Price Transparency.

Search and browse your out-of-pocket costs for provider care & services.

search
Charge Type Price  
Service Code CPT C1713
Hospital Charge Code 41601681
Hospital Revenue Code 278
Min. Negotiated Rate $81.58
Max. Negotiated Rate $101.17
Rate for Payer: Aetna Commercial $93.99
Rate for Payer: Cash Price $67.44
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: United Healthcare Commercial $85.72
Service Code CPT C1713
Hospital Charge Code 41601681
Hospital Revenue Code 278
Min. Negotiated Rate $35.90
Max. Negotiated Rate $524.16
Rate for Payer: Aetna Commercial $91.81
Rate for Payer: Aetna Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $62.47
Rate for Payer: Anthem Blue Cross of IN Traditional $68.00
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $41.28
Rate for Payer: CareSource Indiana of IN Medicare $39.49
Rate for Payer: Cash Price $67.44
Rate for Payer: Cash Price $67.44
Rate for Payer: Centivo All Commercial $55.48
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Humana Medicare $55.48
Rate for Payer: Lucent All Commercial $55.48
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Plain Church Group Ministry All Commercial $42.42
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: Three Rivers Preferred All Commercial $92.46
Rate for Payer: United Healthcare Commercial $85.72
Rate for Payer: United Healthcare Medicare $35.90
Service Code CPT C1713
Hospital Charge Code 41601682
Hospital Revenue Code 278
Min. Negotiated Rate $35.90
Max. Negotiated Rate $524.16
Rate for Payer: Aetna Commercial $91.81
Rate for Payer: Aetna Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $62.47
Rate for Payer: Anthem Blue Cross of IN Traditional $68.00
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $41.28
Rate for Payer: CareSource Indiana of IN Medicare $39.49
Rate for Payer: Cash Price $67.44
Rate for Payer: Cash Price $67.44
Rate for Payer: Centivo All Commercial $55.48
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Humana Medicare $55.48
Rate for Payer: Lucent All Commercial $55.48
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Plain Church Group Ministry All Commercial $42.42
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: Three Rivers Preferred All Commercial $92.46
Rate for Payer: United Healthcare Commercial $85.72
Rate for Payer: United Healthcare Medicare $35.90
Service Code CPT C1713
Hospital Charge Code 41601682
Hospital Revenue Code 278
Min. Negotiated Rate $81.58
Max. Negotiated Rate $101.17
Rate for Payer: Aetna Commercial $93.99
Rate for Payer: Cash Price $67.44
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: United Healthcare Commercial $85.72
Service Code CPT C1713
Hospital Charge Code 41601683
Hospital Revenue Code 278
Min. Negotiated Rate $35.90
Max. Negotiated Rate $524.16
Rate for Payer: Aetna Commercial $91.81
Rate for Payer: Aetna Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $62.47
Rate for Payer: Anthem Blue Cross of IN Traditional $68.00
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $41.28
Rate for Payer: CareSource Indiana of IN Medicare $39.49
Rate for Payer: Cash Price $67.44
Rate for Payer: Cash Price $67.44
Rate for Payer: Centivo All Commercial $55.48
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Humana Medicare $55.48
Rate for Payer: Lucent All Commercial $55.48
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Plain Church Group Ministry All Commercial $42.42
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: Three Rivers Preferred All Commercial $92.46
Rate for Payer: United Healthcare Commercial $85.72
Rate for Payer: United Healthcare Medicare $35.90
Service Code CPT C1713
Hospital Charge Code 41601683
Hospital Revenue Code 278
Min. Negotiated Rate $81.58
Max. Negotiated Rate $101.17
Rate for Payer: Aetna Commercial $93.99
Rate for Payer: Cash Price $67.44
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: United Healthcare Commercial $85.72
Service Code CPT C1713
Hospital Charge Code 41601684
Hospital Revenue Code 278
Min. Negotiated Rate $35.90
Max. Negotiated Rate $524.16
Rate for Payer: Aetna Commercial $91.81
Rate for Payer: Aetna Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $62.47
Rate for Payer: Anthem Blue Cross of IN Traditional $68.00
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $41.28
Rate for Payer: CareSource Indiana of IN Medicare $39.49
Rate for Payer: Cash Price $67.44
Rate for Payer: Cash Price $67.44
Rate for Payer: Centivo All Commercial $55.48
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Humana Medicare $55.48
Rate for Payer: Lucent All Commercial $55.48
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Plain Church Group Ministry All Commercial $42.42
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: Three Rivers Preferred All Commercial $92.46
Rate for Payer: United Healthcare Commercial $85.72
Rate for Payer: United Healthcare Medicare $35.90
Service Code CPT C1713
Hospital Charge Code 41601684
Hospital Revenue Code 278
Min. Negotiated Rate $81.58
Max. Negotiated Rate $101.17
Rate for Payer: Aetna Commercial $93.99
Rate for Payer: Cash Price $67.44
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: United Healthcare Commercial $85.72
Service Code CPT C1713
Hospital Charge Code 41601685
Hospital Revenue Code 278
Min. Negotiated Rate $81.58
Max. Negotiated Rate $101.17
Rate for Payer: Aetna Commercial $93.99
Rate for Payer: Cash Price $67.44
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: United Healthcare Commercial $85.72
Service Code CPT C1713
Hospital Charge Code 41601685
Hospital Revenue Code 278
Min. Negotiated Rate $35.90
Max. Negotiated Rate $524.16
Rate for Payer: Aetna Commercial $91.81
Rate for Payer: Aetna Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $62.47
Rate for Payer: Anthem Blue Cross of IN Traditional $68.00
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $41.28
Rate for Payer: CareSource Indiana of IN Medicare $39.49
Rate for Payer: Cash Price $67.44
Rate for Payer: Cash Price $67.44
Rate for Payer: Centivo All Commercial $55.48
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Humana Medicare $55.48
Rate for Payer: Lucent All Commercial $55.48
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Plain Church Group Ministry All Commercial $42.42
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: Three Rivers Preferred All Commercial $92.46
Rate for Payer: United Healthcare Commercial $85.72
Rate for Payer: United Healthcare Medicare $35.90
Service Code CPT C1713
Hospital Charge Code 41601686
Hospital Revenue Code 278
Min. Negotiated Rate $35.90
Max. Negotiated Rate $524.16
Rate for Payer: Aetna Commercial $91.81
Rate for Payer: Aetna Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $62.47
Rate for Payer: Anthem Blue Cross of IN Traditional $68.00
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $41.28
Rate for Payer: CareSource Indiana of IN Medicare $39.49
Rate for Payer: Cash Price $67.44
Rate for Payer: Cash Price $67.44
Rate for Payer: Centivo All Commercial $55.48
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Humana Medicare $55.48
Rate for Payer: Lucent All Commercial $55.48
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Plain Church Group Ministry All Commercial $42.42
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: Three Rivers Preferred All Commercial $92.46
Rate for Payer: United Healthcare Commercial $85.72
Rate for Payer: United Healthcare Medicare $35.90
Service Code CPT C1713
Hospital Charge Code 41601686
Hospital Revenue Code 278
Min. Negotiated Rate $81.58
Max. Negotiated Rate $101.17
Rate for Payer: Aetna Commercial $93.99
Rate for Payer: Cash Price $67.44
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: United Healthcare Commercial $85.72
Service Code CPT C1713
Hospital Charge Code 41601687
Hospital Revenue Code 278
Min. Negotiated Rate $35.90
Max. Negotiated Rate $524.16
Rate for Payer: Aetna Commercial $91.81
Rate for Payer: Aetna Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $62.47
Rate for Payer: Anthem Blue Cross of IN Traditional $68.00
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $41.28
Rate for Payer: CareSource Indiana of IN Medicare $39.49
Rate for Payer: Cash Price $67.44
Rate for Payer: Cash Price $67.44
Rate for Payer: Centivo All Commercial $55.48
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Humana Medicare $55.48
Rate for Payer: Lucent All Commercial $55.48
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Plain Church Group Ministry All Commercial $42.42
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: Three Rivers Preferred All Commercial $92.46
Rate for Payer: United Healthcare Commercial $85.72
Rate for Payer: United Healthcare Medicare $35.90
Service Code CPT C1713
Hospital Charge Code 41601687
Hospital Revenue Code 278
Min. Negotiated Rate $81.58
Max. Negotiated Rate $101.17
Rate for Payer: Aetna Commercial $93.99
Rate for Payer: Cash Price $67.44
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: United Healthcare Commercial $85.72
Service Code CPT C1713
Hospital Charge Code 41601688
Hospital Revenue Code 278
Min. Negotiated Rate $35.90
Max. Negotiated Rate $524.16
Rate for Payer: Aetna Commercial $91.81
Rate for Payer: Aetna Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $62.47
Rate for Payer: Anthem Blue Cross of IN Traditional $68.00
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $41.28
Rate for Payer: CareSource Indiana of IN Medicare $39.49
Rate for Payer: Cash Price $67.44
Rate for Payer: Cash Price $67.44
Rate for Payer: Centivo All Commercial $55.48
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Humana Medicare $55.48
Rate for Payer: Lucent All Commercial $55.48
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Plain Church Group Ministry All Commercial $42.42
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: Three Rivers Preferred All Commercial $92.46
Rate for Payer: United Healthcare Commercial $85.72
Rate for Payer: United Healthcare Medicare $35.90
Service Code CPT C1713
Hospital Charge Code 41601688
Hospital Revenue Code 278
Min. Negotiated Rate $81.58
Max. Negotiated Rate $101.17
Rate for Payer: Aetna Commercial $93.99
Rate for Payer: Cash Price $67.44
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: United Healthcare Commercial $85.72
Service Code CPT C1713
Hospital Charge Code 41601689
Hospital Revenue Code 278
Min. Negotiated Rate $81.58
Max. Negotiated Rate $101.17
Rate for Payer: Aetna Commercial $93.99
Rate for Payer: Cash Price $67.44
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: United Healthcare Commercial $85.72
Service Code CPT C1713
Hospital Charge Code 41601689
Hospital Revenue Code 278
Min. Negotiated Rate $35.90
Max. Negotiated Rate $524.16
Rate for Payer: Aetna Commercial $91.81
Rate for Payer: Aetna Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $62.47
Rate for Payer: Anthem Blue Cross of IN Traditional $68.00
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $41.28
Rate for Payer: CareSource Indiana of IN Medicare $39.49
Rate for Payer: Cash Price $67.44
Rate for Payer: Cash Price $67.44
Rate for Payer: Centivo All Commercial $55.48
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Humana Medicare $55.48
Rate for Payer: Lucent All Commercial $55.48
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Plain Church Group Ministry All Commercial $42.42
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: Three Rivers Preferred All Commercial $92.46
Rate for Payer: United Healthcare Commercial $85.72
Rate for Payer: United Healthcare Medicare $35.90
Service Code CPT C1713
Hospital Charge Code 41601690
Hospital Revenue Code 278
Min. Negotiated Rate $81.58
Max. Negotiated Rate $101.17
Rate for Payer: Aetna Commercial $93.99
Rate for Payer: Cash Price $67.44
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: United Healthcare Commercial $85.72
Service Code CPT C1713
Hospital Charge Code 41601690
Hospital Revenue Code 278
Min. Negotiated Rate $35.90
Max. Negotiated Rate $524.16
Rate for Payer: Aetna Commercial $91.81
Rate for Payer: Aetna Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $62.47
Rate for Payer: Anthem Blue Cross of IN Traditional $68.00
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $41.28
Rate for Payer: CareSource Indiana of IN Medicare $39.49
Rate for Payer: Cash Price $67.44
Rate for Payer: Cash Price $67.44
Rate for Payer: Centivo All Commercial $55.48
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Humana Medicare $55.48
Rate for Payer: Lucent All Commercial $55.48
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Plain Church Group Ministry All Commercial $42.42
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: Three Rivers Preferred All Commercial $92.46
Rate for Payer: United Healthcare Commercial $85.72
Rate for Payer: United Healthcare Medicare $35.90
Service Code CPT C1713
Hospital Charge Code 41601691
Hospital Revenue Code 278
Min. Negotiated Rate $35.90
Max. Negotiated Rate $524.16
Rate for Payer: Aetna Commercial $91.81
Rate for Payer: Aetna Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $62.47
Rate for Payer: Anthem Blue Cross of IN Traditional $68.00
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $41.28
Rate for Payer: CareSource Indiana of IN Medicare $39.49
Rate for Payer: Cash Price $67.44
Rate for Payer: Cash Price $67.44
Rate for Payer: Centivo All Commercial $55.48
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Humana Medicare $55.48
Rate for Payer: Lucent All Commercial $55.48
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Plain Church Group Ministry All Commercial $42.42
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: Three Rivers Preferred All Commercial $92.46
Rate for Payer: United Healthcare Commercial $85.72
Rate for Payer: United Healthcare Medicare $35.90
Service Code CPT C1713
Hospital Charge Code 41601691
Hospital Revenue Code 278
Min. Negotiated Rate $81.58
Max. Negotiated Rate $101.17
Rate for Payer: Aetna Commercial $93.99
Rate for Payer: Cash Price $67.44
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: United Healthcare Commercial $85.72
Service Code CPT C1713
Hospital Charge Code 41601692
Hospital Revenue Code 278
Min. Negotiated Rate $81.58
Max. Negotiated Rate $101.17
Rate for Payer: Aetna Commercial $93.99
Rate for Payer: Cash Price $67.44
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: United Healthcare Commercial $85.72
Service Code CPT C1713
Hospital Charge Code 41601692
Hospital Revenue Code 278
Min. Negotiated Rate $35.90
Max. Negotiated Rate $524.16
Rate for Payer: Aetna Commercial $91.81
Rate for Payer: Aetna Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $62.47
Rate for Payer: Anthem Blue Cross of IN Traditional $68.00
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $41.28
Rate for Payer: CareSource Indiana of IN Medicare $39.49
Rate for Payer: Cash Price $67.44
Rate for Payer: Cash Price $67.44
Rate for Payer: Centivo All Commercial $55.48
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Humana Medicare $55.48
Rate for Payer: Lucent All Commercial $55.48
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Plain Church Group Ministry All Commercial $42.42
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: Three Rivers Preferred All Commercial $92.46
Rate for Payer: United Healthcare Commercial $85.72
Rate for Payer: United Healthcare Medicare $35.90
Service Code CPT C1713
Hospital Charge Code 41601693
Hospital Revenue Code 278
Min. Negotiated Rate $35.90
Max. Negotiated Rate $524.16
Rate for Payer: Aetna Commercial $91.81
Rate for Payer: Aetna Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN Medicare $35.90
Rate for Payer: Anthem Blue Cross of IN PPO/Exchange $62.47
Rate for Payer: Anthem Blue Cross of IN Traditional $68.00
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise $524.16
Rate for Payer: CareSource Indiana of IN Just 4 Me $41.28
Rate for Payer: CareSource Indiana of IN Medicare $39.49
Rate for Payer: Cash Price $67.44
Rate for Payer: Cash Price $67.44
Rate for Payer: Centivo All Commercial $55.48
Rate for Payer: Cigna All Commercial $93.88
Rate for Payer: CORVEL All Commercial $101.17
Rate for Payer: Coventry All Commercial $95.73
Rate for Payer: Encore All Commercial $100.13
Rate for Payer: Frontpath All Commercial $100.08
Rate for Payer: Humana ChoiceCare $93.95
Rate for Payer: Humana Medicare $55.48
Rate for Payer: Lucent All Commercial $55.48
Rate for Payer: Lutheran Preferred All Commercial $97.90
Rate for Payer: Managed Health Services Medicaid $524.16
Rate for Payer: MDWise Medicaid $524.16
Rate for Payer: PHCS All Commercial $81.58
Rate for Payer: PHP All Commercial $82.50
Rate for Payer: Plain Church Group Ministry All Commercial $42.42
Rate for Payer: Sagamore Health Network All Products $83.98
Rate for Payer: Signature Care EPO $90.29
Rate for Payer: Signature Care PPO $95.73
Rate for Payer: Three Rivers Preferred All Commercial $92.46
Rate for Payer: United Healthcare Commercial $85.72
Rate for Payer: United Healthcare Medicare $35.90