|
| Rate for Payer: Signature Care PPO |
$41.11
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$39.71
|
| Rate for Payer: United Healthcare Commercial |
$36.82
|
| Rate for Payer: United Healthcare Medicare |
$14.95
|
|
|
HC VP CANDIDA DNA DIR PROBE
|
Facility
|
IP
|
$46.72
|
|
|
Service Code
|
CPT 87480
|
| Hospital Charge Code |
63087804
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.04 |
| Max. Negotiated Rate |
$43.45 |
| Rate for Payer: Aetna Commercial |
$40.37
|
| Rate for Payer: Cash Price |
$28.03
|
| Rate for Payer: Cigna All Commercial |
$40.32
|
| Rate for Payer: CORVEL All Commercial |
$43.45
|
| Rate for Payer: Coventry All Commercial |
$41.11
|
| Rate for Payer: Encore All Commercial |
$43.01
|
| Rate for Payer: Frontpath All Commercial |
$42.98
|
| Rate for Payer: Humana ChoiceCare |
$40.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$42.05
|
| Rate for Payer: PHCS All Commercial |
$35.04
|
| Rate for Payer: PHP All Commercial |
$35.43
|
| Rate for Payer: Sagamore Health Network All Products |
$36.07
|
| Rate for Payer: Signature Care EPO |
$38.78
|
| Rate for Payer: Signature Care PPO |
$41.11
|
| Rate for Payer: United Healthcare Commercial |
$36.82
|
|
|
HC VP GARDNER VAG DNA DIR PROBE
|
Facility
|
IP
|
$46.72
|
|
|
Service Code
|
CPT 87510
|
| Hospital Charge Code |
63087805
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.04 |
| Max. Negotiated Rate |
$43.45 |
| Rate for Payer: Aetna Commercial |
$40.37
|
| Rate for Payer: Cash Price |
$28.03
|
| Rate for Payer: Cigna All Commercial |
$40.32
|
| Rate for Payer: CORVEL All Commercial |
$43.45
|
| Rate for Payer: Coventry All Commercial |
$41.11
|
| Rate for Payer: Encore All Commercial |
$43.01
|
| Rate for Payer: Frontpath All Commercial |
$42.98
|
| Rate for Payer: Humana ChoiceCare |
$40.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$42.05
|
| Rate for Payer: PHCS All Commercial |
$35.04
|
| Rate for Payer: PHP All Commercial |
$35.43
|
| Rate for Payer: Sagamore Health Network All Products |
$36.07
|
| Rate for Payer: Signature Care EPO |
$38.78
|
| Rate for Payer: Signature Care PPO |
$41.11
|
| Rate for Payer: United Healthcare Commercial |
$36.82
|
|
|
HC VP GARDNER VAG DNA DIR PROBE
|
Facility
|
OP
|
$46.72
|
|
|
Service Code
|
CPT 87510
|
| Hospital Charge Code |
63087805
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$43.45 |
| Rate for Payer: Aetna Commercial |
$39.43
|
| Rate for Payer: Aetna Medicare |
$14.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$20.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$14.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$21.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$21.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$20.05
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$17.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$16.45
|
| Rate for Payer: Cash Price |
$28.03
|
| Rate for Payer: Cash Price |
$28.03
|
| Rate for Payer: Centivo All Commercial |
$25.42
|
| Rate for Payer: Cigna All Commercial |
$40.32
|
| Rate for Payer: CORVEL All Commercial |
$43.45
|
| Rate for Payer: Coventry All Commercial |
$41.11
|
| Rate for Payer: Encore All Commercial |
$43.01
|
| Rate for Payer: Frontpath All Commercial |
$42.98
|
| Rate for Payer: Humana ChoiceCare |
$40.35
|
| Rate for Payer: Humana Medicare |
$14.95
|
| Rate for Payer: Lucent All Commercial |
$25.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$42.05
|
| Rate for Payer: Managed Health Services Medicaid |
$20.05
|
| Rate for Payer: MDWise Medicaid |
$20.05
|
| Rate for Payer: PHCS All Commercial |
$35.04
|
| Rate for Payer: PHP All Commercial |
$35.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$18.22
|
| Rate for Payer: Sagamore Health Network All Products |
$36.07
|
| Rate for Payer: Signature Care EPO |
$38.78
|
| Rate for Payer: Signature Care PPO |
$41.11
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$39.71
|
| Rate for Payer: United Healthcare Commercial |
$36.82
|
| Rate for Payer: United Healthcare Medicare |
$14.95
|
|
|
HC VP TRICHOMONAS VAGIN DIR PROBE
|
Facility
|
OP
|
$46.72
|
|
|
Service Code
|
CPT 87660
|
| Hospital Charge Code |
63087806
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$43.45 |
| Rate for Payer: Aetna Commercial |
$39.43
|
| Rate for Payer: Aetna Medicare |
$14.95
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$20.05
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$14.48
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$21.47
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$21.47
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$20.05
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$17.19
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$16.45
|
| Rate for Payer: Cash Price |
$28.03
|
| Rate for Payer: Cash Price |
$28.03
|
| Rate for Payer: Centivo All Commercial |
$25.42
|
| Rate for Payer: Cigna All Commercial |
$40.32
|
| Rate for Payer: CORVEL All Commercial |
$43.45
|
| Rate for Payer: Coventry All Commercial |
$41.11
|
| Rate for Payer: Encore All Commercial |
$43.01
|
| Rate for Payer: Frontpath All Commercial |
$42.98
|
| Rate for Payer: Humana ChoiceCare |
$40.35
|
| Rate for Payer: Humana Medicare |
$14.95
|
| Rate for Payer: Lucent All Commercial |
$25.42
|
| Rate for Payer: Lutheran Preferred All Commercial |
$42.05
|
| Rate for Payer: Managed Health Services Medicaid |
$20.05
|
| Rate for Payer: MDWise Medicaid |
$20.05
|
| Rate for Payer: PHCS All Commercial |
$35.04
|
| Rate for Payer: PHP All Commercial |
$35.43
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$18.22
|
| Rate for Payer: Sagamore Health Network All Products |
$36.07
|
| Rate for Payer: Signature Care EPO |
$38.78
|
| Rate for Payer: Signature Care PPO |
$41.11
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$39.71
|
| Rate for Payer: United Healthcare Commercial |
$36.82
|
| Rate for Payer: United Healthcare Medicare |
$14.95
|
|
|
HC VP TRICHOMONAS VAGIN DIR PROBE
|
Facility
|
IP
|
$46.72
|
|
|
Service Code
|
CPT 87660
|
| Hospital Charge Code |
63087806
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.04 |
| Max. Negotiated Rate |
$43.45 |
| Rate for Payer: Aetna Commercial |
$40.37
|
| Rate for Payer: Cash Price |
$28.03
|
| Rate for Payer: Cigna All Commercial |
$40.32
|
| Rate for Payer: CORVEL All Commercial |
$43.45
|
| Rate for Payer: Coventry All Commercial |
$41.11
|
| Rate for Payer: Encore All Commercial |
$43.01
|
| Rate for Payer: Frontpath All Commercial |
$42.98
|
| Rate for Payer: Humana ChoiceCare |
$40.35
|
| Rate for Payer: Lutheran Preferred All Commercial |
$42.05
|
| Rate for Payer: PHCS All Commercial |
$35.04
|
| Rate for Payer: PHP All Commercial |
$35.43
|
| Rate for Payer: Sagamore Health Network All Products |
$36.07
|
| Rate for Payer: Signature Care EPO |
$38.78
|
| Rate for Payer: Signature Care PPO |
$41.11
|
| Rate for Payer: United Healthcare Commercial |
$36.82
|
|
|
HC WAND SERFAS ENERGY 50-S SWEEP
|
Facility
|
OP
|
$1,812.20
|
|
| Hospital Charge Code |
41606316
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$1,685.35 |
| Rate for Payer: Aetna Commercial |
$1,529.50
|
| Rate for Payer: Aetna Medicare |
$579.90
|
| Rate for Payer: Anthem Blue Cross of IN Medicaid |
$31.20
|
| Rate for Payer: Anthem Blue Cross of IN Medicare |
$561.78
|
| Rate for Payer: Anthem Blue Cross of IN PPO/Pathway |
$1,040.75
|
| Rate for Payer: Anthem Blue Cross of IN Traditional |
$1,132.81
|
| Rate for Payer: CareSource Indiana of IN Hoosier Healthwise/HIP |
$31.20
|
| Rate for Payer: CareSource Indiana of IN Just 4 Me |
$666.89
|
| Rate for Payer: CareSource Indiana of IN Medicare |
$637.89
|
| Rate for Payer: Cash Price |
$1,087.32
|
| Rate for Payer: Cash Price |
$1,087.32
|
| Rate for Payer: Centivo All Commercial |
$985.84
|
| Rate for Payer: Cigna All Commercial |
$1,563.93
|
| Rate for Payer: CORVEL All Commercial |
$1,685.35
|
| Rate for Payer: Coventry All Commercial |
$1,594.74
|
| Rate for Payer: Encore All Commercial |
$1,668.13
|
| Rate for Payer: Frontpath All Commercial |
$1,667.22
|
| Rate for Payer: Humana ChoiceCare |
$1,565.20
|
| Rate for Payer: Humana Medicare |
$579.90
|
| Rate for Payer: Lucent All Commercial |
$985.84
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,630.98
|
| Rate for Payer: Managed Health Services Medicaid |
$31.20
|
| Rate for Payer: MDWise Medicaid |
$31.20
|
| Rate for Payer: PHCS All Commercial |
$1,359.15
|
| Rate for Payer: PHP All Commercial |
$1,374.37
|
| Rate for Payer: Plain Church Group Ministry All Commercial |
$706.76
|
| Rate for Payer: Sagamore Health Network All Products |
$1,399.02
|
| Rate for Payer: Signature Care EPO |
$1,504.13
|
| Rate for Payer: Signature Care PPO |
$1,594.74
|
| Rate for Payer: Three Rivers Preferred All Commercial |
$1,540.37
|
| Rate for Payer: United Healthcare Commercial |
$1,428.01
|
| Rate for Payer: United Healthcare Medicare |
$579.90
|
|
|
HC WAND SERFAS ENERGY 50-S SWEEP
|
Facility
|
IP
|
$1,812.20
|
|
| Hospital Charge Code |
41606316
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,359.15 |
| Max. Negotiated Rate |
$1,685.35 |
| Rate for Payer: Aetna Commercial |
$1,565.74
|
| Rate for Payer: Cash Price |
$1,087.32
|
| Rate for Payer: Cigna All Commercial |
$1,563.93
|
| Rate for Payer: CORVEL All Commercial |
$1,685.35
|
| Rate for Payer: Coventry All Commercial |
$1,594.74
|
| Rate for Payer: Encore All Commercial |
$1,668.13
|
| Rate for Payer: Frontpath All Commercial |
$1,667.22
|
| Rate for Payer: Humana ChoiceCare |
$1,565.20
|
| Rate for Payer: Lutheran Preferred All Commercial |
$1,630.98
|
| Rate for Payer: PHCS All Commercial |
$1,359.15
|
| Rate for Payer: PHP All Commercial |
$1,374.37
|
| Rate for Payer: Sagamore Health Network All Products |
$1,399.02
|
| Rate for Payer: Signature Care EPO |
$1,504.13
|
| Rate for Payer: Signature Care PPO |
$1,594.74
|
| Rate for Payer: United Healthcare Commercial |
$1,428.01
|
|
